Probing Day

Couple of things to put on the table first.

This is going to be graphic. They don't call this the "G-Rated, Happy Fluffy Bunny" procedure. They call it a "Needle Biopsy" with the kind of clinical detachment that only the medical profession could embrace. Even the Spanish Inquisition was more creative when naming devices designed to inflict pain. On the other hand, maybe "The Rack" is just as alarming as "Ratcheted bone dislocation procedure".

If you are a man facing the prospect of a needle biopsy of the prostate, the one thing I want you to take away from this post is this: Ask the urologist if they do a local anesthetic prior to the tissue sampling. If they say no, FIND ANOTHER UROLOGIST. Would you use a dentist that didn't use Novocaine? Apparently, quite a few urologists don't use a local prior to taking the tissue samples. Everyone who told me the procedure was really painful went through it without anesthetic. I had anesthetic. It didn't hurt.

But I'm getting ahead of myself.

The morning of the biopsy I started another round of antibiotics and gave myself the first of what I suspect will be many Fleet enemas. Prostate biopsies are not without some risks, blood poisoning being one of them, hence the antibiotics. One of the concerns about the PSA blood screen is that it often leads to unnecessary biopsies. I was getting grumpy because I was convinced I was one of that group, though I can understand why a doctor would follow through with the procedure. High PSA indicates the possibility of a cancer that is too small to see or feel. No doctor would look at me and say: "You're too young for prostate cancer so this must be a mistake." They have to know and there's only one way to do that.

The procedure was performed in Portland, about an hour and a half from home. We arrived an hour early and walked around NW 23rd looking at all the closed shops and pig statues with surgical masks. There really were pig statues with surgical masks. When we arrived at the office we were informed that there had been a double scheduling so we ended up sitting around for an hour more waiting. That was horrible. Keeping moving is a big part of getting past this and being forced into a holding pattern was awful. They finally got me into the examination room. I undressed from the waist down and lay down on my side on the examination table. By the way, if you want to follow along with pictures, Ohio State University has a great website outlining the procedure. The doctor and nurse arrived and he explained the procedure. He would be inserting a probe into my rectum.The probe would provide ultrasound images of my prostate that would assist in identifying possible tumors and also assist in guiding the biopsy needles. He would then apply a local anesthetic to several spots in the rectum and then take the tissue samples.

Now, the documentation says the probe is about the size of a finger. I thought it looked a bit more... well, adult novelty sized, though I wasn't focusing very well. My curiosity about the procedure was getting a beat down from the feral part of my brain that didn't want anything to do with this and would just as soon I hid under the table or maybe lept out the window. It certainly felt alarmingly large when he put it in. After a minute, I got used to it - as used to it as someone who just had a dildo shoved up their ass by a relative stranger with another complete stranger looking on - can get.

The procedure takes maybe 20-25 minutes. He stopped at one point to show the nurse some hydraulic oddity in my urinary tract. She had never seen it before. I was happy to provide the educational opportunity. I couldn't get a clear answer about what it was. I finally asked if it was a bug or a feature, proving that I can get a laugh out of someone even while getting an anal probe. Once he had the probe where he wanted it, he injected me with the local in a couple places. The needles pass through tubes in the ultrasound probe. They are alarmingly long and unfortunately, they were all arranged on the table that I had been staring at the whole time this had been going on. Still, once I got over processing that the doctor was sticking six inch long needles up my ass, it wasn't so bad. Really no worse than getting numbed up for a filling. After a few minutes, he started taking the tissue samples.

The needle guns rapidly shoot through the wall of the rectum into specific quadrants of the prostate. They're sprung so it only takes a fraction of a second. They sound just like a hand stapler. All I felt was pressure. No pain. Note that I've been speaking of samples in the plural. They take a lot. I thought I counted eight but the lab report said seven with six sites measured. Maybe the seventh was for luck, I don't know.

Once he had the samples he removed the probe and that's when the only really frightening thing happened. He pulled that probe out and I felt like my bowels totally let go. I lay there with my eyes wide open praying to God Almighty that I didn't do what I felt like I just did. Apparantly I didn't. When you think about it, removing a probe from your anus would feel just like a bowel movement, and I was kind of numbed up so I probably wasn't processing much about what was going on down there. Besides, there was nothing in there. The enema cleared that out.

The doctor told me to call his office on Thursday so they would move my file up on his desk. He should have the results by then. I got dressed, met Carolyn in the lobby and headed off to the one bit of poor planning I made. Since we were in PDX, I thought it would be a great idea to have lunch with my dear friend Katie. We got to be friends when she was the chaplain at Linfield. She married Carolyn and I seven years ago and is going to marry my sister and Joe this June. Marrying couples who've been together for decades is turning into a sort of specialty for her. She has her own church now and we don't get to see each other as much as we used to. I really felt pretty good so off we went to Milwaulkee, south of Portland to meet for lunch and check out her new church and new home. It was wonderful to see her and after a quick tour of the sanctuary, we went off for Mexican for lunch. About halfway through my tamales, the anesthetic began to wear off. Katie wanted to show us her new house so we headed over there next. I still didn't feel too bad. There were a lot of stairs in her house. The anesthetic was gone now and while it wasn't painful, per say, it was uncomfortable. The worst part was the curious, analytic part of my brain was beginning to process what I just went through and had come to the conclusion that the feral part of my brain might have been right after all. I just felt really, really, funky and I wanted to go home. So guys, if you're spending the morning with a bunch of people rooting around in your hindquarters, don't plan on socializing for a few days. Just don't.

I made apologies to Katie and Carolyn drove me back. It would have been hard for me to drive in a near fetal position. Once home I poured a nice big glass of Chablis, ran a hot bath, and, finally following my doctor's suggestion, soaked in the tub for a couple hours.


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