Color Doppler Update: Good News and Bad News

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nodaker
Regular Member


Date Joined Dec 2008
Total Posts : 22
   Posted 11/13/2009 10:49 AM (GMT -6)   
The good news is that my husband does not have pc.  Our trip to Rochester Hills to see Dr. Lee was very good and very much worth the while.  We found Dr. Lee and his nurse Ingrid to be extremely nice and professional people.  It was the first time I had been in the room when my husband had a biopsy (this was his 4th), and I learned a lot.  Dr. Lee found two areas in the very upper transisition zone that were suspicious of infection/inflammation, but did it not have the appearance of cancer.  Dr. Lee was very confident that my husband is dealing with prostatitis and not pc, but the only way to find out was through biopsy.  He left the choice to my husband and me.  Since we had driven two days to see Dr. Lee we wondered if we chose not to biopsy -- 6 months down the road when his PSA would come back high again -- would we regret not getting the 4 core biopsy?  Four cores is all that Dr. Lee was going to take.  So, my husband went with the biopsy.  Before the biopsy was done, antibiotics were administered  via IM (a shot in the butt so to speak). 
 
This is where the bad news begins. 
 
After we left Dr. Lee's office we started our journey home, arriving in Rockford, IL around 5:00 p.m.  We got settled into the hotel, went out to dinner, came back and hit the sack early since we knew we had a 10 - 11 hour drive home the next day.  Around 2:30 a.m. my husband woke up with shakes so bad -- literally convulsive shakes.  He was shaking so badly there was no way I could even get him dressed or in the car to the hospital so I had the front desk call an ambulance.  To make a long story short -- he ended up in the hospital for 5 days  with gram negative (Klepsiella) bacteremia/sepsis -- and near septic shock.  Fortunately, the ER started him on the right antibiotic immediately so he did not lose his life.  Our son flew in from D.C.  that first night and stayed with us since I was in a strange town and knew no one.  He also helped me drive my husband home.  I can tell you first hand that septic shock can come on WITHIN HOURS!! -- and it is one helluva nightmare.  My husband was so incredibly ill and so fast.   One thing is for sure -- he'll probably never have another prostate biopsy.  BTW, this is no reflection on Dr. Lee and his very competent staff.   Whenever an invasive procedure is done and one reads the list of risks, 'infection' is always listed, but like so many --  a person tends to think it really doesn't happen or it happens to someone else.   Trust me, it can, and it does happen.
 
We are very grateful that my husband survived.  He has a long ways to go, but he is getting better each day.  It has been two weeks now.  We are also grateful that he does not have prostate cancer, and for the next year or more he is going to let his prostate rest.  Dr. Lee said he was way over biopsied -- so many cores taken over the last couple of years in the area where they were never going to find anything.  The main reason we went to Dr. Lee is because it looked like my husband's future was going to be repeat PSA's and biopsies every six months.  When TURP was mentioned that is when we knew we had to get a color doppler done.  Dr. Lee said that my husband was in a cycle where he would get a large sample biopsy done -- which would raise his PSA and then another biopsy was done and the cycle was repeated every six months.  He recommended that my husband not even get a DRE for at least a year so his prostate can do what it needs to do -- HEAL.   The inflammation/infection (confirmed by the pathology report which said all cores were completely infilterated) was probably caused by his BPH and a bladder that did not empty completely.  In fact, my husband retains about 250cc of urine in his bladder.  NO ONE has ever mentioned this before!!  No one has told him that his bladder wall is thickened.  No one ever got a core sample that even showed inflammation.   Although my husband got so ill we consider the trip to Dr. Lee very valuable.  Oh!  And for those men, I'm thinking of Dan on this forum specifically, who have a low free % PSA -- another thing we learned... if your prostate is enlarged, the fPSA values are skewed!  Dr. Lee only uses the fPSA if the prostate is of normal size.  He is mostly concerned about PSA velocity.   My husband and I have been so freaked out over his 7% fPSA these last couple of years and NO ONE, not ONE doctor ever mentioned that his enlarged prostate makes that number virtually useless!!
 
Here is the thread where I talk about my husband's journey for those who are reading this for the first time.
 
 
I want to thank each and every one of you on this forum for sharing so willingly your journey.   I have learned so much from you. 
 
Deb

Post Edited (nodaker) : 11/13/2009 8:53:57 AM (GMT-7)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 11/13/2009 11:09 AM (GMT -6)   
Deb,

That was an incredible and scary story at the same time. First all, glad there is no PC dx for your husband. Second, I am so sorry that he had to go through the ER episode, people die every day because of that, glad he got help and the right kind of help.

One thing I picked up on what his Dr. said , was that he was concerned about velocity. Glad someone said that. In my own journey, its always been about the PSA veolocity, both pre-surgery and even post surgery. High velocity rates tell a darker story in most cases, and should be paid close attention. BTW, I was never checked for free psa in any of my 3 biopsies prior to my dx.

I hope your poor husband continues to heal from what could have been a very dangerous situation. My best to the both of you.

David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out  38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sess/72 gys cath #8 33 days, 11/2- SP Cath #9 in place


AKRoamer
New Member


Date Joined Nov 2008
Total Posts : 15
   Posted 11/13/2009 10:59 PM (GMT -6)   
Wow,
 
That is some scary stuff.  Glad to hear your husband is doing better, really glad to hear the color doppler did not find PCa.  I've been watching
this forum to see how the doppler biopsy went for you.  I've had to fly down to Seattle for both my biopsies, I've always thought do I want to fly home right after or stay a day just to be sure things are okay?  I've stayed overnight both times.  I went sepsis when I had a UTI a couple of years ago, in the hospital 5 days too; don't want to repeat that again.
 
That's good info about fPSA and an enlarged prostate.  Dr. Lee's thoughts on inflammation and letting the prostate heal make sense to me. I'll get the results of my latest PSA test on Monday, scheduled to see the urologist on Dec 4.  If my PSA stays elevated, I think I'm going to get an appt with Dr. Bahn for a Color Doppler ultrasound.  I'd just like to know what is going on, whatever it may be.
 
Thanks again for your post.  Wishing you the best, sounds like that doppler ultrasound gave you some peace in the long run.
 
Dan 
Age 49
PSA 6/2003 1.5
PSA 7/2/2008 4.8, % free PSA 8
PSA 7/14/2008 5.2, % free PSA 8
3 weeks Levaquin
PSA 9/2008 5.8, % free PSA 7
Biopsy 10/08 10-core all neg, no sign of PCa, told prostate was enlarged
PSA 12/2008 5.2, % free PSA 7
PSA 2/2009 4.7, % free PSA 8
PSA 5/2009 5.2, % free PSA 8
Biopsy 6/2009 12-core all neg, no sign of PCa, prostate "slightly enlarged".


Sleepless09
Veteran Member


Date Joined Jul 2009
Total Posts : 1267
   Posted 11/13/2009 11:11 PM (GMT -6)   
Deb, as has been noted, that's quite a story and it's so good it has a happy ending.

You are so right about any procedure having risks.

I do hope you'll come by from time to time to give us an update report.

Best of luck,

Sheldon AKA Sleepless
Age 67 in Apil '09 at news of 4 of 12 cores positive T2B and Gleason 3 + 3 and 5% to 25% PSA 1.5
Re-read of slides in June said Gleason 3 + 4 same four cores 5% to 15%
June 29 daVinci prostatectomy, Dr. Eric Estey, at Royal Alexandra Hospital Edmonton one night stay
Flew home to Winnipeg on July 3 after 5 nights in Ramada Inn  ---  perfect recovery spot!
Catheter out July 9, so far, so good
Final pathology is 3 + 4 Gleason 7, clear margins, clear nodes, T2C, sugeron says report is "excellent"
First post op PSA Sept 09  less than 0.02
PSA on Oct 23 test again less than 0.02
Oct 1st 09 -- dry at night, during day some stress issues, but better every week. 
Feel free to email me at:  sheldonprostate@yahoo.com    

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