PSA on PSA (The Greenfield Diaries)

Now that you are well versed in the beginning stages of my Prostate ordeal, I think it is only fitting that we go over some important words and phrases that I will be using in the upcoming part 3 of this saga a.k.a. "The Boyfriend I Never Wanted."

Part 2 of the PSA on PSA "The Greenfield Diaries" wasn't originally planned at first. I was just planning on doing some research on WebMD or something to give definitions. However, it turns out a college friend of mine has made something for himself and is a Board Certified Urologist. So on a whim, and not really speaking with him formally in 10 years, I asked if he would be so kind to answer some questions for the site. He did and it was exactly what I wanted: straightforward answers with minimal amounts of conservatism. This saved me tons of research time and time figuring out how to give credit to a website. So, thank you Dr. Jason Greenfield for your professional input here. Also you should be able to tell the difference between Dr. Greenfield's comments and mine.

So on to the show. We'll start at the beginning. How many of you actually know what your Prostate does? I am going to bet that most of you that are under 40 know very little. Maybe general location or that your dad isn't thrilled when he goes and gets it checked. The prostate is a gland specific to the male gender. It is located next to the bladder and envelops the urethra as it begins from the bladder neck. Its main function is to contribute secretions that compose semen and is the entry point of the the ejaculatory ducts where sperm from the vas deferens and secretions from the seminal vesicles enter. So, without this walnut shaped glad, there wouldn't really be a Suburban FATHER Alliance.

Now that we are squared away on its location lets get more into its function. The Prostate produces PSA. PSA stands for "Prostate Specific Antigen" and its major function is to liquefy semen. It can also be found in blood and is currently used as a tumor marker for prostate cancer. Essentially, the higher the PSA level, the more in your blood. It is a better marker of prostate size but doctors use it to screen for cancer because it is still one of the best markers they have right now. Although, in truth, it is terrible in terms of specificity. It is important to know that a lot of other medical problems can cause the PSA to rise such as urinary infections. -- If  I can pause, this last sentence really hits home for me and after talking to Dr. Greenfield, I wished I would have gotten a second opinion with my symptoms. Second opinions only cost a copay but could save you a huge amount of stress.

So a bit more on PSA. When PSA is measured in the blood there is a level associated with it. Now what constitutes a "normal" PSA level is a very complicated answer. A normal PSA level depends on the patient's age, prostate size, and previous levels. For example, most laboratories give a range of 0-4.0 as normal. However, it is definitely not normal for a 30 year old to have a PSA of 3.5. A level of 5.0 may not be abnormal for a man in his 80's. As another example, a very small prostate and a PSA of 3.5 may be concerning whereas a very large prostate and a PSA of 5 or 6 may not be. As a final example, we also look at "PSA velocity". If your PSA one year was 3.9 and the next year was 4.1, that may not be very concerning. If it was 1.5 one year and the following year was 3.0, that can be a red flag. There are also a multitude of other tests involving PSA and it's subtypes. It can be very confusing and one could write volumes of text about PSA itself. Perhaps the best advice is to be aware of what your PSA is and ask your urologist what, if anything, you should be doing about it.

Now, like many substances in our blood stream, PSA exists both bound and unbound to other proteins (mainly albumin). Unbound PSA is often referred to as a "free PSA". Testing for free PSA was developed in the hopes that it would be a more specific test for identifying men who were at risk for prostate cancer. It is given as a percentage and, unlike the test for total PSA, a "lower" value is considered MORE suspicious for prostate cancer versus benign disease. However, it should be noted that the free PSA test has been somewhat disappointing as a tool for identifying higher risk patients. It certainly has not relieved us in our quest for a highly sensitive and specific test for identifying men with prostate cancer.

Finally, one very common complication with Prostates is BPH or an enlarged Prostate. The most important thing to know about an "enlarged" prostate is that a large prostate is in no way a risk for having cancer. It may lead to an elevated PSA but as  mentioned above, that does not mean cancer. An enlarged prostate can eventually cause urinary problems as the prostate grows to obstruct the flow of urine through the prostatic urethra. This is often called "BPH" which stands for "Benign Prostatic Hyperplasia". Note the word "benign". This is not cancer. BPH occurs in the central part of the prostate where the urine passes through. Prostate cancer usually occurs in the peripheral part of the gland.

Ok we covered the location, function, and what doctors measure in the Prostate. We can also confirm that each person's Prostate is going to be different in size and in producing PSA. There's no clear formula on what is going to constitute if you have cancer or not. What Dr. Greenfield does recommend is talking with your doctor briefly about whether or not you wish to be screened. If you decide that you do, the recommended age to start screening for a Caucasian male with no significant family history of prostate cancer is age 50. Men of certain ethnic backgrounds, especially men of African descent, are recommended to start at age 40 as well as men with a family history of prostate cancer.

Overwhelmed with info? Mission accomplished. I really hope you all have taken some time to read & re-read this info. Its a lot, but it is necessary to stay informed as patients and to ask the right questions when we visit with our doctors. I cannot thank Dr. Greenfield for his time on this subject. He has probably opened a Pandora's box by being so open and thorough.

Now, for the the final post of this Trilogy I will talk about my experience when I went to the Urologist for the first time not knowing what any of this was and having some discouraging news dropped on me in the middle of a St. Patrick's Day Parade. Thanks for reading.

-S

The Charity Episode

So I mentioned to my mom that I had a few blogs the other day (oh, you didn't know? I also blog internally at work, on the SAP Community Network, and for the Americas SAP User Group - membership required - and yes, I'm hilarious and good looking on all of them) and she asked me to share some easy charity links with all of you. So, as a Christmas gift to my mom, I strongly encourage you to go answer trivia questions (which is awesome anyway) and help raise food for people, dogs, cats, and little people. I don't even like cats. Merry Christmas, Mom. My other gift to her? Never giving her the link to this site.

As part of the thoroughly-exhaustive (and redundantly-restated) fact-checking that each of our posts goes through, I'll have you know that I snoped at least one of those links, and it was indeed legit. So clicking through any or all of those sites on a daily basis could, with no cost to you, help feed things. And things are hungry this time of year.

There are also lots of charities that are happy to take your money and not just your sweet trivia knowledge. The Missouri Attorney General has been kind enough to put together a list of those that are least likely to use your money for things you'd expect them to. If you are going to consider donating to those charities, might I recommend instead making my Christmas a little brighter? I promise that 100% of any donations given to us will be spent on us. Other good ways to waste your money? Burn it, flush it, or buy a Randy Moss jersey. From pretty much any team he goes to for a 3 or 4 month stint.

Really, though, most charities are upstanding corporate citizens who like to help people (or dogs or stupid cats). Like this one I built a dashboard for, the United Way which helps route money to reputable charities (but which has never once asked me to build them anything sweet), or Mid-America Transplant Services which helps people with organ donations. Do you have a favorite charity? Feel free to post it in the comments below.

Happy Holidays. Now go spread a little cheer, would ya?

PSA on PSA (The Agitated Walnut)

At the ripe age of 32 I know more than I want to know about my Prostate than I care to. Its not a bad gland, one of the best in fact, but to have issues with it this young is not necessarily normal. The next few posts from me will delve into a very hard to reach part of my body and why something the size of a walnut can freak you out. Later in the series, we will also have a guest appearance from Jason M. Greenfield M.D., Board Certified Urologist. I'll be asking him some questions along the lines of definitions, preventative measures, and a bunch of other stuff I wish I would have asked my doctor at the time. This is valuable information that he's providing, and since we aren't backed by Google yet, he's doing this for free. So for that we are extremely grateful.

The Agitated Walnut

It was a fairly normal day. I was at work pretending to do my best, making customers happy, and counting the hours as they rolled by. Halfway through the day I noticed that I wasn't feeling incredible well and my mediocre drive to excel was going farther downhill. I was starting to feel funny. My muscles were achy, I had a headache, lots of low back pain, and I was getting a fever. I pushed through the end of the day like all great employees but by the time I got out of the office, I was a wreck and completely sick. I went home, took some ibuprofen, and for the most part went straight into bed. I was fairly confident the fever would break and I'd be fine the next day, but I was proved wrong. That night I got up to relieve myself and I was struck with 2 things: 1) it burned like fire and 2) it didn't all want to come out. After about 15 min in the bathroom and achieving about what i am guessing to be about 90% evacuation I went back to bed. I laid there for about a minute and it felt like I still had to go. So I went back to the bathroom. This cycle happened a few times before I could go back to sleep. When I woke up to do my morning routine, my symptoms weren't any better and the pain was still there. If I can go off track for a second, the pain is different than if you get kicked or something down there. It was like lava was trying to escape my body through my water hole. Also, when I would "finish" the left-over lava that hadn't escaped made an extremely uncomfortable sensation.

And we're back... With the fever still in full force, my muscles sore, and the pain when I had to pee, I decided to call the doctor. Like most men, I am not one to frequently call or visit the doctor. Normally things work themselves out, but the trifecta of symptoms warranted at least a call. I was told to get right in there. When I arrived, I was greeted by the friendly receptionist with a slight look of disgust after seeing that a man so foul looking could exist. I made my way back to the room and met with my doctor. I was a bit hesitant to explain my symptoms in the lower half of my body to my doc, but figured that wouldn't be fair to either of us if I didn't. When I mentioned my symptoms down there, he broke out the rubber glove and asked me to drop my pants. Well, thats what I get for telling the truth. He did his examination which I don't necessarily need to explain, but I can tell you there's really only one way to reach the prostate. Luckily my doctor had done a few of these before and he could tell very quickly that my prostate was inflamed. I had an infection, most likely a Urinary Tract Infection (UTI). He prescribed me some anti-biotics and referred me down the hall to set up an appointment with his office neighbor the Urologist. I had to make an appointment 2 weeks out since the doctors wanted to have the anti-biotics run their course and the results of my exam with the Urologist weren't skewed.

With-in 24 hours of taking the anti-biotics I was feeling better. The fever was gone, my muscles weren't sore, no hot lava, and 100% evacuation. I am very glad I decided to tell my doctor all of my symptoms when I went in and was on the road to recovery. I just had to meet with a Urologist in a couple weeks. No biggie.

My next post will get side tracked just a little bit from the this story. I think it would be a good idea to go over some terminology before I continue on. Also Dr. Greenfield provided a ton of info and I don't want any of it to go to waste.

So in the meantime, I will just encourage you all to be up front with your doctor. If you are embarrassed for some reason to explain any symptoms to him/her, go find a new one that you are comfortable with. An open and honest dialog with your doc should be one of the top lines of communication in your life.

Reviewing Moosehead. Yes, the beer.

First off, since this is my first beer review, I need to share a little secret with you. I'm sort of in a bad spot with beer. I used to drink all light beers (except Bud Light, which gives me a headache as I'm drinking it). Then, I decided I should probably cut back in an effort to lose weight and improve my overall health, but I still loved beer, so I switched to good beer, thinking that I would obviously drink less. It hasn't really worked out that way, but at least now I buy more expensive beer than I used to, which is nice.

Anywho, one night last week I found myself at a local grocery story in dire need of refreshment. I found myself walking the cooler aisle, as I often do, looking for some sort of beer that "looks" good (which, admittedly, is stupid) and that is on sale. I finally settled on Moosehead, as I didn't remember ever having tried it, it was on sale, and it was Canadian, which is supposed to mean something in terms of beer production.

I brought it home, poured a bottle into a glass (yes, I am that particular variety of d-bag) and was immediately greeted with skunky beer. And not "I've been sitting around too long and got skunky" skunky, which is unfortunate and a sin but very seldom the actual brewer's fault. No, this was the much more insidious "some a-hole thinks Heineken tastes good, so we are going to emulate their intentional skunkiness" type of skunky, which is still a sin, still unfortunate, but entirely the brewer's fault. I'm not a fan of that type of skunk. Or any skunk, really. If you like skunky beer, Moosehead does seem to be OK  and in fact better than Heineken, but that's kind of like saying I prefer Moulin Rouge to Mamma Mia.

The SFA Snap Judgment: Don't believe the hype when it comes to Canadian beer just because its Canadian. And don't drink Moosehead. Because it kind of sucks.

Identity Crisis

Well the SFA has been official for a little over 3 weeks now. I think we've explained who we are and what we want to accomplish, but we think it would be a jerk move not to tell you what's up behind the scenes, and get some feedback about what you want to read about. We've had a series of articles about times and trials of a Vasectomy and there are some other man-health related items that will be coming out soon (think Prostate). We've also reviewed a couple products/services for our Padre Knows Best section.

Now call us lazy, but what we have decided to do (for now) is to add our "Padre Knows Best" content to the SFA blog. If you recall, PKB is the first and only limb of the SFA focusing on various product reviews so we can get free stuff. What this will do is provide a single feed for our wonderful followers (until you get annoyed with the hodge-podge format and tell us to separate it out).

So I bet you still have a lot of questions or at least I have had some inner dialog with myself:

Q. Hey man, what do you talk about your junk so much?

A. 2 reasons: 1) The movie Braveheart lied to us when Mel Gibson's uncle said "It is our Wit that makes us Men." Wrong. It is our wang. With out this we wouldn't be called fathers or dudes. 2) We feel that the best way to build Street Cred is to present lots of Scrotally-Based articles out of the gate. If a guy can talk about his junk openly, he's got nothing to hide.

Q. Do you accept donations or do public speaking?

A. No donation is too large, but an audience might be a bit too much for now unless there is a large donation.

Q. What makes you guys experts on these subjects?

A. We do not claim to be experts on anything, just 2 guys that want to help an under-served group of people on the internet.

Q What can I do to help other than give you all my money?

A. We want feedback on how we're doing and what you want. We'll take any constructive criticism you can throw at us, kindly tell you where to stick it, and make adjustments accordingly. Oh and one more thing, SPREAD THE WORD. Right now we are sitting at a whopping 8 followers on Facebook. We need followers to get this train moving. Thanks in advance for all your help.

That's it. Now give us money or feedback or both.

- O & S

They Call Him Dr. (Free) Love

This is a follow up to an earlier post where I talk a little about the decision I made to sign my manly bits up for a date with another man. Please be warned, this is all clinically accurate, so some descriptions may be more descriptive than you want to read or imagine. The better you know me, the more likely that is.

So I met the doctor who would be giving me the big snip (or, as I later learned, the one incision, two snips, four cauterized ends, four clamps, and five stitches) and I was really comfortable. We reviewed all of the same stuff I had already learned (I'd still be firing live rounds for 6-8 weeks, it might magically work again at some point in the future, it was WAY safer for me than the missus) and went over some new stuff (I wouldn't be developing bigger breasts, everything else would be normal except for the swimmers).

The Pre-Game

Easily the most important thing I took away from this meeting was my pre-op instructions, which was awesome in several ways. First, I could eat and drink normally before the exam, which is perfect for me, as I actually have a to-do to eat and drink more normally. Second, no blood-thinners the week before the procedure. I know someone who didn't listen to that particular rule and looked like a a pair of grapefruits choking out a baby carrot for a week (which is probably actually really, really cool right up until the pain kicks in). Also, for the very first time I got to take a Xanax.

Xanax Rocks

I have a reputation for being pretty laid back. I'm mostly just riding on fumes from college when I was actually laid back. Now, trying to raise kids, work, blog, yada, yada, and yada, I'm a raving freakin' lunatic and I have one heck of a time relaxing. So I usually don't. Let's just say that if I ever need to lie down quietly while someone manhandles my manhandles, I'm going to need something that can instantly relax me, Xanax is that thing.

The Procedure

Xanax rocks. I could feel some tugging, some pressure, but honestly, nothing too bad. My wife even watched the whole thing (with minimal laughing and NO pointing). Other than that, nothing really that you wouldn't expect from a procedure where some dude and a parade of nurses spend 10 minutes huddled around your berries.

The Recovery

As is so often the case, the recovery is much worse than the actual procedure. One bit of advice here: your doctor will tell you to buy an athletic supporter, and you will think "Nah, I've got some grippy drawers, I'll be fine" to which I say "buck up for the jock strap."

Early on the recovery was fine. Sure, I spent a day and a half feeling like I had been kicked in the {insert unused euphemism here} unless I was positioned just so (and I got very, VERY good at positioning myself just so) and another day and a half walking like a cowboy (admittedly more Dirty Steve than Dick), but still largely not too bad. Until a few days later when I noticed a dimple in my dangle. The medical term (and I'm speculating here) is a "double chin, you know, down there." I called the nurse the next day, and after 2 minutes of trying to explain it was told "if it is that hard to describe, he'll want you to come in and see it." So I went in to see him. It turns out that a stitch had stuck.

The Pain

I'm not going to fret on this too much, but let's say I'm impressed that a procedure centered around fixing a stitch could be so much worse than the procedure that produced said stitch. I had no Xanax and no wife, just an open mind and a doctor with the wherewithall to keep pumping in anesthetic (for which he should get a refund from the manufacturer) and the uncanny ability to get two hands elbow deep into a 1/4 inch incision.

The Recommendation

Despite my one-in-10,000 complication, I still totally recommend the snip. I just recommend getting it right the first time. And if that isn't possible, I'd try to have the doctor operate on them while they still sit securely in your wife's purse.

iPadre Knows Best?

I'm writing this blog from an iPad. Not my iPad mind you,but an iPad.
I've really wanted one for a while now, so I borrowed one for a few weeks to decide whether or not it's worth 6 months of allowance (yes, I'm on an allowance, and yes, that is a very good thing). So I've got one on loan for a couple weeks for work, and I'm trying it out. The simple run-down follows.

Pros

- Fantastic as an e-reader, although I was pretty limited by not being able to sync it from my iTunes.
- Surfing the web is pretty good, but it depends on how interactive you want to get. The way web-based gmail looks on the iPad will make you want to browse the mobile site from your computer. Seriously.
- Angry Birds. It doesn't look or play any better on the iPad than on other devices, but if buying an iPad is the only access you would have to that game, its worth the price of admission.
- The official Twitter app is awesome. Again, it makes you wonder why you cant use it on your pc.

Cons

- This freaking thing is slippery. The one I borrowed didn't have a case, and I've spent the last several days petrified I'm going to drop it.
- It is much easier to type on than the iPhone, but it is really limiting to lose half of your screen to a keyboard when you want to type, anything.
- Not all iphone apps work on the ipad and vice versa, so you may end up repaying for some stuff. Also, because Steve Jobs is a control freak without any real need to adjust to peoples needs, there's the whole iTunes, syncing, accounts cluster going on.
- I borrowed this one from work, so I can't, you know, use it for what the internet is best for.

Conclusion

I can see where the iPad and other tablet devices could be really useful, but it really depends on what sort of tasks you use (or would
use) your computer for. As long as you you don't expect it to replace your laptop, and you spend a lot of time using not-terribly-hardcore software, the iPad could be a way to get to what you need quickly and easily without lugging around a laptop.

[Note: I used the Wordpress official app to write this, but it wouldn't let me publish it, so I had to email it to myself and go from there. Which was a real pain, as was trying to format it.]

Check Yourself

There is a battle going on for your business. Its starts by letting the world know where you are and how great it is there.

As I browse the Android Market and its hundreds of thousands of apps I see more and more of them out there focused on creating a real-life game out of people's daily routines. The social check-in is the big thing right now. Some use it for discounts, some to get badges, and some who believe the world revolves around themselves and think we actually care where they are. There's even  a TV show in the works about it.

So while the Social Behavior and the psychology of why people like to share location information is an interesting topic, it involves waaay more research than I am willing to do for free. So, what I'd like to do is review the 2 biggest Apps out there for telling the world where you are: Foursquare & SCVNGR.

Both have an extensive user base, both offer free stuff & discounts, & both want you to check in somewhere. However, when you break down their version of the "game" its a little different.

Foursquare

The "old man" when it comes to socially checking in at places. Foursquare's game is straight forward: check-in and leave tips for others. If you check in frequently to a particular location, you can become "Mayor". Some businesses reward their mayor for his/her patronage by offering special incentives that all other "non Mayors" can't get. This creates a huge competition for these coveted spots and it is thought to drive business for those locations. Foursquare also has a Badge System. So the more you check in, you become more eligible for badges. There are badges out there for everything: Going to work, Going to the Gym, Staying out late, Voting, etc). You name it, there's probably a badge for it. This is also a great way to invoke participation from the user base. Businesses can also create badges to drum up business and rewards. Apple, Sports Authority, & RadioShack are just a few that have done this. Is it working for these businesses? I don't know. This is where the "I need money for my research time" comes in. I can tell you with very little research that its working for Foursquare and they are growing like crazy. They are hiring in their NYC &  San Francisco offices. You can find me at http://foursquare.com/runsheprun. I am always willing to add friends.

SCVNGR

SCVNGR is a bit newer to the game, but is roping in clients like crazy also (GameStop, Journeys, & The New England Patriots to name a few). So what sets SCVNGR apart? Users still check-in to a location, they can still receive badges & cool stuff for completing certain check-ins. That's about where the similarities stop. SCVNGR uses a point system for users to accumulate points and play against friends. Its more of a healthy competition between Friends than Foursquare. SCVNGR also (in my opinion) is more based on the "social" aspect of the Social Check-in rewarding users more points if they check-in simultaneously with other users, take a picture or complete some other task at a venue. SCVNGR also has developed "Treks" which are a series of locations remotely close to one another in which a user must complete a challenge at a venue in order to complete that leg of the Trek. So not only do you rack up Points you also rack up completed Treks to brag about. Where SCVNGR has really found a niche is College Campuses. This is a great idea to get lazy college kids to class and become more active on Campus. I surely would have been more active at college if I got points (imaginary or real) for attending class. You can find me at http://scvngr.com/runsheprun. I will score more points than you.

What about (insert app I haven't downloaded here)?

As mentioned prior, I'm not getting paid for this review and have to devote some time to Family & Work.  There are some other Apps out there that are worth mentioning that do this similar thing but I haven't had the time or willingness to try out. So here's a quick "Thanks for Playing" list:

Gowalla - Based out of Austin, TX. this app seems to be big at Colleges also but seems to favor the large Coastal Cities instead of the bubbling metropolis of St. Louis.

Facebook - Yes the giant has added a Locations feature to their site along with txt, email, and a whole bunch of other stuff. I like Facebook for what it is: A way for me to post links and make funny comments on peoples pictures. Thats it. I don't want to live in Facebook.

Brightkite - I will be honest. I don't know much about this app. It looks to incorporate some qualities of all of the above, but alas I have no funding and no bias.

Who Cares?

This over-sharing of one's self might be a little too much for some people to handle or really even care about for that matter. However, its nice to keep your daily routine somewhat on its toes if you can potentially rewarded for just living your life. I for one really strive on encouragement and these types companies do a good job at keeping me active and trying new stuff.

Ok, so thats my rundown on the social check-in and my humble opinion on the 2 big players (read: downloaded on my phone).

Did I miss anything? Want to tell me about how great some other Apps are? I want to hear about it.