October 20th, Monday afternoon, rather than starting the Proton Beam Radiation Treatment, Carrie and spent most of it waiting to meet Dr. Ricardo Gonzalez, a notable Urologist based in Houston, that we had been referred to by Dr. Choi of MDAnderson. His credentials’ were outstanding, and his office walls had plaques, degrees, magazine awards, and one honorable mention. I’m not sure I understood what an honorable mention means to an Urologist and thought it best not to ask.
We were escorted to his office and not an examining room. Which was a relief to me since every time a urologist sees me they have their own way of saying: “it’s time for the Texas Handshake, and here’s your box of Kleenex.”
After several long minutes, our 2:00pm appointment started about 3:00pm when our very energetic, young, personable doctor arrived, introduced himself to us and asked if we could be a little more patient as he was backed up with appointments.
He left for a few minutes to see another patient and Carrie and I started counting the sky cranes we could see from his office window overlooking the Houston Medical Center. We agreed that it was six, and then after getting up and walking around his office four more come into sight. That meant ten new high rise buildings. Houston’s Medical Center isn’t a building, it’s a city. A brand new light rail ran passed this building on Fannin Street, and the skyline, already filled with buildings labeled Baylor, St. Luke’s, Texas Children, MDAnderson, University of Texas, a Marriott Hotel, etc., was staggering. I can remember while living here and flying into Hobby Airport, on Southwest, that the skyline was remarkable and separated from downtown by just a few short miles. Now, it has become a major footprint as a worldwide destination.
Today, I was happy we were here.
Dr. Gonzalez, returned to his office, while apologizing for his hectic scheduled. He had just returned from Santa Fe, New Mexico where he had conducted a seminar for other Urologists’ on the same condition that I have. While smiling he pulled up a Power Point presentation he had delivered last week so we could see of photo of what the inside of my body looks like. As he put it: “this view is off a bladder similar to yours where the camera extends into the urethra and turns around and looks back at itself”.
This is where sometimes my brains goes into a paralysis mode – and it’s like trying to look at yourself in the mirror while trying to cut a few strands of hair with a pair of scissors. The reverse reflection makes me crazy as I move where my brain says to go, while the image in the mirror is heading in the opposite direction. Finally, my brain relaxed and I could see this black hose coming out of a bulbous opening. And there it was – a nodule sitting on the top (which is really the bottom) of the bladder. That is the bad boy my proton physician, Dr. Choi, said needs to go before I can start the Proton.
We were told that we need to be cautious, safe, careful, not too aggressive, but, just right, in the procedure to remove the excess protrusion and reduce its size to fit nicely below the bladder. I felt comfortable with his presentation and admired his ppt skills, too. He asked if “needed anything to drink yet?” Within a few minutes a diet Coke was delivered with the promised he’d check back on me.
Carrie and I were left alone and I couldn’t help myself from reaching across his desk, at which time, Carrie said, “sit down”. I found his mouse and backed the presentation up a few slides to see that photo of the inside view again. I took this opportunity to view each of the slides he didn’t show us. “You are going to get caught,” Carrie warned. A few minutes later, after returning his display to the slide he left us with, we were escorted to an examination room. I do not think it had anything to do with taking control of his mouse, either.
Carrie wasn’t convinced.
His nurse asked us to wait until the doctor was available, that he wanted to “examine me” and when I had the “urge” and that I’d be “observed”.
I’d be what? Observed?
After another long wait, I poked my head out of the examining room to see if I could find where they kept the sodas’. The nurse caught me and asked if I was ready. I gave in. She took me to the nurses’ station where she was waiting on a printer for some labels and finally said, “This way.” I was led to a small room with a sink and a contraption I’d not seen before. She didn’t have the standard beaker for me – and what I saw was a large stainless steel frame, about knee high, holding a round plastic funnel aimed at a catchment of some kind at the bottom. To the right of the device was a hole in the wall, about the right level to “observe me.” The hole was small, crudely shaped cut in the sheet rock, a wire protruding through it to the bottom of the catchment container. My instructions were to drop trou for the “observation” and return to the examining room when I was complete.
The door closed behind me and I thought, “This is a first.” Doing what I was told, I dropped trou and while looking at the small crudely shaped hole in the wall with the wire sticking out of it, I thought, “It must be tough to get a good view of me through that thing and still hit the funnel.” I got on with my business?” After washing up I opened the door to come through the nurses’ station, after having been “observed.”
A few minutes later, Dr. Ricardo Gonzalez appeared and he said he had good news. He had what look like an EKG paper strip and showed us that my flow was “average” and that due to the enlargement, I did retain about two ounces of urine and that his procedure would fix that. “We are scheduling you for a procedure on Thursday, October 23. I’ll sculpt your prostate so you can begin Proton Therapy as soon as you completely heal, which may take between six weeks and three months.” Following his new procedure using the latest in technology, he said, I’d be as good as new. Rather than the obsolete, Indio Laser Surgery used on me six years ago, they would use a combination of “green laser” and a new TURP type of device to pull a specimen for further analysis. I’d be up and around by Saturday will little to no pain. “Carrie”, the doctor asked while gloving up, “do you want to stick around for what’s next?” She laughed as she got out of her chair and said, “No thanks, I’d seen it before.”
While on my elbows, toes turned in, he noticed my Microsoft Blue ID Badge hanging from my belt which was down around my knees and asked – “what’s that?”
For some reason, I was speechless.