Saturday, 23 September 2023

The Bladder (Slight Fault) #2

Seeing blood when you pee is a sign it’s not right.  Happened to me in 2003 while I was visiting Syracuse, NY.  Fear and panic in a small American john.  I went to the ER where they said I shouldn’t worry and gave me a prescription  for antibiotics.  Should settle it in ten days, but they didn’t. 

By the time I reached South Carolina I was back in the ER.  This time the nurse,  brandishing a sample of my urine that looked more like a lava lamp than the crystal clear it should,  told me “you’re a keeper”.  Scans, tests, and the whole razzmatazz rolled until a middle-aged Doc advised, in his southern cowboy drawl, that I should enjoy the rest of my holiday and not to worry.  But be sure I see a urologist when I return home.     

But you can’t, can you, enjoy your time with such a great, howling fear up ahead. 

I looked it up on the net.  Blood in urine.  All the US sites told me that the Surgeon General advises seeing a urologist immediately, waste no time, this could be serious.   The British, in contrast, suggest going slow, taking an aspirin, and only if that doesn’t help actually visiting your GP. 

I rang her on landing and next thing I knew I was attending  Ambulatory Care for a flexible cystoscopy.  Ambulatory Care.  They’ve renamed it since as ambulating doesn’t appear in most punters’ vocabularies.  It’s called the Short Stay Surgical Unit now.  Trips off the tongue, doesn’t it. 

The flexible camera discovered a papillary growth.   We’ll need to take that out, the consultant told me.  I was readmitted for an encounter with flexible’s big brother rigid.  This was a little like having Dyno-Rod round to fix the house drains although, being under general anaesthetic, you experienced little. 

The fun started when you came round.  Fog, fuzz, thick head, the catheter still in and aching, mitomycin chemo wash like a bag of nails and then, following the drinking of gallons of water, successfully peeing again and being allowed home. 

In the consultant’s office a few weeks later  he told me that this papillary growth was a cancer of the lowest grade, the lowest, non-invasive level, and so insignificant (in the scale of things) that it wasn’t really worth considering it a cancer at all.  We’ll need to check you regularly and, if we find anything, just scrape it off.  These things return in at least 80% of cases.  Don’t worry.  You’ll last.

And I have done, too.  Nineteen cystoscopies later with several episodes of burning the recurrence off there and then plus at least three more full-blown rigid cystoscopies I’ve managed to navigate thirteen years of superficiality.  Mostly without pain or fear.  The general anaesthetic always whaps me but I manage that.  With the flexible insertions I simply wiggle my toes and don’t look. 

But that’s changed.  Slight Return has now morphed to Full On Big Return.  G1 (the grade applied to my old friend the almost not a cancer growth) has become G3.  G2 never happened, at least if it did I wasn’t told. 

Things The Doctor With My Results In Front Of Him Could Have Said:

Mr Finch, Things have changed.
Cancers are tricky things.
How long have you been coming here?
Now I don’t want you to worry too much.
As this is sounding complicated I’ll write it down.
You’ve got choices and you need to spend some time considering them.
This is a whole new ballgame.
Survival rates are good.  Here are the statistics.
This Urology Department has some of the leading specialists in the country.
We can cure this so long as we prevent it from spreading.
This is just one of those things life throws at you.
Have a good day.

I watched him in action again  two weeks later when I was back to see the specialist nurse for the start of my treatment.  He ushered a middle-aged man in a suit into his small office, all smiles and handshakes.  The guy spent twenty minutes inside before remerging pale and red-eyed and with that haggard-look you only get when your own mortality confronts you.  I know how you feel, I thought.  The miasma of disbelief.     Then my name was called and I carried on.

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