It Only Hurts When I Pee Hee Hee
or How to Kill an Entire Summer—Part III
July 8, 2023
10:23 a.m. The day following the surgery, during Doctor V’s morning round: I gained his permission to record on my iPhone what he was about to tell me beside at Covenant Hospital. I later transcribed our conversation for use here:
Dr. V: … type of bladder cancer, but yeah there are other types and variants, but ninety-nine times out of a hundred, it’s transitional stuff.
RJ: Okay, so you caught it early?
Dr. V: Well, yeah, I mean, the CT does not show that there’s anything outside of that, but one of the key things about bladder cancer, you know, it comes from that transitional epithelium of lining of the bladder, but there’s a muscular wall to the bladder, so one of the key aspects of pathology: Is it just in the lining or is it also growing in the muscle …?
RJ: Mm.
Dr. V: When it’s in the muscle, that’s where the blood vessels and lymphatics are, that’s how the cancer could escape out of the bladder.
RJ: Mm.
Dr. V: So the treatment for muscle-invasive bladder cancer as opposed to what we call superficial bladder cancer is different.
RJ: Okay.
Dr. V: Muscle-invasive actually is a much more aggressive disease stage, and the treatment ideally for a relatively healthy man like yourself, is the removal of the bladder. Which is a big operation. Whereas superficial bladder cancer you trim it off, you basically instill… The drug of choice is BCG, it’s a live, attenuated form of TB, it activates your immune system, to counteract early cancer cells within the lining of your bladder, because they tend to be recurrent. By doing that, it’s not really chemo, it’s immunotherapy for your bladder. It significantly reduces your chances of recurrence.
RJ: Mm.
Dr. V: All right, sir. Fill him full. Make sure he can pee [speaking to nurse]. See me in about two weeks is our plan.
But I must return to the day before. I was feeling quite good actually; I never experienced any pain in my bladder. But about four hours after surgery, I began to feel extreme cramps in my bowels. I suspected, as with most surgeries I’ve had, that the anesthesia had locked my bowels. A night of hell ensued, by which I could not seem to make clear to the nurses where the pain was coming from as my stomach appeared visibly to distend. They gave me everything from tramadol to a shot of morphine when I told them my pain was a “10.” I had been hooked up to a foley—a catheter that collects one’s urine in a bag. After the doctor told me I’d be going home, they disengaged it, and the nurses did fill me with water—four glasses-worth. Problem was, my urological innards were locked up, as well—I couldn’t pee!—and they sent me home with a different foley. Two sullen nurses entered the room (their routine with their patients had been disrupted) to install it because my nurse didn’t know how, and they were trying like hell to get me out of that room by ten p.m. So I was sent home with that urine bag saddled to my side like I don’t know what. Six days later, it was finally removed at Doctor V’s office, his nurse following the correct procedure (I shall spare you the description). The only problem was that after six days of that damn foley chafing my urethra, it actually hurt to pee. In situations like this you want to blame someone, but whom? The huffy nurses who might have injured me in their haste? The doctor and hospital who insisted I go home without being able to pee? The insurance company that was only going to pay for one night for a supposedly out-patient procedure?
In any case, starting Wednesday, August 16, 2023, I will begin BCG cancer treatments, once again, in Doctor V's office. Not the hospital! BCG stands for Bacillus Calmette Guerin, a procedure by which the doctor will directly inject (by way of that still handy urethra) a “live attenuated form of TB” into my bladder. Six Wednesdays in a row, ending on one of the last days of summer, September 20. Maybe autumn will be a better time for me, for us all. I sure hope so. We shall have earned a break from the heat.
Coming Next:
TUES: A Writer's Wit | Marjorie Kinnan Rawlings
WEDS: A Writer's Wit | Barbara Delinsky
THURS: A Writer's Wit | Mark Doty
FRI: My Book World | Jhumpa Lahiri, Whereabouts
or How to Kill an Entire Summer—Part III
July 8, 2023
10:23 a.m. The day following the surgery, during Doctor V’s morning round: I gained his permission to record on my iPhone what he was about to tell me beside at Covenant Hospital. I later transcribed our conversation for use here:
Dr. V: … type of bladder cancer, but yeah there are other types and variants, but ninety-nine times out of a hundred, it’s transitional stuff.
RJ: Okay, so you caught it early?
Dr. V: Well, yeah, I mean, the CT does not show that there’s anything outside of that, but one of the key things about bladder cancer, you know, it comes from that transitional epithelium of lining of the bladder, but there’s a muscular wall to the bladder, so one of the key aspects of pathology: Is it just in the lining or is it also growing in the muscle …?
RJ: Mm.
Dr. V: When it’s in the muscle, that’s where the blood vessels and lymphatics are, that’s how the cancer could escape out of the bladder.
RJ: Mm.
Dr. V: So the treatment for muscle-invasive bladder cancer as opposed to what we call superficial bladder cancer is different.
RJ: Okay.
Dr. V: Muscle-invasive actually is a much more aggressive disease stage, and the treatment ideally for a relatively healthy man like yourself, is the removal of the bladder. Which is a big operation. Whereas superficial bladder cancer you trim it off, you basically instill… The drug of choice is BCG, it’s a live, attenuated form of TB, it activates your immune system, to counteract early cancer cells within the lining of your bladder, because they tend to be recurrent. By doing that, it’s not really chemo, it’s immunotherapy for your bladder. It significantly reduces your chances of recurrence.
RJ: Mm.
Dr. V: All right, sir. Fill him full. Make sure he can pee [speaking to nurse]. See me in about two weeks is our plan.
But I must return to the day before. I was feeling quite good actually; I never experienced any pain in my bladder. But about four hours after surgery, I began to feel extreme cramps in my bowels. I suspected, as with most surgeries I’ve had, that the anesthesia had locked my bowels. A night of hell ensued, by which I could not seem to make clear to the nurses where the pain was coming from as my stomach appeared visibly to distend. They gave me everything from tramadol to a shot of morphine when I told them my pain was a “10.” I had been hooked up to a foley—a catheter that collects one’s urine in a bag. After the doctor told me I’d be going home, they disengaged it, and the nurses did fill me with water—four glasses-worth. Problem was, my urological innards were locked up, as well—I couldn’t pee!—and they sent me home with a different foley. Two sullen nurses entered the room (their routine with their patients had been disrupted) to install it because my nurse didn’t know how, and they were trying like hell to get me out of that room by ten p.m. So I was sent home with that urine bag saddled to my side like I don’t know what. Six days later, it was finally removed at Doctor V’s office, his nurse following the correct procedure (I shall spare you the description). The only problem was that after six days of that damn foley chafing my urethra, it actually hurt to pee. In situations like this you want to blame someone, but whom? The huffy nurses who might have injured me in their haste? The doctor and hospital who insisted I go home without being able to pee? The insurance company that was only going to pay for one night for a supposedly out-patient procedure?
In any case, starting Wednesday, August 16, 2023, I will begin BCG cancer treatments, once again, in Doctor V's office. Not the hospital! BCG stands for Bacillus Calmette Guerin, a procedure by which the doctor will directly inject (by way of that still handy urethra) a “live attenuated form of TB” into my bladder. Six Wednesdays in a row, ending on one of the last days of summer, September 20. Maybe autumn will be a better time for me, for us all. I sure hope so. We shall have earned a break from the heat.
Coming Next:
TUES: A Writer's Wit | Marjorie Kinnan Rawlings
WEDS: A Writer's Wit | Barbara Delinsky
THURS: A Writer's Wit | Mark Doty
FRI: My Book World | Jhumpa Lahiri, Whereabouts
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