Well, as you learned from my last post, I finally decided to have the operation I’d been putting off for years. In the modern medical age it is quite easy to engage in such avoidance; drugs designed to alleviate the most problematic enlarged-prostate symptoms have enabled men to delay surgical intervention for a long time. In my case, I was on Flomax (I’m sure you’ve seen the ads on TV) for about a decade. The ultimate reason for my decision? — the number of trips to the bathroom per unit time was getting pretty damn ridiculous. And, really, I just didn’t feel well anymore.

I’m an academic; I work on a campus. So, given that this was an elective procedure, for a non-life-threatening condition, and in trying to be a most-responsible employee, I thought I should do the operation at the end of Fall semester. Things can be sort of frantic at the end of an academic term, but after that things slow way down and campus is totally closed between Christmas and New Year’s. So, in the middle of November, I scheduled this to happen during the first week of December.

Of course, being the perpetual worrier I am, as I entered the last few days prior to the big event, I became more and more anxious. I had never had a surgery before. And, wouldn’t you know? — I watch all the doctor shows on TV, always have (from Ben Casey and Dr. Kildare, to St. Elsewhere, ER, Chicago Hope, Grey’s Anatomy and House … I’ve always been fascinated). I had good reason to worry, I thought: Murphy’s Law seems to rule. If something can go wrong, it will. Right?

Oh my god, I said to myself. Here I am, 64 years old, and I am having this first-time experience … that could all go terribly, terribly wrong. What would happen if I went under anesthesia and the knife … and then stayed under? You know, like forever! What then?

I have neither a will nor an advanced healthcare directive. Further, there’s the fact that no one is present in my life to provide advocacy for me while I’m in the hospital, no one to make decisions if I don’t wake up, no one who knows what to do in case I die. Shit! Have I really lived this long? Do I really have no one? What the heck do I do NOW?

Well, in the absence of any paperwork, or even having ever talked out any of these issues with anybody, I thought maybe the most responsible thing to do was to let someone in on this particular bout of existential angst.

As it turned out, Katrina and I had been having a brief email exchange about my situation, and in one of her notes, she had asked me about the length of my hospital stay and the anesthesia for my procedure. So I wrote her back telling her what I knew about the spinal anesthesia that would be administered, and then I said…

Speaking of anesthesia … would you consider doing me a favor?

I don’t have a will or an advanced health care directive. If for some reason I don’t wake up from this, could you use this email as evidence of my last wishes? (OK, yes, morbid, I know…)

My last wishes, as of this afternoon, as I write this from a Starbucks in Mill Valley, would be to be cremated with the ashes spread on the top of Mt. Pisgah. If that’s legal up there, that is. So just in case: would you consider communicating this message to my blood relatives — and see if you could make that happen for me?

I will rest easier tonight having said this to someone. If that's too over-the-top a request, just say so, please.

-jim

Thankfully, amazingly, she agreed.

So, yes, thanks again, Katrina. I went into all of this with some peace of mind, imaging myself, in the worst-case scenario, spending eternity on one of my favorite hiking trails in Oregon

Soundtrack Suggestion

All that I know is I’m breathing
All I can do is keep breathing
All we can do is keep breathing

(“Keep Breathing” — Ingrid Michaelson)

[The story continues here.]

I have written before about my old-geezer struggles with benign prostatic hyperplasia (BPH, i.e., “enlarged prostate”), PSA tests, biopsies — and intense discussions with my physicians about interpreting the numbers. August 1999 was the month when a routine blood test yielded a distinctly- elevated PSA, resulting in a referral to a urologist. As it turned out, that appointment was merely the first of many over the intervening years, resulting, so far, in 29 blood tests for PSA, two prostate biopsies, a decade of taking Flomax, and a November 2009 emergency room visit for urinary retention that resulted in catheterization for six days. (Now, that was a memorable Thanksgiving!)

Over 15 years of testing, my PSA numbers have risen steadily (sometimes dramatically), my prostate gland has continued to grow, and my symptoms have become progressively worse. In the course of all those doctor visits, one fact became increasingly evident: should I be so fortunate to keep on living, I would eventually need surgical intervention for my condition.

And, so, that time finally came. During the summer and fall of last year, living with this condition became more and more problematic, and even a double-dose of my medication didn’t provide adequate relief. Reluctantly, very reluctantly, I came to acknowledge that the procedure known as a “TURP” (transurethral resection of the prostate) was imminent.

On December 6, 2011, almost six weeks ago now, I entered Marin General Hospital to have the operation. So, dear reader, be on guard. I’ll be writing more about this journey in coming posts.

[The story continues here.]