Consulting the Consultant

OK, so, five years ago, having established that I could not simply ask for a blood test to check my PSA level, I made an appointment to see my GP who administered the other relatively common test, the DRE (Digital Rectal Exam) or gloved-finger-up-the-backside test. He suggested that my prostate felt normal but organized a PSA blood test and referred me to the urology clinic at my hospital.

For my first appointment with the urology clinic I was instructed to drink 2 litres of water an hour before attending at the radiology department – curious – and not to urinate in between times. Oh great! I complied and eventually sat waiting, a little uncomfortably, outside the radiology department wondering what was going to happen next. What happened seemed quite ingenious, to me, at least. Not wishing to pass too many loos without availing myself of the facilities, I was beginning to get used to playing the part of a female. Now, however, my rôle was extended as I played the part of a pregnant lady with my slightly distended bladder cast in the part of her womb. I was smeared with cool jelly and given an ultrasound scan. The pressure of the ultrasound scanner on my already uncomfortably full bladder did nothing to increase my comfort but it was all in a good cause.

Finally, I was allowed out into a room to relieve myself. My task was to pee into a high-tech cup device which measured my flow rate. ‘T was a very small target but somehow I managed it. Not only did the device measure flow rate but it printed out a graph of flow rate against time, rather like a weather station’s barometric pressure graph. Clever!

I returned to my rôle of expectant mother for a second act with the cool jelly and ultrasound scanner, this time more comfortably.

A few weeks later, I had my first meeting with the urology consultant for his initial assessment.

1. My flow rate had not been good – quite restricted. The most fascinating revelation to me, however, was that the ultrasound scan had enabled them to estimate the subsequent contents of my bladder which was, apparently, 120ml. How clever is that? The bladder being essentially a spherical balloon, I think radius (r) along with ⁴/₃πr³ must come into play here. The downside was that I had not emptied my bladder anything like completely. This is another effect of the restricted flow.
2. I was treated to another DRE, this time by the specialist. He was somewhat disparaging of a GP’s ability to interpret the feel of one’s prostate. In his opinion, my prostate was not completely normal – there should be a slight cusp which he couldn’t feel – but he didn’t seem overly concerned.
3. My PSA level had been 2.09(ish – as far as I remember). Somewhat higher than might be expected for “a young guy” (52 – his phrase, not mine) but not desperately high. He seemed to be using a level of 5 as an upper limit for chaps under 60. [Ed: Much more on this in a subsequent post.)

He decided that the most appropriate course of action was to monitor my PSA level over the coming months with two more blood tests at 6-monthly intervals.

Time to wait on tenter-hooks while I looked forward to more blood-letting visits to the nurse at my GP surgery and eventually to more fights with the totally inadequate provision of hospital parking. Oh joy!

Still, at least action was being taken and I was being monitored.