Pain is an issue no matter what our health-related issues might be. At least for me, it’s an issue that gives me pause. I don’t like pain. I’m not one of those people who thrives off of it or gets excited by it, either giving or receiving. So when I receive pain unexpectedly, especially at high levels, I get angry. It’s a problem for me.
The day was approaching for me to get the fiducial marker balls and spaceOAR gel placed in my body. For some reason when I say, “Fiducial markers” The image of Drax from Guradians of the Galaxy pops into my head when he kept saying “Harbulary batteries.” I don’t know why, but it makes me laugh.
Previously I mentioned that I chose my urologist, Dr. Sulek, to do this procedure because of the promise to give me a general anesthetic. At that time, it was mentioned it would be a prudent measure due to the fact that I recently had a biopsy, which could make the marker placement more painful. Spring forward to this week.
The care team for Dr. Sulek called to give me my prep routine for getting ready for the procedure. Since I wasn’t getting a general anesthetic anymore, I could eat and drink the night before and even drink the morning of up to 2 hours before the procedure. I just couldn’t eat. And, by the way, I would need to do not one, but TWO enemas- one the night before and one the day of. Terrific.
Truth to be told now that I had one under my belt, these other two came and went no problem. I even knew which way to insert it without the instructions. To paraphrase an old Johnny Bench commercial about paint, I had no runs, no drips and no errors. I also had none left, to continue the baseball talk. I knew they wanted me to do these to eliminate any “obstructions” while trying to place the gel, but I also wondered if they helped get rid of gas so that that didn’t become an issue during the procedure, either. Time will tell.
But I digress. As I waited for the appointment time to come, I started researching things like the effect of Pronax gas. Would I really not feel anything? Would I be so out of it, I really wouldn’t “feel a thing?” And I researched the procedure itself. These fiducial markers (harbulary batteries) were approximately the size of a grain of rice. A little bigger than I thought and that meant we were talking about a larger gauge needle. Great. Something else to look forward to. But I steeled myself and I remembered the words of Schnelle, Dr. Sulek’s assistant, who said “Trust me. You won’t feel anything, I promise.” This reminds me of the old joke, “How do they say ‘fuck you’ in New York City? ‘Trust me.’”
The time came and we hopped in the car and had a pleasant, traffic free ride there. It was the same building as all my biopsies, so pretty easy to find. And there were two doors, which I had never really noticed before, so we parked near the second. Little did I know what awaited me inside and exactly how much Schnelle has said “fuck you” to me.
After receiving the required mispronunciation of “Mr. Ree-ah-mart” (fuck it, I might just change the pronunciation at this point), I took a seat and was told I’d get called back in the next 30 minutes, Sure enough, about 20 minutes later, a young barely-out-of-high-school girl called me back and off I went. Everything would go downhill from here.
She introduced herself but I missed her name because I was deep in thought regarding what was about to happen, so I’ll call her nurse Jenny, because that might actually have been her name.
“How are you today?” nurse Jenny asked with a smile.
I tried to come up with something whimsical to say, but everything was a blank.
She seized on the silence, “Probably as good as you can be considering the circumstances, right?”
“Yep, I’d say that’s about right,” I agreed.
She lead me down a long, straight hallway which occasionally intersected with other hallways and had doors every few feet on both sides. This place was actually pretty massive.
“Do you need to go to the bathroom?”
Now I considered it for a minute because I did have to pee, but I wondered if they would make me pee before I left today. But since no one had told me that, I told her “yes” and evacuated my bladder.
A few chairs lined the halls outside the bathroom so I waited in one for her to return, then she lead me to another small room around the corner.
“This is where we’ll be doing your procedure,” she informed me
The room was small and had some cabinets and a sink making nearly a “U” in the first half. The second half of the room, which was divided by a curtain, had a bed, some surgical equipment and the internal ultrasound in a cart to my left. I immediately regretted It that I had even looked around
All in all this room reminded me of every room my wife had given birth in, only a lot smaller. There was a bed with stirrups with a table covered with one of those paper medical thingies (sorry for the technical language) just in front of the end of the bed that held the stirrups.
The big mistake was looking to my left (the right side of the bed) where the ultrasound camera rested. I now knew exactly how they were going to find my prostate and, brother, this thing looked way thicker than it needed to be. Take all five fingers and pull them into a tight circle and then turn the circle towards you. That’s how thick it was.
“You can take off your pants and underwear and lay on this table and put your butt right here in this crack,” she slid her hand in the crack between the stirrups to demonstrate.
“So I can keep my socks?” I asked.
“Oh sure, you can keep those on. Then cover yourself with that big paper towel there and tell me when you’re ready.”
I did as instructed while nurse Jenny disappeared behind the curtain like the Wizard of Oz. But I thought back to the scrotal ultrasound and how they unceremoniously just ripped off the towel when I told them I was ready.
I told her I was ready and nurse Jenny unceremoniously ripped the towel right off as she walked in. What, the actual fuck? Why do we even bother?
She helped me place my legs in the stirrups and then shimmied me down a few inches towards the end of the bed. Then she sat on stool at the end of the bad and eyed my junk like a catcher waiting for an incoming pitch.
“So first I need to shave you.”
Shave me? Why the hell doesn’t someone give you at least the faintest idea of what you were in for during one of these procedures?
She didn’t pause but went right to work. I felt the scraping around my genitals and I just stared at the ceiling.
“I’m going to lift these now and shave down here. I’ll be shaving from here to your belly button,” by “these” she meant my balls and I felt them lifted and the scraping start on an area even I never see on my body.
“I bet you didn’t think you’d be getting a shave today, did you?” nurse Jenny said sweetly.
“Nope,” I admitted, “I had no idea.”
She kind of chuckled and went back to work, finishing by wiping everything so that I was clean as a daisy.
“I shave you so that after I add the tape, it doesn’t feel like a waxing when I have to take the tape off. Now I need to apply the iodine solution. Sorry but it will probably be a little cold.”
I really didn’t care about that at all. In fact the solution was cold and she was very thorough in her cleaning. What bothered me is as I felt the solution touch my anus, my asshole was suddenly on fire.
“Whoa, that burns a little,” I underplayed it.
“Yeah, sorry, that’s probably from where I shaved.”
Well, it wasn’t from where she shaved but I had no energy to argue with her now. A few minutes later she finished. After that, it was time to tape up the boys and attach them to my stomach.
When she was done, she said, “You’ll be glad I shaved you when we take that off. Now I’m going to come around and start the nitrous oxide for you.”
Now it concerned me that she said nitrous oxide. I thought I was getting something called “Pronax gas” that was stronger than nitrous oxide, but I guess I’d just take what I could get. She took a long plastic tube with two hoses coming out the other end and handed it to me.
“Put that between your teeth. Take deep, relaxed breaths. In a few minutes you’ll feel the nitrous start to take effect. Okay, I’ll go tell Dr. Sulek you’re ready.”
That was a matter of opinion, but she returned a few minutes later and asked what kind of music I liked. I told her classic rock would be good, but it wouldn’t mean anything. I don’t remember a single song that played except The Police, King of Pain. How fitting.
I focused on taking those deep, relaxing breaths. I thought the nitrous really didn’t taste very good but I closed my eyes and continued to breath. Dr. Sulek walked in a few minutes later shadowed by another guy who I had never seen before. He was young, thin, tall and had a clean-shaved face and head that made him look like a white pickle. His silver-rimmed glasses looked huge on his narrow face. I’m sure Dr. Sulek introduced him but, once again, I had different thoughts in my head and didn’t really give a shit about him, anyway. I really didn’t even like the fact that we were inviting even more people in. Was there anyone left in Nashville who had not seen my cock and balls by now?
Dr. Sulek sat on the stool and Dr. Pickle stood to his left. Nurse Jenny stood next to Pickle and they all stared at my junk.
As far as I could tell, the nitrous had not done shit for me. I wasn’t even dizzy, so now I got scared.
“Um, am I getting more anesthetic than this because I don’t really feel anything,” I asked and then put the tube back between my teeth.
“Oh yeah, we’re going to get you fixed up here. The anesthetic is the first thing I’m going to give you. But before that I need to put the ultrasound in, so I’m going to lube you up.”
Now I felt the cold gel getting spread across my anus and suddenly inside my anus without even a warning. Next he took the ultrasound and crammed it in my cramhole like I was a prison bitch in American Me. It hurt and once it was completely lodged, it was extremely uncomfortable. But the pain was only starting.
“Okay, Mr. Reimert,” he pronounced correctly, “Just a little pinch here.”
The first shot was the anesthetic. Schnelle’s words “trust me, you won’t feel a thing” rang in my head.
The pinch was more like a knife stabbing into my taint. My whole body tensed and I growled.
“Try to stay still, Mr. Reimert,” Dr. Sulek said. Easy for him to say when he doesn’t have a donkey dick in his ass and what felt like a nail getting hammered into his taint.
I closed my eyes and tried to relax and focused on breathing. Surely if I just kept breathing nice consistent, long breaths the nitrous would do something.
Dr. Sulek removed the needle and that’s when I noticed out of the corner of my eye Dr. Pickle lean over to nurse Jenny and whisper something, to which they both giggled. Now I was getting mad. There is nothing more insulting for a man than to be naked from the waist down in front of other people only to have them whispering and giggling. I have no idea what they were giggling about, but I felt it was inappropriate at the least.
“Those are some good, deep breaths you’re taking, Mr. Reimert.”
“No shit,” I growled with the tube firmly clenched in my teeth.
“Ok, big stick here now, Mr. Reimert.”
BLAM! White hot pain shot through my pelvis and I growled as close to a scream as I have. Especially with a plastic tube clenched between my teeth. The stabbing pain coursed through from my taint all the way to my left hip. It was honestly agony.
Dr. Sulek conferred with Dr. Pickle as they stared at the ultrasound screen non-plussed about my suffering. They discussed the placement of the marker and, when they were satisfied, Dr. Sulek pulled the needle out. New rivulets of pain shot through my left testicle and down to my asshole. I growled again. I thought I had been making some pretty loud sounds, but no one else acted like I was even there.
“Ok Mr. Reimert,” Dr. Sulek finally acknowledged me, “Another big stick.”
No pause. A searing pain shot through my pelvis and continued through my testicles all the way up through the tip of my penis. It honestly felt like someone stabbed me with a sword. I screamed with my teeth clamped so tightly on the nitrous tube I thought I might bite through it. My hands tightened into fists and I involuntarily straightened my arms and my fists slid to my thighs. Subconsciously I leaned on my right ass cheek, probably from an instinct to escape the pain piercing through my left side, and my left leg stiffened and I brought it up out of the stirrup.
“Oh, Mr. Reimert, you need to keep your hands on your chest,” nurse Jenny said.
I pulled them slowly back up to my chest and released the tube from between my teeth.
“Fucking hell!” I said, “That…hurt.”
Even though I was staring at the ceiling I could see Dr. Sulek and Dr. Pickle in my peripheral vision give each other a look.
“Maybe we should give the anesthesia another minute,” Dr. Pickle suggested quietly to Dr. Sulek.
“Yeah, we’ll give this anesthesia another minute before we do the next one.”
I didn’t say a word. I was trying to catch my breath and stop my hands from shaking.
“I don’t know if it means anything but you’re doing really well,” nurse Jenny chimed it.
“Not a damn thing,” I snarled and placed the nitrous tube back in my mouth, although I really don’t know why I bothered.
Now dr. Sulek slowly rotated the ultrasound to get better images of the other side of my prostate and I released several farts. I wasn’t even embarrassed about it and I actually hoped I had made a mess to exact some kind of infantile revenge. Now I also knew that enemas don’t eliminate gas.
After what felt like the shortest minute in history, Dr. Sulek resumed his torture. Part of me wondered if he got mad because I snapped at his nurse, but I didn’t really give a shit if I hurt her feelings at that point. I was pissed. “I promise, you won’t feel a thing,” went to feeling EVERYTHING.
“Okay, one more big stick here, Mr. Reimert,” and now pain shot through my right side as he rammed the needle in like a Civil War soldier re-loading his musket. Although the pain was not as intense as the left side, it still nearly lifted my whole body off the table. Either due to the anesthetic kicking in a little more or the fact I think I was slipping into some kind of shock, it didn’t hurt quite as bad. It did hurt, however. I’m not trying to say I didn’t feel anything and my fists once again involuntarily slid down to my thighs as I growled profanities into the nitrous tube.
“Mr. Reimert, please keep your hands on your chest,” nurse Jenny chided.
I pulled them up again, but my left leg still remained hovering over the stirrup as it had since the second shot. I couldn’t seem to relax it quite yet. Dr. Sulek removed the ramrod from my pelvis and I growled again as the stabbing pain followed the needle. I relaxed back onto the bed as Dr. Sulek readied needle number 5.
Now nurse Jenny hurried around the bed to my side, I presume to stop my fists from moving off my chest. Dr. Sulek warned of one last stick and he poke it into my taint and I felt something spread deep inside my rectum. I grabbed my shirt this time as my body stiffened in reaction to the pain, but I was either too tired or in too much shock to growl or curse again.
As he slid the last needle out, he pulled the ultrasound out of my ass like he was trying to start a lawn mower. What the hell was his hurry? I felt the lubricant and God knows what else follow the ultrasound out of the orifice it had been lodged in and stream down my ass crack and onto the bed.
Good, I thought to myself, I hope it made a big mess.
I heard his voice again, “Well we’re all done here now, Mr. Reimert. Nurse Jenny will get you cleaned up and then your free to go.”
And that was it. Not another word out of the guy. No apologies for the level of pain. No post-operative instruction. Not even a fuck you.
Nurse Jenny did her part and I lay there still staring at the ceiling while she cleaned me off. When she finished, she covered me with the towel and told me I could sit up and offered me her hand. I took it and pulled myself up and immediately pulled the towel off myself. It had barely been there so far, why start now? I had gotten very hot, all of a sudden, and I like the cool air.
I sat there for a few minutes naked from the waist down while nurse Jenny stood in front of me staring at me. She finally walked off behind the current and I gathered my wits about me. I used the bit paper towel to wipe my ass off just in case Nurse Jenny had missed anything, then I stumbled to my feet and got dressed.
I took one more deep breath and turned around to grab my phone and glasses.
“Oh yeah, don’t forget your stuff,” Nurse Jenny was such a help.
I groggily stepped towards the door and nurse Jenny lead me outside.
“The exit is down there,” she pointed to a brown door at the end of the long hallway, “You did really good in there today.”
Fuck you, Jenny, I wanted to say but somehow restrained myself. I slowed down and half turned to her and growled, “Thanks” at the wall.
I emerged into the lobby and my wife jumped to her feet and grabbed my coat. I took it and wobbled a little, breathing deeply and running my fingers through my hair.
“Are you okay?” She asked, concern wrapping the words and her face.
“I just want to get out of here,” I told her, “I don’t care what they said, that hurt like hell,”
“So you could feel something?”
“I felt EVERYTHING,” I growled again, “I’ll tell you the rest in the car.”
I filled her in on every detail as we drove home. By the time we got there, she was as angry as me and wanted to drive over to Sulek’s office and give him a talking to. I told her that he usually called a day or two after the procedure, so I would express my misgivings then and she shouldn’t have to worry about it. We were both pissed off all night and I vented about it several times to her, my family and my closest friends.
That was two days ago. Not a word from Dr. Sulek or his office since. No calls or attempts to see how I was doing. Nothing. I even fired off an e-mail to him, which also has not yet received a reply. This whole thing has caused us to suddenly consider firing him and finding a new urologist. There better be some good conversations soon, because if not, that was exactly what was going to happen.
Tomorrow I would have my treatment simulation, so at that time I figured I would talk to my oncologist about it to get his opinion since he also did this procedure. I would ask him what pain level he expected when he did it and probably get to show him the two large, black bruises that had emerged below my scrotum from the injection sites. I figured he could tell me if those were normal, too. One way or the other, we would be getting some answers soon on how I went from being told I wouldn’t feel a thing to being in agony as I lay on that bed. Someone had a lot of ‘splainin’ to do.