I write this both for those people going through it, but also as an anology for what can occur in life and a way to view it.   There's a number of "life lessons" imbedded in here, methinks. 


I had done the normal 17-20 samples biopsy up the canal.   Then my urologist, after a rise in my PSA, recommended the new "super-biopsy" which one of the other doctors had learned.  It seems the one up the canal to reach the prostate could reach only a portion of the prostate due to the angle, but that the superbiopsy could reach it all, but have to go from outside the body - alot more invasive.  

The choice seemed like no contest.  I didn't want to be like the drunk who dropped his keys in the dark but spent his time searching for them under a street light, since it was alot easier to see there.  Nope.  I might as well have a definitive answer (maybe not a perfect one, but one that was more likely to work.

And, of course, I wanted a definitive answer as soon as possible so that I catch the cancer earlier, making it more treatable with much better odds.  (Though people do say that if you're going to have a cancer that is the one to have, as it is so slow that you're more likely, in other than the extreme cases, to die from something else, such as old age.)


Warned that I would probably wake up with a catheter (and a tube to a urine bag) after the operation, I was put "out" for the hour plus procedure.  When I awoke, I had zero pain. 

And then I felt like going to the bathroom so they got me a container, which I easily flowed into, but mostly blood.  They figured I could "go", so they decided not to insert the catheter. 

But I found out that swelling, etc., can build over time.   [And they logically should have scheduled a "retention" check later in the day.]


The flow seemed to slow, but the phone advice nurse said to drink lots of water, so I did, and because of the pressure sat on the toilet, trying my best.  My significant other was encouraging me to drink more water, but with all the pressure that is the last thing in the world I wanted to do.   I was hoping the "pressure" would force open the urethra, but my theory was totally unfounded.


About 9 hours after the operation, off to the Emergency Room (I am thankful my angel drove me, for I was very impaired).   As a fellow sufferer termed it, I was in excruciating pain, with lots of pressure and nowhere to go, so to speak.  I pushed one foot hard onto the car floor, holding the muscle tight, to perhaps distract me from the pain or to seek to control it.  I practiced every technique I had learned:  breathe into it, slow and deeply; "it'll be over soon, this is only passing"; "this is a small sliver in time and it is no big deal",  "this is minor compared to what a number of people have had to go through: breast cancer, etc." (small sizing, comparison); "I am the observer, I am looking at this from a perspective of seeing myself as a witness" (distancing, objectifying) - so I reduced the suffering that I could have added to the pain, and the pain was just what was so - an incident in life, soon passing...


Finally, at the Emergency Room, hardly able to walk, I hurried them up as soon as possible, and thank God that I was "triaged" as a time priority, going to a room and quickly getting a nurse, who had to prepare the materials (taking some more time - aaaargh!), and then he inserted the catheter, which was painless, and then...instant relief, as the fluids (mostly blood) came gushing out - a feeling of pure bliss (everything is relative!). .  But there was still some bloating, so the nurse used a "flushing" procedure, where he squirted in fluid through a syringe (slightly uncomfortable and a feeling of filling up, but not bad at all) and then sucked it back out, with lots of blood clots coming out.  The on-call urologist also did some, as did one of his colleagues. 


And, then, concerned about whether the bleeding would stop, the doc put me in the hospital, after inserting another special catheter with an "inflow" tube, which was used to run fluid through, with hopefully the outflow being less and less pink.  Otherwise, he would have to go in with a camera and cauterize any bleeding areas.

I made the mistake of considering myself a bit of invalid (the word also means "not valid", so I invalidated myself a bit), stuck there plugged into the drip into the catheter and out to the bag, besides the normal drip to hydrate people while in the hospital, plugged into my arm.  Hard to move alot and change positions.  But then I finally realized I needed to walk and that I was able to do so. 

The tendon on the back left of my left knee was painful, which I assumed was because I didn't move much in bed.  When I walked I couldn't put any weight at all on the left leg or it would buckles and be hugely painful.  The nurse said I should use hot and cold on it.  (After I got home, I called "advice" and had a phone appt with a doc - but after I read the Cipro antibiotic side effects, which included problems with the tendons!) - so he changed me to a new antibiotic and had me take ibuprofen, which relieved it rather quickly - now I didn't have to be a cripple unable to walk, carrying around my bag, but mostly just sitting around without walking!


Two days in the hospital, after a doc flushed me out again and clear urine was consistent, they unplugged me and then tested urine samples and my ability to flow.  The retention sonogram showed I was not quite working, so they recatheritized me and sent me home with a leg bag too, but without full instructions, so I couldn't figure out how to change to it.  (I should've had them do it for me before sending me home.  A leg bag is vastly superior, making one more mobile and functional and normal, and not so "invalidlike".) 


After going home from the hospital on Friday, the catheter was scheduled to be taken out Thursday morning.  I was looking forward to being "mobile again, with no attachments". 

So, they pulled it out and then I was unclear about whether I should stay around, but the nurse said to go home and just drink lots of water. 

Thinking I had a little bit better stream, I kept at it, but stayed up all night trying to dribble out a little more.

And then a repeat of the emergency trip, at 9 am, and the pain.  And a very slow orderly who finished up some stuff on his computer while I was urging him to take me back before I burst.   And then...relief...and what seemed another eternity while they were getting out all the materials.

Then they scheduled me for the next Wednesday to remove the catheter with another appointment in the afternoon to do a retention check.  (The earlier scheduler should have done the same on the prior appointment!!!!!!!  Make sure that is scheduled for you!)

So, it failed again, and I was reconnected, but this time trained to work the leg bag - much superior.


After the 4 failures to get flow, I am wondering if it will solve itself or if there is an operation that will have to be done.  My System One, of course, anticipates it would hurt, but System Two knows it will just be what is necessary to solve the problem - and that I'll deal with it fine when it happens. 

At a time like this, we typically seek to avoid triggering anything that will cause pain, even if it will be best. That's a System One (automatic self) thing, to fear fear or fear pain.  The cure that takes it out of anxiety, at least mostly, is simply to write down the details of "the truth".  So I did that in email to my doc, about a bit of bleeding and possible reinsertion of a larger catheter.  Nailing things down like that actually remove such things from the concern of System One, as it knows you've done what is to be done and it no longer needs to pay attention to it.  (See David Allen's book, Making It All Work, a time management book that uses this psychological reality to reduce stress and lack of productivity.)

I am concerned about whether this can be cleared up ("flowing") naturally and whether there has to be an additional operation.   But I realize, from the other side, is that what will occur will occur - and that there is no point to making myself feel down about it - I need only do the best I can and always accept the outcomes and reality that will come my way.


Yes, I was a tiny bit "less abled", but I also saw that I still had plenty of "abled" to be grateful for.  And I was so, so grateful for how the human body works.  I saw a constant flow into the bag, my body at work on my behalf - what a blessing!  And, how can the body have such a large bladder and fit all of its pieces into such a small body?!!!   I was fortunate for having also had the gratefulness viewpoint exercised in India - the experience is written out in My Enlightenment Experience Being Sick In India, Gratitude And My Non-Suffering.   And, of course, my studies in philosophy and psychology were very helpful to me.


Because of the protective instincts in our System One (primitive, evolved part) we have to use System Two (higher, determinative brain) to realize that we are not in harm's way.  The nurses and doctors are all trained and careful, though it did "alert" me whenever there was a jiggling of anything connected in that area!  There was only (other than the flow problem) very minor discomfort or sensations, none any worse than the nothing of pulling the super bandage off of my skin, taking the hair on my leg with it.  No big deal.

The catheter is secured to a holder that is about 5 inches diameter for the part that sticks to the leg, with a clamp that hold the catheter very securely, even if you dropped the urine bag sharply - the holder is absolutely protective. 

As you move your leg, the catheter may slide in or out a little but it is smooth and almost unfeelable. 


Besides heightening the sensitivies of System One and its useful paranoia, I was reminded of my human body vulnerability and of being less and less able over time as one is likely to experience as one ages.  I do not fear death, though I would prefer to last as long as possible (see Death.) 

In keeping my perspective, I remind myself that we started out with few abilities and lower consciousness and that even after the decline from our peak, we still have many abilities and things we are able to enjoy - and we need to focus on that.  Once we see that we don't need to add "ain't it awful" to the reality or the "unhappiness gap" where we have unreasonable expectations, and we see what there is that we have, then we can enjoy the remainder of life, just with a few things less, but still a magnificence that we can still treasure.  And, at some point... perfect peace.


As in the book The Checklist Manifesto, Guwande, the nurses and docs should have operated off of complete checklists, as no one, even an expert, will remember all the steps and cautions without a great checklist - and, yes, they are worth the seeming extra time, though over the long run they save time - and save mistakes and costs later on!

For us lay people, we need to have back up checklists so that, if others don't do what is needed, we will, at least for our portion of everything.  I did get some directions and instructions, but, as for most of us, we forget or we slide by.  Nobody I know of rereads the directions, so it is essential, in my opinion, that we have a checklist to provide the order of what to do (and we can refer to the details in the instructions if we need to understand a particular line item on the checklist. 


This is a really special time where it is appropriate and very beneficial to take great care of yourself - and to be meticulous about it, as a way of caring for and loving oneself.  Be sure to move and exercise and to rest and take great conscientious care of yourself.  Take all the vitamins and medicines etc. on time and perfectly.   Be sure to pause and be silent for a minute or two several times every day, as it keeps perspective and also signals the body to re-balance, which is what it needs to do anyway in order to operate maximally - and I want to operate as maximally as possible when I've got a physical problem of any sort, so the body can care for itself well.  Also, the pause and the silence give a physical signal to the amygdala that you are safe and there is nothing to worry about in this regard....


It's been a little over two weeks and the results are not yet in.  When they come in, I'll write about what my reactions and thoughts are. 

Is It Smart To Get A Prostate Super-Biopsy?

Foley Catheter:


Procedure links:

   How To Irrigate Foley

   Urinary Catheter

       Video Manual 


The Patient's Checklist: 10 Simple Hospital Checklists To Keep You Safe, Sane & Organized, Bailey