Michelangelo's David  with clipping path

Forgive the title.  I want to be clear upfront on the following content.  I held off blogging about this until I talked to my mom to give her a heads up.  Since she reads this blog, I have to be fucking careful about what I write.  A blood analysis last fall indicated an elevated PSA level.  I elected to take a second reading a few months later rather than proceed directly to a prostate biopsy.  Do-overs are standard policy in my book.  Unfortunately, the second test didn’t work out in my favor.

In case you’re interested because you expect a prostate biopsy in the future, the following is my experience.  I can tell you this is not some cavalier test.  Without even taking medication, simply having the procedure has potential side effects.  I find the risks acceptable, major inconveniences though for sure.  I can see not every guy feeling the same way.  Most of what I read suggests the side effects are temporary over the course of several weeks or months.  I find the more I subjugate myself to doctors and the more dignity I relinquish in their offices, the easier it becomes to accept such potential side effects.

I have to compare this procedure to a colonoscopy, mostly because I’ve had one of those too.  There’s the obvious rectal component.  In that sense, the biopsy is a mini colonoscopy.  There’s no prep to drink – so right there the biopsy wins.  And we’re talking about a rectal intrusion in terms of inches rather than feet, hence the mini.  There isn’t even anesthesia.  I was offered Valium but turned it down.  I needed to return to work afterward and I’m not exactly clear on IBM’s Valium in the workplace policy.  Believe it or not, I’ve never taken any of the popular anxiety drugs so I don’t truly know if there would be cause for concern.  Based on performance reviews, I do know that I’m overly transparent as it is at work.  I don’t need to be telling my coworkers what I really, really think.

My experience began with the nurse instructing me to undress from the waist down and to lay on my side covering myself with a sheet made from paper.  This picked up my spirits a bit as, on some metaphorical level, I found this preferable to having to bend over.  If you’re concerned you might get an erection, trust me – you won’t.  The experience is overwhelmingly emasculating.  I was like a dog with its tail between its legs.  She registered my heart rate at 56bpm so I was managing the anxiety fairly well.  She then asked for my permission to allow a 3rd party into the room, a woman technician, to train the urologist on their brand new prostate biopsy ultrasound machine and monitor the imaging.  Like I was going to say no to that.  “No, let the doctor learn as he goes.  We’ll learn how to operate this thing together.”  While I don’t think of myself as an exhibitionist, I was actually fine with it.  The more the merrier.

Dr. Webster was quite good at setting my expectations.  The procedure took maybe 20 minutes.  While extremely uncomfortable, it didn’t really hurt.  The most painful aspect was two needle injections of something to numb my prostate.  This hurt on the level of any flu shot to the arm, only it wasn’t to the arm.  My online research led me to expect the biopsy pinpricks to feel similar to bee stings.  Had the doctor told me this I was prepared to reply, “American bees or African bees?”  I’m still a little disappointed I couldn’t reference that Monty Python skit.  Reminds me though, I need to erase my search history.

I received 12 biopsies and only two of them hurt a little, but less so than the initial shots.  After the fourth biopsy, my penis began to burn – acute dysuria. The sensation was fairly strong actually and maybe hurt more than those two initial shots.  Apparently, this is normal, I’m guessing from a dramatic change in the pH balance suddenly streaming through my urethra.  In other words – bleeding.  I should have asked what causes it because I’m just guessing.  Feels better this morning.  Dr. Webster told me I would jump at the first biopsy – which I did – but I didn’t overreact to any of the subsequent biopsies.  Each biopsy made a clicking noise like a cap gun being fired, or a mousetrap being sprung.  It’ll spook you the first time.

I review the results with Dr. Webster in a week.  I’m not nervous.  Cancer is far from the worse prostate malady from what I’ve read.  Everything is essentially treatable at my age.  That’s why you don’t procrastinate on health issues.  Just ask Steve Jobs.  Oh yeah, you can’t.  I already know from the exam that I don’t have an enlarged prostate, which is a good sign.  The elevated PSA levels are likely from running.  I might be a bit preoccupied waiting for the results; considering I’m up at 5:30 am blogging about it.  Karen and I are going snowshoeing in a couple of hours though.  That’ll take my mind off it.