PROCEDURE DATE?

ADRIATIC ANTALYA

So next step.........set a date!
It was January 2016 and i'd upgraded my health plan (just in case) which one is entitled to do at the beginning of each year.
My oncology benefit,previously set at R200 000/annum doubled to R400 000 and of course my previous "hospital plan" became useful for most other likely consultations etc.,albeit at a premium of around 3 x my previous monthly subscription.
Aaah well.....can't take it with you!!

After much thought in the matter,and a 2 year hiatus since diagnosis,the date of 4th April 2016 was set in stone.
My oncologist (also a new one) warned me that,once I'd"signed on the dotted line" I'd be liable for some costs if I were to chicken out en route!
Oh by the way..........my new oncologist had gone into the different available radiation methods in great detail,taking the trouble to show me graphs and research data which (provided one understands this type of data) spelled out the efficacies and potential shortcomings (side effects) of each.

They very clearly led me to my ultimate conclusion to go the brachy route!

One last check though on my "flow rate".Huh?I'd had one at just about the time of diagnosis and it wasn't great!
At the time (as previously mentioned) the one "symptom" I'd experienced was a fairly putrid "flow rate"when my bladder became too full.
My normal "breaking the seal" when drinking beer at a pub ,which had previously come in at close to 3/4/5 pints was now far lower,and when I tried to go with the bladder full experienced considerable difficulty "kickstarting".
I often ended up coming straight back just 30 minutes or less later in an attempt to void my swollen bladder.

It's imperative, when undergoing brachy, to be able to pee freely as the procedure,and obvious after effects of a shitload of radiation pellets (I had 63 eventually) swells the prostate and can cause cystitis and bladder infections,resulting in serious potential problems in urination.

AMPHITHEATRE EASTERN TURKEY

This (and ED) I wished to avoid at all costs,in that order!
The "flow" test involves filling ones bladder to absolute capacity and then peeing into a cylindrical device which pumped out your "flow" rate from a printer connected in the office.
Well now I understand the feelings experienced by a poor student!.
I've always been a pretty good student so this was the 1st test I've ever failed dismally........on 3 separate occasions!
Each time i returned with a bursting bladder,only to "lock up" !
One is expected to pass around 350ml and each time I could barely manage 100ml and left with a full bladder.
In such situations,provided I didn't allow my bladder to fill up I was half OK,but a full bladder was my nemesis!.

EPHESUS NEAR SELCUK

OK.......so what was plan "B"?

ROMAN BATHS HIERAPOLIS

PENSION SELCUK

ANTALYA

Another consultation with my urologist ,who explained that,unless my flow rate was "x" brachy was out of the question and I'd either have to go the dreaded RP route or alternatively do a "pre-op"consisting of:

~a bladder incision where the bladder meets up with the prostate to create a sort of a "flap" where my tight prostate was restricting the urethra

CUISINE AT PENSION SELCUK

~at the same time a partial TURP (trans urethral resection of the prostate) which involves scraping (shaving really) some of the offending prostate tissue placing pressure on the urethra

My oncologist had previously suggested (strongly) that i should undergo another targeted biopsy before brachy but I'd chosen to forego her sage advice as I wasn't keen on having two major procedures (the above procedures are considered major operations).
So here was the opportunity to go "all out" so to speak as i was going to have to have all of the above anyhow whilst under.
I suggested to my urologist that he do another biopsy (at the same time) to check on the "progress"' of the disease since diagnosis some 2 years prior.
It's most important ,if brachy is the only form of treatment,that there is very little chance that the disease has become a higher GLEASON score than 7 and is contained inside the prostate.

So....in for a penny in for a pound.....as they say in the classics!
My set date of 4th April was to be set up for this procedure and hopefully,at the same time,provide me with a little extra support for brachy if the disease hadn't progressed too much.
If not It'd be back to the drawing board (again).

Shit man......who said it was going to be easy?