Medical Update

1 I'm kinda numb. That's where medical uncertainty will leave you. Bottom line... It's an infection, inflammation or bladder cancer. As for discovering which it is, that's what the following screed is about. I went to UCLA Medical Center a week ago today, to Clark Urology. You may have doctors as good in your neck of the woods, I'm not going to say mine are better, but I am going to say this is one of the advantages of living in the city, the access to first class medical care. It's one of the many reasons why I will never leave Los Angeles. Now there are excellent medical facilities around the country, from Johns Hopkins and the Cleveland Clinic in the east to the Mayo Clinic in the midwest and MD Anderson in Houston. But pound for pound, you want to be in the metropolis. I'd boil that down to New York and L.A. Your mileage may vary. Also, you want a PPO, not an HMO. Now I know some people don't have medical insurance at all...either because they can't afford it or they don't think they need it. But if you have the option, go for a PPO, so you can see your own doctors, sorta. The truth is in the city so many doctors don't take insurance at all, which the Eagles referenced in "Life in the Fast Lane," i.e. "The doctor say he's comin', but you gotta pay in cash." However, if they work for the hospital, they do take insurance. Which is great. And the other thing is Medicare is so damn good. But if you're on the cusp of being 65, I must tell you, be sure to purchase a supplemental policy. ALSO, and this is very very important, sign up for a drug plan at the same time. For if you do not, you'll be penalized when you ultimately do. You'll be paying more for the rest of your life. ALSO, you will need medication and don't be afraid to take it. For some reason, the Greatest Generation and the Boomers are anti-pill. And sure, there are addicts, but the bottom line is these medications keep you alive...statins, blood pressure meds... All I've got to tell you is I know a woman who was in her fifties, thin, and the doctor said she needed to go on blood pressure medication. She said she'd treat her high blood pressure naturally. Bottom line, SHE HAD A STROKE! So let that be a warning to you. Then again, trying to set someone straight about their health is like trying to get them to switch political allegiances. But you're not going to live forever, and you want a fighting chance. You're not gonna live forever. You think you are, but you're not. And something is gonna come along and bite you in the ass. The average life expectancy in the U.S. is 79...but that means half of the people die before that. So... I mean I've already got cancer, what are the odds I've got it again? But that's no insurance. May feel like it, but you can get it again. So... Last Tuesday I went for a scope. It's funny, the nurse lifts up your gown and prepares the area, spreading all this yellow anti-infectant on your dick while you're talking all the while. And in this case we were discussing football... I always talk to the people in the hospital. Not only does it assuage my anxiety, you want to let them know that you're on the case, sharp, so they don't punch the clock with you. She lived in Long Beach, and I asked her how long it took her to get to the hospital, that's a natural next question in L.A., the traffic. She said it varied between forty minutes and a bit over an hour to get there, but two hours to get home. And what did she do during this time? Listen to football podcasts! Whereupon she waxed rhapsodic about the Chargers and started talking about individual players in the league at the level of the commentators on TV. Me? I know enough to get by. She actually thought I knew more than I did. Pay attention, read enough, and you can fake it pretty good. And then she shot lidocaine up my penis. I'd say it was uncomfortable but it was nothing compared to what was coming. And then the doctor came in. He wasn't happy. This was breaking protocol. You don't do a scope without a prior consultation. So he was reluctant. Then he got out what appeared to be a caulking gun, with a long tube at the end, he stuck it up my dick, it started shooting water and he said it would be painful... You've got no idea. I've got a very high threshold of pain. But when it breaks, when it hits the limit... Usually if you're going to get this far, they numb you out completely. Believe me, I could feel it. I'm about ready to burst. And then the doctor says to look at the screen. Which is now filled with blood. Not the deep red of the previous weekend's piss, but red nonetheless. And then he says he's going to shut off the water in the pistol, that the pain will decrease, which it does, but only a bit. And when the tool is removed... He says the bleeding is coming from a spot on the bladder and I need a biopsy, to determine if it's cancer. As for the odds, he goes on record that they don't believe in "might," he will not speculate. So walking as if I'd been kicked in the nuts, I go to scheduling and get an appointment with the biopsy doctor, I just got home from this second appointment. 2 Now I didn't have to wait. But the assistant remembered me as a friend from an appointment back in October, it was like we were old school buddies, and I'm working the mental rolodex, trying to remember his story and it comes to me that he'd recently been married... He said it was his one year anniversary. And didn't he like to go to the show, wasn't he scheduled to go to a festival? I threw that out there...no, his wife went back to school, they're saving money now. And I'm just scanning Instagram Reels. When you're in the hospital you're in suspended animation, the outside world doesn't matter, life almost stops. And I don't want to work and be distracted, because I want to be totally present when the doctor comes in so I can I tell my story directly and completely and listen to the feedback. But his nurse comes in first. And she immediately starts talking about the biopsy. That first I needed "clearance." Did this mean I had to argue with insurance? No, my primary care doctor had to say I was okay for the procedure, which would be done in either the hospital or surgery center, they'd put out my lights. However, the odds of me staying overnight were slim, since I wasn't physically hobbled, in a wheelchair. So now this was totally real. And then the doctor came in... And he's talking about the biopsy and then he lets slip that he didn't do the scope, so he didn't see what was there, and if he had... And here's where my personality comes in, or maybe my education. I start asking questions. I'm looking for nuance. And I'm asking some questions more than once, because sometimes they respond with different answers. I'm slicing it by hair, after all, it's ME, and I want to do the right thing and get the best result. Sometimes I'm buying something and a friend is along and they don't understand the process. The salesperson has given an answer, let's move on. But I find if I quiz further, address the subject from different angles, usually ask the same questions ultimately two or three times, I reach a definitive answer/conclusion, I'm then comfortable with what I'm going to do. Now obviously, every purchase is not critical. But a lot, having to do with ski equipment and... You can read all you want and most salespeople are transitory and not as informed as I am on the subject, but when you get an expert, you want to hear what they have to say, cross it with what you already know. So... I pick up on the fact that this guy didn't do the scope and therefore it's unclear to him. What exactly is unclear? And that's when he says if HE did the scope he'd know if it was cancer or not. OK, so this begs the question, should we do another scope? And this seems to appeal to him, after all, it would avoid anesthesia, and the rest of the issues of surgery. For now anyway. But is this the right approach? You can't be scared, you've got to do what is right. Unlike all the men who are afraid of a colonoscopy. You've got to jump through the hoops if you want to live. I'm willing to have the biopsy, I'll go there, but...maybe I don't. So we kick the ball back and forth. Why would he be different from any other urologist? Well, this is what he does all day long, look for bladder cancer, and he can tell... So what are the odds he scopes me and misses it? Single digits. Well, those are not quite good enough odds for me. So I start parsing it out further, I want the guy to admit that this is the right choice, to get a scope first. And I'm slicing and dicing and then he commits. That's what he would do, get a scope first. So that's what I'm gonna do. 3 Now the wheels of medicine turn slowly. Unless you're about to die on the table. Oh, believe me, if there's a crisis, an emergency, they'll address it right away. However, methodically, they don't get as anxious and uptight as you do. So they said they'd squeeze me in. Which is in three weeks. But now it's more real. I mean it could be cancer. And if it is...I asked the guy the spectrum of outcomes... Well, he could cut it out or have to remove the entire bladder, somewhere in between those two. That made it real. But that's when I made him go through the possibilities once again... And that's when he said definitively, it could be cancer, an infection or inflammation. Well, I haven’t pissed blood since the day of the first scope. And although the tip of my dick still hurts, my urine has been clear. He was not too impressed with that, he didn't consider that definitive. So now I'm internalizing it... Well, the blood is gone, I was taking Aleve, which is an irritant... God, I've got no idea what it is. If you asked me to give an instinctual response I'd say it's nothing serious. I have no pain, I am not bleeding, I was taking anti-inflammatories and was very active. Furthermore, my kidneys are riddled with stones, that's been established, and a kidney stone can irritate the bladder. Then again, I had no pain, and with kidney stones you almost always do. Then again, I'd had that episode of being cold and shivering, and that tends to go along with an infection, but that's not definitive. So, as Jimmy Cliff would say, I'm sitting here in limbo. It could be worse, I've had it worse. I just don't know. 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