The first entry in Keith Reimert’s blog series in regard to his experiences and thoughts as he battles prostate cancer. You can see the entire series by going to the Index page
The Day it All Began:
“You have prostate cancer.” The doctor said it in that matter-of-fact delivery that you would expect from a doctor. After all, unless it’s General Hospital or the doctor is a personal friend, there isn’t going to be a lot of emotion to it.
Early February of 2023 was unseasonably warm. And even warmer in the doctor’s office discussing my results. My PSA (Prostate-specific Antigens, heretofore only listed as PSA’s because I’m not typing that out every time) had been on the rise the previous two years.
They check those with blood tests once you hit over 50 because, apparently, they always need to look for more reasons to find things wrong with you as you get older. A.K.A. annual checkups. Yeah, I know they are necessary and it helped catch mine early. But, seriously, other than finding more things wrong and making you feel guilty (you could stand to lose some weight, Mr. Reimert. How many drinks do you have a day?), why else do we have them?
According to these tests, my PSA’s had risen from 3.2 to 3.7 to 4.3. Not good and a fairly steep rise in two years. Not over the top numbers, but a steep enough rise to cause concern. And something the even more popular “bend over” digital test from my PCP might not always identify. In fact, if the first warning sign about prostate cancer presents itself is because a doctor can feel it with their finger, it’s already more advanced than it should be.
When I had that rise in PSA, my PCP sent me to a Non-invasive urologist, Dr. Jay Sulek. I certainly liked the sound of “non-invasive.” I mean I was only 55, so I’m thinking I’m too young for this crap. It’s just my body acting out and of course I don’t have cancer. Don’t be ridiculous. And I have a phobia about surgery, anyway, so the thought of having my prostate cut out was not at the top of my list. I’d had two good friends who had that done in the past 4 years and they both had side effects I wanted no part of. But we’ll get to that later.
When I met Dr. Sulek, I liked him right away. He did tell me about the preferred non-invasive approaches if I did have cancer. And that most times prostate cancer was very slow-growing and something that we might not have do anything about for years or possibly ever.
Then he asked, “would you mind if I check your prostate?” Which in doctor speak means do you mind if I put my finger up your ass? So much for non-invasive. I mean, how do you answer that? Of course I mind. I’m really not into that, dude, but I guess I really have no choice. So after what felt to me like we re-enacted a scene from American Me (why do all these doctors have such big fingers?), he told me he didn’t feel any lumps or bumps. So far so good.
“So we’ll need to get you set up for a biopsy, however. That’s the only way to really rule it out.”
Now my heart jumped. Panic started to well up and I found myself a bit shocked. I really didn’t expect that as the next step. But I don’t know what I did expect. Maybe more blood tests and more fingers up my ass, but not needles or surgical tools.
I left the office being too shocked to really ask enough questions, so I made the mistake of just doing my own internet research on what a prostate biopsy would really entail. These searches talked of spring-loaded needles and being awake during the process that created images of medieval torture chambers run by sick perverts who enjoy causing anal damage. How different could a spring-loaded needle be from a jack-hammer? Sounded the same to me.
My wife, who was as concerned as me, also had some questions, but I had no answers. She stood by me from the start and helped in a lot of areas that I didn’t often excel. Like paying attention to everything the doctor said, taking notes or asking questions. She amazed me at her ability to concentrate on the big words the doctor said when I just completely zoned out. She was always there for me. The ying to my yang. But she had not been there at this first visit, so I kept doing research on my own.
But doing this research really didn’t do any more than put the fear of God in me about the process. Talk of local anesthetics applied in my rectum and a needle blasted either through the rectal wall (called transrectal) or through my taint (called transperitoneal) both sounded awful. After freaking myself out with questions and worry and a few days internet research (and only for a few minutes per day), I finally had to step away. It really only made things worse and gave me way too much anxiety. Little did I know that would not improve.
The good news was there had been no hurry to perform the biopsy. After all, my youngest child was only a junior in high school and I was the main equipment dad for the Marching band, as I had been for eleven years, and couldn’t have something silly like prostate cancer interfering with that. Not at least until he graduated. The doctor’s office called and we set the date for January, 2023, which gave me four more months to agonize over it.
Time flew by, as it always does when something is coming you aren’t looking forward to. Like a root canal or a vasectomy or any number of things I’ve already had done. The office calls you the week before two different times. One call to tell you not to eat or drink because you are having anesthesia and to make sure you have a driver. A second to tell you how much you owed and when you had to pay it. My part for the use of the office itself was $1200. There were also more bills later that they tell you to expect, but never having had this done before, I figured they couldn’t be that much. Another stupid conclusion to jump to.
And I didn’t ask if I would be completely knocked out by this anesthesia. I assumed I would since I wasn’t allowed to eat or drink, but there was still a lingering doubt. I continued to fret with visions of jack-hammer needles ramming through my taint 19 times. They did at least tell me I would have a peritoneal biopsy and I actually found relief in that. If they went through my rectum I figured it would bother me every time I took a shit for the next few weeks, so, hey, one less thing to worry about.
I remember the morning of the procedure it was cold and there were actually some snow flurries as my wife drove me to downtown Nashville. The office itself was very large and busy. Many people sat and waited their turn. I walked to the desk and they asked me my name, my birthday and the reason for my visit. Next they took my money and gave me a wrist band. Neato, a $1200 plastic wrist band.
Waiting for my name I actually stayed pretty calm just hoping to get it over with already. It was almost lunchtime and I was hungry. Plus my wife was at my side holding my hand and ready to help me through it all. Occasionally she looked at me and asked, “How you feeling?” Surprisingly, I really did feel fine.
They called my name and told my wife she could come along, or wait in the lobby. Of course she came with me and I wanted her to, although I’m a man so I had to act tough so I told her it was up to her, but thankfully she didn’t hesitate. I would need to hold her hand just a little more.
Down a little hallway the room expanded to a large rectangle. They usher you off to a curtained off area, about 4 times as big as a voting booth, I think, with two chairs and an IV inside. There were at least 10 of these little areas all surrounded by curtains and a couple hospital beds that I could see, too.
After stripping down to my glory and covering myself with a very stylistic gown, which my wife had to tie for me, and a pair of ugly socks with plastic traction, I had a seat. One thing that had struck me since the time we entered the building was that it wasn’t just men who were there for procedures today. There were some women there, too. As I sat there, a young blond in the same gown and socks shuffled past the opening in the curtain. That made my heart sink as I realized that she was probably there for far more serious concern than I had. And it also helped make me realize that, at least as far as serious cancer concerns go, I was pretty lucky. We had caught it early.
Next thing I knew a nurse whisked in with a clipboard. She asked me my name, my birthday and the reason for my visit. Then she verified a little bit more info from their records and told me she would be the one “wrapping me up” (wrapping me up? What the hell did that mean?). Next she put in my IV and then she was gone.
Next came the anesthesiologist who, much to my shock, asked me my name, my birthday and the reason for my visit. After successfully answering these questions for the third time, he told me the anesthesia would act quickly and assured me I wouldn’t feel anything. Sounded good to me.
Now Dr. Sulek came in. He did not ask me those questions but he did tell me what to expect from the biopsy and after. Gave me the warnings about blood in my pee, semen and feces but that none of that should last too long. After presenting me with a lot of info about potential side effects or problems and what to do if I have them, he left.
As we sat there waiting, my wife and I made some jokes about my gown and engaged in small talk that helped ease my mind. One thing we had in common was that we loved to laugh, no matter the circumstances. Something else I love about her. She always seems to “get me.”
It was about that point that we realized there was an older couple (older than us, any way) in the voting booth next to mine. I even heard a conversation with the nurse where they proudly announced they had been married 50 years. The nurse left them and we heard them engage in small talk, little jokes and some giggling. My wife and I eavesdropped and got some chuckles out of it, and somewhere in my own mind I thought, “I bet that will be us in 20 years’, although I hoped not in a hospital setting.
A few minutes later, which seemed like hours, the nurse came back in, grabbed my IV and said, “Ok, let’s go.” I gave a quick smile to my wife and then I followed her to a small room with a gyno style chair to my left and a lazy boy style chair to my right with a pee pad on it. More to look forward to, I could tell already.
The nurse made me sit at the end with the stirrups, lay back and immediately put my legs up in them. Even without a vagina, I suddenly had a much better appreciation for what women go through annually. She wasted no time in exposing my goodies to what felt like the entire world, even though it was only two people, and she started touching me. This was significant at the time because no other woman than my wife had touched my genitals in over 30 years. It freaked me out a little bit. She pushed them back against my pubis, took a wide piece of medical tape and strapped it behind my boys, pressing it so it stuck even with my pubic hair in the way, and proceeded to pull the tape as hard as she could (at least it felt that way to me) and taped it all down to my stomach.
“Don’t worry,” evil nurse whatever-her-name-was muttered through her mask, “We’ll take this off before you wake up.”
She obviously had a vendetta against testicles.
The image of the dad from A Christmas Story getting the bowling balled dropped on his nuts and replying with a falsetto, “Thanks a lot” popped into my head, but I didn’t have the wherewithal to utter an imitation. Wish I would have.
The doctor came in and started getting a gown on himself. Now my heart started pounding. Would I feel anything? Would my worst fears come true? Would a humpback man with a gimpy leg and eyepatch hobble in with torture devices?
The anesthetist took his turn. First he strapped a thin, clear tube around my head the plugged into my nostrils and informed me it was laughing gas.
“Okay, Mr. Reimert, I’m going to make you sleepy now.”
New fear unlocked. “Sleepy?” I asked frantically, “How sleepy?”
‘Sleepy’ to me just meant drowsy or not quite all there. It could mean a lot of things.
He seemed perplexed by my question and just said, “All the way.” And my fears were once again relieved. However I didn’t quite go out right away, maybe due to the adrenaline. I could feel the anesthesia begin to make my eyes go goofy, but I still was not asleep.
“How we doing, Mr. Reimert?” Dr. Sulek asked.
“I’m not asleep yet!” I replied immediately.
“No worries,” he said evenly, “We’ll give it another minute or two. We won’t start until you’re out.”
An eternity later I’m waking up in another room, sitting on a lazy boy type chair on something that felt wet. As I regained consciousness, I found myself genuinely impressed that they could get me from the bed to the lazy boy and all the way to another room and I never woke up. My wife sat next to me, my feet up on the recliner and that strange-feeling wet paper underneath me. Had I pissed myself, too? Surely not. Much to my relief it was just a blood stained pee pad from the 19 injections that had been pushed through my taint.
A nurse came in as I got more of my faculties about me and told me I had to pee before I could leave. And I had to pee a certain amount. She told me a second bag of IV had been placed in the stand to help me, but she also asked what I wanted to drink. Having nothing to drink for about 13 hours now, I had developed quite a thirst. I asked for a coffee and a coke and tried to let nature take its course. It took frustratingly longer than I hoped it would, which wasn’t easy on my wife. They hand you a clear, plastic pitcher and you have to urinate to a line drawn in it with a sharpie. And you are supposed to wait until you fill it above the line or you need to start over. You have to fill it all at one peeing or it doesn’t count.
The thing is, the multiple injections and medieval torture done to you while asleep creates a pressure on your bladder so you feel like you have to pee, but you don’t. You have to be patient, which I am not. After about 30 minutes I was getting pissed about not being able to piss, plus I was really hungry now, but the blessed moment finally happened. It’s kind of a strange feeling to be so proud to hand a nurse your full pitcher of fresh pee, but here we are. After completing that final task, we ventured on home. All told I was probably there only about 2 hours.
A week later Vicki sat with me again but this time in the waiting room of my urologist. We sat there for an infuriatingly long time. We were obviously the last appointment of the day (5:30) because everyone else was gone by the time they called us in over 60 minutes later. We sat down and now waited another 30 minutes for the doctor to arrive. I tried to remain even keel and Dr. Sulek did apologize multiple times for our wait, so what could we do? He didn’t mince words about the results and got right to it. He reviewed the tests for 19 core samples and gave us some medical jargon that didn’t all make sense to me, so he summarized it quite simply.
“Most of your cores came back benign, but there are some that carry adenocarcinoma.”
It didn’t quite register, so he came back more directly.
“You have prostate cancer.”