What We Men Don’t Like to Think About

In these posts I usually don’t share too much of what personally goes on with me since I want to spend as much time talking about general retirement and retiring to Thailand as I can. But for this post I wanted to share some personal stuff that might be important for my many retiring readers, especially men, and women who have men in their lives, to know about.

The National Football League has a week each season to increase awareness of breast cancer. All the players and coaches and even the referees wear pink, pink ribbons, pink shoes, pink socks, pink wrist bands, pink penalty flags. This is a very good thing and I am sure that the increased awareness about breast cancer has saved many lives. But maybe they should also have a week where we work on the awareness of a problem that is solely that of men. Prostate cancer. Everyone could wear blue.

So I thought I might do my part to help my readers become more aware of a condition that many of us feel uncomfortable thinking about let alone talking about. Try to get as much info about this condition as you can because just about every man on the planet, if he lives long enough, will be faced with it someday. To aid in that I have included lots of links in this post. And, although I am still cancer free, I thought I would tell my story.

As so many men of my age, I have had prostate problems. Mine started about 10 years ago when I was 58. In an annual physical checkup we found that my PSA (Prostate-Specific Antigen) levels were somewhat high. A high PSA level may indicate an enlarged prostate or possibly prostate cancer – although there is quite a bit of controversy around relying solely on PSA levels. Further checks did show that my prostate was enlarged, a non-cancerous condition called benign prostatic hyperplasia (BPH).

So for the past 10 years I have been keeping track of my PSA levels, taking medication, and doing that annual procedure that most men really hate, the “digital rectal exam” (DRE). Please note that “digital” here has nothing to do with computers, which at first I thought. Digital also means “finger”. Most men my age will know what that means.

For people who believe in “intelligent design” I have a question. Why would you design a gland that encircles your urethra, when you know that gland will eventually become enlarged and block off that nice canal we use for urination? That is exactly what happens as men age. Seems like a design flaw to me.

I was beginning to have the classic symptoms of an enlarged prostate, trouble urinating, getting up lots of times in the night to relieve myself, and urinary tract infections (UTI).  At one point I had an ultrasound of my prostate (This can be done from the outside on the abdomen, or from the inside when something much larger than a finger, called a transducer  gets inserted “where the sun don’t shine”.) They thought they saw a shadow so I was advised to get a biopsy of my prostate. Think being kicked in your butt with a steel-toed cowboy boot over and over again and you’ll know how that feels.

But nothing was found and I was given a clean bill of health.

But the prostate was still growing. And causing me problems. Once, in order to get some sleep, I took an antihistamine on a long plane flight to the U.S. Little did I know that antihistamines and enlarged prostates do not go well together and I wound up in an ER in Seattle Washington not being able to urinate (and for those who ask, that is a condition called “urinary retention” or I like the term “aenuresis”). It is something you definitely want to avoid if you can.

The treatment: can you spell “catheter”? Or to be more precise a Foley catheter. BTW, I was in the U.S. for my son’s wedding. Foley catheters and dancing at weddings do not mix too well but luckily I recovered and was able to get it removed before going out on the dance floor.

One more time a few months ago this condition recurred and I wound up in the ER here in Chiang Mai. I also have had a number of UTIs; the symptoms being blood in the urine. Things seemed to be getting worse. Along with that, my PSA levels had jumped to 30, normal being around 3 or 4.

So my urologist, Dr, Bannakit from Chiang Mai Ram Hospital, was quite concerned and recommended another biopsy, but this one much more thorough than the first. Nightmares of steel-toed cowboy boots circled around my head.

I let Dr. Bannakit know my fears and he said that it would be best if I went under general anesthesia to get the procedure done. Here is how it went.

• Two days before I began taking antibiotics to make sure that the procedure didn’t cause an infection.
• The procedure would be done at 6:00 pm on Thanksgiving Day.
• No eating or drinking after 10:00 am so no worries about overeating this Thanksgiving.
• I arrive at the hospital at 4:00 pm.
• The doctor greets me and says, “Ready for a nice sleep?”
• They set me up with a glucose IV, pump me full of antibiotics, and do an enema.
• I am wheeled into the operating room.
• The anesthesiologist attaches the sleeping potion to my IV, and I say “Good night” to what seemed like a dozen nurses surrounding me.
• Then one second later (by my count) I awake in the recovery room.
• I have a sore butt and am really hungry but I have to hang around for 2 hours to make sure I can make it home.
• I am given more antibiotics to take when I get home.
• We pay the bill, $600.
• My wife tells me later that the doctor has looked around with an ultrasound and taken 12 biopsy samples, and is certain that I am still cancer free.
• I whisper a silent “O frabjous day! Callooh! Callay!” and my blood pressure drops back to normal.

This is a few days later and I am feeling fine.

I hope this helps with some info about the mystery surrounding this condition that we older men find hard to think about. And if you haven’t lately, do yourself and your loved ones a favor and get a good checkup.

I am not yet out of the woods and Dr. Bannakit is thinking of entering my prostate into the Guinness’s  Book of World Records as the largest one he has ever seen. So it looks like a little surgery to reduce the prostate size is in my future. Guess I won’t be in the Guinness’s Book of World Records after all.

All in all this was one of the more interesting Thanksgiving Days I can remember. And I have lots to be thankful for. Callooh! Callay!

May you all have a happy and healthy holiday season.

One Day of Hell (At Thai Immigration)

Posting a little late this month, but I have a good excuse. My son, daughter-in-law, and their three children came from Okinawa for a nice visit to Chiang Mai and Krabi. For ten days Pikun and I were in grand parents’ heaven. Now, with lots of empathy for the two long-suffering parents,  we are trying to recuperate.

Sonya, Brandon, Natalie, Ethan, Warren

But the “One Day of Hell” came a few days before they arrived.

I have a retirement visa for Thailand. This requires an 800,000 baht deposited into a bank account for at least three months before applying for the visa or extension. Then once a year you take some forms, a picture, and a letter from your bank proving the amount in your account down to the immigration office. Then the fun begins.

Here is how it goes at Chiang Mai Immigration.

1. You can book a time online to be interviewed by immigration but it must be not before 100 days in advance. The visa companies have booked most of the spots by the time you get online so I have not yet been able to book a time. That means I have to show up at immigration and get in (a real) line
2. Woke up at 4:30 am on immigration day (can be up to 45 days in advance of the visa expiring) and got all the forms, pictures, letters, and passports ready. Got to the immigration office just before 5:30 am. By that time there were a dozen or so people already in line. They had found some plastic chairs and each person was sitting in a zig zagging line. The office opens at 8:30 am.
3. The line continued to grow and by 8:00 am there were 40 or 50 people in line. The plastic chairs had run out long ago. This is when they hand out a card with a number on it. At first I thought this was a card telling what place in the queue you were. But noooo! We were led into the smallish waiting room and told to wait.
4. And wait.
5. At 8:30 they began calling out numbers. When mine was called I went up to the counter. There they gave you another number. This was the queue number. I was number 10. Not bad I thought. Little did I know.
6. At around 9:00 am they began calling out our numbers. There are a number of different sets of numbers because people are there for different kinds of visas. In our line one number was called about every 15 – 20 minutes. That means that in about two and a half hours I would be done. Little did I know.
7. At about 10:45 am my number got called. You go up to an immigration officer. The one I had had seen me many times. She was quite friendly and efficient. I have much respect and sympathy for the immigration officers. I titled this post “One Day in hell”. They are here six days a week, all year. And every day for them is hell.
8. In about 20 minutes, after going out and making copies of pages in my passport which I had missed (happens every time), we were done. At 11:00 am I paid my 1,900 baht and was told to go back to the waiting room and wait.
9. And wait.
10. At noon an immigration officer stood at the counter and told us all “We are closing for lunch. Come back after 1:00 pm.” No explanation. No “Sorry to inconvenience you.” Just come back after lunch.
11. Since I hadn’t eaten for about 18 hours at this point my brain went postal and for one of the very few times in Thailand I got angry and demanded an explanation – in a rather loud and annoyed voice (which never works very well in Thailand). We were told that the colonel was at a meeting and wasn’t here to sign the receipts for the visa fees. And he was the only one who could sign. I turned to the 50 or so of us still waiting (including one guy I had talked to earlier who had been on line since 4:00 am) and explained the situation. So we went to lunch.
12. At 1:30 I returned and went up to the woman I had been abrupt to and apologized telling her I had been in a hypoglycemic fit at the time and I was sorry for getting angry. Really, it wasn’t her fault.
13. At 2:00 pm I was given back my passport and my “Day of Hell” was over – at least until next year. All together, from waking at 4:30 am to getting my visa at 2:00 pm it really wasn’t one complete day of hell, simply nine and a half hours. Piece of cake.
14. As I left there were at least another hundred visa applicants still waiting in the waiting room. I hope by now they have their visas.

What all the fuss is about