St. Lukes Hospital, Houston.

I spent the last two days slogging through medico-bureaucratic hell. I’ve been x-rayed, prodded, injected with radioactive goop, scolded (high blood pressure), weighed, and scanned. Each doctor wanted new blood and urine samples. Apparently none of them trust the other guy’s lab work. I’ve got tracks on my arms—I look like a drug addict.

The administrators, too, have taken shots at me. My insurance card is worn out. Processing co-pays has rubbed the gilt paint off my credit card. I’ve recited my address and phone numbers a dozen times. All records from prior visits to my doctors were full of errors. Nurses complained that Doctor A hadn’t received a report from Doctor B and threatened to snatch away my precious surgery slot unless I straightened out the mess.

In the USA Medical System, this exercise is called “Pre-Op.”

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I chose surgery as treatment for my prostate cancer. The procedure is called radical prostatectomy—removal of the entire prostate gland. Major surgery, today it’s usually done laparoscopically using robots. Unfortunately, I have too many abdominal surgery priors for this approach. My doctor will do conventional open surgery, picking his way through scar tissue and adhesions to reach the prostate. Remember that frog you dissected in Biology 101A? I’m going to look like that.

Six months ago, I didn’t even know what the prostate gland was for except to cause problems for aging men. Now I’ve learned it’s pretty darn useful, and I’m gonna miss it.

Shortly after prostate surgery, urinary continence can be a problem, so preparation includes learning how to do Kegel exercises. Laura took this photo in the lab where a lovely Nurse named Kara helped me learn proper technique using biofeedback.

Kegel exercises strengthen the muscles of the pelvic floor. Biofeedback involves using sensors and computers to monitor one’s ability to properly flex those muscles. I’ll leave it to your imagination as to how flexing is sensed.

Throughout the training, Kara entertained us with the story of her semi-arranged marriage (she’s from India).

“... my cousin knew this medical student over in the States that she thought was just right for me... Oh! I think that sensor has slipped. Let me just fix that... There. Now it should stay in... so she wrote my mother and suggested she talk to his mother...”

I found the whole encounter kind of homey and almost pleasant, if a little surreal.

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Pre-Op was hugely stressful. Surgery will be much less so since I won’t be present when it happens. It’ll be harder on the surgeon, the anesthesiologist, the nurses, and especially on Laura, than it will be on me.

I’m feeling sadness from the realization that I’ll be changed. Hereafter, my body will function differently. I won’t know if I’ll be cancer-free until a month afterward, when the biopsies are complete. I won’t know how functional I’ll be for up to a year or eighteen months afterward, as the affected structures and nerves slowly heal.

This isn’t my first major medical milestone and with luck, it won’t be my last. The surgery should be completed tomorrow afternoon. Then recovery, a process that’s becoming all too familiar to me, will begin.

Many, many people have shown concern for me and have told me they are keeping me in their prayers. I cannot begin to express how grateful I am for all the support I have received.

Blessings to you all.