I’ve just taken the longest break from running since I started back in August of 2010. I usually run (train) 5 (sometimes 6) days a week. I have a full race calendar planned and I never like to finish a race without my next one scheduled. I’m the guy that when you ask what I am doing a few months from now I check my training calendar first.
This post is going to be a little long, a little graphic (descriptive not visual) but it does have a happy ending (thankfully).
My work medical insurance plan covers an annual physical. Since I started my journey to fitness I have been very steadily recording my activities, managing my weight and trying hard to maintain a healthy lifestyle. A little bit of family history also has led me to making sure I take the opportunity to schedule these annual physical exams which I do every year now around my birthday.
This year I made my usual plans, blood work just before my birthday and the exam a week later after my birthday. That way I can have year on year comparisons on my health. I should point out that I have (thankfully) a doctor who is alert and maybe a little conservative. Based upon some family history he has started some preventative screening of the prostate at 40 rather than 50 as is recommended.
So the day arrives of my physical exam. My resting heart rate thanks to all my changes in lifestyle is 42 beats per minute. All the blood work looks good, the Prostate-Specific Antigen (PSA) test is low (0.5ng/ml). Finally we get to the ‘physical exam’. The doctor puts on his rubber glove, looks and me and says ‘Drop ’em”. Okay guys, it’s not as bad as you think. It is usually over in a few seconds. Well….usually it is. I wasn’t sure why it was taking so long. I almost asked if he’d lost his keys or something!!!
As I was getting myself back to normal states of dress he tells me that he feels some type of abnormality and wants me to see someone to get it checked out further. Okay, no problem. Better safe than sorry. He refers me to a local urology practice at the hospital and I make my appointment which is set for the following month. I left the physical exam a little concerned but I tried to not think too much about it. I couldn’t do much at that point as this was a preliminary exam and I hadn’t seen a specialist to confirm anything yet.
On the day of the appointment I head over to the hospital with all the paperwork complete and sit in the waiting room for what seemed a very long time. When it’s my turn I meet up with the nurse who goes through all my paperwork and preps me for the doctor. Finally I get to meet the doctor. That day I was wearing my Philadelphia Marathon shirt and he mentioned he had run the race one year too. Cool. I think I’m going to like this guy. Anyway, on with the exam.
So mentally I’m prepared for the exam knowing that it might be a little longer than usual. I assume the ‘position’ and wait for it to finish….but whoa!!! The picture below doesn’t quite capture my expression but I thought at some point he was going to hand me a banjo and ask me to sing the ‘Rainbow Connection’!!!
Here is the scene playing out in my head as this is happening.
So the doctor also detects an abnormality, tells me he agrees with my family doctor’s concerns and decides he wants to send me for some further testing. He tells me that my options are an ultrasound, and MRI and ultimately a biopsy. I wasn’t really prepared to hear that final option but at this stage the doctor had the upper hand (ooooh…that’s a bad reference). Based upon my age he wants to do the test sooner than later and recommends I get the MRI which might provide more info. Okay, now I start to feel a little more concerned. I left the appointment with the doctor’s office telling me they will call with the details to make appointment for the MRI.
A few days pass and I follow-up with the doctor’s office about the appointment. Nothing yet. So I wait a few more days and still nothing. I’m eager to get this test done and behind me so I follow-up another time and this is when I find out that the insurance company had other ideas saying that at my age the MRI wasn’t necessary so after about a month of back and forth between the doctor and the insurance company the doctor says that we should just go straight to the biopsy and tells me my options.
The biopsy procedure requires the doctor to insert a needle into various places in the prostate 12 times and take a sample of tissue each of those times. The needle would be inserted ‘Jim Henson’ style. I had the option to do this in his office which will take about 10-20 minutes while I was awake or do this under anesthesia in the hospital. Guess which one I chose!
With the New Jersey Marathon a couple of weeks away (April 27th) I asked him if we could wait until I had run the race and I would take his first available appointment the following week. He was fine with that, actually he recommended that, so the date was set for April 30th.
The week before the biopsy was scheduled I had to do some pre-admission testing. Simple blood work and checking medical history, height and weight. They also provided me with pre-admission instructions which generally include no food after midnight before the procedure (not a major issue) and no anti-inflammatories or other meds or supplements that could thin the blood for up to a week prior to the procedure. Hmmm…didn’t I say something about a marathon?
As I mentioned in my previous post (the New Jersey Marathon race recap) after the race because I was unable to take any anti-inflammatories I relied on an ice bath to reduce post run inflammation and a couple of days later (the day before the procedure) a took a brief 3 mile run to keep loose. I was able to keep loose but I was still just a little sore.
So the day of the procedure arrives. I spend the time waiting for my ride to the hospital pacing around the house. I hadn’t had my usual morning coffee and I was feeling antsy. I had to be at the hospital at 10:15am and I was dropped off a little early and was sent pretty much straight away into pre-op. I got myself my fancy ID band from the nurses and was provided with the always awesome backless gown. The last time I had one of these plastic wrist bands I was at Disney and got a few medals. Not this time.
So having got changed into my stylish surgical outfit I brought out the decoy…yes, I figured I could provide the doctor with a substitute so I didn’t have to have the needles. Neh…didn’t work.
So I sat in my gown from about 10:30am until about 12:30pm with occasional visits from the nurses, the anesthetist, the surgical RN and the doctor. Funny that when they all came in to take my vitals they looked at the charts and said “Oh, you’re a runner” as they noticed the low heart rate. I was feeling proud each time they said it. The anesthetist told me essentially he was going to put me unconscious. I was okay with that. The doctor also came in and repeated what the procedure was going to be. He checked that all the pre-op checks were done and that I had my IV with fluids, the antibiotic ready in the IV to be administered during the procedure and that I was ready to go.
The surgical RN came in to get take me to the operating room and administered a pre-anaesthetic sedative (basically a ‘Valium’ injected into my IV line. Having got my buzz on I let the nurse take me in for the procedure. As I entered I was already a little woozy, I heard someone say the word ‘propofol’ (think Michael Jackson) and then nothing else. The next thing I know they are waking me in the recovery area.
I was told by the doctor that there would be no pain as the procedure was localized to the point and duration of the needles being inserted but there may be some bleeding in my ‘fluids’ for up to a week later. Fine. I think I can handle that and at least I knew what to expect. I was still lying down for the most part until they took me back to the post recovery area. The nurse there made sure I was able to sit up and offered me some food and drink and called my father in law to come and pick me up. All good.
When I felt okay I told them that I thought I was ready to go. They came and removed the IV from my arm and left me to get dressed. It was at this time that I stood up from the bed and asked where the bathroom was. I walked across the hall to do my stuff (I had been pumped full of fluids through my IV) as I felt the need to go. So, like a guy, I’m standing there and….nothing. What? I totally need to go but nothing happened. Eek. Next thing I know I’m seeing drops of blood but nothing else. I call the nurse who takes me back to my room and tells me she will call the doctor.
I’m just a teeny but worried now.
I tell her that the doctor said there may be a little bleeding and so I thought I would try again so she took my back to the bathroom. I’m hoping this was just a post op effect and I would get over it and be able to go home shortly, after all I was in the middle of being discharged at this stage. So I’m back in the bathroom standing there and praying to go. I dug deep and tried very hard to ‘Let It Go’!
Nothing but a few more drops of blood.
I went back to the nurse and she told me to lie down and called the doctor again. The nurses station was right next to the room I was in and I heard for the first time ever a word used in the same sentence as my name. Something I hoped I’d never really have to hear. That word was ‘Catheter’ and the doctor had just suggested I have one!!!
The nurse looking after me asked a male nurse to set this up for me as she felt I would be more comfortable with a male nurse. At that point I wasn’t comfortable with any nurse doing it quite frankly. Not knowing what to expect but knowing where to expect it I was quite a bit more than just anxious. The male nurse came in with the kit and all the related paraphanalia. He said he does this all the time and hasn’t had any complaints. I didn’t find out until after he was done that he was an OR nurse and that, yes, he does this all the time but the patients are all asleep when he does it so that’s probably why he hasn’t had any complaints. I will say though that he moved so darned quick I didn’t even have chance to catch my breath and before you new it I was…well, um…connected!?!
This is probably what I looked like right about now.
The discomfort however was overtaken by the relief that my overly inflated bladder was now under a lot less pressure. Then just like that my father in law walked in, took a look at me and looked confused as to why someone had called him to take me home. He saw the predicament I was in and decided to tell me he would wait outside for a little while. Good choice. I wasn’t going anywhere for right now. For the time being I was hooked up to a bag and producing some ‘fine wine’ by the bottle or something that pretty much resembled it 😦
The doctor eventually came back to see me. He checked my fluid lines and mentioned that in about 3% of cases there may be a chance of complications. Hey…what can I say, I’m special. He told me that he would give me a little time to get some fluids through me and that they would provide me with supplies and tell me how to use the catheter when I got home. WHAT???? I was going to need this when I got home? Ummm….I have two boys at home. I’m not going home all tubed up!!! My eldest son would very probably keep his distance, my youngest on the other hand… Let’s just say that when we recently visited the New Jersey State Museum in Trenton he saw the sign ‘DO NOT TOUCH THE ARTWORK’ as a challenge. He’d see the tube and…I shuddered to think 😦
The doctor left and my father in law came back into the room to sit with me. It was around this time that I started shaking. I got really cold and could not stop shivering. The nurse came in and put an extra blanket on me but that didn’t seem to stop the shivering. Next thing she came and put some heated blankets around me, wrapping my head and shoulders and turned on the heat lamp above the bed. We were not sure if it was due to all the fluid and the ice water I was drinking. She took my temperature and it seemed I had spiked and my temperature was now over 100 degrees. She called the doctor back and we waited for him to come by. She provided me with a cup of coffee which I was shaking so much my father in law feared I would spill it. Not good.
The doctor came back and checked me over again. He decided that the fever was a result of me being in that special 3% of complications and I had picked up some form of infection during the procedure. He wasn’t happy with the ‘wine’ I was still producing and subsequently had the nurse give me a new IV line and presribed more fluids and a dose of antibiotics. Additionally I had some blood cultures taken for the lab to check. My arm felt like a human pin cushion at this stage.
The doctor determined I should be admitted overnight for observation. Secretly I was more than relieved that I was going to not have to go home with the catheter that night, but for good measure, he put some ‘traction’ on the catheter and said he would check on my later. Guys, if you weren’t squeemish before, traction entails pulling the tube taught and taping it down so there is tension. My eyes are watering again just writing that last sentence.
So there I am. Not going home. I had planned this grand day of going home and watching DVD movies with my feet up. Now I am admitted into the hospital with a fever and my own personal water feature. When life gives you lemons…make red wine!!!
My wife had called my father in law while the doctor was in the room and so she had a chance to speak to him in case she didn’t see him later. Between my wife and father in law, arrangements were made to pick up the boys from school and stay with them at home so that my wife could visit.
I’d taken a couple of tylenol by the time my wife had arrived so the fever had broken but I didn’t feel particularly well when she came it. I was pleased to see her but wasn’t exactly comfortable with my tube in traction. Once she arrived my father in law bid me well and left for the night. We sat waiting until there was a room available. It was a looooong wait. I think the call to admit me was around 4pm. I didn’t move out of that room for almost 4 hours. Luckily my wife brought her own entertainment (in the form of arts and crafts for our son’s 4th birthday party) while I sat uncomfortable and bored. I hadn’t moved in hours and my wife pointed out that my feet were hanging off the end of the bed as I was too big.
At long last a room opened up and by 9pm that night I was wheeled across a very bumpy route (traction or no traction the bumps didn’t help) and finally made it to my room. Finally I was in a bed where I could support my feet and I veeeeeery slooooowly moved across onto the bed so as not to jiggle my tubing.
My wife bid me good night and the nurses on the floor started the whole admittence procedures which pretty much involved taking my vitals every 30 minutes through 4am!! Not that I got much sleep that night. I was over tired, I was a little sore, I was too terrified too move with stuff hanging out of the sensitive bits and I was a little concerned about the biopsy results (yeah…rememeber that?) I was also pretty freaked out that there was still the possibility of me going home like this with my two boys (the Heir and the Spare) lying in wait to see me. Additionally I was being pumped full of fluids so much that I pretty much felt like Niagara Falls.
As the night progressed I listened to (and caught up on) podcasts that I had stored on my phone. The nurses came in every 30 minutes to check my vitals and to empty my ‘wine bag’. We had now moved from a deep claret to fruit punch (in volume).
This same cycle happened over the next few hours and I was pretty much awake most of it. At one point the lack of movement, the fact that my feet had been somewhat unsupported most of the day and probably the after effects of the marathon finally caught up with me and at around 2:30am I started cramping up in my legs really bad. I called the nurses who wrapped my legs in compression sleeves that alternatively inflated and squeezed my lower legs for while I was lying there. Nice. I wanted a pair of these at home for after my long runs.
The next thing I know it is around 6:45am and I open my eyes to see the doctor visiting and inspecting my ‘tube’ for signs of progress. Overnight I had flushed Lake Erie through my system and I was starting to look ‘pink lemonadish’. This was a good sign. My vitals had also stabilized although my pulse was still a little high. The doctor told me he would check back on me around noon. I confessed I was concerned about going home with the catheter around my sons and he said if all goes well I would have it removed before I left and they would keep me in under observation until that time arrived. Phew. I immediately felt a little more relieved (although I should not use the word ‘relieved’ considering everything else that was still going on).
I settled in for a long morning which actually passed by pretty quick. The doctor’s assistant came over at noon to check on me and was very pleased with my progress that morning. She whipped out her iPhone to take a picture for the doctor (I know what your thinking but the picture was of the fluid…not the connector) and got a text message back that it was okay to ‘disconnect’ me. Woohoo!!!! I wasn’t jumping for joy physically but mentally I did a triple backflip with a double twist and stuck the landing.
They sent in a male (student) nurse to do the honors. He said he would uninflate the catheter and then a quick pull. If there was any tension when he pulled he would stop. I closed my eyes and he told me to take a deep breath. Before I knew it (actually I knew it) it was out. Phew. Finally I was able to sit up and move my body a little. Once they get me unhooked from the compression sleeves the nurse helped me sit up and get out of the bed finally. For someone who leads an active lifestyle not moving for more than 24 hours is tough. I got out of bed and sat in the chair just as they brought in lunch. I was still hooked up to the IV and receiving the antibiotics and fluids but was much more comfortable.
The goal was to have me ‘go’ naturally until they knew I was able to go consistently. So in addition to the IV fluids I was drinking mass quantities of water. Around 3pm the doctor’s assistant came back and checked me over. I was pleased to show her my current state which was as good as it gets.
With that I was told I could get dressed and they were going to discharge me and send me home with a prescription of antibiotics and instructions to continue drinking for the next few days and return to visit with the doctor the following Friday.
I got home and immediately started drinking. I didn’t want to have to go back any time soon. All I can say is that I drank so much that night that I was up every hour and each time before I got back into bed I drank another bottle of water. When I weighed myself the next morning, figuring I’d hardly eaten in the last couple of days I had probably lost a pound or two, I was surprized to find I had gained 6lbs…all fluid!!
The next day I took it easy and logged into work from home. Drinking constantly. I must have been taking in more than 4 liters of fluid (that’s about 8 bottles of water…a little more than the average 8 glasses a day). Later that morning the doctor called and told me that he had been contacted by the ‘Infectious Diseases’ department….did he say ‘Infectious Diseases’? Apparently I had picked up another infection and so he prescribed another set of antibiotics for me. This set of meds came with a warning label that was pretty much a bio-hazard warning on the safety label. Eek!!
What made me laugh was that the instructions said to take with lots of water LOLOLOLOL!!!
That afternoon I went to pick up both my boys from school. As I was about to leave the parking lot the doctor called. We hadn’t expected any pathology reports until the following week but he wanted to call me as soon as he had received them. It was good news. All the tissue samples came back NEGATIVE. I was very very relieved. All this other stuff seemed unimportant at that moment. I thanked the doctor and immediately called my wife with the good news and them my parents and my in-laws. Everyone was, needless to say, relieved. The doctor did add that there may have been some contamination in one of my blood cultures but he would let me know more on Monday.
I went to bed early that night. I was pretty tired after the last couple of days. I did feel a little sore. Kind of like I had sat on a bike for too long. I didn’t think too much of it and fell asleep pretty easily.
The next day was opening day at Sesame Place where my wife works. I had to continue my streak of 12 opening days (my eldest son is 7…don’t judge me). I hadn’t planned on doing any rides but just to walk around with the boys. I took in a couple of shows but just didn’t feel right. Finally I reached out to the doctor to see if I could take anything for discomfort. He told me tylenol was fine, take a warm bath to relax my pelvic muscles and he would check in with me later. I had a slight recurrence of my ‘pink lemonde’ post warm bath (which is waaaaaaay better than an ice bath by the way) but returned back to my pure ‘Evian’ state with much fluid later.
Taking it a little easier on Sunday I decided that if I needed to see the doctor on Monday regarding the contaminated blood culture I would work from home so I was 10 minutes away should I need to have more blood work. Late morning on Monday the doctor called and told me that yes the blood was contaminated but it was some of my cells and that I could stop taking the second antibiotic (you know, the biohazard one). Phew 🙂
So this week I was really focused on my Fitbit….I had to earn my food calories somehow. It’s amazing what I used to take for granted running all the time. It takes a lot to reach 10,000 steps everyday. I barely made that number some days (which did involve a secret trip up and down from the basement a couple of times to make my goal). I’ve also been much more careful with my daily intake of food. When training I can get pretty ravenous. I had to exert quite a lot of self control this week. I’ve only been (slightly) under my daily calorie allowance twice during the week.
My other activity during the week is logging into my medical insurance account and waiting for the bills to hit. Somehow I have a feeling that there may be a little more pain to come 😦
My follow up appointment with the doctor was on Friday afternoon. I had been antsy all week without being able to run. I had tried my very hardest to rest but I couldn’t sit still. I ended up taking daily walks around the campus where I work to try and get in at least a mile or two just walking. I was hoping the doctor would clear me to run…I kind of anticipated this and actually went to the appointment in my running gear hoping that he would say yes and I would then drive to the nearby park and get some distance in even if it was just a slow 5K.
The doctor laughed when he saw me in my running gear but said everything looked okay. I have to go back in 6 months for a check up and another PSA blood test but I’m good to go. So I set up my appointment and jumped in the car and drove straight to Core Creek Park and ran 4 miles!!! 🙂
It felt great to be back. I’m a lucky fellow for sure. I have to thank my family for being very patient with me the whole week and I think we are all relieved that 1) I’m okay and 2) I can get out there and run again and not be such a grump!!
Thanks for reading.