Tuesday, November 5, 2013

PSA & Prostate Exam For Your Entertainment

In a departure from my usual nonsense and begging for people to buy my books, and as a public service to my multitude of (7 or 8) readers I am taking this moment to discuss a high PSA result from a routine blood test. First of all, let me say that I am NOT advocating ignoring high scores. And I am NOT advocating not going to see a qualified urologist after receiving the news that your PSA is high. 

For those who don’t know what a high PSA means, I will give you the basics in layman’s or, more accurately, lame man’s terms: PSA is a doctorish acronym for Prostate-Specific Antigen. A PSA reading of 4 or higher, depending on age, is an indicator of an increased risk of prostate cancer. But don’t let that scare you. It could mean any number of other more benign things as well, such as an infection called prostatitis. Or BPH, which is an enlargement of the prostate. Other reasons could simply be because you had sex the day before your blood test or even the DRE itself can cause the elevated numbers. Age is also a factor as are, and I repeat this, any number of other things, so don’t crap yourself thinking the end is near. Regardless of potential causes, your high PSA should NOT be ignored. Go get another blood test, abstaining from any form of sex for a couple days prior and get a DRE to see if the prostate gland is enlarged. 

What is a DRE you ask? Well I’m about to tell you and I believe it’s the reason why a lot of guys don’t get the exam. (Trust me, it’s not a rapper/mogul/producer, but it does involve seeing a doctor). DRE is another of those doctorish acronyms for Digital Rectal Exam. Digital, meaning finger; Rectal, meaning asshole; and Exam, meaning the doctor sticking his finger in your asshole and feeling around as if he were searching for his lost wedding ring. I’m gonna be honest here—I don’t care what lifestyle you live, getting prodded with a greedy middle finger is not a pleasant experience. As unpleasant as it may be, I’ve had it done about 5 times in the past year because my numbers are all over the place. In fact, I believe my urologist and my derrière are on a first name basis now. 

“Good morning Mr. Tookus,” says the doctor. “Open up and say ah.” 

“Sure thing doc,” Mr. Tookus says. “But don’t go digging too deep, I had Mexican food last night.” 

I have been fortunate so far, in spite of my high PSA numbers, that I am showing no other symptoms of prostate cancer and other tests have strongly indicated that I do not have it as of yet. However, if it does come to that, I am way ahead of the game and will catch it early. As a side note: It is called Prostate not Prostrate. Prostrate is when you lie face down. And while you might feel like lying in said position after the exam, they have two different meanings. So don’t tell people you had a prostrate exam, they’ll think you took a test while lying on your stomach. [BTP] BTP means Back To Point for those of you who are not regular readers of this amazing blog. 

Even though you might have high numbers, it’s not a diagnosis of anything. Further test are absolutely necessary. Today, I had one those further test. It involved the doctor pressing on my prostate until some prostatic fluid came out of the only other opening below the belt so it could be collected on a slide for further examination. As unpleasant as a DRE is, this takes it to a new level. It is really uncomfortable. However, I don’t want to scare anybody away from getting these necessary tests so to that I say, “Man-up and go get fingered. Real men get fingered. Quit being a puss!” 

During this exam, my doctor said, “Don’t stand on your tip-toes, it makes it harder.” Now the first thing that crossed my mind was, ‘What the hell is getting harder?’ The last thing I wanted to hear while somebody had their arm buried up to their elbow in my backside and also while giving me a nightmare of a reach-around, was for him to mention something was getting harder. However, much to my relief, I soon realized what he meant to say was I was making it more difficult. Phew! Perhaps he should choose his wording more carefully. 

But my relief was short-lived. When the doctor withdrew his severely elongated middle finger and while he was squeezing my manliness like a farmer trying to milk a dry cow to get the last drop of  fluid out, the female medical assistant knocked once, threw open the door and entered the exam room, proclaiming that she had found the lost lab results she had earlier misplaced. I now know what the saying ‘getting caught with your pants down’ means. There I stood, pants around my knees, with the door wide open, while nurse googly-eyes fixed her gaze upon things that I would rather not have googly-eyes fixed upon, especially during a time such as this. I scrambled to raise my undergarments while she backed out of the room, eyes still glued and googly. The doctor then handed me a box of tissue. Told me to clean up, and then walked out while I was still attempting to cover up. 

To be honest, it was nothing like Peter Griffin’s prostate exam on Family Guy.

After all was said and done, the exam showed nothing was amiss, so I get to repeat the process in three months. While it was not a fun time, it was necessary. And I did leave with a story to tell my wife. In the United States, Prostate cancer has the second highest mortality rate of cancers in men behind lung cancer. Early detection is the key to survival. Get your PSA blood test yearly to keep a close eye on it, regardless of whether or not you think you need it. Some common risk factors are a close family history of the disease, age and race, and a high fat diet. So quit eating those burgers and pizza, fat ass (I can say that because I am guilty and I’m saying it more to myself). If you go into your first exam with a humorous mindset it will help make it all the easier. Make a comment to the doctor during or after like “Did the canary survive?” or “Did you find your keys?” or even, “Next time I at least want dinner and a movie,” or “I better not feel both hands on my shoulders.” Joke with your friends afterward to raise awareness, because if you have testosterone and a prostate you’re at risk. Personally, even though my grandfather died from this disease, until I got the blood test I never thought I was at risk. Hopefully it won’t progress because I’m only 46 and I still have a bunch books to write and to beg for you to buy. 

For more information about Prostate crap check these sites: 



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