PSA on PSA (The Boyfriend I Never Wanted)

Well here it is the final episode of my Prostate trilogy. Its been an epic writing journey for me as I don't think I have written so much about 1 topic since College. I will recap just a bit but you can read the full stories here & here.

I first started with a story about how I became ill and it was discovered that I had an inflamed prostate and a UTI. The next step was to go to see a Urologist (which this post will cover). The second post was a complete breakdown of everything the normal person would need to know about their prostate, what it does, and how doctors diagnose issues with it. I think this second post was a huge success as we had a true professional give his expert opinion instead of just getting a bunch of stuff from the internets.

The Boyfriend I Never Wanted

So on with the show. We pick up the story 2 weeks after my UTI. The antibiotics had run their course and I was feeling normal again. I just had to get past this one visit and go on with my life. I met with my doctor who is highly respected in the St. Louis area. In fact there is a college with his Family's name on it. I went over my symptoms with him and he had gotten a full write up on me from my primary care. We started with the "exam" and right away he noticed that my Prostate was still enlarged.  He also prescribed some blood work as my Prostate should have gone down in size over the past couple weeks with the infection.

Within a few days the blood results were back and my PSA level was at 4.5. Which at the time to me seemed low. My calmness was squashed in the matter of a second when I heard that for my age a PSA lower than 1 was more normal. I was then asked to come back into the office for some more testing and examining. The next test was still looking at my PSA but they wanted to know the Free:Bound ratio. Now for some reason I will never forget where I was when I received the info back from this test. It was St. Partick's Day and I was celebrating my Irish Heritage at 10am and I think it was a Tuesday or something. I was well on my way to having a great day. Then my phone rang... The results came back with my Free PSA was at 3%. Which if you recall from Dr. Greenfield, the higher the Free PSA the better. My doctor advised that he likes to see around 20-25% Free PSA. What really makes this call really stick out in my head however, is it was the first time the "Cancer" word was mentioned. The timing was terrible.

With 2 strikes against me (Elevated PSA & Low Free PSA) my doctor was concerned. He gave another exam and the size had not gone down. He advised that the next step was to perform an ultrasound of my Prostate. He wanted to get a visual of the area, to see if there was some asymmetry and just try identify if something crazy was going on. The ultrasound was not the same as the one that was performed on my wife's belly when she was pregnant either. In fact, to get a REALLY good look at it they had to dive in. This was the second most uncomfortable experience in my life. He looked around for what seemed like 3 hours took some pictures and went about his ANALysis. He identified some scar tissue that had been there from a previous infection (not the one I just had) and noticed my walnut was large and asymmetrical. Stirke 3.

With all the information gathered, there was but one choice (so I thought). My Doctor seemed almost certain that I had cancer. He even wrote a "Thank you" letter to my primary care. I don't know if he was excited about the thought of a 30 year old with cancer or what... Anyway the biopsy was put on the calendar and my one visit to the Urologist had blown up into 4 visits, 2 rounds of blood work, 1 ultrasound, and now 1 biopsy.

As I said before the Ultrasound was the second most uncomfortable event in my life. The Biopsy remains number 1 and I really hope it doesn't get trumped any time soon. If you are unfamiliar with a biopsy, they have to take small pieces of whatever is at risk, send them off to a lab, and check to see if there's cancer. The Biopsy itself took I think about 30-45 min. They took 16 samples (4 from each region). It was painful and almost humiliating at the same time. When finished I thought the pain would be over, just a little pain here and there, nothing crazy. I was wrong. The rest of the day and the next I had to sit on one of those horseshoe-like pillows. Not to mention when I did business in the bathroom there was a lot of blood associated with it (from both ends). I will chalk that up to not asking about the side effects before i went in. Now with all the physical pain, there's another interesting feeling going on, not knowing if you have cancer or not. That seemed to weigh on me as much as the pain.

To save the suspense, the bioposy results came back negative for cancer. Which was one of the greatest phone calls I've every received. So for the record, I didn't want this to turn into a pity blog for me, I wanted to share this story with you to educate and hopefully make you a better patient. If I would have been armed with future goggles and Dr. Greenfield's information, I don't think I would have gone down this long painful path.

After talking with Dr. Greenfield and going over my history (with no exam +1), he has suggested that I possibly have Prostatitis, chronic swelling of the Prostate. Unfortunately, there is no real silver bullet for this and he did not suggest I take Avodart or Proscar as there are potential side effects that will hinder my baby making abilities. He suggested that I just live a healthy lifestyle, eat well, and exercise. I can live with that.

Thank you to everyone for taking some time to read this and a big thanks to Dr. Greenfield who took these posts to a new level. I hope my mission of providing you with some information & advice was successful. I think this will be the last post about wang for awhile. Til next time...

-S