Is The Prostate Biopsy Exam Multiple Choice

Over the last twelve months, because of appointments with specialists, different procedures and scans, and fortnightly immunotherapy treatments, I’ve spent, on average, at least two days a week at the hospital. The excision of a melanoma tumour and lymph node, ongoing infusions, blood draws, multiple Ultrasounds, MRI and PET scans, and the removal of skin lesions has conditioned me to be no longer surprised by most medical environments and strange surgical tools. I’m no longer surprised at being ushered into a strange room partially lit by a dull blue glow emanating from a beast-like, humming medical appliance. But I’m still uncomfortable, though no longer overwrought when wheeled on a hospital bed into a well equipped operating room or scanning suite.

image source: jmcadam

Although I no longer felt uneasy at the sight of freakish medical machines, and with my inner child was unfailing in telling me stainless steel medical instruments were never designed to cause pain and suffering, I was still apprehensive about the upcoming procedure to have samples of suspicious tissue removed from my prostate. I was told it would be painless because it was standard practice to numb the area during the procedure. The day before it was to happen, I received a call from the hospital telling me the apparatus had just broken down and they were waiting for new probes to be delivered; they would reschedule the biopsy when they arrived.

When the procedure was first scheduled, I never gave it a second thought as to how it was done, so the mention of probes sent my brain into overdrive. In no time, I was suffering mental exhaustion and did what I had vowed never to do. I turned to the Google machine. Whenever you’re freewheeling the Net, it’s a challenge to stay clear of the chatbots and armchair experts. And if you’re searching for medical procedures and surgeries, you’ve got the problem of symptom checkers. How do you trust a checker that tells you when you fill in a couple of symptoms about a headache that you’re suffering from mumps or a brain tumour?

I successfully navigated away from the chatbots and armchair experts and found several reputable sites describing the prostate biopsy procedure in nanoscopic detail. A thin ultrasound probe and biopsy needle get whacked into your bunghole. The areas of the prostate where they’ll snag samples from are numbed with lidocaine to reduce any discomfort. So I need to remember to remind my dentist when they start to numb my upper gum with lidocaine and adjust the chair that I’m here for a filling and not a prostate procedure. The spring propelled needle gets steered into place by aligning a live-action ultrasound image with an image from a previous MRI scan. When the needle is where it should be, it’s whammo, and it gets fired into the prostate to snag a sample of tissue.

image source: jmcadam

The new probes arrived, and so, therefore, did my prostate procedure. Two nurses ushered me into a room lit by a dull blue glow from a beast-like brooding medical appliance. They asked that I undress from the waist down and drape myself with a towel, gesturing to a side room. When I reentered the blue dimly lit room, it seemed as if it was humming to itself. I heard a soft gasp. The two nurses turned toward me and fixed me with an incredulous stare.

Me: Not a bad awning over the toy shop ah?
Biopsy Nurse:: I’ve never seen that before.
Me: Crikey!!! I hope ya talking about the towel.
Biopsy Nurse:: How did you get it to stay around your waist like that?
Me: Ya wrap the towel around ya waist and then tuck one end of a corner between your guts and the towel. It’s how I used to change into me togs at Willy beach.
Biopsy Nurse:: There were no changing rooms at the beach?
Urologist: Yeah but it was quicker to change by the Lifesavers clubhouse wire fence. That’s where ya bike was. When you finished changing you’d wrap ya undies, shirt, and shorts in ya towel and put it under the pedals of ya bike, and bob’s your uncle.

image source: jmcadam

As the nurse guided me to the examination table, I couldn’t help but look at the tools the Urologist would be using for the procedure. I became fixated on the ultrasound probe; not the probe itself but the slim metal tube attached to its end. It was the same metal tube I’d seen on my prostate biopsy procedure, web searching; it was the barrel of the needle gun. Needles get shot down the metal tube by a spring-loaded biopsy gun and through the wall of your bunghole to snag samples from my prostate. The nurse positioned me on my left side and curls my knees up toward my chest so that I’m now in a loose fetal position. She places a couple of pillows around and under me; the last one between my knees. I feel a gentle pat on my right shoulder.

Urologist: And how are we this morning, looks like we’re ready to start.
Me: Am I numb yet?
Urologist: I’ll talk you through every step. We don’t want any surprises. I’m just doing a little cleaning of the area and applying some gel.
Me: Am I numb yet?
Urologist: Just relax, you’ll feel a little pressure as I insert the ultrasound probe.
Me: Crikey mate, you’re moving this thing around in me bunghole like a rat up a drain pipe.
Urologist: Doing okay? Now you’ll hear a clicking sound every time I collect a sample.
Me: Blimey, it sounds like you firing off a bloody staple gun.
Urologist: Just five more samples to go.
Me: I bet watching that thing moving every which way through me dark bunghole reminds you of the River Caves at Luna Park.

image source: jmcadam

Luna Park Melbourne is a still-operating historic amusement park on the St Kilda foreshore of Port Phillip Bay. I remember mum and dad taking me as a young boy and then as a young teenager heading off by myself or together with some mates to Luna Park. As a young boy, I thought of Luna Park as the most magical place in the world; I was held in wonder by the colour and movement and the sounds and the smells of the attractions. None more so than the River Caves of the World. The River Caves was a gentle meandering little wooden boat ride through different scenes of the world’s landscapes. As a young boy, I never thought of them as sculptured from plaster, paper mache, and chicken wire. The boat slowly carried you through Toy Land and then Eskimo Land. You became spellbound by the odd-looking paper mache misshapen Eskimos staring at you and were unaware of the fan visible through the peeling walls blowing air to simulate a cold howling wind. The current carried you around winding curves to each new scene. And who could forget the Jungle with its garish backgrounds and the paper mache mountains with bears, antelopes, and tigers on the top of them, and its waterfall with a pond filled with flamingos? I didn’t see the holes in the animal’s bodies or their heads falling off; it was the most magical place in the world.

image source: pinterest

As a teenager, the River Caves were still an adventure to me but, they had lost their magic. I remember the recorded safety announcement when you got in the boat cautioning against rocking and that you must keep your hands in the boat at all times. I dutifully obeyed it as a young boy, but as a teenager, I ignored it because you rode the River Caves for two reasons. One was to try and stop the little boat by pushing against the paper mache cave walls and ceiling, and therefore, cause a boat jam in the caves. The other was to get your mates as wet as you could by rocking the boat, and trailing your hand in the River, and splashing water where ever. The second reason was to try and coax a girl into sitting next to you in the little wooden boat. If that happened, both of you knew what was next. As soon as the boat entered the dimly lit cave and rounded the first winding curve, your arm was around her shoulders, and you were in for a pash session before leaving Eskimo Land. You never felt the cold howling wind of Eskimo Land because you were floating through the Tunnel of Love.

image source: flickr

If your adolescent banter hadn’t persuaded a young lass to accompany you on a journey through the River Caves after an hour of trying, you and the mates would head off to The Rotor. The Rotor was a big cylinder that spun passengers at high speeds. When the centrifugal force it generated glued the riders to its wall, the floor dropped away. The timid could watch the antics of the riders as they became glued to the wall from a viewing platform that ran around the top of the cylinder. There were no safety regulations back then, so some would do handstands before the cylinder reached full speed, and others would contort themselves, causing their arms, legs, and hair to fly everywhere. As one of the timid, I kept my fingers crossed there was someone who’d just eaten coloured fairy floss, and they would puke, so I could get to watch green foam splatter back into their face and fly around and land on people. The hope of all the timid teenage boys watching was that the girl’s skirts would ride up and show their upper thighs.

At the end of the ride, the cylinder slowed down, gravity took over, and the riders would slowly slide down the wall to the floor that had magically reappeared. The Rotor was dismantled in 1977 and thrown in the old Port Melbourne tip under the West Gate Bridge bridge; buried just across the Yarra River from where I grew up.

image source: jmcadam

I felt a comforting pat on my right shoulder and the Urologist announces that it’s the last sample, and he’ll talk to me in a few days when he has the biopsy results. A nurse is now standing behind me, I may be a little unsteady on my feet when I get up from the examination table, and she guides me to the side room where I’d undressed. I wash the lubricant gel from the work zone, change back into my clothes, and reenter the blue dimly lit room. As I fasten the Velcro straps on my Tevas, I ask the nurses if the probe had floated past the palace of King Neptune with his bevy of beautiful mermaids.

 

Prostate Biopsy

Luna Park Melbourne

Williamstown Beach

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