I received an email today commenting on my last post.  The writer mentioned two things, first relating to the commentary of the friend to which I referred and also wondering about the outcome of my catheter incident.  The former provoked additional thoughts of how we view things, our perspective on life’s experiences.  The latter, well, I think it simply a matter of curiosity, a completion of the story and tying of a loose end.

I’ll start by tying up the loose end, that is the outcome of the catheter and its eventual removal last Thursday – about a week after its insertion.  If uninterested, feel free to skip down about 9 paragraphs.  It was an interesting experience, quite different from the prior week when Matt C. did the insertion.  Ironically, this week Matt C. was not in the clinic so I saw another young doctor who was also named Matt, but whose last name ended with an “L” – so he is Matt L.

Initially the appointment was scheduled for a nurse who would be charged with removal of the catheter.  Had all been well, things would have been limited to the simple process of the nurse performing the procedure, however, since my bladder decided to start bleeding again, they saw bag full of blood colored urine.  That brought in the nurse with whom I had spoken on the phone, I could tell from her voice which had a distinct New England accent, Boston if I’m correct.  This is not to say people from Boston are, by nature, mean, it is just a description of the person – one must admit that Boston accents, as with others, a bit harder tenor, when compared to even Maine and New Hampshire.  Anyway, she made it abundantly clear to me that there was no way they would remove the catheter without the approval of a doctor, she didn’t even listen to my description of how the urine had been “crystal clear” the day before.  Enter Matt L., another clinic resident.

Matt L. had a very different demeanor than Matt C., he was, as evidenced by his admonition he didn’t know everything, more centered and secure in his knowledge of the discipline – he didn’t feel the need to “sound smart”.  I liked that about him as I do with all doctors with whom I interface because after all, they practice and even the most seasoned continue to learn.  Anyhow, Matt L went on to describe the procedure and posed his thesis that since I was a bit more active the previous day, it was likely the catheter was itself irritating the my bladder.   He concluded that at this point I would be well served to have the catheter removed and went on to explain how the nurse would disconnect things and fill my bladder with saline just before removing the catheter.  Whether the catheter stayed out would depend on my ability to displace at least as much as the nurse put into me.

So, the fun began with the nurse, different than the phone nurse, but one who did assist in my “send off” the prior week.  She also had an appreciation for the pain I was in the week before and the related physical challenges associated with all that my body had gone through to that point – referring to the cancer, subsequent radiation and so forth.  Lastly, she was both pragmatic and funny, recognizing things like the possibility I could “spray” her when she removed the catheter if I didn’t get the container in place quickly enough.

The procedure began with the “pinching off” of the end of the catheter near my penis followed by the removal of the tube and the “Y” thing which was supposed to allow for flushing while keeping the bag tube in place.  Anyhow, it was at this point the nurse gave me the container, which had marks to enable the measurement of output.  In went 200 mls of saline, at which point I felt considerable pressure in my bladder – both the nurse and i thought my bladder to be full.  She then instructed me to stand and get ready to put my penis into the end of the container to be sure I’d catch anything expelled.  I was also told that I needed to expel the 200 mls or the catheter would have to be reinserted.  So, out came the catheter and into the container went my penis – nothing came out.  I stood for a minute and still nothing.  The nurse said to continue to try and left the room.  Shortly after she left I was able to painfully, it really burned when I went, expel 100 mls of fluid.  When the nurse returned she performed an ultrasound on me and it determined I had over 200 mls in my bladder – it didn’t really make sense.

So, now I was instructed to try some more and I did.  Now given that this whole ordeal started with my straining to expel urine, I was loathe to do that again.  The other thing was I knew, from the initial expulsion, when anything came out ti would burn.  But try I did and nothing happened.  So the nurse sent me walking around with the idea that doing so would relax me.  I walked and walked and nothing happened.  Then, after waling around the hospital for about an hour, as well as drinking some water, I was able to expel another 50 mls, they weren’t impressed.  So I was sent off to work up some more urine, carrying my little container in case the urge came while I was away from the clinic.  I walked around for another hour and nothing really happened.  So I found a lounge chair in a hallway where I took a nap.   After about an hour snooze, I woke up and was able to make another 100 mls of urine.  Again they were too impressed but they did do another ultrasound.  Unfortunately, they found that I now had over 300 mls in my bladder.

To put a bit of perspective on this ordeal I think it important to note that I first entered the clinic at about 9:15 am and it was now closing in on 1:30 in the afternoon.  Matt L. who had been quite “patient” with this whole process began to start talking with the nurse in the hallway, just outside the room I was now in.  I heard him say he was thinking he was “just going to  have to put the catheter back in” and they (he and the nurse) heard my rather loud “oh God!” – which by the way, was less about dealing with the catheter itself, but more about the anticipation of how much the last one hurt going in.  They decided to give me another chance to produce some urine, but this time the nurse suggested I go get some lemonade.  She said it should help me, wasn’t she why exactly, but she said it typically worked in these situations.  So off to the cafeteria I went where I had some chili and a 12 oz. bottle of lemonade.

Upon my return the nurse let me go into a bathroom and try to produce some more urine, which I did, 100 mls.  She then had me go into a room where she did another ultrasound and found, to her disbelief, I now had nearly 400 mls in my bladder.  She thought the machine was wrong for a couple of reasons, first, she didn’t think I could produce that mush so quickly and second, she didn’t think my bladder should hold that much.  After checking things out with another nurse, they concluded that yes, indeed I must have that much in me.  She went to talk to Matt L.  While she was gone, I was able to produce another 100 mls and when they returned, there was a sense of relief with the added volume.  Matt L said he thought it ok to send me home without the catheter, confident that if I had a problem I would get in touch with them asap.  He also began to think the lack of production was more a function of the irritation caused by the catheter and was something that would normalize.  He was right and things have normalized, and continue to be so, or at least in the context of “me”.

I am supposed to return to the clinic for another checkup in 3 months.  So much for that loose end.

On to the reference to the comment about my friend made by another friend.

I think it’s important to mention that the comment came from someone who is not in the best of shape, but whom I’ve come to see as having a pretty good attitude about her lot in life.  She does concede challenges, but does not succumb to them.   In thinking about her, I weigh our respective situations and concede that while I am certainly on the path to a young death, for all intensive purposes I feel  and appear normal.  I can maintain most of my normal activities – skydiving, whitewater rafting, skating and just laying around as the mood strikes.  In contrast, she tells me of challenges with memory, joint pain and other things affecting her daily living.  In short, while things like inconvenient urination and a quarterly PSA are there to remind me, they are minor and easily forgotten.  For her, her affliction is afforded the ability to put forth constant reminders.

So with the “complaining” friend, my other friend mentioned how she too noticed the negativity in her comments.  She also noted they both practice some of the same theologies and holistic approaches.  She noted that any times she is unable to read some of the comments.  It kind of made me thin a bit about many people whom I’ve met or are in my life – many who are similarly negative and many who are also very positive.  In this exercise, I began to notice my propensity to limit exposure to the negative people and gravitate to the more positive.  I also noticed in evaluating my very close friends, that many of them had survived significant life challenges and while wounded and scared, they remain positive; they push forward with little reflection on the bad and stray from the role of being the victim.  The whole process made me think about my attitude and how I tend to look forward, rather than backward, how I retain a positive and sensible approach to life despite my circumstance.  It made me think how fortunate I am and for all of which I’m thankful.

As always, feel free to comment or you can email me at lifeabstractions@gmail.com

ciao

Lifesabstractions

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