My Father's Health, Part 3: Urology

So, my Dad's health has improved steadily since he was released from the hospital. He is slowly getting his strength back, and is able to walk (short distances) with the aid of a cane. His mental facilities are gradually improving as well, although he still has trouble remembering what day it is.

Last week I accompanied him and my Mom to the urologist's office for a check up. A great deal of the work he had done over his extended stay in December and January was due to his bladder.

For a quick lay-person's explanation, think of the bladder like a balloon. As it fills with urine, it expands. After a while, the muscled walls of the bladder contract to expel the excess fluid. Unfortunately for my Dad, his wasn't quite working right.

Many years ago, he had his prostate removed due to cancer. It's very common for men of a certain age to get prostate cancer. Some say that all men get it, it's just that something else kills them first. Anyway, after having it removed, they later went back and did some radiation treatment to make sure the cancer was gone. This is something I've recently learned that they no longer do. Good thing, since that procedure seems to be what caused all of my father's problems.

His bladder had stop expelling fluid. After an exploratory surgery (December), they discovered a large amount of blood clots in the bladder. It seams that the radiation had residual effects which caused the scarring and clotting in his bladder. As this built up, his bladder continued to stretch out, but had trouble restricting again. So, a surgeon went in, literally scooped out the blood clots, and sewed his bladder back shut.

Sadly, he didn't do a very good job. A week or so later, my Dad is in a different (better) hospital repeating the surgery. There were other errors as well, but I won't digress into them now. The point is, my Dad's bladder was finally cleaned out, urine was flowing as expected, but the "balloon" had been stretched out so much, it would likely never function properly again.

So, if you don't have a functioning bladder, how do you get rid of the fluid? I'm glad you asked! Boys and girls, let me introduce you to a word: catheter. Doesn't sound so bad-- like kitty cat, but with a soft ending. Basically, a catheter is a very benign object. It's simply a tube inserted through an orifice to drain or insert fluids. My Dad has a catheter in his torso to facilitate dialysis. But there are types of catheters. For example, be on the look out for the "Foley" catheter. That doesn't sound too bad. Dave Foley, the guy from Kids in the Hall, right? Sadly, no. A Foley catheter is inserted up one's urethra directly to the bladder to allow it to drain. Except the urethra is in a man's penis. I apologize if this is too graphic, but I assume we're all adults here.

My Dad has had to endure several Foley catheters. For that alone he deserves respect. This time, however, they were going to do something different: a supra-pubic catheter. This one is a minor surgery that makes an incision in your lower abdomen and sticks a tube straight into the bladder. No muss, no fuss, just a tube going down your pants leg leading to a bag of pee.

And finally, we're caught up to the present day. Since leaving the hospital, my Dad has had this tube and bag contraption attached to his abdomen. He was scheduled for a follow up to see if they could remove it, but it so happens that the night before his appointment, he accidentally pulled it out during the night.

Now, to me, this is inconceivable. How could anyone with a tube sticking directly in an organ through a hole in your flesh, pull it out? And not be bleeding, crying, screaming, killing your way to the hospital? But, I guess I just don't understand.

Anyway, we go to the urology doctor to talk about it. We were expecting it to be removed about now anyway, so maybe this is normal. Doc says, "Sure, no problem. The hole seems to have closed properly, let's just go back to a Foley." I'm sure all men reading this can imagine the look produced on both my and my Dad's face at the sound of that.

So the doctor tries to put in a Foley. Right there. In the office. Dad is very, very uncomfortable, but far too polite to use the sailor language I was formulating. The doctor stops. "Hmm," he says, "that's odd. Let's take a look." This is always fun, because doctors have so many ways to "look" at things.

First, they do a sonogram. Don't try the "Is it a boy or a girl" routine here, guys. They've heard it and don't appreciate it. So, using radar to look at the bladder, they see that it is full, but not too full; meaning-- no emergency.

Next, they decide to do a scope (I don't remember the technical term), where they'll insert a camera and take a look at his urethra. A camera! In his pee pee! I ask the nurse if I should wait outside, and she says, and I quote: "No, it's really cool. It's just like a big balloon. You should stay and watch."

As a quick aside, I have to say that I've been blessed with not being squeamish about blood, guts, the human body, or any of that sort of stuff. This is basically the complete opposite of my older brother, who passes out at the mere thought of blood.

So, of course, I'm in.

The doctor and nurse do the necessary preparatory work. My Mom was kind of hoping to leave, but since I was staying she did too. My Dad was just beside himself, wishing it were all over, and regretting his decision to return to the doctor.

So, there it is. Live on a closed-circuit TV in crisp color, my Dad's urethra. Now, understand, I haven't seen the inside of my Dad's penis in almost 43 years, so my memory of it is pretty hazy. But basically, it's just a tube. As we try to reach the bladder, we hit a road block. Literally. It seems that since my Dad's surgery (and other issues), the scar tissue in his urethra has completely closed it off. That is why the Foley wasn't working.

This means that he has to get another supra-pubic. This means that he has to go to the hospital. Because of delays and wanting to keep him under observation, this means another overnight stay. This leads to more sundowning craziness, during which he pulls the catheters out (again) and requires another surgery, and another night in the hospital. So, what we thought was going to be a routine check up ended up being a three-day weekend stay at the hospital. I suppose it could have been worse, but that was bad enough.

He's home now, and better for it. He still has the tube running down his leg leading to a bag of urine, which isn't exactly "sporty." But we're hoping to get a different type of bag that is like a long tube that hides in the pants leg. Part of the problem is that my Dad's organs just won't commit to either working or quitting. Usually, when you experience kidney failure, you produce little to no urine and that is taken care of by dialysis. My Dad is producing some urine, but not a lot. On the positive side, that means there is still a chance his kidneys may regain functionality. On the bad side, he has to carry around a bag full of his own pee.

It is times like these that make you ponder what medical treatments will be available in 20 years. Will I have to have tubes and a bag of pee? Or will they just take a tissue sample and grow me a new bladder? Let's hope I live long enough to find out.