Fun With Cancer

September 2009 – And Thus Begins the Web

Since high school ended, September has always been my favorite month of the year for a variety of reasons. Living in the San Unbearable Valley in LA, September means the diminishing of the 100-degree temps. Baseball winds down to its only purposeful month as teams race toward the finish and set up playoff matchups. Football kicks off five months of Bullshot Sunday mornings. The new Fall TV season begins. The crappy Jockbuster summertime testosteronies give way to the Oscar-worthy flicks. And the best holidays of the year are right around the corner.

September to me, more than January, represents change…and usually for the better.

Last September, I changed doctors. Not because I wanted to, but because Blue Cross forced me to.

The American health care system is certainly broken, beaten and scarred, but every now and again, completely by happenstance, the fetid system works in favor of the man.

My company was looking to cut some budgetary corners, and we asked our Blue Cross rep for some alternative plans to save a couple bucks. In so doing, I switched from a PPO to a standard HMO. In turn, I had to change doctors.

For the past several years, I had been seeing a nice Indian doctor in the kind of office that recalled the days of elementary school. Crude diagrams of open hearts and cigarette-addled lungs adorned the walls. The weight scale was one of those ancient slide-rule jobs about as precise as cutting your own hair in the mirror. Dr. Alibaba had never talked about the prostate before and when I did have blood work done, I was mostly focused on my liver’s status for reasons only Dr. Absolut Smirnoff understands.

So all was well until the company switched plans, and I was forced to find someone new. After a brief encounter with Doc Brown whose wild white hair, coffee-stained lab coat and 24-pack belly scared the fuck out of me, I opted for a new doctor.

To my surprise, Dr. Joey Brett’s office was clean and upscale. The zines in the waiting room were actually from this decade. When I finally met him – I admit with a scant amount of gender, ageist and culture bias – I was glad that he was a young, white dude.

I felt an instant connection with Dr. Brett until he slapped on a rubber glove and asked me to drop my jeans and bend over. “Dr. Brett,” I demurred, “I don’t really have to worry about the prostate until I’m like pushing 50, right?”

Wrong.

The Doc proceeded to scare me anally straight with tales of gents in their mid-30s who had been diagnosed with the big PC (that’d be prostate cancer). So quicker than you could say, “Moon River,” I bent over for a most uncomfortable booty call.

He frowned as he poked and prodded, and then cautiously said that my prostate gland had an “odd shape.” Being an LA guy, I figured that meant a little plastic surgery would correct the issue and off I would go to live my life.

Not so. He recommended I see a urologist, and I made the next appointment.

Summary: July 22, 2009 (previously reported).

PSA 1.4

Digital Rectal Exam (DRE): Slight deformity (not enlargement) of the prostate gland.

 

 September 15, 2009 – Means to My End

I met Dr. K, a urologist at Northridge Hospital. Dr. K was very much in the Zach Braff mold with enough sense of humor about the job to keep me at ease, but enough look-you-in-the-eye seriousness to make you aware that you really weren’t in Kansas anymore. Clearly, this potential problem needed to be addressed.

So, if you’re a dude and don’t know what the prostate is or does, then you obviously failed junior high bio. The prostate is a walnut-sized gland located deep inside the anal cavity at the base of the balls. It serves to produce that fluid which produces life. Yeah, it’s a little semen factory.

The PSA test is a non-intrusive gauge of whether the prostate is healthy or out of whack. Not a public service announcement, PSA stands for prostate-specific antigen, which is a chemical the gland produces. Low levels of PSA can indicate a healthy prostate while high levels fly a red flag for trouble.

My PSA results in late summer charted at 1.4. In very broad terms (because age plays a major role in determining healthy PSA scores), anything under a level 4 isn’t considered an issue. For younger men who should have smaller prostates, however, 2.5 to 3 is sort of the cut-off level for further observation. I was a 1.4, so I felt Scott free until Dr. K also felt a small irregularity when he went finger surfing.

Probably nothing to worry about, he said, but he ordered a return visit and an additional PSA test in three months.

Summary: September 15, 2009.

PSA 1.4

Digital Rectal Exam (DRE): Second opinion confirmed a slight deformity (not enlargement) of the prostate gland.

 

 December 17, 2009 – Bloody Hell

So the PSA test is a simple procedure. A vampire takes a vile of blood from your arm. The lab analyzes the blood for whatever creates the PSA level and passes that onto the urologist.

Back for my second visit to Dr. K three months later, my PSA had skyrocketed in just three months to an alarming 3.7. He showed great concern and didn’t even proceed with the de rigueur digital rectal exam. Instead he ordered a biopsy. We agreed to wait until after the holidays for the ultimate chestnut roasting on an open fire.

I began researching exactly what differing levels of PSA really mean. I also discovered some interesting info that was never shared with me by my doctor. Many reports I read stressed that activities that directly affect the prostate area of a man’s body can adversely hamper the results of a PSA test. For example, riding a bike where your anus is grinding against a hard seat can cause temporary stress to the prostate gland that lies just beneath. In addition, ejaculation within 48 hours of the blood taken can also make the PSA levels rise.

Upon reflection, I had the double-whammy working against a clean test. I had tweaked a knee in the week prior to the blood test and had switched from doing standing cardio to sedentary exercise. Thus, I was peddling hard and fast on a stationary bike in the days before the blood was taken. And, I most certainly had my way with myself the night before the screening.

On a later visit, I asked my doctor how these activities might affect the PSA levels and, although he said there was no specifically empirical data proving that they did, I’m convinced those activities made my results more than double.

Summary: December 17, 2009.

PSA 3.7

DRE: Not performed. Biopsy recommended.

 

January 12, 2010 – The Poop Shoot

 If you’ve never had anything larger than a whisp of wind on a hot summer day skinny dipping at the pool sneak up your ass, it’s really hard for a guy to mentally prepare for a prostate biopsy.

I’m gonna describe it here; so consider this a warning. If you’d rather not know what goes on – and in – skip to the next entry.

And here we go.

A prostate biopsy is the (not-so) simple act of collecting tissue samples from the prostate for study back at the lab. They remove 12 sets of cells, called “cores,” and label them accordingly to their geographical location. That way, if they do find an evil empire, they will know how bad it is and where it’s located to plan an appropriate attack.

There’s no big pre-biopsy prep other than a prescribed anti-infection pill to be taken the day before, day of and day after the procedure. Then there’s the enema that needs to be self admitted just before you leave the house for the appointment. You know, the usual drill: Keys…check. Wallet…check. Enema….double check. I won’t elaborate on the pure joy of this self-inflicted torture other than to say that:

a) There’s no way to not be embarrassed by the absurdity of the administration and…

b) Don’t ever buy generic brands. It’s Fleet or nada, compadres. In a point: it’s all about the lubricated tip.

I chose a morning appointment for the biopsy. No sense letting the dread build.

The actual procedure starts with a dimming off the lights. Seriously. Not sure whether he was just setting a mood or needed it to see the scope screen better. You instantly have the urge to ask, “So you gonna buy me a drink first?” but resist because you know that one’s been used before…probably that same morning.

You drop trou and lie on the exam table in an extreme fetal position like you’re about to perform a hardcore cannonball into the deep end a pool. Then, hands clenched onto a bedrail, head facing a wall and bare ass thrust into the doctor’s face, the merry-go-round begins. Seriously, who chooses this as a profession?

The Doc first slides a gloved finger slathered with a numbing lube up the chute. After a few minutes when the secret agent has taken effect, a scope the size of ping-pong paddle handle with a camera at the tip is awkwardly forced into the forbidden zone. The worst moment is the first forced entry where rejection is not only natural, but a necessity. Once past the first inch or two the scope meets the numbing agent – they shake hands – and Mr. Peepers continues easily on his merry way until he finds the promised prostate land.

The pooper prankster moves that magic wand around and observes – almost like an ultrasound – the shape of the gland on his tiny computer screen. He looks for egregious irregularities and, at the same time, slides a thin needle into the bummed out bum and fires some local anesthetic into the prostate region. This will help numb the gland and ease the pain when they take the actual samples. You feel a little prick at the base of the balls as if the needle is poking from the inside trying to get out. I sympathize with John Hurt’s character in Alien as if a monster is trying to escape through my taint. It’s a strange sensation, to say the least, which sends a tiny shock through the body, not unlike chewing tin foil.

With all this playful prodding, the penis decides it needs to speak up at this point and usually spits out whatever urine was hiding in the bladder. Your body instinctively clenches like a pissed off fist ready to strike. Sweat seeps from every pore.

Now, the Doc is ready to play Scavenger Hunt with the prostate cells, collecting several samples with the help of a Sharpie-sized stick that is now inserted, while the ping-pong paddle remains lodged inside for this entire procedure. Needless to say, more than your mouth is agape.

The trash collector is almost like a tiny air gun crossed with a small claw. Because the prostate is encased in a tiny egg-shell-like sheath, he must crack the shell to get to the cells.

So the claw goes in…the Doc counts one…two…and pop! Your eyes water. Your brow sweats. Your body instinctively jumps. And you try your best to breathe deeply and find a happy place.

The good news is that after that first one, you only have to repeat the process 11 more times!

After handing each sample one-by-one to the nurse standing by, the samples are separated by location and then encased in individual Petri dishes.

After the final sample, the scope is removed and the doctor re-inserts another finger – either because he gets a sadistic kick or he wants to make sure that he didn’t pull the lower intestine even lower with all that ruckus.

And that’s it. The whole procedure lasts about 20 minutes if the guy is on his game. And off you go in desperate need of a Cadillac Margarita on the rocks.

Summary: January 12, 2010.

PSA: No new one taken

Biopsy performed: Results in 1 week

 

 January 17, 2010 – Blood Will Follow Blood

Some say that in life you can’t take the good without the bad. So after my anal intrusion, I had been prepared for several days of blood accompanying all bodily excretions below the waist.

Bloody piss…fine. Bloody stools…okay if you must. Yet no amount of “heads-up” prepared me for the bloody orgasm.   

Dr. K had said it could be weeks before the semen became vanilla again. But the first time you take the lad out for a stroll, the pop at the finish line is like the horrific climactic scene from In the Realm of the Senses when the sadistic Japanese wife and her equally whackjob husband chooses to cut off his penis at the point of orgasm.

Those who have seen the uncut version of that often censored mid-70s film will never forget the brutal end where the camera fades amid a Roman Candle of red and white spouting from the base of the man’s severed spigot.

That was my first thought when I first took myself for a test drive…well, that and the next time I’ll use a blue towel to at least make my scene at least patriotic.

 

 January 21, 2010 – Biopsy 1 Results

The following is a brief summation I wrote after learning the results of that first biopsy as printed on my Facebook page to spread the word about prostate health:

This is a Precautionary Tale about a boy and his prostate. Yes, that which produces the very special sauce that creates life can also take it. In fact, nearly one of every six men will be diagnosed with prostate cancer at some point in his life. So when I was the one faced with the evil empire last week, the feeling was less, “why me?” than “why not me?”

This note is intended to let my male brothers know some things that I have only recently come to find out: namely, this shit can happen to you and it can happen a lot sooner than you think.

I had always been under the impression that screening for prostate issues was something easily put off until your mid-40s. For the past several years, I had been going to an elderly Indian HMO doctor whose idea of a thorough physical was tapping one of those little rubber hammers against your knee. He was perfect; don’t ask and he can’t tell. Dudes are like that…we don’t want to know.

Actually, you do.

My company’s insurance changed late last year, and I was forced to find a new doctor. By a stroke of luck, I selected a young guy more on the cutting edge of medicine who actually wanted to look for problems. I was 42 when he ordered a PSA test and performed my first-ever rear-view-terror. PSA is a protein produced by the cells in the prostate and measured by a blood test to decipher healthy levels. Normal levels depend on a variety of factors, including age. My level was normal, but he felt a minor enlargement of one side of the gland and sent me off to a urologist.

I laughed at his dogged precaution until he mentioned that he had discovered advanced prostate cancer in a patient several months prior who was only 38 years old. So…what’s that urologist’s name again?

Two ever-increasing PSA-level tests later, and the specialist had me ass-up with cameras, probes and god-knows-what-else poking and prodding to eradicate chunks of the gland for a microscopic third degree. “Twenty Minutes in Heaven” it was not, but at least I would be sure.

A week after the biopsy, Leslie and I visited the urologist for the results. We were so confident about what was obviously gonna be thumbs-up results that we were planning margarita destinations during the wait.

Then, the urologist walked in and said matter-of-factly, “So it turns out you have a little cancer.”

It was so nonchalantly uttered that he could have been talking about tomorrow’s weather forecast. “Slight showers with a chance of cancer; you won’t even need an umbrella.” In fact, my initial reaction was, “Cool, so I’ll just rub some dirt on it, and it’ll go away, right?”

Turns out not.

My mind started spacing as he broke down exactly what this meant today and will mean tomorrow without treatment. His voice turned into one of those teachers in a Peanuts cartoon.

Whomp-whomp…whomp-whamp, whomp whomp.

I rewound my life a good three minutes and imagined him opening the door once more. “Hi Mr. Schalin…I’m Mortality. Nice to meet you. Could you please ask your friend, Invincibility, to wait outside?”

Forty-fucking-two. Really? Fortunately, the malignant cells were caught in their infancy, giving me time to study, query and make an educated decision on what to do. In addition, prostate cancer is a very slow-moving army of divide-and-conquering cells; so catching it early is clutch.

The treatment options range from external and/or internal radiation to removal of the gland completely. Each boasts its own desirable set of side effects and physical fuckclusters, not least of which is an end to procreational desires and, at worse, dysfunction of that hobby favored by men for millions of years.

But this narrative is not intended to be a Johns Hopkins treatise on the latest advances in violating a grown man’s body. Rather it’s a friendly warning to all my friends over 35 years old. Don’t wait. Take precaution. Ask your doctor for a PSA exam (again, done with a simple blood test). Had I stuck with my last doctor, the taxi driver, I wouldn’t have asked for an exam for another three years. Who knows by then how far the disease would have advanced and what my more limited options might be.

God bless the God that built this flawed machine.

So, yes I had a “little cancer.” I won’t bore anyone with explanations about what the following numbers mean (prostate cancer guys know this shit like a second language and the laymen need not be disturbed).  Suffice it to say, I had the lowest grade of prostate cancer that a man could have.

Now come the choices: removal of the gland (prostatectomy) or radiation therapy to hopefully attack the cells before they could have a chance to spread. Dr. K was already advising for removal based on the biopsy results, although he gave me a radiology referral to get a different take. Either solution came with its own pros (exterminating the cancerous cells before they had a chance to move on) and many, many, did I say many, cons.

Summary: January 21, 2010.

PSA: No new one taken

Biopsy Results (from Quest Diagnostics): T2a cancer in 1 of the 12 cores. Gleason 3+3 = 6

 

January 22, 2010 – I’ve Got What?

I woke feeling confused and more perturbed than angry. The feeling of annoyance that I would now have to spend weeks of time researching all there was to know about a disease that should only strike old men.

I laughed at the irresistible irony of me being a part owner of an herbal supplement company whose biggest-selling product was something called Prostalex Plus, a prostate health supplement. I had been taking the supplement daily for about two years and, while it is absolutely not designed to prevent or treat the onset of cancerous cells, it is proven to promote overall prostate health. Or not.

Initially when I was told of the diagnosis, I recalled my favorite scene from Monty Python’s Meaning of Life.

It’s the scene where the Zulu warriors are fighting the British in the African tundra. Inside a tent, one of the officers (Eric Idle) sits calmly in his bed reading a book when a doctor walks in and inquires about the problem.

Idle calmly points to a bloody stump where his right leg should be and says, “Not sure, Doc, but it seems I’ve been bitten during the night. Woke up this morning…one sock too many.”

The doctor taps the grisly stump with the tip of his pipe and proceeds to “reeeeeassure” Idle that everything will be alright. “Nothing to worry about. Probably a mosquito that got through the net. Get plenty of rest and if you’re playing any futbol this weekend, try to favor the other leg.”

The patient smiles, satisfied, and as the doctor leaves, Idle muses, “So it’ll just grow back then, will it?”

At this point the doctor feels the need to “come clean” and confess that the leg thief is probably something slightly more substantial than a mosquito. Perhaps a tiger. Wherein the cast looks to camera, horrified and asks the question, “A tiger??? In Africa?!?” To which the dim doctor promptly assures everyone that it probably just, “escaped from the zoo.”

I thought of that scene because my initial reaction to my “little cancer” was as if I had the flu. That would be the denial phase and while educating myself about what was in store for me, the sudden realization hit that this was more than just a mosquito bite.

This was something serious and dangerous. Deadly at worst, debilitating at best.

I decided to name the disease something other than cancer. Not that there’s anything inherently wrong with the word itself: good hard “c” followed by a slithering c made for an evil purse of the lips. My issue is that I associate the word with blue hairs drooling into paper cups while Benny Goodman records crackle from the corner of purgatory.

So I decided to call my problem Cody, in honor of screenwriter extraordinaire Cody Diablo (she of the look-at-me pop culture junk like Juno, Jennifer’s Body and the offensively lame United States of Tara). I had prostate Cody.

 

January 22-31, 2010 – Research & Destroy

Weeks and weeks of research followed. You really understand the beauty of the internet and how it can be used for good in these situations. I visited hundreds of sites, searching definitions of my diagnosis and where I was in the scheme of other cancer patients. I joined an array of prostate-specific groups and blogs to post a myriad of questions. I was amazed and moved by the outpouring of advice, info, guidance and sympathy that so many men I had never met before provided.

I learned that prostate cancer is one the slowest growing cancers a man can have. Because of the tiny shell encasing the gland it’s harder for the bad cells to multiple and break on through as opposed to being in an exposed node or organ. In fact, as the doctor maintained, many men  diagnosed with prostate cancer much later in their lives —  say 70 – just let it go untreated as something else is gonna probably kill them first.

But I was in a special, select group of men under 45 who have to deal with this sooner than later. Choices suddenly needed to be made. Leslie and I have no kids, and we have always been very much on the fence about the notion. In the past, there was always tomorrow to make that decision.

Now, there wasn’t.

Without a prostate, there would be no chance of procreation. Hell, there would no physical ejaculation whatsoever.

Which brought me to the other tragic realization. I’ve become rather found of my little nappy-headed friend below my waist. In many hard times, he’s been my closest, most reliable buddy. Hell, if he looked better in a suit, I’d have made him the Best Man at my wedding. So the thought of suddenly losing his companionship was beyond scary. It was impossible. It was the end of so many vital aspects of my life as I knew it.

Now understand the difference between the two primary options of treatment: A prostatectomy removes the gland completely. By so doing, especially for a person with such a low score of cancer, there was a strong chance that I would eliminate the problem at its root. A few years of subsequent blood tests would tell for sure if the varmints had escaped and spread elsewhere, but all that I read assured me that surgical elimination would be the most conclusive way of not having this cancer kill me.

Of course, removal of the gland generally leaves a very sordid trail of fucked-up side-effects which can/will include erectile dysfunction, pissing yourself when you cough, sit, stand, laugh or generally do anything that humans do, a loss of libido and the ability to procreate. (Here’s a little-known Cliff Claven factoid, unlike women, men actually have two sphincters. When you remove the prostate, you rip one of those important vise grips out, leaving the bladder more-or-less to its own comical devices.) Oh, and if you do finally get back in the game and enjoy a non-prescriptive erection again, there’s a little something called “dry orgasms” to deal with.

On the other hand, radiation therapy, while also killing a chance to inseminate, can (operative word) preserve the nerves that allow for semi-healthy erections. 

Hundreds of pages were printed, highlighted and shoved into folders marked “Cody”.

 

 January 22, 2010 – Emotion in the Ocean

These things hit you in both very obvious and then very sneaky ways. By no means did I think this was death sentence, but its hindrances of life’s simple pleasures could be profoundly frustrating.

Some days, I wallowed in depression about the obviously debilitating side effects. Yet other days, I actually welcomed this as new challenge. It was something to deal with, overcome, persevere and maybe even test my meddle.

I also went through a typical rollercoaster paradox of both A) “Now it’s time to get your shit together, get super healthy and slow down on the nonsense,” and B) “Fuck it, let’s drink like we mean it and enjoy the excesses in case this is our last dance.”

Each month, B usually won by a score of three to one.

 

 February 2, 2010 – Radiation Calling

So now armed with files full of questions, I met with a radiologist. Going into this meeting, I was convinced that non-surgical radiation would be the best treatment for me. It was less intrusive and had a bigger upside sexually.

Dr. Ko at Northridge Med turned all my preconceived notions upside-down. She advised that radiation was mostly geared for older patients who could be in danger by invasive surgery. She said that, at my age, radiation had a good chance of merely containing the dangerous cells for a period of time. Five years; maybe ten years. But I would always be living under the specter that at any time, after any checkup, the cancer might have suddenly found its sea legs and spread.

A prostatectomy was the only way to ever be sure that I had removed the cancerous cells and that they had not come back. Plus, she added, that with my age and healthy lifestyle, I would have the greatest chance of recovering from the side effects and was best poised to re-gain normal erections without a lifelong Cialis crutch.

And then she said something that changed my life, at least at that moment. It was something so simple and so off-handed that it seemed like she was simply saying my shoe was un-tied.

“Did you get a second opinion on the pathology report from your biopsy?”

“Uh…no. Hadn’t even thought of that nor was it ever recommended by anyone else.

 “Oh, well you should,” the demure Asian doctor said. “Ask Dr. K to send the reports to Johns Hopkins. You never know.”

 And so I did.

 Summary: February 2, 2010.

PSA: No new one taken

DRE: Finger exam confirmed irregular shape of the prostate, but she admitted that it was so minor that had she not been briefed on my pre-disposition, she may not have noticed it.

Recommendation: Second opinion on biopsy pathology report.

 

February 16, 2010 – Second Opinions Are Not Like Assholes

And so Dr. K was more than happy to send my pathology off for a second opinion.

I had requested a phone call this time for the results. No need for me to spend another $25 co-pay and drive across town just to hear the same news. We had already done the faced-to-face cancer fest.

And so he called late in the afternoon and in his typically low-key, matter-of-fact manner said, “Well good news. Hopkins doesn’t see cancer for certain.”

Ok, what the hell does that mean?

“They see are abnormal cells classified as High-Grade PIN as opposed to cancer.”

High-Grade PIN cells are defined as a small, atypical group that are too small to be defined as either benign (good cells) or malignant (bad ones). Thus, High-Grade PIN is an Agnostic group of cells that just can’t make up their dirty little minds what they wanna be when they grow up.

The good news: that means there is a chance that they aren’t cancerous. That beats, “It turns out you got a little cancer” any day.

A second biopsy was ordered to get a new cluster of samples and see if we could get a stronger declaration one way or another.  

Suddenly a Doors song starts wafting through my head. I could hear the swirling, haunting organ and the words push their way to the frontal lobe:

 Strange days have found us,
Strange days have tracked us down,
They’re goin’ to destroy our casual joys,
We shall go on playing or find a new town…

Summary: February 16, 2010.

PSA: No new one taken

Biopsy Results (from Johns Hopkins): Focus of High Grade PIN with adjacent, small atypical glands. Findings are highly suspicious for carcinoma (cancer). While these small glands may represent an infiltrating cancer, we cannot exclude that they represent an outpouring of the adjacent PIN glands only. Repeat biopsy is recommended.

 

 March 5, 2010 – Train in Vein

Another day, another bloodletting. But this time, I made sure not ride a bike, ejaculate or shove small rodents up my ass for a good 72 hours prior to the test. I won’t reveal which activity was the hardest to abstain, but I was curious how this new strategy would affect the score.

 

 March 16, 2010 – A Second Biopsy? Butt, of Course

Dr. K, to his benefit, did not want to wait too long to perform the second biopsy. Even though prostate Cody is slow moving, you wanna attack the bastard before it stops its slumber and starts to lumber.

At the same time, the good doctor also wanted to let my prostate heal enough from the first biopsy so that my inner sanctum didn’t become like the slaughterhouse scene from Rocky.

So almost two months to the day, I arrived for the second biopsy. The goal was that the results from this one would (hopefully) determine which way the eagle flied.

The best news was that results from a new PSA test showed my level down from 3.7 in December to a glorious gutter low of just 1.1. We were both amazed at the positive fluctuation and the results convinced me that all I read about pre-PSA blood screening behavior was correct: abstain from anything that disturbs the prostate.

It is said that love is better the second time around, so I’d love to report that the second biop was a breeze. It was actually worse.

The brain is a funny monster. It renders bad situations better when it doesn’t have a clue what is about to happen. Sure, my brain had some expectations of the horrors the first time around, but there was no baseline, no barometer by which to measure exactly what would transpire and how bad it would be. All I knew was I was gonna have shit shoved up my ass. The blow-by-blow process, however, was unknown.

Now, heading into the second lap, I knew exactly what was coming – and what was going. I knew in what order and in how long a time sequence. I know the sights, the sounds, the smells and the painful humiliation of the experience. And thus, aggravated anxiety precipitated these 30 minutes in Heaven.

While doing my best cannonball position on the table, I pondered this principle and thought maybe that’s why you shouldn’t fear death. It’s really only the second thing in everyone’s life that can and will happen exactly once. So, who knows what it will feel like. As a fetus, I don’t recall thinking, “How the fuck am I gonna squeeze through that?”

And maybe dying is the best goddam mushroom trip of all time. Maybe it is just frozen moments of blissful reflections of a life lived and loved before the deepest, soothing sleep of all time. And – what the hell – maybe there are moments in the dying throes where you feel weightless, and you’re running naked through a poppy field with an ice-cold martini, a full plate of carnitas and the TV remote control. And all your dead pets are running around dressed in suits and ties wondering, “What’s with the naked guy?”

And then again, it could be all that but without any olives, Cholula or a flat screen TV.

The good news is – if death sucks ass, well, at least you won’t have to do it again.

Summary: March 16, 2010.

PSA: 1.1

Biopsy Results: Pending

 

March 17, 2010 – Leaving the Present Behind

In a very rollercoaster year, Leslie had succeeded in capping her two-year boot camp of nursing school by graduating and passing the state’s NCLEX test. She was now officially a Registered Nurse and ready to start her new life as a made woman.

Before she started applying for nursing gigs, we decided to take a trip which could be our last for some time.

After much debating, we decided to avoid airlines, exchange rates and basically take a vacation that wouldn’t require a vacation afterward.

A drive, we thought. So we planned a roadie up the gut of California with Seattle as a northernmost destination. Then we’d turn around and swerve over to the coast where Oregon meets the Emerald State and slowly meander our way down the Western spine of America.

We couldn’t wait for the trip, but I also couldn’t stomach the unknown results hanging over my head for the two weeks while I was slurping oysters and gulping martinis. So I asked Dr. K to give me the results over the phone to save time. Neither good news nor bad was going to matter as I had already dealt with the bad, so if it’s still the Big C, at least I was now prepared for my options.

 

 March 24, 2010 – All Aboard!

The day before our roadie was to commence, Leslie and I were drunk-packing like giddy college kids. We happily scurrying around the house collecting everything we would never need. There’s a multitude of freedoms that a long road trip allows. First and foremost, it affords you the opportunity to pack the car with every single item in the house.  (How we got the Viking fridge in the car remains a mystery.)

We stocked the cabin with a myriad of driving snacks (large pretzels, power bars, juice pouches, gummy everythings), maps, Magellan’s, pillows, shoes and clothes for all-weather conditions. You would think we were scaling Mt. Everest with all the crap we loaded into the tiny, white Prius. 

Minds and bodies were focused on the trip. In fact, even when my cell rang around 4:00 flashing an unrecognizable 818 area code, I still had forgotten that today was the day for The Call.

“Hello.”

“Scott, this is Dr. K.”

Of course you know that moment at the highest apex of a rollercoaster where the cars seem to stop for an eternity and float in outer space before they ease forward and then with a rush of blood to head, heart and thighs you plummet. And six or seven seconds into the freefall your stomach literally makes its way up your torso headed straight for your throat like a drunk who’s heard the words, “Last call.”

Triple that.

That’s how I felt in an instant. Leslie knew who it was and she remained at the dining-room table as I walked into the bedroom. I needed to focus and hear the results alone.

His words were mannered as he was quite obviously reading from the report for the first time with me. “Benign prostatic tissue with focal chronic prostatitis…hmm…atypical small acinar proliferation…Oh, I see, okay. Stains for high molecular weight keratin demonstrate positive straining for basal cells in the focus in question, ruling out carcinoma.”

Time to butt in. “Dr. K…do I have cancer or not?”

“Nope…it appears not.”

You talk about burying the lead. “You know, Doc, you really could’ve opened with that.”

He laughed. “Yeah. So what it looks like is that you do have a few atypical cells that are classified as ASAP. This stands for Atypical Small Acinar Proliferation which means they could become cancerous more so than if you didn’t have them.”

“But I don’t have cancer now?”

“You don’t have cancer now, but we need to keep a very close eye. Since three sets of eyes have now found three different classifications of some abnormal cells, I recommend another biopsy. But it’s no rush. We’ll let your tuckus [yes, a nice Jewish boy, he used tuckus] rest and come back in the summer, and we’ll give this hopefully one more look and be convinced.”

I was speechless but managed a, “Thanks Doc.”

“Have a great time on your vacation.”

I hung up the phone and for the first time since the start of this bungee jump, I welled up as I walked into the kitchen where Leslie was waiting and watching.

“It looks like I may not have cancer.” And we hugged and wiped away a few dribbles of happiness. Or relief. Did any of that really happen?

In silence, Leslie and I just stared at each other and shook our heads, laughing now with no tears. And one of my favorite songs popped into my head, and I started humming the lyrics made famous by Nina Simone and covered brilliantly by Muse…

 Birds flyin’ high… you know how I feel
Sun in the sky… you know how I feel
Breeze driftin’ on by you know how I feel
It’s a new dawn, it’s a new day, it’s a new life for me…
And I’m feelin’ good.

 

 March 25 thru April 7, 2010- A Long, Strange Trip

Leslie and I took a thoroughly necessary and revitalizing vacation meandering up the belly of California and Oregon en route to Seattle to see Muse at Key Arena. My girl with the joyful relief of nursing school and passing the state board behind her, and me with a fresh, seemingly healthier perspective. We hadn’t a care in the world for those two weeks (save the 24 hours I spent vomiting from an evil oyster in Seattle).

The highlights should have included the concert, but Seattle fans are dopes when it comes to getting into a show, and Key Arena is a floating turd that allows you to buy beer in the concession area but does not allow you take said beverage to your seat. Say what?

Highlights included the bacon doughnut at Voodoo Donuts in Portland, hitting every Tom Douglas restaurant in Seattle, the hand-crafted salami sandwich at Mario Battali’s father’s El Salumi sammy shop across from Safeco, driving the breathtaking cliffs overlooking the rugged Pacific in Oregon, the wine treasure hunt in Healdsburg and every single living, breathing second spent with my best friend.

When we returned home, reality hit for both of us. For Leslie, the toughest task lay ahead of finding a job (who knew the education would be the easy part). For me, it was time to hit Al Gore’s invention and find out just what the ASAP cells were inside my ass and how they differed from High-Grade PIN which was determined on second sight of Biopsy 1.

In the lamest of layman terms, you really don’t want either. Both basically infer that you have a class clown cluster of cells that will continue getting sent to detention and, most likely, grow up to be a cancerous loser.

One study from the American Society for Clinical Pathology determined that 24% of patients who had PIN in one biopsy will have cancer in a follow-up. Worse still, 41% of proud ASAP bearers will have cancer in a follow-up biopsy.

ASAP and its “cousin,” PIN (prostatic intraepithelial neoplasia) are two critical findings that are not actually prostate cancer but which seem to be highly predictive of the likelihood of current or future prostate cancer.

In other words, before patients get prostate cancer, many of them may have either PIN or ASAP or both.

It is because of this troublesome statistic that my urologist, Dr. K wanted me back in the summertime for yet another biopsy. He said if I was 65 or older, he wouldn’t be too alarmed to stay so tightly on top of this, but at my age, early detection is key to making sure that class clown doesn’t ditch early to go beat up other healthy cells at the bike racks.

I spent June and July in complete avoidance. I stopped obsessively searching sites and reading blogs about the goddam prostate and pretended – for a precious several weeks – that all of this had just gone away. I drank martinis, Leslie and I experimented with an array of new recipes in our test kitchen, I acquired a special new cat that acts like a dog and follows me everywhere named, Cooper. I enjoyed what I feared would be Vin Scully’s last season of painting my summer a deep and vibrant blue talking up the Dodgers. I watched the Lakers sack up and beat the Celtics in a poetic Game Seven, and I counted the days until August 24 when my next biopsy would arrive like Santa sliding down the chimney.

 

May 6, 2010 – Checkup Please

I went back to see my original general doctor, Joey Brett. I thanked him for his due diligence and insistence on looking at my prostate.

The PSA was 2.2, and I was feeling pretty good about my chances entering the next biopsy.

 Summary: May 6, 2010

PSA: 2.2

DRE: No new rectal exam performed

 

August 24, 2010 – Third Time’s No Charm

Reality doesn’t bite so much as it pinches. If I had forgotten about the love and glory of a prostate biopsy, waiting 50 anxious minutes in Dr. K’s waiting room brought the memories very much alive and unwell in my mind.

Once inside the chamber of horrors, I assumed the cannonball position with ass in the face of my good doctor and – crash, bang, wallop! – we did the dance for yet a third time in just eight months.

As always, I tried to find a happy place while the dirty deed unfolded. This time, I couldn’t seem to shake the vivid story of a childhood friend, Robbie Cormack, who was riding his Mongoose bike along a bumpy dirt road when he was 13 years old. Rob was the elementary-school stud, the tough kid destined to be a high-school quarterback in years to come.

This day, as he demonstrated dope tricks and jumps, he did so without a seat attached to his bike. I’m still not sure why, and I’m sure he would have rather re-thought that omission when his bike hit a series of bumps we called whoop-te-dos and his bike whooped, but his butt te-doed and came down hard on the exposed post where the seat would have sat.

That little bit of Evil Knievelry forced the kid into emergency anal reconstructive surgery. True to form, and as legend has it, tough guy Robbie was so intrigued by the procedure that he requested a local anesthesia and a strategically placed mirror, so he could watch his shit shute sewn back together.

Yeah, my “happy places” tend to be a bit fucked up.

I had blood taken a week prior to this visit and – good news – is that my PSA has stayed low and well under acceptable levels at a 1.9. My doctor and I were encouraged by that sign, but then no urologist can seem to agree on the true importance of the PSA test. In many cases people with high PSAs never develop cancer and people with low scores do. So while I’d much rather be low than high on the scale, I can never be over-confident that a low PSA means I’m out of the woods.

Summary:  August 24,2010

PSA: 1.9

DRE: Not done.

Biopsy: Performed and waiting results.

 

 August 27, 2010 – Pins and Anals

As I sit here studying more about ASAP and PIN cells, a line on a urology site really hits home: There is no known cure for ASAP cells.

I have been deluding myself into thinking that I don’t have cancer, but I have not been taking the ASAP diagnosis seriously enough. The fact remains, that I do have some kind of fucked up cells in there that are far more likely to become cancerous at some point than if I didn’t. And they ain’t going away. Which means, I’m now a slave to my inner arse. Even if this latest biopsy comes back with no cells, they are certainly gonna report the abnormal cells as either PIN or ASAP.

So it hits me that my ass is now like Buckingham Palace where I must have watchful guards constantly on duty. I’m certainly doomed to multiple PSA tests every year (no biggie, cause I’ve always got the blood) and, worse, probably an annual biopsy just to make those ASAPs haven’t matured into something deadly.

A week later, I’m still sitting in wait. Fuck Tom Petty, but the waiting really is the hardest part.

September 3, 2010 – And Waiting…

If patience is truly a virture, then still not having results now what will be two weeks later come Tuesday is more than taxing my virtue.

I had a brief conversation with Dr. K earlier in the week, and he said he would call the moment they came in. You would think a lab, in this case Quest Diagnostics, would put a little giddy-up  in their gait when they knew the potential seriousness of the outcome. And isn’t everyone in the medical profession always preaching about “early detection and treatment.”

Two weeks seems unreasonable, at best, and downright insulting, at worst, when a man’s life is on the line – particularly when that man is me.

 September 7, 2010 – Denying Bargaining, Acceptance and Anger

So it’s now been two weeks since my last biopsy and there’s still no word. You would think that they would put a red tag on these specimens to fast-track the status. But no. Instead I wait for a doctor’s call that never comes. Even phoning into Dr. K’s office leaves only messages with no returns.

And then he called.

The Doc rattled off a lot of nonsense before he revealed that no cancer was evident. Yeah there are some suspicious cells to keep an eye (and finger on

2011-May 2016 – Sunny With a Chance of Cance

I continued with the annual fun-loving regimen of have a random digit shoved in my not-so-random posterior and with each passing year the news was wonderfully the same: The prostate had reduced to its normal walnut-size without any scare of abnormalities. Every new PSA test remained under 2.0, and I took care with each exam to avoid the activities that, I feel, induced the higher reads when I was naïve as to not stressing the prostate a good week prior to the blood draw. So riding a bike and the random orgasm were stopped within that time frame and, lo and behold, the PSA levels have been dynamically consistent in a very good way.

Having moved to Seattle in September, 2015, I entered a whole new health world with a new doctor who pleasantly informed me that digital rectal exams were a thing of the past. In the current medical state, only a blood PSA test was required to determine if anything was out of the norm. Music to my….uh, loins to say the most.

PSA: 1.7

February 2017

As much as I love

September 2009 – And Thus Begins the Web

Since high school ended, September has always been my favorite month of the year for a variety of reasons. Living in the San Unbearable Valley in LA, September means the diminishing of the 100-degree temps. Baseball winds down to its only purposeful month as teams race toward the finish and set up playoff matchups. Football kicks off five months of Bullshot Sunday mornings. The new Fall TV season begins. The crappy Jockbuster summertime testosteronies give way to the Oscar-worthy flicks. And the best holidays of the year are right around the corner.

September to me, more than January, represents change…and usually for the better.

Last September, I changed doctors. Not because I wanted to, but because Blue Cross forced me to.

The American health care system is certainly broken, beaten and scarred, but every now and again, completely by happenstance, the fetid system works in favor of the man.

My company was looking to cut some budgetary corners, and we asked our Blue Cross rep for some alternative plans to save a couple bucks. In so doing, I switched from a PPO to a standard HMO. In turn, I had to change doctors.

For the past several years, I had been seeing a nice Indian doctor in the kind of office that recalled the days of elementary school. Crude diagrams of open hearts and cigarette-addled lungs adorned the walls. The weight scale was one of those ancient slide-rule jobs about as precise as cutting your own hair in the mirror. Dr. Alibaba had never talked about the prostate before and when I did have blood work done, I was mostly focused on my liver’s status for reasons only Dr. Absolut Smirnoff understands.

So all was well until the company switched plans, and I was forced to find someone new. After a brief encounter with Doc Brown whose wild white hair, coffee-stained lab coat and 24-pack belly scared the fuck out of me, I opted for a new doctor.

To my surprise, Dr. Joey Brett’s office was clean and upscale. The zines in the waiting room were actually from this decade. When I finally met him – I admit with a scant amount of gender, ageist and culture bias – I was glad that he was a young, white dude.

I felt an instant connection with Dr. Brett until he slapped on a rubber glove and asked me to drop my jeans and bend over. “Dr. Brett,” I demurred, “I don’t really have to worry about the prostate until I’m like pushing 50, right?”

Wrong.

The Doc proceeded to scare me anally straight with tales of gents in their mid-30s who had been diagnosed with the big PC (that’d be prostate cancer). So quicker than you could say, “Moon River,” I bent over for a most uncomfortable booty call.

He frowned as he poked and prodded, and then cautiously said that my prostate gland had an “odd shape.” Being an LA guy, I figured that meant a little plastic surgery would correct the issue and off I would go to live my life.

Not so. He recommended I see a urologist, and I made the next appointment.

Summary: July 22, 2009 (previously reported).

PSA 1.4

Digital Rectal Exam (DRE): Slight deformity (not enlargement) of the prostate gland.

 

 September 15, 2009 – Means to My End

I met Dr. K, a urologist at Northridge Hospital. Dr. K was very much in the Zach Braff mold with enough sense of humor about the job to keep me at ease, but enough look-you-in-the-eye seriousness to make you aware that you really weren’t in Kansas anymore. Clearly, this potential problem needed to be addressed.

So, if you’re a dude and don’t know what the prostate is or does, then you obviously failed junior high bio. The prostate is a walnut-sized gland located deep inside the anal cavity at the base of the balls. It serves to produce that fluid which produces life. Yeah, it’s a little semen factory.

The PSA test is a non-intrusive gauge of whether the prostate is healthy or out of whack. Not a public service announcement, PSA stands for prostate-specific antigen, which is a chemical the gland produces. Low levels of PSA can indicate a healthy prostate while high levels fly a red flag for trouble.

My PSA results in late summer charted at 1.4. In very broad terms (because age plays a major role in determining healthy PSA scores), anything under a level 4 isn’t considered an issue. For younger men who should have smaller prostates, however, 2.5 to 3 is sort of the cut-off level for further observation. I was a 1.4, so I felt Scott free until Dr. K also felt a small irregularity when he went finger surfing.

Probably nothing to worry about, he said, but he ordered a return visit and an additional PSA test in three months.

Summary: September 15, 2009.

PSA 1.4

Digital Rectal Exam (DRE): Second opinion confirmed a slight deformity (not enlargement) of the prostate gland.

 

 December 17, 2009 – Bloody Hell

So the PSA test is a simple procedure. A vampire takes a vile of blood from your arm. The lab analyzes the blood for whatever creates the PSA level and passes that onto the urologist.

Back for my second visit to Dr. K three months later, my PSA had skyrocketed in just three months to an alarming 3.7. He showed great concern and didn’t even proceed with the de rigueur digital rectal exam. Instead he ordered a biopsy. We agreed to wait until after the holidays for the ultimate chestnut roasting on an open fire.

I began researching exactly what differing levels of PSA really mean. I also discovered some interesting info that was never shared with me by my doctor. Many reports I read stressed that activities that directly affect the prostate area of a man’s body can adversely hamper the results of a PSA test. For example, riding a bike where your anus is grinding against a hard seat can cause temporary stress to the prostate gland that lies just beneath. In addition, ejaculation within 48 hours of the blood taken can also make the PSA levels rise.

Upon reflection, I had the double-whammy working against a clean test. I had tweaked a knee in the week prior to the blood test and had switched from doing standing cardio to sedentary exercise. Thus, I was peddling hard and fast on a stationary bike in the days before the blood was taken. And, I most certainly had my way with myself the night before the screening.

On a later visit, I asked my doctor how these activities might affect the PSA levels and, although he said there was no specifically empirical data proving that they did, I’m convinced those activities made my results more than double.

Summary: December 17, 2009.

PSA 3.7

DRE: Not performed. Biopsy recommended.

 

January 12, 2010 – The Poop Shoot

 If you’ve never had anything larger than a whisp of wind on a hot summer day skinny dipping at the pool sneak up your ass, it’s really hard for a guy to mentally prepare for a prostate biopsy.

I’m gonna describe it here; so consider this a warning. If you’d rather not know what goes on – and in – skip to the next entry.

And here we go.

A prostate biopsy is the (not-so) simple act of collecting tissue samples from the prostate for study back at the lab. They remove 12 sets of cells, called “cores,” and label them accordingly to their geographical location. That way, if they do find an evil empire, they will know how bad it is and where it’s located to plan an appropriate attack.

There’s no big pre-biopsy prep other than a prescribed anti-infection pill to be taken the day before, day of and day after the procedure. Then there’s the enema that needs to be self admitted just before you leave the house for the appointment. You know, the usual drill: Keys…check. Wallet…check. Enema….double check. I won’t elaborate on the pure joy of this self-inflicted torture other than to say that:

a) There’s no way to not be embarrassed by the absurdity of the administration and…

b) Don’t ever buy generic brands. It’s Fleet or nada, compadres. In a point: it’s all about the lubricated tip.

I chose a morning appointment for the biopsy. No sense letting the dread build.

The actual procedure starts with a dimming off the lights. Seriously. Not sure whether he was just setting a mood or needed it to see the scope screen better. You instantly have the urge to ask, “So you gonna buy me a drink first?” but resist because you know that one’s been used before…probably that same morning.

You drop trou and lie on the exam table in an extreme fetal position like you’re about to perform a hardcore cannonball into the deep end a pool. Then, hands clenched onto a bedrail, head facing a wall and bare ass thrust into the doctor’s face, the merry-go-round begins. Seriously, who chooses this as a profession?

The Doc first slides a gloved finger slathered with a numbing lube up the chute. After a few minutes when the secret agent has taken effect, a scope the size of ping-pong paddle handle with a camera at the tip is awkwardly forced into the forbidden zone. The worst moment is the first forced entry where rejection is not only natural, but a necessity. Once past the first inch or two the scope meets the numbing agent – they shake hands – and Mr. Peepers continues easily on his merry way until he finds the promised prostate land.

The pooper prankster moves that magic wand around and observes – almost like an ultrasound – the shape of the gland on his tiny computer screen. He looks for egregious irregularities and, at the same time, slides a thin needle into the bummed out bum and fires some local anesthetic into the prostate region. This will help numb the gland and ease the pain when they take the actual samples. You feel a little prick at the base of the balls as if the needle is poking from the inside trying to get out. I sympathize with John Hurt’s character in Alien as if a monster is trying to escape through my taint. It’s a strange sensation, to say the least, which sends a tiny shock through the body, not unlike chewing tin foil.

With all this playful prodding, the penis decides it needs to speak up at this point and usually spits out whatever urine was hiding in the bladder. Your body instinctively clenches like a pissed off fist ready to strike. Sweat seeps from every pore.

Now, the Doc is ready to play Scavenger Hunt with the prostate cells, collecting several samples with the help of a Sharpie-sized stick that is now inserted, while the ping-pong paddle remains lodged inside for this entire procedure. Needless to say, more than your mouth is agape.

The trash collector is almost like a tiny air gun crossed with a small claw. Because the prostate is encased in a tiny egg-shell-like sheath, he must crack the shell to get to the cells.

So the claw goes in…the Doc counts one…two…and pop! Your eyes water. Your brow sweats. Your body instinctively jumps. And you try your best to breathe deeply and find a happy place.

The good news is that after that first one, you only have to repeat the process 11 more times!

After handing each sample one-by-one to the nurse standing by, the samples are separated by location and then encased in individual Petri dishes.

After the final sample, the scope is removed and the doctor re-inserts another finger – either because he gets a sadistic kick or he wants to make sure that he didn’t pull the lower intestine even lower with all that ruckus.

And that’s it. The whole procedure lasts about 20 minutes if the guy is on his game. And off you go in desperate need of a Cadillac Margarita on the rocks.

Summary: January 12, 2010.

PSA: No new one taken

Biopsy performed: Results in 1 week

 

 January 17, 2010 – Blood Will Follow Blood

Some say that in life you can’t take the good without the bad. So after my anal intrusion, I had been prepared for several days of blood accompanying all bodily excretions below the waist.

Bloody piss…fine. Bloody stools…okay if you must. Yet no amount of “heads-up” prepared me for the bloody orgasm.   

Dr. K had said it could be weeks before the semen became vanilla again. But the first time you take the lad out for a stroll, the pop at the finish line is like the horrific climactic scene from In the Realm of the Senses when the sadistic Japanese wife and her equally whackjob husband chooses to cut off his penis at the point of orgasm.

Those who have seen the uncut version of that often censored mid-70s film will never forget the brutal end where the camera fades amid a Roman Candle of red and white spouting from the base of the man’s severed spigot.

That was my first thought when I first took myself for a test drive…well, that and the next time I’ll use a blue towel to at least make my scene at least patriotic.

 

 January 21, 2010 – Biopsy 1 Results

The following is a brief summation I wrote after learning the results of that first biopsy as printed on my Facebook page to spread the word about prostate health:

This is a Precautionary Tale about a boy and his prostate. Yes, that which produces the very special sauce that creates life can also take it. In fact, nearly one of every six men will be diagnosed with prostate cancer at some point in his life. So when I was the one faced with the evil empire last week, the feeling was less, “why me?” than “why not me?”

This note is intended to let my male brothers know some things that I have only recently come to find out: namely, this shit can happen to you and it can happen a lot sooner than you think.

I had always been under the impression that screening for prostate issues was something easily put off until your mid-40s. For the past several years, I had been going to an elderly Indian HMO doctor whose idea of a thorough physical was tapping one of those little rubber hammers against your knee. He was perfect; don’t ask and he can’t tell. Dudes are like that…we don’t want to know.

Actually, you do.

My company’s insurance changed late last year, and I was forced to find a new doctor. By a stroke of luck, I selected a young guy more on the cutting edge of medicine who actually wanted to look for problems. I was 42 when he ordered a PSA test and performed my first-ever rear-view-terror. PSA is a protein produced by the cells in the prostate and measured by a blood test to decipher healthy levels. Normal levels depend on a variety of factors, including age. My level was normal, but he felt a minor enlargement of one side of the gland and sent me off to a urologist.

I laughed at his dogged precaution until he mentioned that he had discovered advanced prostate cancer in a patient several months prior who was only 38 years old. So…what’s that urologist’s name again?

Two ever-increasing PSA-level tests later, and the specialist had me ass-up with cameras, probes and god-knows-what-else poking and prodding to eradicate chunks of the gland for a microscopic third degree. “Twenty Minutes in Heaven” it was not, but at least I would be sure.

A week after the biopsy, Leslie and I visited the urologist for the results. We were so confident about what was obviously gonna be thumbs-up results that we were planning margarita destinations during the wait.

Then, the urologist walked in and said matter-of-factly, “So it turns out you have a little cancer.”

It was so nonchalantly uttered that he could have been talking about tomorrow’s weather forecast. “Slight showers with a chance of cancer; you won’t even need an umbrella.” In fact, my initial reaction was, “Cool, so I’ll just rub some dirt on it, and it’ll go away, right?”

Turns out not.

My mind started spacing as he broke down exactly what this meant today and will mean tomorrow without treatment. His voice turned into one of those teachers in a Peanuts cartoon.

Whomp-whomp…whomp-whamp, whomp whomp.

I rewound my life a good three minutes and imagined him opening the door once more. “Hi Mr. Schalin…I’m Mortality. Nice to meet you. Could you please ask your friend, Invincibility, to wait outside?”

Forty-fucking-two. Really? Fortunately, the malignant cells were caught in their infancy, giving me time to study, query and make an educated decision on what to do. In addition, prostate cancer is a very slow-moving army of divide-and-conquering cells; so catching it early is clutch.

The treatment options range from external and/or internal radiation to removal of the gland completely. Each boasts its own desirable set of side effects and physical fuckclusters, not least of which is an end to procreational desires and, at worse, dysfunction of that hobby favored by men for millions of years.

But this narrative is not intended to be a Johns Hopkins treatise on the latest advances in violating a grown man’s body. Rather it’s a friendly warning to all my friends over 35 years old. Don’t wait. Take precaution. Ask your doctor for a PSA exam (again, done with a simple blood test). Had I stuck with my last doctor, the taxi driver, I wouldn’t have asked for an exam for another three years. Who knows by then how far the disease would have advanced and what my more limited options might be.

God bless the God that built this flawed machine.

So, yes I had a “little cancer.” I won’t bore anyone with explanations about what the following numbers mean (prostate cancer guys know this shit like a second language and the laymen need not be disturbed).  Suffice it to say, I had the lowest grade of prostate cancer that a man could have.

Now come the choices: removal of the gland (prostatectomy) or radiation therapy to hopefully attack the cells before they could have a chance to spread. Dr. K was already advising for removal based on the biopsy results, although he gave me a radiology referral to get a different take. Either solution came with its own pros (exterminating the cancerous cells before they had a chance to move on) and many, many, did I say many, cons.

Summary: January 21, 2010.

PSA: No new one taken

Biopsy Results (from Quest Diagnostics): T2a cancer in 1 of the 12 cores. Gleason 3+3 = 6

 

January 22, 2010 – I’ve Got What?

I woke feeling confused and more perturbed than angry. The feeling of annoyance that I would now have to spend weeks of time researching all there was to know about a disease that should only strike old men.

I laughed at the irresistible irony of me being a part owner of an herbal supplement company whose biggest-selling product was something called Prostalex Plus, a prostate health supplement. I had been taking the supplement daily for about two years and, while it is absolutely not designed to prevent or treat the onset of cancerous cells, it is proven to promote overall prostate health. Or not.

Initially when I was told of the diagnosis, I recalled my favorite scene from Monty Python’s Meaning of Life.

It’s the scene where the Zulu warriors are fighting the British in the African tundra. Inside a tent, one of the officers (Eric Idle) sits calmly in his bed reading a book when a doctor walks in and inquires about the problem.

Idle calmly points to a bloody stump where his right leg should be and says, “Not sure, Doc, but it seems I’ve been bitten during the night. Woke up this morning…one sock too many.”

The doctor taps the grisly stump with the tip of his pipe and proceeds to “reeeeeassure” Idle that everything will be alright. “Nothing to worry about. Probably a mosquito that got through the net. Get plenty of rest and if you’re playing any futbol this weekend, try to favor the other leg.”

The patient smiles, satisfied, and as the doctor leaves, Idle muses, “So it’ll just grow back then, will it?”

At this point the doctor feels the need to “come clean” and confess that the leg thief is probably something slightly more substantial than a mosquito. Perhaps a tiger. Wherein the cast looks to camera, horrified and asks the question, “A tiger??? In Africa?!?” To which the dim doctor promptly assures everyone that it probably just, “escaped from the zoo.”

I thought of that scene because my initial reaction to my “little cancer” was as if I had the flu. That would be the denial phase and while educating myself about what was in store for me, the sudden realization hit that this was more than just a mosquito bite.

This was something serious and dangerous. Deadly at worst, debilitating at best.

I decided to name the disease something other than cancer. Not that there’s anything inherently wrong with the word itself: good hard “c” followed by a slithering c made for an evil purse of the lips. My issue is that I associate the word with blue hairs drooling into paper cups while Benny Goodman records crackle from the corner of purgatory.

So I decided to call my problem Cody, in honor of screenwriter extraordinaire Cody Diablo (she of the look-at-me pop culture junk like Juno, Jennifer’s Body and the offensively lame United States of Tara). I had prostate Cody.

 

January 22-31, 2010 – Research & Destroy

Weeks and weeks of research followed. You really understand the beauty of the internet and how it can be used for good in these situations. I visited hundreds of sites, searching definitions of my diagnosis and where I was in the scheme of other cancer patients. I joined an array of prostate-specific groups and blogs to post a myriad of questions. I was amazed and moved by the outpouring of advice, info, guidance and sympathy that so many men I had never met before provided.

I learned that prostate cancer is one the slowest growing cancers a man can have. Because of the tiny shell encasing the gland it’s harder for the bad cells to multiple and break on through as opposed to being in an exposed node or organ. In fact, as the doctor maintained, many men  diagnosed with prostate cancer much later in their lives —  say 70 – just let it go untreated as something else is gonna probably kill them first.

But I was in a special, select group of men under 45 who have to deal with this sooner than later. Choices suddenly needed to be made. Leslie and I have no kids, and we have always been very much on the fence about the notion. In the past, there was always tomorrow to make that decision.

Now, there wasn’t.

Without a prostate, there would be no chance of procreation. Hell, there would no physical ejaculation whatsoever.

Which brought me to the other tragic realization. I’ve become rather found of my little nappy-headed friend below my waist. In many hard times, he’s been my closest, most reliable buddy. Hell, if he looked better in a suit, I’d have made him the Best Man at my wedding. So the thought of suddenly losing his companionship was beyond scary. It was impossible. It was the end of so many vital aspects of my life as I knew it.

Now understand the difference between the two primary options of treatment: A prostatectomy removes the gland completely. By so doing, especially for a person with such a low score of cancer, there was a strong chance that I would eliminate the problem at its root. A few years of subsequent blood tests would tell for sure if the varmints had escaped and spread elsewhere, but all that I read assured me that surgical elimination would be the most conclusive way of not having this cancer kill me.

Of course, removal of the gland generally leaves a very sordid trail of fucked-up side-effects which can/will include erectile dysfunction, pissing yourself when you cough, sit, stand, laugh or generally do anything that humans do, a loss of libido and the ability to procreate. (Here’s a little-known Cliff Claven factoid, unlike women, men actually have two sphincters. When you remove the prostate, you rip one of those important vise grips out, leaving the bladder more-or-less to its own comical devices.) Oh, and if you do finally get back in the game and enjoy a non-prescriptive erection again, there’s a little something called “dry orgasms” to deal with.

On the other hand, radiation therapy, while also killing a chance to inseminate, can (operative word) preserve the nerves that allow for semi-healthy erections. 

Hundreds of pages were printed, highlighted and shoved into folders marked “Cody”.

 

 January 22, 2010 – Emotion in the Ocean

These things hit you in both very obvious and then very sneaky ways. By no means did I think this was death sentence, but its hindrances of life’s simple pleasures could be profoundly frustrating.

Some days, I wallowed in depression about the obviously debilitating side effects. Yet other days, I actually welcomed this as new challenge. It was something to deal with, overcome, persevere and maybe even test my meddle.

I also went through a typical rollercoaster paradox of both A) “Now it’s time to get your shit together, get super healthy and slow down on the nonsense,” and B) “Fuck it, let’s drink like we mean it and enjoy the excesses in case this is our last dance.”

Each month, B usually won by a score of three to one.

 

 February 2, 2010 – Radiation Calling

So now armed with files full of questions, I met with a radiologist. Going into this meeting, I was convinced that non-surgical radiation would be the best treatment for me. It was less intrusive and had a bigger upside sexually.

Dr. Ko at Northridge Med turned all my preconceived notions upside-down. She advised that radiation was mostly geared for older patients who could be in danger by invasive surgery. She said that, at my age, radiation had a good chance of merely containing the dangerous cells for a period of time. Five years; maybe ten years. But I would always be living under the specter that at any time, after any checkup, the cancer might have suddenly found its sea legs and spread.

A prostatectomy was the only way to ever be sure that I had removed the cancerous cells and that they had not come back. Plus, she added, that with my age and healthy lifestyle, I would have the greatest chance of recovering from the side effects and was best poised to re-gain normal erections without a lifelong Cialis crutch.

And then she said something that changed my life, at least at that moment. It was something so simple and so off-handed that it seemed like she was simply saying my shoe was un-tied.

“Did you get a second opinion on the pathology report from your biopsy?”

“Uh…no. Hadn’t even thought of that nor was it ever recommended by anyone else.

 “Oh, well you should,” the demure Asian doctor said. “Ask Dr. K to send the reports to Johns Hopkins. You never know.”

 And so I did.

 Summary: February 2, 2010.

PSA: No new one taken

DRE: Finger exam confirmed irregular shape of the prostate, but she admitted that it was so minor that had she not been briefed on my pre-disposition, she may not have noticed it.

Recommendation: Second opinion on biopsy pathology report.

 

February 16, 2010 – Second Opinions Are Not Like Assholes

And so Dr. K was more than happy to send my pathology off for a second opinion.

I had requested a phone call this time for the results. No need for me to spend another $25 co-pay and drive across town just to hear the same news. We had already done the faced-to-face cancer fest.

And so he called late in the afternoon and in his typically low-key, matter-of-fact manner said, “Well good news. Hopkins doesn’t see cancer for certain.”

Ok, what the hell does that mean?

“They see are abnormal cells classified as High-Grade PIN as opposed to cancer.”

High-Grade PIN cells are defined as a small, atypical group that are too small to be defined as either benign (good cells) or malignant (bad ones). Thus, High-Grade PIN is an Agnostic group of cells that just can’t make up their dirty little minds what they wanna be when they grow up.

The good news: that means there is a chance that they aren’t cancerous. That beats, “It turns out you got a little cancer” any day.

A second biopsy was ordered to get a new cluster of samples and see if we could get a stronger declaration one way or another.  

Suddenly a Doors song starts wafting through my head. I could hear the swirling, haunting organ and the words push their way to the frontal lobe:

 Strange days have found us,
Strange days have tracked us down,
They’re goin’ to destroy our casual joys,
We shall go on playing or find a new town…

Summary: February 16, 2010.

PSA: No new one taken

Biopsy Results (from Johns Hopkins): Focus of High Grade PIN with adjacent, small atypical glands. Findings are highly suspicious for carcinoma (cancer). While these small glands may represent an infiltrating cancer, we cannot exclude that they represent an outpouring of the adjacent PIN glands only. Repeat biopsy is recommended.

 

 March 5, 2010 – Train in Vein

Another day, another bloodletting. But this time, I made sure not ride a bike, ejaculate or shove small rodents up my ass for a good 72 hours prior to the test. I won’t reveal which activity was the hardest to abstain, but I was curious how this new strategy would affect the score.

 

 March 16, 2010 – A Second Biopsy? Butt, of Course

Dr. K, to his benefit, did not want to wait too long to perform the second biopsy. Even though prostate Cody is slow moving, you wanna attack the bastard before it stops its slumber and starts to lumber.

At the same time, the good doctor also wanted to let my prostate heal enough from the first biopsy so that my inner sanctum didn’t become like the slaughterhouse scene from Rocky.

So almost two months to the day, I arrived for the second biopsy. The goal was that the results from this one would (hopefully) determine which way the eagle flied.

The best news was that results from a new PSA test showed my level down from 3.7 in December to a glorious gutter low of just 1.1. We were both amazed at the positive fluctuation and the results convinced me that all I read about pre-PSA blood screening behavior was correct: abstain from anything that disturbs the prostate.

It is said that love is better the second time around, so I’d love to report that the second biop was a breeze. It was actually worse.

The brain is a funny monster. It renders bad situations better when it doesn’t have a clue what is about to happen. Sure, my brain had some expectations of the horrors the first time around, but there was no baseline, no barometer by which to measure exactly what would transpire and how bad it would be. All I knew was I was gonna have shit shoved up my ass. The blow-by-blow process, however, was unknown.

Now, heading into the second lap, I knew exactly what was coming – and what was going. I knew in what order and in how long a time sequence. I know the sights, the sounds, the smells and the painful humiliation of the experience. And thus, aggravated anxiety precipitated these 30 minutes in Heaven.

While doing my best cannonball position on the table, I pondered this principle and thought maybe that’s why you shouldn’t fear death. It’s really only the second thing in everyone’s life that can and will happen exactly once. So, who knows what it will feel like. As a fetus, I don’t recall thinking, “How the fuck am I gonna squeeze through that?”

And maybe dying is the best goddam mushroom trip of all time. Maybe it is just frozen moments of blissful reflections of a life lived and loved before the deepest, soothing sleep of all time. And – what the hell – maybe there are moments in the dying throes where you feel weightless, and you’re running naked through a poppy field with an ice-cold martini, a full plate of carnitas and the TV remote control. And all your dead pets are running around dressed in suits and ties wondering, “What’s with the naked guy?”

And then again, it could be all that but without any olives, Cholula or a flat screen TV.

The good news is – if death sucks ass, well, at least you won’t have to do it again.

Summary: March 16, 2010.

PSA: 1.1

Biopsy Results: Pending

 

March 17, 2010 – Leaving the Present Behind

In a very rollercoaster year, Leslie had succeeded in capping her two-year boot camp of nursing school by graduating and passing the state’s NCLEX test. She was now officially a Registered Nurse and ready to start her new life as a made woman.

Before she started applying for nursing gigs, we decided to take a trip which could be our last for some time.

After much debating, we decided to avoid airlines, exchange rates and basically take a vacation that wouldn’t require a vacation afterward.

A drive, we thought. So we planned a roadie up the gut of California with Seattle as a northernmost destination. Then we’d turn around and swerve over to the coast where Oregon meets the Emerald State and slowly meander our way down the Western spine of America.

We couldn’t wait for the trip, but I also couldn’t stomach the unknown results hanging over my head for the two weeks while I was slurping oysters and gulping martinis. So I asked Dr. K to give me the results over the phone to save time. Neither good news nor bad was going to matter as I had already dealt with the bad, so if it’s still the Big C, at least I was now prepared for my options.

 

 March 24, 2010 – All Aboard!

The day before our roadie was to commence, Leslie and I were drunk-packing like giddy college kids. We happily scurrying around the house collecting everything we would never need. There’s a multitude of freedoms that a long road trip allows. First and foremost, it affords you the opportunity to pack the car with every single item in the house.  (How we got the Viking fridge in the car remains a mystery.)

We stocked the cabin with a myriad of driving snacks (large pretzels, power bars, juice pouches, gummy everythings), maps, Magellan’s, pillows, shoes and clothes for all-weather conditions. You would think we were scaling Mt. Everest with all the crap we loaded into the tiny, white Prius. 

Minds and bodies were focused on the trip. In fact, even when my cell rang around 4:00 flashing an unrecognizable 818 area code, I still had forgotten that today was the day for The Call.

“Hello.”

“Scott, this is Dr. K.”

Of course you know that moment at the highest apex of a rollercoaster where the cars seem to stop for an eternity and float in outer space before they ease forward and then with a rush of blood to head, heart and thighs you plummet. And six or seven seconds into the freefall your stomach literally makes its way up your torso headed straight for your throat like a drunk who’s heard the words, “Last call.”

Triple that.

That’s how I felt in an instant. Leslie knew who it was and she remained at the dining-room table as I walked into the bedroom. I needed to focus and hear the results alone.

His words were mannered as he was quite obviously reading from the report for the first time with me. “Benign prostatic tissue with focal chronic prostatitis…hmm…atypical small acinar proliferation…Oh, I see, okay. Stains for high molecular weight keratin demonstrate positive straining for basal cells in the focus in question, ruling out carcinoma.”

Time to butt in. “Dr. K…do I have cancer or not?”

“Nope…it appears not.”

You talk about burying the lead. “You know, Doc, you really could’ve opened with that.”

He laughed. “Yeah. So what it looks like is that you do have a few atypical cells that are classified as ASAP. This stands for Atypical Small Acinar Proliferation which means they could become cancerous more so than if you didn’t have them.”

“But I don’t have cancer now?”

“You don’t have cancer now, but we need to keep a very close eye. Since three sets of eyes have now found three different classifications of some abnormal cells, I recommend another biopsy. But it’s no rush. We’ll let your tuckus [yes, a nice Jewish boy, he used tuckus] rest and come back in the summer, and we’ll give this hopefully one more look and be convinced.”

I was speechless but managed a, “Thanks Doc.”

“Have a great time on your vacation.”

I hung up the phone and for the first time since the start of this bungee jump, I welled up as I walked into the kitchen where Leslie was waiting and watching.

“It looks like I may not have cancer.” And we hugged and wiped away a few dribbles of happiness. Or relief. Did any of that really happen?

In silence, Leslie and I just stared at each other and shook our heads, laughing now with no tears. And one of my favorite songs popped into my head, and I started humming the lyrics made famous by Nina Simone and covered brilliantly by Muse…

 Birds flyin’ high… you know how I feel
Sun in the sky… you know how I feel
Breeze driftin’ on by you know how I feel
It’s a new dawn, it’s a new day, it’s a new life for me…
And I’m feelin’ good.

 

 March 25 thru April 7, 2010- A Long, Strange Trip

Leslie and I took a thoroughly necessary and revitalizing vacation meandering up the belly of California and Oregon en route to Seattle to see Muse at Key Arena. My girl with the joyful relief of nursing school and passing the state board behind her, and me with a fresh, seemingly healthier perspective. We hadn’t a care in the world for those two weeks (save the 24 hours I spent vomiting from an evil oyster in Seattle).

The highlights should have included the concert, but Seattle fans are dopes when it comes to getting into a show, and Key Arena is a floating turd that allows you to buy beer in the concession area but does not allow you take said beverage to your seat. Say what?

Highlights included the bacon doughnut at Voodoo Donuts in Portland, hitting every Tom Douglas restaurant in Seattle, the hand-crafted salami sandwich at Mario Battali’s father’s El Salumi sammy shop across from Safeco, driving the breathtaking cliffs overlooking the rugged Pacific in Oregon, the wine treasure hunt in Healdsburg and every single living, breathing second spent with my best friend.

When we returned home, reality hit for both of us. For Leslie, the toughest task lay ahead of finding a job (who knew the education would be the easy part). For me, it was time to hit Al Gore’s invention and find out just what the ASAP cells were inside my ass and how they differed from High-Grade PIN which was determined on second sight of Biopsy 1.

In the lamest of layman terms, you really don’t want either. Both basically infer that you have a class clown cluster of cells that will continue getting sent to detention and, most likely, grow up to be a cancerous loser.

One study from the American Society for Clinical Pathology determined that 24% of patients who had PIN in one biopsy will have cancer in a follow-up. Worse still, 41% of proud ASAP bearers will have cancer in a follow-up biopsy.

ASAP and its “cousin,” PIN (prostatic intraepithelial neoplasia) are two critical findings that are not actually prostate cancer but which seem to be highly predictive of the likelihood of current or future prostate cancer.

In other words, before patients get prostate cancer, many of them may have either PIN or ASAP or both.

It is because of this troublesome statistic that my urologist, Dr. K wanted me back in the summertime for yet another biopsy. He said if I was 65 or older, he wouldn’t be too alarmed to stay so tightly on top of this, but at my age, early detection is key to making sure that class clown doesn’t ditch early to go beat up other healthy cells at the bike racks.

I spent June and July in complete avoidance. I stopped obsessively searching sites and reading blogs about the goddam prostate and pretended – for a precious several weeks – that all of this had just gone away. I drank martinis, Leslie and I experimented with an array of new recipes in our test kitchen, I acquired a special new cat that acts like a dog and follows me everywhere named, Cooper. I enjoyed what I feared would be Vin Scully’s last season of painting my summer a deep and vibrant blue talking up the Dodgers. I watched the Lakers sack up and beat the Celtics in a poetic Game Seven, and I counted the days until August 24 when my next biopsy would arrive like Santa sliding down the chimney.

 

May 6, 2010 – Checkup Please

I went back to see my original general doctor, Joey Brett. I thanked him for his due diligence and insistence on looking at my prostate.

The PSA was 2.2, and I was feeling pretty good about my chances entering the next biopsy.

 Summary: May 6, 2010

PSA: 2.2

DRE: No new rectal exam performed

 

August 24, 2010 – Third Time’s No Charm

Reality doesn’t bite so much as it pinches. If I had forgotten about the love and glory of a prostate biopsy, waiting 50 anxious minutes in Dr. K’s waiting room brought the memories very much alive and unwell in my mind.

Once inside the chamber of horrors, I assumed the cannonball position with ass in the face of my good doctor and – crash, bang, wallop! – we did the dance for yet a third time in just eight months.

As always, I tried to find a happy place while the dirty deed unfolded. This time, I couldn’t seem to shake the vivid story of a childhood friend, Robbie Cormack, who was riding his Mongoose bike along a bumpy dirt road when he was 13 years old. Rob was the elementary-school stud, the tough kid destined to be a high-school quarterback in years to come.

This day, as he demonstrated dope tricks and jumps, he did so without a seat attached to his bike. I’m still not sure why, and I’m sure he would have rather re-thought that omission when his bike hit a series of bumps we called whoop-te-dos and his bike whooped, but his butt te-doed and came down hard on the exposed post where the seat would have sat.

That little bit of Evil Knievelry forced the kid into emergency anal reconstructive surgery. True to form, and as legend has it, tough guy Robbie was so intrigued by the procedure that he requested a local anesthesia and a strategically placed mirror, so he could watch his shit shute sewn back together.

Yeah, my “happy places” tend to be a bit fucked up.

I had blood taken a week prior to this visit and – good news – is that my PSA has stayed low and well under acceptable levels at a 1.9. My doctor and I were encouraged by that sign, but then no urologist can seem to agree on the true importance of the PSA test. In many cases people with high PSAs never develop cancer and people with low scores do. So while I’d much rather be low than high on the scale, I can never be over-confident that a low PSA means I’m out of the woods.

Summary:  August 24,2010

PSA: 1.9

DRE: Not done.

Biopsy: Performed and waiting results.

 

 August 27, 2010 – Pins and Anals

As I sit here studying more about ASAP and PIN cells, a line on a urology site really hits home: There is no known cure for ASAP cells.

I have been deluding myself into thinking that I don’t have cancer, but I have not been taking the ASAP diagnosis seriously enough. The fact remains, that I do have some kind of fucked up cells in there that are far more likely to become cancerous at some point than if I didn’t. And they ain’t going away. Which means, I’m now a slave to my inner arse. Even if this latest biopsy comes back with no cells, they are certainly gonna report the abnormal cells as either PIN or ASAP.

So it hits me that my ass is now like Buckingham Palace where I must have watchful guards constantly on duty. I’m certainly doomed to multiple PSA tests every year (no biggie, cause I’ve always got the blood) and, worse, probably an annual biopsy just to make those ASAPs haven’t matured into something deadly.

A week later, I’m still sitting in wait. Fuck Tom Petty, but the waiting really is the hardest part.

September 3, 2010 – And Waiting…

If patience is truly a virture, then still not having results now what will be two weeks later come Tuesday is more than taxing my virtue.

I had a brief conversation with Dr. K earlier in the week, and he said he would call the moment they came in. You would think a lab, in this case Quest Diagnostics, would put a little giddy-up  in their gait when they knew the potential seriousness of the outcome. And isn’t everyone in the medical profession always preaching about “early detection and treatment.”

Two weeks seems unreasonable, at best, and downright insulting, at worst, when a man’s life is on the line – particularly when that man is me.

 September 7, 2010 – Denying Bargaining, Acceptance and Anger

So it’s now been two weeks since my last biopsy and there’s still no word. You would think that they would put a red tag on these specimens to fast-track the status. But no. Instead I wait for a doctor’s call that never comes. Even phoning into Dr. K’s office leaves only messages with no returns.

And then he called.

The Doc rattled off a lot of nonsense before he revealed that no cancer was evident. Yeah there are some suspicious cells to keep an eye (and finger on).

2010 – May 2017

For seven years now, my PSA levels have been as clean as whistle. Digital exams have certified that my prostate was intact at its proper walnut size and the blood work had not once eclipsed 2.0. So what had been a terrible scare was now nothing more than an ugly blip on the health horizon.

In September, 2015, I moved to Seattle to be closer to water and further from the freeways of Los Angeles. While finding a new set of doctors, I was told that digital rectal exams were a dinosauric thing of the past. No more poking or prodding. The doctors in the Pacific Northwest simply relied on the PSA findings to determine if anything was askew down South. And so far….so great.

PSA, May 2016: 1.7

PSA, February 2017: 1.3

April, 2018 – Scare Tactics

And just when I thought it was safe to go back to being normal, an elevated PSA reared its ugly head. I went by normal protocol – a good two weeks of healthy eating sans sex and bike riding, assuming I’d reclaim my ninth straight PSA reading of under 2.0.

Instead a 3.7 was revealed.

For everyday Joes in their very early 50s this would be a non-event, but for someone who had a scare a decade ago, this was alarming. My lifestyle hadn’t changed to merit the sudden climb. Thoughts warble as to why – I’d had a colonoscopy a year ago…could that intrusiveness affected the prostate size? I also had an annually invasive, uber uncomfy surgery in the past 12 months. Perhaps that bothered the gland and caused additional swelling that still lingered. Impossible to say. But possible that the prostate is, again, in a state of disrepair. Only time will tell and me thinks a new PSA in about six months, as opposed to waiting another year would be in order to placate my growing fears. Anything to avoid the dreaded biopsy which is less fun than eating a frozen pizza….while still frozen…in the rain…in my underwear. 

PSA, April 2018: 3.7