I had my first appointment with the new urologist Thursday as the doctor I've been seeing has retired. Last time I saw him ("The biopsy was negative.") he was on his way to Cuba. Seems like a good place to shoot photographs, I guess. I don't know if I had thoughts about switching doctors in mid diagnosis, other than well, maybe this is good, maybe this is bad. Who's to know? Another roll of the dice.
It went well. Perhaps a portent for the coming year. The new doctor explained that many people develop high PSA counts without the presence of cancer - and, unfortunately, about 10% of the men who develop prostate cancer do so with normal PSA counts, which means, I guess, it comes when the doctor finds a "bump", which means it's been around for a while, which sucks - and people like me with two negative biopsies statistically, at least, usually don't have the disease. What a thought. When the doctor comes through the door with the biopsy, you're expecting the big scene.
So I'm taking an antibiotic twice a day for the next two months and then another PSA test. Same with the kidney stones. He wants an xray. Sonograms, it seems, can, um, exaggerate, and sometimes a low level prostate infection (hence the antibiotic) can accelerate a PSA. Sitting (or sleeping) on something uncomfortable can have similar results.
Now my suspicion, since I'm old and suspicious (and cranky), is he's introducing himself using a "calm the patient" approach. Maybe he's discovered "Hi! I'm your new doctor", as he's glancing through your file, "and boy are you fucked!" is not the smoothest way to start a doctor - patient relationship. He told stories of patients and fellow doctors who'd seriously freaked when they learned they had PSA's even higher than mine yet never found the thing itself. His "put him at ease" approach. Which is fine. I like "at ease". "At ease" is good. Take the pills, "ease" the mind, try not to drink too much whiskey while I'm on antibiotics. ("Call me about the antibiotics if you turn yellow. Some people turn yellow.")
"Hey, Prop, this is great. How many biopsies did your cousin have before they found (and successfully eliminated) his cancer?"
"Three. Well, uh, you've had two, but his PSA's were higher than yours, right?"
"So, same deal as the last, but his guy is ladling it out with sugar.
Friday. Now for the beaten and battered member of the household. Wuss had his heart sonogrammed today. He's sitting on the chair beside me, a big patch of fur shaved off, looking frazzled. The vet asked me to call him Monday to go over the results, but his heart is not in good shape and the heart pills I'm now feeding him make him pee. So we talk on Monday. Is the Wusser in pain? No. He didn't think so, but I suspect it's feed him pills and let him take the rest of his time comfortably here at home. Which will probably be years and years. Cats who pee on your rugs last forever, in dreams, if not in life.