What We Men Don’t Like to Think About

November 30, 2014

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.

21 Responses to “What We Men Don’t Like to Think About”

  1. Gary said

    Great article

  2. kohsamuipete said

    Good blog, Hugh. I’m where you are, but no biopsies, yet. My concern is that if there is ever a need for a surgical intervention on that prostate guy, am I then condemned to a lifetime catheter? Like my vericose-vein lined legs… Get ’em stripped and be forced to wear thigh-high pressure stockings for the rest of my days… I think there would have to be a major improvement/trade off to do either surgical thang…

    • Pete,

      Today surgery techniques are pretty good. If I had to remove the prostate the doctor would do it using robotics. They are much more accurate and he has told me that I should worry about nerve damage. Here is a video of how the robots work (https://www.youtube.com/watch?v=TRBpP-MipRo). It’s a little scary but it looks pretty straight forward. Let’s hope we won’t need this. Be well old friend.

  3. Helen Dymock said

    Hi Hugh, glad to hear you are ok. My husband went through all of the above and as there was cancer present had the robotic surgery which took 7 hours as his was size of a large orange, so I think that probably beats your record LOL. He ended up with massive blood clots that only a filter that was inserted before surgery saved his life. Yes you are right also to mention nerve damage because when it is very large robotics or no robotics you will still get damage. I guess you know what that means, but it is better to be alive. Anyway he is well now and 6 years free of the prostate cancer and 5 years free of the throat cancer that came to visit the following year, totally non related. Any how good news story is our housein Australia is on the market as we are moving to Thailand next year. Time for a big change. Life is too short and there is so much more to do. Cheers Helen

    • Helen,

      Thanks so much for sharing and good to hear your husband is through with the cancers. Yes, even though I haven’t experienced the other, I am sure that being alive beats the alternative. I mean, the birds in my garden wake me up every morning. Don’t know if they have that on the other side but I’ll stick with my birds for as long as I can.

      Good luck with your retirement plans.

  4. tommorrisonibiza said

    My very best wishes for your continued good temper and improved health. I think that most older men have a higher likelihood to die before their prostate cancer reaches an ultimate stage without serious intervention, and therefore are best advised to let their lives   go on without surgical procedures. Simply put, we probably will die before our prostate takes our lives.  Tom

    Sent from Samsung Mobile

  5. Lani said

    Hope your health stays with you! Glad everything is good now. Take good care, and happy holidays to you and your family 🙂

  6. dannyol said

    Thanks Hugh,
    I too went through the biopsy routine a few years ago with a clear outcome. I have since found out that having sex (orgasm) the night before a PSA blood test will spike the numbers. This is exactly what prompted my doc to order a biopsy. I recomend abstinence before a PSA test.

    PS: If doctors know this they should ask if you’ve “done it” the night before when taking the blood test.

  7. John said

    Greetings Hugh,

    Thank you for sharing your personal story with us. It sure sounds very challenging. I just wanted to share with you one of Dr Mercola’s articles about prostate health. Nutrition seems to be a very important component of prostate health, especially staying away from grains and starches / sugars/fructose as much as possible. Also vitamin D deficiency seems to be a factor.


    I also like Dr Wilson’s nutritional balancing approach which can rejuvenate the body. It is a more gradual approach, but it can really restore health “from top to bottom”. Actually the only certified SE Asia practitioner of Dr Wilson’s program happens to be in Chiang Mai !


    A friend of mine’s prostatitis recently flared up due to excess consumption of carbs and he cured it by avoiding those foods as well as supplementing with 3 tablespoons a day of colloidal silver for a week.

    Hope you can reverse the enlargement, and lead a normal life. I believe it is entirely doable, and can be done in many ways.

    Best wishes for staying healthy, happy and strong,


  8. Bruce M said

    There is a month for prostate cancer. It has become quite big here in Canada. http://www.prostatecancer.ca/get-involved/events/movember#.VIMY59q9KSM.

    Thanks for writing about your experience, Hugh.

  9. Lou said

    I had a prostate biopsy in January of this year in the U.S.. I know what you went through. No fun. I had mine with just a local anesthetic . I was awake during the whole procedure. It felt like a nail gun going off with each biopsy they took, 12 in all. Mine turned out positive and my urologist who is a surgeon recommended surgery, of course that is where he makes his money! So I decided to do a little research on my own and thats where I discovered Proton Radiation Therapy. Boy am I glad I did this. I went to the University of Florida Proton Center in Jacksonville, Fl. What a fantastic place. It is one of 14 operating Proton Centers in the U.S. as of right now and they are building others. The Mayo Clinic is building 2 centers. Proton therapy radiation has the least side effects of any treatment for prostate cancer. I finished treatment in June and have no side effects at all. No catheter, no diapers absolutely nothing at all. My PSA was 8 before I started treatment and is down to 2.9 now. Just had my 6 month checkup with my doctor and he said everything is going great. If you or any of your readers has any questions, please send me an email and I will be glad to answer them. And yes Medicare covers proton therapy! I would say about 90% of the men being treated where I went were getting it paid for by Medicare. I am only 63 but luckily my Blue Cross from work covered it. Here is a link that covers a lot about Proton Radiation Therapy and where the current and future centers are. http://www.proton-therapy.org
    My thai wife of 29 years and myself are happy we chose this route, and we both can’t wait to retire next year and move to Thailand.

    Take care and good health,


    • Lou,

      Thanks so much for your input and the info you gave. Good to hear things are going well for you. I am going to look into proton therapy. Not sure if they have it here in Thailand yet. I’ll get back if there is. For those who don’t know, Medicare does not pay for overseas treatment so we have to take care of that ourselves. Although cheaper than in the U.S. treatment here can still be expensive.

      Lots of luck to you and hoping for your good health.

  10. Kris Hoover said

    Glad to hear that things worked out well for you, Hugh. After our meeting at Chiangmai Ram a couple of weeks ago, I ended up having surgery (urethrostomy) for the second time with Dr. Bannakij on Dec. 22. Without insurance this time, I elected to have the procedure done at Sriphat Medical Center for half the price it cost at Chiangmai Ram. Just had the catheter removed yesterday after having it in for 8 days and thankfully I can pee freely again. Unlike your case, my diagnosis was a stricture caused by trauma inflicted during catheterization for knee surgery at Bumrungrad Hospital in Bangkok in July of 2013. It seems that strictures can and do reoccur after the initial damage is done with few alternatives to surgery. I’m hoping that in my case twice is enough.

  11. […] important for men, and women who have men in their lives. This post on WLT is a companion piece to What We Men Don’t Like to Think About. If you have time, take a look at my post. It is full of info and web links about this condition […]

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