Ahh....Maui....

God, I wish the biopsy was as dramatic as Alien's mouth ripping through my rectal wall, tearing out chunks of my poor prostate as Howlin' Wolf belted out Back Door Man into my ears...but it wasn't like that at all. Really.



After my second PSA test result came back high, my doctor told me I would now be seeing an Urologist. As it turned out, he is actually the head of the department of this medical group's Northern California district. Hmmm..my eyebrow raised a bit wondering if there was any particular reason why I would be referred to the department head but ultimately decided it certainly couldn't hurt!

A few days later I got a phone call from the Urologist telling me that the numbers (here we go again..) tell him that I need to get a biopsy. At that point I think my brain took me on a nice little visual vacation to Maui, and I remained calm, even when he told me the procedure would be relatively quick, a bit..uncomfortable (I've discovered that doctors use that description often), and that it involves needles in the rectum.

Come again, doc?

Fortunately, I already had a pretty good idea as to what I would be going through because a co-worker went through all of this about 4 years ago. But it does involve two things that can make men mighty uncomfortable: penetration up the butt, and the added excitement of introducing needles into the mix!

I know a lot of men that just absolutely cannot even talk about a simple prostate exam. The thought of a doctor's finger going in there can make a lot of guys very uptight, and in some cases, even...angry. Maybe it's because I've had a lot of exams of this nature, but it just doesn't bother me one bit. I've had women doctors do this, and of course men doctors. I guess the embarrassment factor ramps up a teeny bit with a woman doctor, but it's really no big deal.

Maybe it's as simple as the fact that I'm an artist, a rock musician, and I absolutely adored David Bowie and Alice Cooper! I'm culturally hip (in a 70's way!), and penetration down there should be not only tolerated, but..celebrated! Yes! Super sensitive progressive bi-sexual acceptance! I'm down with that!

;-)

That sounds full of shit, and by no means am I relating medical procedures in the butt to an act of sexuality (though I've seen pictures...), but honestly, the men I've seen turn the whitest with just a mention of a prostate exam are generally not involved in the arts in any way. Such philistines!

And then there's the thought of needles. Needles can make any type of person wig out, but I'm fine with those, too. (while I like a few of the Velvet Underground's songs, I don't think there's a cultural discovery to make here...)

Of course I did no further research on the procedure, I just went and did it. Stacey came along for support, and while I don't remember me being too freaked out about it, I just wanted her to be there once the deed was done.

The nurse lead me into the room and I immediately started to joke a bit with her. "Gosh! I'm so excited! I can't wait!" She said "Really?" I said "Just kidding." At that point the all important levity factor was in place, and as long as I can just bring a smile out of a lab worker, nurse (hot or not) or a doctor, I find that this puts me at ease and hopefully the folks doing the work at ease.

This is exactly what happened, as I laid on my side, butt exposed. Of course, as I have discovered over the years, there is a 90% chance that the doctor's aide or nurse will be female, young, pretty and hot. Never fails.

Digital exam - been there, done that. Bring it on, Doc. About 1 minute.

Ultrasound tube goes in - this is a camera not nearly as big as a sigmoidoscopy tube -we'll say 2 fingers wide. This is so the doctor can get an image of the prostate which is surprisingly not very far in. I believe this stayed in during the whole time. No big deal at all.

After he's checked out the image (which I could've seen had I wished, but since I am in fact me, I opted out of looking at the screen. I do this at any procedure that shows an image of my insides. I just don't want to see. If there's something abnormal, I'll freak out. If it's fine, I can then imagine what it would look like if it wasn't fine.

Next came the 4 (!) injections of a Novocaine - type medicine that is to help numb the areas that the biopsy will take place. (note: for those of you that do not know where the prostate gland is situated, it's on the outside of the rectal wall, surrounded by a lot of very important stuff that's extremely difficult to get to). He mentioned that it's just like getting Novocaine at the dentist. (uh...not really, doc!) He said I will mainly feel pressure, possibly feel that I need to pee (but not to worry - there's plenty of pads under me), and a little sting. And guess what? That is exactly what it was like. I told him at that point he was good. He responded by agreeing, and that he's done hundreds of these. Suddenly I was at ease with this doctor and we actually carried on a conversation during the scariest part, the biopsy itself.

I purposely avoided seeing what the biopsy instrument looked like, and frankly, I still don't know, so nothing to report here. During the procedure, I didn't notice any sensation of anything else being in me aside from the ultrasound tube. Using the image on the monitor, he took 12 samples, by needles, from 12 specific locations on the gland. This is called mapping. Each...sample felt like a bit of pressure, a small sting, and a click that sounded a bit like of a small staple gun. It went rather quickly, but after the 3rd one I said "Only 9 more to go, Doc?" He responded with "Are you counting?" "You bet, Doc" At that point he started to talk about the sound quality of vinyl vs Cds, and before I knew it he said "Ok, last one." He's good, alright. Really good.

I then was told to sit up slowly, some men feel faint after the procedure (wimps). I sat up feeling fine and took a deep breath of air and exhaled slowly. He asked if I was ok, and I told him that I was just relaxing for the first time in about 2 weeks!

Total time on the table: 10 minutes. I've had way worse times just getting my teeth cleaned!

One of the weirder preparations for this procedure was to "arrive with a full bladder". WTF? Turns out that right after the biopsy, he had me pee into a cup to make sure I wasn't bleeding, though I should expect "some discoloration" over the next few days.

Another thing to expect following a prostate biopsy is probably the most mind-blowing thing so far...Now, this does make me squeamish and I find no need for details, but 12 puncture wounds in a prostate gland result in blood getting in the prostate gland.

I'll let your own imagination fill in the blanks as to how one goes about getting that blood out of the prostate gland.

Ah....I bet Maui is beautiful this time of year...