In 2015 (26.3.15) I went to Dr M for a check-up. After
shafting me with a gloved and lubricated forefinger she told me my prostate was
hard and enlarged, and
recommended I have a blood test. I complied and my PSA (Prostate Specific
Antigen) count was 5.4. She suggested I see a urologist in Hermanus. This I
eventually did on the 4th of August.
Dr J was a short man in his late thirties. Slight of build
and fit looking, he was economical with his words and reluctant to explain
anything more than once. His hands were small and soft. He used them to bend my
penis in different directions, to pull down its foreskin and to palpate my
testicles. This was before getting me to lie on my side with knees drawn up and
giving my prostate a digital once-over. I also had to pee into a large paper
cone held at an adjustable height by a contraption that measured volume and
strength of urine flow.
Back on the bench he smeared cold gel on my lower abdomen
and slowly slid about with a hand-held ultrasound sensor while looking at his
laptop. I had a capacious bladder, he told me, and it was nowhere near empty.
Across his office desk he gave his diagnosis. My prostate
was enlarged and might or might not be cancerous. It was probably not, but only
a biopsy could determine this. It would also be wise to perform a resection,
which entailed reducing the size of the prostate by cauterization.
A few weeks later in August 2015 K took me into Hermanus to
the Mediclinic. I checked in at Reception at 6a.m. and we went up to the ward.
I had my own east-facing room overlooking Westcliff. K stayed with me while I
changed into my newly acquired pyjamas and dressing gown and she helped with
the filling in of forms and questionnaires. The sun had come up by the time she
left.
A nurse told me to change into theatre gown and underpants
and to get into bed. Blood pressure, pulse and temperature readings were taken
and I was given an ECG. J called in briefly, and the Sister told me later that
his father had died in the night. This information made me more apprehensive,
as I thought his emotional state might impair his surgical ability. A female
anaesthetist was next. She asked me questions and sketched what would happen
when I was wheeled into theatre. The Sister later told me that this
anaesthetist was J’s wife.
After a while a male and a female nurse came to fetch me and
I was trundled at considerable speed down a long corridor, through two sets of
swing doors and into the pre-op area, which was also the post-op recovery room.
Presently a sister in theatre garb welcomed me and ascertained that I was who I
was and not somebody else and the anaesthetist appeared. She found a suitable
vein in my left arm, inserted a needle and taped it in position ready to
receive the drugs that would put me under. Ten minutes later they wheeled me
into the theatre and told me to move across from the bed onto the operating
table. I noticed an apparatus with stirrups that reminded me of gynaecological
equipment and hoped they didn’t mistakenly try giving me a hysterectomy.
As a pleasant drowsiness began to blur my senses, a mask was
placed over my nose and mouth and I was told to breathe deeply. The transition
from here to nowhere was so instantaneous it left no memory of an experience.
On returning to the surface, I found myself back in bed in the recovery room
with a nurse talking to me. I felt warm and free of pain. It had been an
interesting episode and could even be regarded as enjoyable. I was particularly
impressed by the suddenness of losing consciousness and by the total lack of
content regarding where I had been while anaesthetized. Optimistically, I
imagined this was what death would be like. One would depart to a realm of
complete oblivion.
On returning to the ward, it seemed as if my senses were
back to normal and I was aware that I was connected to a drip and that a
catheter tube was taped to my thigh. Nurses came and went, observing my
condition with half-hourly blood pressure, temperature and pulse checks. They
also kept an eye on the two bags suspended from a drip stand. The smaller one
contained antibiotics and analgesics, while the larger one held water. When I
leaned over the side of the bed, I was shocked to see that the catheter bag was
already half full, and the contents were stained a dark pink. For the next 48
hours my urinary tract was to be flushed through to prevent clotting in the
prostate.
They brought me tea and a sandwich and after about an hour I
got up and stood beside the bed. A sister gave me permission to walk up and
down. With my new blue dressing gown draped about me I slowly pushed the drip
stand with my left hand and carried the catheter bag in my right. As I made my
way down the long corridor, I passed art works on the walls. They all shared
the same theme, depicting horizons and skies at sunrise or sunset. I took a
slow drive up and down and returned to the ward. After an hour or so I went for
another jol along Sunset Boulevard. Two women in white coats approached and as
they passed gave me a haranguing.
“Lower the bag! Lower the bag!”
“Lower it! It’s going back into
you!”
Yes, I should have set out with
an empty bag and held it below bladder height, but why the anger? They must
have been offended by the spectacle of this obscene old man carrying a bag of
bloody piss that was being filled to capacity through a naked tube protruding
from its loathsome source.
I spent three days and three
nights in the Hermanus MediClinic. The pink liquid in the bag gradually turned
to a paler hue and in the late afternoon of the third day J said the drip and
catheter could be removed and, if I could pass urine without difficulty in the
morning I could go.
That evening I experienced a
paranoid panic attack that raised my blood pressure. If J didn’t release me in
the morning I was going to discharge myself.
After taking a shower and pissing
in the toilet I phoned K. She arrived just before midday, I checked out, and we
headed home after collecting pain-killers and a box of Movicol sachets from the
dispensary. I never needed the Synaleve but I took the laxative morning and
evening for a month in order to keep the contents of my bowels hydrated and
soft. Straining at stool is strictly forbidden after prostate resection.
I wasn’t in pain but there was a
feeling of internal tenderness and a slight burning sensation on passing pale
pink urine.
Two days after leaving the
MediClinic following the resection there was a call from J’s rooms to say that
my urologist wanted to see me. He had asserted that it was unlikely that my
prostate was cancerous, but only the biopsy could confirm this. The trepidation
I felt on the way into Hermanus the next day was warranted. J informed me that
the biopsy revealed early signs of carcinoma on both sides of the prostate. I
could either have the gland removed entirely, or undergo radiation treatment.
The latter was called brachytherapy and entailed the implanting of fifty to
sixty radioactive seeds that would kill the cancer cells. It was my choice but
I got the impression he favoured brachytherapy.
“And if I do nothing?”
“You will still be alive in five
years’ time.”
So, I had cancer. It was a bit of
a shock and took some getting used to. I even thought about ways to commit
suicide before the quality of life deteriorated too far. Gassing myself in the
garage would probably be the most practical.
K surprised me with her tears.
She said she felt so guilty. All she could think of was how alone she would be.
I tried to comfort her by saying there was nothing wrong with these feelings.
If the cancer spread and I was to die in the next year or two it wouldn’t be me
having to cope with grief and loneliness. How many times had we spoken about
our tenuous hold on life, and how it was just a matter of luck one of us hadn’t
kicked the bucket already? This should serve to remind us of our mortality and
I quoted Henry Fuckit: ‘You never know what’s lurking in the bloodstream, or
squatting in the liver, or skulking under the foreskin, or flitting hither and
thither from branch to branch in the bronchial forest.’ Now I could add ‘or
crouching in the prostate.’
For the next two or three weeks I
experienced discomfort rather than pain. It wasn’t long before I was going
through the night without having to get up to the toilet. It wasn’t long before
my urine was back to normal straw-coloured liquid, but I did experience a scare
on one occasion when taking a leak out in the garden. To my horror I found that
I was pissing blood and not urine. The sight of that dark red liquid issuing
from my cock was so shocking I thought I was going to have a panic attack. J
had warned that this might happen if there was a minor bleed, and I shouldn’t
be concerned unless it persisted. The next time I relieved myself I was
overjoyed to see a stream of pink that soon changed to clear water tinged with
a beautiful hue of pale yellow.
I decided to opt for brachytherapy and a date was set: 19
February 2016. This would give the oncologist time to order the radioactive
material from the UK. Before undergoing the procedures, though, it was
advisable to check the status of my bladder by means of a urodynamic test.
K’s Hospital Plan covered the biopsy, resection and
radiation but not the test, which cost over R5000. I presented myself at J’s
rooms on a Friday afternoon at the beginning of October while he was in theatre
and was introduced to the medical technician. I had been hoping for a
grey-haired woman whose lumpy shape would be no incentive for speculation about
what was inside the white uniform. Instead, I was dismayed to find myself in
the presence of a female in her late thirties wearing jeans and a white cotton
blouse beneath a maroon velveteen waistcoat. Her long black hair was swept back
and held in place by a silver comb. She was small and slim and although not
voluptuous, definitely attractive enough to cause both of us some
embarrassment.
Her paraphernalia had been set up in the surgery and consisted
of two monitors connected to electronic equipment stacked in tiers on a
trolley. There was an office chair on castors, a commode and a drip stand.
First, she explained the procedure so that I knew what to
expect. She was going to catheterise me and insert a pressure sensor, and then
slowly fill my bladder to capacity while monitoring urinary tract responses.
Then, as I emptied my bladder, important information would be gathered. She
asked me to go to the toilet next door and discharge all the urine that was in
me. When I returned, she had me put on a gown and remove my shorts and
underpants before lying on the examination table. She draped a green surgical
draw sheet across my middle, donned gloves, opened the catheter pack and went
to work on my organ.
Having exposed it to view through a slit in the cloth, she
grasped it in her left hand, retracted the foreskin and swabbed the glans. The
end of the catheter tube was dipped in a sachet of anaesthetic lubricant before
being inserted. As the tube was fed through the urethra into the bladder the
novel sensation that I experienced was unpleasant but not particularly painful.
Once the catheter was in place, I turned on my side, raised my knees and
offered her access to my anus. She thrust a cylindrical sensor about the size
of a tampon into my rectum.
I carefully got down from the table and stood alongside the
electronic equipment and faced the drip stand, one tube dangling from my cock
and another hanging from my arse. It was at this point that I realised I had
nothing to fear. Even if she had stripped and performed a belly dance my member
was now in a state of deep coma and incapable of responding to external
stimuli.
The catheter was connected to a litre bag of sterile water
that was hung from the elevated drip stand. The sensor cable was plugged into
one of the machines and she sat down in front of her monitor. The force of
gravity would slowly transfer the water to my bladder, and when I felt a strong
urge to urinate, we would know the process had been completed. Then I would
empty the water into the commode. She warned me that it could take a good hour
or so for my bladder to fill.
In fact, it took over two hours. Two hours of standing in
one position while tethered front and rear. It was physically demanding and
would have proved excruciatingly boring if she hadn’t been a chatty person. We
exchanged personal information and talked about our interests, which helped to
pass the time until I finally replied in the affirmative when she asked me for
the umpteenth time if I felt the urge.
Getting up she told me she would leave the room while I
urinated into the commode. The catheter tube was to remain in place and I was
not to worry if there was some splashing. After I had completed a slow and
lengthy leak she returned to her stool in front of the monitor and analysed the
results. Some five minutes or so later she looked up and smiled. My bladder
function was normal and she would report this to Doctor J.
The procedure being over, the mood in the room changed abruptly.
Friday night beckoned and we were both in a hurry to get out of there. As she
withdrew the catheter tube the unpleasant sensation was similar to the one on
entry but a little worse. While she flung the catheter tube into the commode I
stood down. She groped under my gown, found the cable and began to pull. When
the sensor reached my sphincter, she overcame the resistance by means of a
yank, and the device flew out like a cork from a bottle. It, too, ended up in
the commode, and as I hastily dressed and threw off the gown I began to laugh.
The indignity of what I had just been through struck me as bizarre and
ludicrous. What wasn’t funny, though, was that it had cost R5000.
On the 5th of
November, the day after I turned 65, K took me through to the oncologist in
Somerset West. This woman, who did not appeal to me in any way, explained how
Dr J would implant the radioactive seeds in my prostate gland using a special
needle inserted through my perineum, the perineum being the area below my
genitals and above my anus. She seemed to take pleasure in telling me about the
possible complications and side effects that I might encounter. To my ears the
most dreadful of these were incontinence and impotence. She also told me with a
smirk that it was not uncommon to experience a certain amount of dribbling. And
obviously that would not be from the mouth.
Christmas came and went, the
radioactive seeds arrived, and on the 19th of February 2016 I was
back at the Hermanus Mediclinic at the crack of dawn. After checking in and
going through the initial ward formalities I donned hospital garb and got into
bed. Even though I had taken a laxative and been nil per mouth for 12 hours, a
nurse arrived, drew the curtains and told me to get on my side with knees
raised. I was to receive an enema. Without finesse she shoved a nozzle up my
arse and squeezed the cold contents of the tube into my rectal passage.
“Keep it in for as long as you
can,” she instructed. “Then hurry to the toilet.”
After holding it in and then
shatting it out with explosive urgency I returned to bed. It proved to be a
lengthy wait of nearly three hours as there were two patients undergoing the
same procedure before me. When I was finally wheeled into theatre my mood was
less than calm and the anaesthesia experience proved to be inferior to my
previous one.
Back in the ward I felt warm and
under the influence of strong analgesics. After a while I was brought tea and
sandwiches, which I consumed in order to restore energy but did so without
relish.
Late in the afternoon they came
round and said the catheter would be removed and I could take a shower. The
nurse snipped through the rubber tube and released the water inflating the bulb
that held the catheter trapped inside my bladder. She began to pull on the tube
and slowly withdraw it. Again, I felt that very unpleasant sensation that
bordered on pain. Instead of following standard practice by restraining my
penis with her free hand, she continued to drag the flaccid member with the
tube further and further away from its source until it was stretched to its
maximum length. She paused, we looked at each other, and she completed the
procedure. What the hell was that about, I wondered.
In the morning J made an
appearance at my bedside, claimed that he had done what he was supposed to do
and if I was feeling alright, I could go. He also said that I would be given a
plastic sieve to urinate through in order to capture any seeds that might
escape my prostate. These should be stored in a lead cylinder that would be
provided, and I should return them for hazardous waste disposal. He warned that
I must not allow babies or small children to sit on my lap, and that if I were
to partake in sexual intercourse, I was to wear a condom.
K collected me and when we got
home, I went into the garden and tried pissing through that sieve. What a mess!
What a wet joke! I tried using it once more and never again. A year or so later
it occurred to me that what I should have done was urinate into a jug with a
spout and then slowly pour it through the fine mesh. Too late.
For two or three weeks I
experienced some discomfort but nothing to whine about or pop pain-killers for.
One unwelcome and somewhat alarming side-effect of the therapy was the
discoloration of my scrotum. Probably as a consequence of the needle repeatedly
penetrating the perineum, bruising must have taken place and the sack
containing my gonads took on a necrotic shade of purplish black. It must have
reminded my wife of the vervet monkeys we had observed with amusement on a trip
to the Kruger Park several years ago. It took months for my negroid complexion
to lighten and regain its pinkish grey pallor.
About a month after the
brachytherapy, I had to go into Hermanus for a CT scan. This was to make sure
that my urologist had got his anatomy right and planted the seeds in the
prostate and not some other gland. It turned out to be an interesting
experience because it made me feel like I was participating in a science
fiction movie.
I removed shirt, shorts, shoes
and socks, and donned a flimsy grey smock before being led into the space
station. Dominating the windowless area was a giant white plastic doughnut. The
radiographer told me to lie down flat on my back upon a gurney and to remain
perfectly still. She then left, closing the hatch behind her. After a few
minutes I felt the trolley begin to move and I was passed very slowly feet
first through the centre of the doughnut. A few seconds elapsed, reverse gear
was engaged, and I returned head first through the doughnut to where I had
started. The radiographer appeared and said the procedure was over and I could
get dressed.
On my next visit to Dr J, he told
me the scan had proved how accurate he was with the needle and that he had not
missed the mark even once. I was pleased to hear this, but I was even more
relieved to know that Medical Aid was going to pay the R6000 for my little trip
into space.
I was obliged to see that
unpleasant woman in Somerset West for one last time and she again told me to
expect the worst.
Back at home I decided to embark
on a project that would keep me physically active while my body and psyche
recovered from the ordeals they had endured. For the next nine months I went
about constructing an outside braai room using old building material that had
been lying around for more than twenty years.
Three months after the
brachytherapy I had a blood test and Dr J gave me a physical examination. With
no unexpected side-effects being detected I was to see him again in six months’
time. Two more six-monthly visits went by and then the check-ups were reduced
to a yearly routine. Now, more than 5 years after being diagnosed, my PSA level
remains low and I feel about as healthy as a decrepit 70-year-old could hope
to. However, as J assured me the last time he gave me the finger, with cancer
you can never say you are cured.
How right he was.
To view my longer work as an author, you can find me on Smashwords here.
