A surprise at the urologist's office #NSFW | Scholars and Rogues

NOTE: “NSFW” isn’t quite right. Not Safe To Read, period, is closer. WARNING: This article contains depictions of a doctor inserting a hypodermic needle into a man’s penis and may leave readers lying in a fetal ball on the floor.

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by Patrick Vecchio

The local urologist is a nice guy, but I wish he and I had not come to know each other so well over the past months. I’ve learned about his personality, sense of humor, professional demeanor and medical acumen. As for what he has learned about me—well, let’s call it inside information. Three times, he has slipped on a latex glove and lubricated his index finger for what I call the “Star Trek procedure.” That is, he boldly goes where no man has gone before. He was almost apologetic the third time and laughed when I shrugged and said, “Buy the ticket, take the ride.”
He and I met about a year ago after a kidney stone sent me to the hospital pleading for industrial-strength pain medication. I knew what I was dealing with; X-rays simply confirmed it. I was hospitalized for two days, spending the first in a narcotic fog. He discharged me after the pain inexplicably vanished the second day and said if the stone didn’t pass in a week, he’d go in after it.

After a week, I didn’t need more X-rays to tell me the stone hadn’t budged. I’ve passed somewhere between a half-dozen and a dozen kidney stones over the years, and as they scrape their way to the outside world, the stone-passer is in what I’ve seen referred to as “exquisite agony.”

 

The last half-inch of the stone’s journey is particularly unpleasant. I force myself to drink lots of water so my urine stream can blast the stone out. When a stone shoots out, it announces itself with a little “tink!” when it hits the porcelain of a toilet or urinal. During the week after I was discharged from the hospital, none of those things happened.

So the doctor booked me for surgery. There is, of course, just one open passageway from the outside world into the kidney, and he took that path while sliding a minuscule camera inside me to find the kidney stone. Fortunately, I was blissfully anesthetized.

After the brain fog lifted, I asked him how big the stone had been. He said he didn’t find one. “You must have passed it,” he said, to which I replied, “I’ve passed kidney stones before, and believe me, I know when they pass.” And the X-rays showed this one was the size of El Capitan.
The only trouble with my theory was that I had been pain-free after being discharged from the hospital, and considering that this particular stone announced itself by putting me in the hospital in the first place, my argument didn’t hold. So I went along with the urologist: I had unknowingly fired an asteroid through my apparatus. “You’re not a doctor,” I reminded myself. “Stranger things have happened.”

Earlier this month, strange things started happening again. My first signal something was amiss came when I was standing at a urinal at work and noticed not one, but two colors: the usual mellow yellow, and red.

Blood in the urine is a tad unsettling. Nonetheless, I tried to rationalize it away. “It must have been my workout on the treadmill last night,” I thought. “I really pushed it. I probably just banged up my guttyworks a bit.” And sure enough, the next day the blood was gone. I congratulated myself for the self-diagnosis.

A week later the bleeding resumed, this time after I’d spent the day mowing my lawn. With a riding mower. Workout? Strenuous? Probably not. I went to bed hoping the situation would again resolve itself overnight.

The next morning, after I had finished peeing, it looked like somebody had poured a carafe of Merlot into the toilet bowl. I couldn’t see to the bottom. This was more than a tad unsettling. As the week passed, so did more blood. Clots, too. I looked into the mirror. “‘Tis but a scratch,” I said. “I’ve had worse.” The guy in the mirror didn’t believe me.

I called the urologist, who ordered a whirlpool of tests. I had blood drawn for analysis so often that I felt whiter than the Pillsbury Doughboy. Soon, just one procedure remained. I had been X-rayed. I had been ultrasounded. This time, I was CT scanned. Immediately after the scan, I had an appointment with the urologist so he could discuss the fresh images with me.

I checked in at his office and waited a few minutes. The usually crowded waiting area was vacant. Then the nurse showed me into what I thought would be one of the routine exam rooms where the doctor and I had met before. But I knew something was amiss when she left the room saying, “Take off your pants and underpants and lie on the table on your back.”

Hmmm, I thought, lying on the table and studying the ceiling tiles. This is a change in the routine. I figured she had told me to take my pants off because the starship USS Enterprise was on its way. But a nagging little voice in my brain told me I was wrong.

I sat up and looked around. I saw strange machines with weird knobs and baffling gauges. I saw mysterious instruments and vaguely menacing medical accessories. The inside of my mouth started to feel like I had eaten a tablespoon of flour. Thinking back to the empty waiting area, I hoped for a moment that I was in this room because the other rooms were full—but the moment passed. My anxiety started to spread like bacteria in an infected urine culture. I had the caffeine shakes even though I hadn’t had any coffee. Trying to breathe was like inhaling cotton.

My adrenaline surged, but before I could flee, the urologist wrapped on the door twice with his knuckles. He and the nurse came into the room, and he said, “You have a bladder stone.” It sounded benign, considering the other possibilities, and relief washed over me like a cool sheet on a July night. I sat up and started to step off the exam table so I could start putting my pants back on.

Then he asked me to lie back down. The nurse was still in the room. She drew a curtain so that nobody opening the door could see what was going on. The cartoon thought balloon over my head was filled with three letters and a punctuation mark: WTF?

And then he started swabbing the tip of my—well, let’s just say he wasn’t swabbing the tip of my big toe. I bolted half-upright, elbows on the table.

“You’re not going in, are you?”

 

“Yes.”

Male readers—and female readers, for that matter—have no doubt begun to wince, shudder, make horrified faces or cross their legs—maybe all four. I say this because I was doing the same thing. And I was doing the same thing because I immediately remembered being in the exact same situation with a different doctor many, many years ago. It had not gone well—at least until they gave me an IV shot of something; I think it was Valium. Once it kicked in, they could have been going in with a chain saw, for all I cared.

As the doctor continued swabbing, there was no talking my way out of it. Couldn’t I get a shot of something first? Did we have to do it today? Before long, the urologist demanded that I lie back and relax because the more I moved and the more I resisted, the more uncomfortable I was going to be. I tried to relax, but it’s never a good sign when doctors use words like “uncomfortable.”

So I tried not to pay too much attention as he began slipping what felt like a needle into me. This was to numb me—or a particular part of me, anyway. “You may feel some discomfort at first,” he said in an all-business voice. Given what I was feeling and where I was feeling it, I wasn’t sure the word “discomfort” was appropriate, but at the time I couldn’t describe exactly how it felt as he was treating my equipment like it was a pincushion.

Next, he threaded one of those tiny cameras inside so he could take a look around. “I’m inside your bladder now,” he said in a voice that sounded like it was coming from another room. “You have a bladder stone.” After a pause, he said, “I don’t see any tumors.” At that moment I realized why he had looked inside instead of simply relying on images from X-rays and ultrasound and the CT scan: He wanted to see for himself. He was finished moments later. I was dazed but grateful.

We met a few minutes later in his office, where he showed me the pictures from the test earlier that morning. “There’s the stone,” he said. “This is causing the blood in your urine.” It looked like it was the size of a black bean. Clearly, it wasn’t going to go anywhere.

For the briefest of moments, I considered asking him whether this was the missing kidney stone. Had it dropped from the ureter into a bladder backwater—and no farther—where it had rolled around and accumulated a mineral coating like a peanut inside an M&M? At that point, though, I only wanted to get out of his office as quickly as possible, so I didn’t ask. I suspect there’s no way to know, anyway.

So now he’s going to go back in again with a laser to break the stone into small enough pieces to pass. Before the surgery, I am flying to Florida for a family get-together. I am not a good flier. At the slightest bump in the flight, I start death-gripping the armrests and watching the flight attendants’ faces for signs of alarm.

But if the ride gets at all choppy either on my way South or on my way home, I’ll simply think of my reaction when the urologist began swabbing me down. That should take my mind off any bumps in the air.

I just hope the passengers next to me don’t freak out when I start wincing and crossing my legs.