Dear Willy

Men do not talk about health issues publicly, nor to each other in a Shed. Somehow we do not have the language or the experience of communicating, to share our feelings.

Well, I’m going to find the words to express what has been going on with me for a couple of months. And it concerns, yes, Willy and the plumbing attached to him.

I’ve had an enlarged prostate (wherever that is!) for many years.  At various times I’ve had the PSA (Prostate-Specific Antigen) blood test. The PSA test can help detect prostate cancer. But it’s not perfect and won’t find all prostate cancers.

Find out the detail in this link to NHS web-site: https://www.nhs.uk/conditions/prostate-cancer/should-i-have-psa-test/

The old waterworks start to play up with age and it can almost seize up or the tap can be left dripping. [women seem to handle these issues quite publicly in ads that will not to let a little wee stop me being me.]  

Men are sensitive about their tackle because it is their manhood!

“Joan, there’s blood in the toilet bowl” was my plaintiff cry from the bathroom of a cabin on a cruise ship at the beginning of last December. It was quite red, not just pink! 

There were decreasing signs of blood in urine for a day or two. Having not had a PSA test for some time, I made an appointment at our surgery with a doctor and then with one of the nurse vampires. Blood taken for the PSA and also for a blood sugar test ready for my annual diabetes check. 

I later learned that blood had been detected in the urine sample I gave. Just before Christmas I could see evidence of a bit of blood in the water again. I was finding it more difficult to pass water easily and I decided to visit the nurse practitioner. A repeat of some blood again (albeit less than originally)was enough to prompt action and off went a referral letter for me to attend a clinic. 

After Christmas, as a treat for grandsons, we attended a Spurs v. Middlesbrough match, the first time in 50 years for me. Wrapped up well, I thought I’d enjoy it but gradually I began to feel very cold and unwell. My son led me downstairs and ultimately to the St. John’s Ambulance teams medical centre. Apparently I was grey faced and a little uncoordinated in my walking. It was not drink. They checked me over (blood pressure, sugar etc) and released me to go – accompanied!

I was taken to my son’s during half time and I slept for a couple of hours absolutely exhausted. 

Two days later I was at Malton Hospital for the investigation. It was to be an ultrasound of kidneys and lower abdomen (in my language) plus internal exploration.

By internal I mean the proverbial finger up the back passage for physically checking (digitally checking?) the prostate plus a “flexible cystoscopy” to check the bladder. That means a flexible tube pushed in the reverse direction up Willy and into the bladder with a camera on the end.  Fascinating, but only the ultrasound test could be done because I had a water infection (urinary tract infection). No can do till I’d had a course of anti-biotics.

Now, both men and women (it’s more common for women to have a UTI because the length of plumbing from outside to in is shorter. Seemingly size (length of travel) does matter! Ahem. But the effect can be very drastic if untreated.  One lady told me she hallucinated. To be fair, my son said I was not that with it! How does anyone know the difference with me? By all accounts I seem to have escaped lightly.

The ultrasound revealed nothing and no kidney stones. 

Two weeks later back to Malton for the “internal”. Oh joy!

I still had the water infection! The particular antibiotics had been ineffective. However, there was a way to take one tablet for short-term cover to prevent infection occurring during the procedure. Offered the opportunity to wait for a week or two or go ahead I opted to go ahead.

Two female nurses, a female student doctor observing, a very friendly male doctor I had met last time and me basically on the couch naked from the waist down,

This is the time for a Shedder to think of a few quips like “I’d prefer her to do it because she’s got smaller fingers” in order to cover the embarrassment and nothing else. A local anaesthetic was squirted in ahead of the probe, I had a conversation with a nurse about traffic and Kirby Moorside and, lo, with minor discomfort I could see the inside of my bladder (or that’s what they said!).

He looked around with the camera and commented on some inflammation and then said “Ah, you’ve got a stone”.  That was followed by a count of about 10 stones. How big are they I casually enquired. The largest is about 2 cm!  Yes, centimetres not millimetres! I was hosting a nice collection of marbles. You’ve got a great maraca, joked the doctor.

Do you know what? At times like these humour comes into its own. It is what Shedders do best to relieve the tension of reality! 

There’s a pre-op assessment in a few days time***. Hopefully, in two or three weeks I’ll be put to sleep. What I mean is that the operation with be under full anaesthetic. I’ll not know the story to tell but I believe it involves the another flexible tube being inserted, with camera to locate the stones precisely, and then the shattering of the stones by ultrasound or laser and the fragments being washed through. Sounds smashing to me.

*** Pre-op assessment now done. Weight, height, ECG (possibly to make sure my heart will take an operation!), and a good conversation about Sheds and young people with anxiety. Op date set for 3 weeks time and I’m just a day case. Once I have woken up, eaten and “passed water” then I’ll be free to leave. “How will you get home and who will be with you?”. “My wife will drive and I’m sure she will care for me”, was my reply said with conviction!

**** A surprise at the Shed today and a trip to minor injuries.  A stone (though not one of the biggies already mentioned) decided to start its journey from bladder to the urinal. I felt an obstruction move along my urethra and stop. So did my flow! I’ll leave out some details but I decided to go to our helpful Minor Injuries unit just a few yards up the hill from the Whitby Shed. A nurse and then a doctor considered my predicament. I had the feeling that my exhaust pipe might explode if the pressure continued! 

I ended up going home with another course of antibiotics and instructions to go directly to Scarborough A&E if my abdomen became distended. I guess the bladder might fill and fill and push out to distend. I must work out the geometry of my body and its tubing. At home I did not feel comfortable and I thought maybe I ought to head for Scarborough (its not round the corner). 

I felt I needed to pee. I could not. The blockage felt as if it was towards the end of my willy but something was stuck fast. I did look down to the tip of my problem and thought I could see a drip. It wasn’t. It was the tip of an iceberg poking its head out. I hardly touched it but I must have dislodged it a bit because the small projectile shot out followed by a high pressure urine flow.

Sweet relief, though the stonelet must have been sharp and there were signs of blood again. Drink, drink, drink had been the advice to me and that is what I am now following. I’m looking forward to my operation – in a strange way. I hope it does not get postponed. Roll on a fortnight’s time.

The day of the Op

The day arrived to remove the stones. Reported at Scarborough  Hospital before 11am. Saw anaesthetist and surgeon  and eventually went down  to be operated on about 4pm. Last of the day.

I’d opted for a spinal injection to numb my lower half as opposed to a full “goodnight! anaesthetic. Having not had a operation in the past 50 years I was a virgin to all things hospital. A prime reason for my option was THIS BLOG. I wanted knowledge of what went on in an operating theatre to entertain you, dear reader!

I felt nothing. When my legs were hoisted and parted I felt nothing. They could have broken the wishbone with me in blissful ignorance. Mainly I looked at back of a monitor the surgeon used to see what was happening at the sharp end.

It was a 90 minute job, longer than anticipated. Various tools were used through the keyhole of my willy. There was no laser technology available so it was all about brute force tools! There was a grabbing tool (I think like a cran in one of the children’s arcade amusements to pick up a toy!). The jaws opened up to 1 cm so that was the limit on size of a stone to be grabbed. Once clasped, there was a method to crack the nut (by crushing in some way). 

6 out of 8 stones were dealt with this way. Two were larger ~ 1.5cm diameter. In came the “jack hammer”. I felt nothing but I could hear the pneumatic drill at work, sounding like a woodpecker. In both cases “debris” was washed away by copious supplies of water. 

Now, I was awake, of course. There was an impressive team of staff as well as the anaesthetist and the surgeon. It was like a Shed, with conversation Very team oriented. All ready to act if necessary in one capacity or another but not in a stressed way. I was not even stressed, strangely, because I was occupied by the experience. Teamwork at its best in terms of atmosphere. 

Apparently, it had been a bit of a wa zone inside my bladder, although it started as a game of snooker with attempts to grab stones. Actions and reactions.

Off to recovery for half an hour and then to a ward to be reunited with my patient wife at 7pm. I’d need a catheter (to drain urine at source) for a few days so I was kept in overnight, to return next Monday morning 8.30am to remove the catheter. Why could it not be done in Whitby? It is quite likely that there may be difficulty in me peeing. Back to the problem of building up pressure earlier! Scarborough has the particular skills to deal with any such problem. I may be there a few hours or all day – it depends on My Willy!!

I thought this was the end of the story as far as reporting but since coming home with the catheter and going to Scarborough on Monday for its removal, things happened.

The following day there was quite a bit of discomfort and catheter leakage (that’s a nice way to put it). I rang the Hospital and was (by a very helpful admissions clerk) given a relevant numbers to call. However, it was about 4.45pm and that is the end of the “admin” day. I tried the number several times and eventually left a message. Next, my phone rang. It was my surgery who had received notification of the operation having taken place and wanting to know basically whether I was OK. Standard practice as part of hand back I learnt. I explained my predicament and was given further telephone numbers for me to try at Scarborough whilst recognising that some lines would not be answered. Meanwhile enquiries were made of the surgery team as to the best course of action. The upshot was that the District Nurses were contacted to give me a call. 

All this and them was, of course, a whole new practical learning curve for me of seeing a jigsaw of help coming together piece by piece:-). A little later I was called and advised to drink 3 pints of water in the following two hours and I would be called back.

I retired early to bed which was more comfortable for me at that time and the catheter bag started to fill better (and me flood less!). The call came and we agreed to assess the next day. On Saturday a District Nurse followed up on the telephone and she said that “what was happening was not uncommon and there was no magical solution”. To which I said that her comment was the magical solution BECAUSE having heard this was to be somewhat expected I felt much better in my mind, if not down there. 

Simply having such grass roots advice based on experience put me at ease to wait another 48 hours for Monday to come. 

I was called back by Scarborough Hospital first thing in the morning after leaving my message. They confirmed that District Nurses was a good course of action.

So, hats off the the District Nurses and the telephone conversations. I received a lot of quite detailed information on the hospital procedures in targeted booklets but I had no knowledge of what would happen on my release procedurally (what support there was automatically by follow up locally and District Nurse services). 

The interactions are complex (there are many specialist roles) so there are many potential gaps. What I experienced was that at every point that gaps seemed to be apparent to me, individuals in the “big” NHS envelope in different places and at different levels helped bridge my “apparent” gaps. People make systems work.

I hope this account helps anyone not knowing what might happen. Especially anyone new to engagement with hospitals.

This is, however, an individual account. Your experience may be different but the process may be similar.

What’s the lesson guys? We just don’t talk about things. Yet I now have met many Shedders who happily admit they had one op or another “down there”. 

Please don’t ignore warning signs. My experience is that it is not that embarrassing – though I’ve never been laid out (with arms on chest) to everyone’s gaze except mine! Guess what, they are doing things for my good and for the good of others. Thank you NHS at all levels.

Thanks too to the Australian Men’s Shed Association for the illustrations from their Men’s Health manual that likens a man body to that of a vehicle. It is called ‘Spanner in the Works’ and is part of a health programme. Brilliant.

I was reminded of this publication that Shedder Len on the Gold Coast of Australian had shown me on Skype as a result of a short discussion with the doctor about future treatment. Let’s first get rid of the stones and look around again and a little later we ought to deal with the enlarged prostate. It’s rather like re-boring a car engine he said. Very reassuring I thought:-)

Take a look at Spanner in the Works by AMSA here as a pdf. To view for better readability click the expansion symbol at the bottom near right hand side.

Information boards in Sheds

We did a couple of boards to hold first aid kit, manual and accident book in Sheds . What I have come across at our surgery, with Heart Foundation, with Mind and with really readable information given to me on the procedures I was to have should be in our Sheds on an information board. We have something to learn from Whitby Beach Sweep boards in this regard.

WOULD ANYONE like to work with the agencies to obtain the top 10 or 20 such leaflets/booklets that could be prominently at our Sheds with some key telephone numbers too maybe? If need not be a Shedder but someone with a leaning towards health information in digestible form. 

The Sheds could make boards and maybe we could get a bit of sponsorship. We should be handshaking with our community and our community leaders.

Finally, let me slightly mischievously introduce the carpenters pencil.

Why is it rectangular in cross section and not round like most? I thought it was so it did not roll off from behind the ear. Not so as you will see from this short video link.    HIT Skip Ads!

   

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