Fantastic, thank you all for the feedback, especially all the right questions from Selmer. If you have a moment, I'll go over a few as this is the information I need for my next appointment. I think my father was about
71 when he was diagnosed. I suspect he did not go early enough to the doc, and as you say the PSA wasn't there. He may have turned down the DRE or it was too late when he did get one.
"Perhaps you need a second opinion from someone who can discuss this with you."
Yes, and I can understand the urologist's position. I personally think we just aren't training enough doctors. I've done the doctor routine in South Florida and now here in Wartburg, Tn. Quite a change, but I'm still asking questions as the doctor is backing out the door, my 10 minutes up. My immediate problem is that my regular urologist for the past 20 years is in West Palm. I may need to go down for a visit and get the second opinion there. My son lives in my house down there, and I hang out in the woods up here in Tennessee. Or, a nurse friend's father had a very successful removal in Knoxville. His doctor could be my second opinion.
"Secondly, did your urologist tell you he felt anything on the digital exam, DRE? lumps, bumps, hardness......greatly enlarged?"
He said the left side seemed a little firmer, and I think I remember feeling a slight difference. It was short and sweet, and he was edging for the door. Jump in PSA, slight abnormality on DRE, father's experience: Go straight to biopsy. I set up the appointment, then put it on hold when I heard of possible complications of the procedure, and learned how invasive it is.
"How many PSA tests have you had recently and how long ago was your last one prior to this year?"
It's been at least 6, maybe 9 months since the previous test, which was a 4 point something. I didn't realized that the point something was important, so I'll have to go to the office and get the exact numbers. I do have a graph of the rise over the last 15 years.
"then did the doctor ever discuss with you that it might be due to something else? Like a infection? Did he give you a course of antibiotics? Did he retest you a few weeks or a couple months later?"
Not much discussion from my primary care doctor, just a flat 'if it's over 4, I must send you to a specialist'.
"Just thought I'd ask because things like a bout of prostatitis can really make PSA results jump around.....even to 10."
I did look up prostatitis when I got home. It's more complex than I thought. I didn't present any symptoms of infection to my primary doctor, and the urologist never even mentioned it.
"I've got RLS at times myself, as did my father............Drives me nuts when its acting up. Recently its been mostly away for months? I have no clue why."
It's a weird one, and I've had it for years but never knew it. Curiously there is a link between orgasms and RLS. The symptoms will disappear for a short time, enough to get back to sleep following an orgasm so I think there must be something linked in the nervous system. Peripheral neuropathy and 3 sciatica attacks have left my right side weak. Mirapex has been my saviour, so to speak, regarding the RLS, as it is maddening.
My gut feeling is to either get my second opinion from my old urologist on my next trip south, in May, or just get a second from the Knoxville urologist who treated my friends father. I'm not worried as much about
the impotence as I am about
the incontinence, and my friend said her father has no problem. Anyway, I guess time is of the essence at this point, to find out just where I'm at, but I'll read the discussions here to get more background. I've got an appointment with my primary doctor for a second PSA scheduled for next friday.
Thanks very much for your imput, all of you. I'm sure I'll need it.
Post Edited By Moderator (bluebird) : 4/13/2008 3:04:23 PM (GMT-6)