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PART 21 of My PC Adventure – see full story HERE>

The headline for this – the penultimate chapter of my prostate story – isn’t what it seems.

SunsetIt’s not a goodbye, nor a resignation to impending death, nor a signal I’m giving in to the vicissitudes of age.

It’s a metaphor, of course, drawn from a famous NZ play by that name ( The End of the Golden Weather  by Bruce Mason ) which spoke to my boyhood of  “…the eternal optimism of the child and the harsh certainty of age…”

To quote one tribute to Mason’s 1959 work:

“Golden Weather tells the story of the loss of innocence and of human fallibility…”

The end of my golden weather refers, in part, to the “official”  finish of my recovery from the surgery that took out the prostate cancer, a two-month idyll during which I’ve researched and written about prostate cancer in this forum, which began as a personal blog and has grown to a website with a following around the world.

(That’s one reason, incidentally, why I have explained “end of the golden weather” – now two of five visitors to this site are from the US. The proportion of Kiwi readers is about one in three).

In this case, “end of the golden weather” also has a literal meaning, since my time at home has been blessed with a remarkable (for Wellington) patch of fine, still weather, an “Indian summer“.

In the last few days, winter has roared in from the Antarctic, bringing snow to the South Island and to hills around Wellington.

Rain hits the windows on the southerly side of the house as I write this, and I know the days of teeshirts and sunhats are over for a while.

Tomorrow, I return to work. Truly, the end of the golden weather, but in fact something well overdue if I am to feel fully restored.

Which is what I want to write about: how do I feel about what’s happened (that classically banal and inappropriate journalistic question)?

Perhaps I should begin with what I don’t feel.

I don’t feel old. At 62, the body and mind are in the kind of shape my parents’ generation, the Depression and war-shaped cohort, associated with their 40s. My mindset accords with that silly epithet, “60 is the new 40”.

I am getting old, of course, but cancer has had no obvious role in that gradual process.

It didn’t turn my beard white, steal the hair from the top of my head, slow up my legs in social soccer games, nor account for loss of memory for people’s names after we’ve just been introduced, nor the keeping to speed limits, and restricting of booze intake to a Heinie a day, and the working day hours to no more than a dozen.

All those things have been creeping up since I was 30.

I don’t feel debilitated. I’m back to the fitness I enjoyed prior to the operation in March, easily able to walk briskly over my personal training challenge, Wellington’s Mt Victoria.

These pictures show the 151 steps I climb on the route to the top, and a view from that top after my first post-surgery ascent, about six weeks after the operation:

MtVic 1

MtVic 2

As I rather over-excitedly reported in an earlier chapter, my urinal turn-around time is reduced to that of a youngster.

I have no major problems with incontinence – just a little drip of a leak sometimes when I’m tired and forget to brace the pelvic muscle when I laugh or cough.

And the big one – suffice to say, that’s not a problem either, without the use of Cialis or the dreaded injections. Bang goes my excuse to browse in the adult shops for a cheap pump.

I don’t feel apprehensive. I’ve got cancer, but we got it early, it would seem, and it was slow-growing – Gleason grade 6 (I’m now thinking it was there for years before my GP, bless him, encountered it with his digit).

It hadn’t migrated out of the prostate, and prior to the operation my PSA was a mere .77.

I’m a little less sanguine about the “let’s cut the bastard out and be done with it” mindset I had early on, because research tells me there’s never any guarantee that something microscopic didn’t escape into my system during the op, or even during the biopsy. Highly unlikely…but possible.

I expect when my PSA is tested in August I’ll show the required nil level, but I’ve also read data which shows it might rise again after a couple of years. I need to show nil PSA for a decade before I can possible say I’m cured.

But something has changed. Ever so subtly.

It can only be described as an odd sense of betrayal. My body – until now more or less organically sound – has finally let me down in a most shocking way.

Okay, I’ve had marginally elevated cholesterol since 1991, but there is still medical disagreement about what that actually means. And I take a light dosage of blood pressure medication for something that runs in the family.

Neither of these has felt anything other than a mild indication of getting through the years towards maturity.

But cancer! That’s systems failure. That’s involved the first major invasion of my body, leaving a scar (physical and mental), and thoughts – which will no doubt recede – of organic deterioration, of a hurrying of the first steps towards the grave.

Sound morbid?

It does, doesn’t it, but actually it’s not something I’m dwelling on in a neurotic way. It emerges merely as one of the more philosophical after-effects of a mortal event, a reminder that, yes, there is death at the end of the journey, and there’s no way to dodge it.

It doesn’t affect my optimistic view of life in the slightest.

I come from a line of long-livers. My great grand-father died in his baker’s shop in London at the age of 99. My grandfather lived to 84, and my father convinced himself he would go at the same age, so did. On my mother’s side (she lived to 80), there was grandma lasting till 94 and grandfather going to 86. We don’t pop off early in my family.

Age expectation is a tricky calculation, incidentally. One of the interesting things in Michael Dattoli’s new prostate cancer book (reviewed recently on this blogsite) is a reminder that average longevity calculated at birth (about 78 for male Kiwis) is way shorter than that enjoyed by someone at 60 and beyond.

This chart from the Dattoli book shows what I mean:

AgeData

This is important in the debate about population-based prostate screening. One of the arguments against it (and against surgical treatment after about 75) is the thesis that because many tumours are slow-growing, something else will getya before the prostate.

As age expectation rises significantly once you’ve reached 60 (compared with what you started out with, when accidents and other factors are probably much more influential), so presumably does the point at which “watchful waiting” should apply.

My life expectation in terms of surviving prostate cancer is also being extended as we speak by the massive effort by scientists and doctors – in the US especially – to achieve breakthroughs in testing, diagnosis and treatment.

Any time soon they’re going to find a quick, non-invasive method of helping the medics know how bad the cancer is and how (or if) it should be treated.

This is undoubtedly an effect of the great surge into old age of my generation, the baby boomers, with our more positive attitude to aging and our demands (and wherewithal to pay) for better medical options.

So. How am I feeling?

Bloody good, bloody lucky, bloody optimistic.

Even so, I will be taking a few precautions.

The number of red meat meals will be dropped from four or five a week to one or two, the already fat-free diet will be applied even more rigorously, the brisk walks will be taken even more regularly, stress at work will be avoided (hah!), sunsets and scenery will be noted more diligently, the regular evening hit of red wine will be replaced with pomegranate juice (which looks exactly the same in a wine glass and, amazingly, tastes like a slightly sweet version of a Central Otago pinot noir)…but the single daily can of that nectar of life, the Heineken (no, they’re not paying me a cent), will continue.

This weekend we had a pleasant visit from my journalist colleague, Barry Young, who also happens to be president of the NZ Prostate Cancer Foundation.

Barry is 10 years free of prostate cancer after his prostatectomy, his PSA is nil, he can enjoy a good glass or three of red wine, and he tucked into seconds of lamb shanks (grown on the open fields of the Canterbury Plains, no doubt).

I’d be tempted to say us journos have an extra gene that bodes well when we get prostate cancer, but I know that’s not true (witness the death of the legendary Frank Haden a couple of years ago).

But our sense of outrage might help. It comes from our journalism-driven suspicion that there are people in positions of medical power who – with their dogmatic opposition to the promotion of prostate testing – are deciding the fate of a lot of men in this country.

This comment in no way applies to the medics who have treated me – surgeon Rodney Studd and the team at Wellington Hospital, Bob Hale at the urology department, the nurse-manager of the rehab clinic, and to GP Rob McIlroy.

Thanks to them, I feel confident of a long life. I don’t care about speaking too soon – I’m just not suspicious about tempting fate.

NEXT (some time away): PSA – wherefore art thou?

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PART 20 of My PC Adventure – see full story HERE>

Having prostate cancer could be a terribly lonely experience, if you let it.

Sounds ridiculous to say that, doesn’t it.

After all, prostate cancer is scarcely a rare disease. In fact, it seems like an epidemic when you start asking around. A lot of famous people seem to die from it.

On any given day there are millions of words written about it on the ‘net.

There is a fully-developed medical structure for dealing with it, and each year there is a well-publicised fund-raising campaign which persuades young men to grow awful moustaches for the cause.

So what’s with the “L” word?

Well, think on this.

If I’d just had a triple by-pass heart operation and did what I did today – climbed to the top of Wellington’s Mt Victoria – people would be saying “Hey, you’re looking fit and healthy. It obviously went well…” etc.

If it was a brain tumour I’d had removed, they would be complimenting me on my restored mental acuity (if I had, in fact, regained it, or had it in the first place).

But the prostate…you can’t invite people into the loo and show them how well you’re peeing.

And there are  those little question marks in people’s minds about manhood, continence and nappies. Does he have a wet patch down there? They can’t take a look, overtly. That would be like staring at a woman’s chest after she’s told you about her breast cancer operation.

Men have been the butt of cruel jokes about prostate problems for a long time, and traditionally they’ve kept discussions about it to spouses/partners, who must get thoroughly sick of the whole thing.

Friends and colleagues are wonderfully concerned and supportive, for a while, but who can blame them for moving on. Even close relatives show a reluctance to go into too much detail (why would they – they might be next?).

The prostate doesn’t exactly have the stigma of Aids or syphilis, but it isn’t something you can readily bring up at a party and hope to sustain dialogue.

It’s just too complicated. A heart transplant sounds easier…and consequently, easier to talk about.

The other problem is where to go to check on all the little hurdles and side issues that arise during recovery.

This is no indictment of the medical system, but once you’re seen to be healing (within a few days of surgery), you’re essentially on your own, unless something goes obviously wrong.

It’s one long wait, in silence. You can’t ring up the surgeon or your doctor every five minutes because you can’t remember what he/she said about such-and-such a development.

How long should there be blood in my urine? Should my boys be this swollen and this colour? And what’s incontinent as opposed to a little bit incontinent in certain circumstances? And how…you get the drift.

This is a long and probably tedious buildup to what I want to discuss next: the discussion group.

Whoa, I hear you say: why would I want to trust the advice of a bunch of fellow patients, who are probably just as unqualified as me?

Fair question. But take a look at these samples from a prostate cancer discussion group on the web and ask the question again (names changed to respect privacy).

First discussion is about PSA levels after surgery:

PHIL: Had RP in January, 2007, Gleason 7, negative margins, cancer (5% volume) contained to prostate. Had seven blood tests since the surgery, with PSA at undetectable levels. At my two year marker (March, 2009), I had a .28 PSA. It was recommended to see a radiation doctor for further treatment. I am presently in the process of gathering information to make a decision in what direction to take. I am 69 years old. I am open for any input.

ANDREW: (same day): What happened to you is the “usual”. PC more often than not, especially G-7 and up, develops microscopic mets very early, outside the Prostate. You might still have area confined disease, though. When my PSA started to “get up there”, I had a detailed biopsy before I made any moves. The results were negative…bad news…the “Horsie was out of the barn”. However, at least my urinary system was not under threat!

You had a different treatment than I did. Nevertheless, I’m not happy with the sudden rise of PSA from undetectable to .28 either. I would discuss this with my doctor. He might advise you to get one or two more PSA tests for comparison in establishing doubling time before making a move, but he probably will suggest an area biopsy somewhere down the road. If it is positive, that, in an important sense, is good news…you might qualify for salvage radiation. If the biopsy of the area is negative, you might want to use some ADT treatment for a couple of years and then come off for a while to see if you have a durable remission.

You are lucky you are 69. It is highly unlikely you will die of prostate cancer! It just looks like you will be obliged to manage your situation as you would manage any chronic condition.

ALAN: (17 days later):  Check out articles by Dr Snuffy Myers and the work they are doing at the Dattoli Center in Florida on radiation therapy for high risk cancers, even after surgery.

PERCY: (same day):  First thing, make sure you got an accurate PSA, same hospital or office, same lab, etc. Also, sometimes it is recommended that you have another in 3 months. Second, regardless of opinions, make sure you get a second or third, to get a good look at what several experts are saying. Some teaching hospitals have a medical staffing on second opinion case where all the oncology Docs make a recommendation. I would for sure use somebody like Dr. Snuffy Myers as recommended by Alan above. He is the best. Keep us posted and up to date on what you do so we are abreast of what’s going on. Keep you in our thoughts.

TERENCE: (a month later): I am 63 and had a RP in 2002. PSA was 7.5 with Gleason of 7. After 2 years, PSA started rising. Had radiation to prostate bed and PSA returned to undetectable. In 2009, PSA was again detectable and rose to a high of 0.85 and has now leveled off at 0.70 for the last few months. Continuing to watch PSA was having it checked about every 6 weeks, but now every three months since it is staying at 0.70.

PHIL: (same day): I decided to get another opinion from a different hospital and Doctor here in the Portland, Oregon: Oregon Health, Sciences University. They recommended I get another blood test and follow up from there. I just received the results: my PSA dropped to .10. They asked me to wait another 3 months and do another blood test. Thanks for all your concerns and prayers.

ANDREW again (same day): It looks like you dodged a bullet to me! Really, those tests can be off and your approach was absolutely correct. Remember, a small amount of healthy prostate tissue sometimes remains after surgery…that tissue obviously produces PSA. If your post-surgical PSA…as accurately measured, shows an actual decline, you have a very good chance of being in the clear! Thanks for keeping us updated!

SITE ADMINISTRATOR: (same day): Hey Phil…That’s good news. Keep the microscope focused on the numbers for a while, just in case, but there’s a great lesson here for everyone – don’t over-react to small changes in the PSA level. It happens.

Second discussion is about the immediate after-effects of surgery:

BILL: Well, the surgery went off w/o a hitch Monday afternoon. Returned home last night. Couldn’t believe my eyes when I stepped on the scale, + 10 lbs! Some minor swelling and bloating, but feeling fine. Even the cath (catheter) isn’t as bad as I thought it would be 🙂 Dr says all went well and was able to save both nerves. However….my palpable “camel hump” concerned him. Will meet 10 days hopefully for cath removal and keep our fingers crossed for a promising path report. Till then…

JED: Great job Bill. Now that is behind you and the healing begins.

BRIAN:  I’m sure the swelling will disappear, as mine did over a couple of weeks. One advantage was I couldn’t look down and see my scar. I’ve found I’ve actually lost about 4 kilograms in the long run (op was a month ago).

BILL:  HELP!! I just noticed that my penis and scrotum are now turning black and blue. Is this normal post op? Feeling fine otherwise. Don’t recall reading or hearing about this. Thanks…

JOHN:  Obviously time to make a telephone call to your urologist rather than rely on “what I did” from other men.

BOB:  Go to the Dr ASAP.

BRIAN:  Good advice. Mine swelled up, but there was no black and blue bruising.

JEFF:  Bill…ask your Dr. After I had mine it shocked me to see my scrotum the size of a small grapefruit!! HAHA…it sounds funny now. I did notice some black and blue there also. Good idea to check it out though.

TERRY:  I can relate to the grapefruit analogy. I also recall discoloration, but don’t know that I would call it black & blue. But I would suspect that it’s in the realm of normal, considering the trauma inflicted.

JEFF:  You’re right, Terry…it wasn’t exactly black and blue, but it was discolored. The size shocked me, they didn’t warn me, so I called my Dr. It was from all the trauma.

Four days later:

ALBERT:  So, Bill, how are you doing now? Please tell us. My surgery is scheduled [next month].

BILL:  Thanks for asking, Albert. Everything seems ok…for now. Meeting w/dr [soon] for path report and (hopefully) cath removal 🙂 My wife is nervous and struggles sometimes. She’s just scared and it seems to get the best of her sometimes. I just try to comfort her and tell her it is what it is. One step (report) at a time. Sure, I’ll be pleasantly surprised if the path report is promising. But the reality of this program is it’s something we will have to manage for the rest of my years. That’s just the way it is and I’ve accepted it. Will update later this week. Sounds like you have a bit of a wait until your surgery. I didn’t catch much of your info other than it appears you’re on top of things. Sounds like we may have similar situations…50-something, 2nd marriage? Any way…good luck & enjoy yourself. It really hasn’t been too bad.

The benefits of this kind of exchange are obvious: lonely patients getting into contact with those who have experienced something similar.

The dangers are obvious, as well: unqualified people passing on their inexpert advice to others. But in the first discussion, note the affirming interpretation from the site administrator, who in this case has considerable expertise available to him.

In the second discussion, see how quickly contributors urged Bill to go and see his doctor. Sometimes, that’s all that’s needed for someone to realise they’re not being neurotic.

The other plus in this kind of forum is the warmth that comes through from fellow patients. Medical practitioners can exude the same compassion, of course, but are necessarily constrained by their professional status.

Nothing quite like reading someone else’s account of something that also happened to you. The sense of affirmation (and relief) is palpable.

NEXT:  End of the golden weather.

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CONNECTICUT POST HEALTH: Q: What should someone like me do when it comes to the prostate cancer test? Please help me make a decision.  For the answer, READ MORE>

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PART 13 of My PC Adventure (read the full story HERE)

The 18-year-old occupies a mystical place in the minds of baby boomer males, because of a piece of supposed medical science that emerged when, for us, it was already too late.

According to this story, men at 18 were at the peak of their sexual powers: from then on it was gradual decline. The same story said women reached this stage at 35. The fodder for fantasy was extensive.

But 18-year-old males have another attribute, much under-appreciated by them – they can pee highest up the wall (even over it).

In the post-RSA generation of testosterone-driven management power games (the days of the Brierly boys) the epithet about young male managers competing to piss highest up the urinal wall ruled supreme. Metaphorically speaking, everybody in the board-room was eternally 18.

Now I’ve discovered a way to get it back: have a radical prostatectomy.

Surgeon Rod said this would be the case (although we didn’t use the 18-year-old simile), but I may have overlooked his advice on one of the better side effects of the treatment, because I was preoccupied with scoping my fears about incontinence and functional dysfunction.

My first pee after getting the catheter removed was spectacular. If you can stand the sight, click on the arrow:

[youtube=http://www.youtube.com/watch?v=yOr8W7hsQQs]

UPDATE: You Tube has removed this video, citing it an offence against their community guidelines. Here’s a still from it:

Getting to this milestone, naturally, was not uncomplicated.

After six days of Mr Catheter, Bob Hale rang from the Wellington Hospital urology clinic to say they’d successfully completed the move to the new building and my tentative appointment for 1pm was confirmed. I got there to discover I was his first ever patient in the new quarters.

I hid my terror beneath talkativeness. How was he going to get this thing out of my thing without it hurting like hell?

First things first. I laid on the bed and he prepared to remove the clear plastic dressing from my wound: “Open your eyes,” I was instructed. “There’s a bit of hair regrowth…” Off it came. No problem. No pain. Every gain.

He had a young Indian med student with him, so Lin and I got a good running commentary on procedure.

Next job: to very gently pump 150 mills of water up the tube and into my bladder. Lying back on the bed, I was unaware of the process.

Then: “Open your eyes.” He was going to withdraw the tube. Oh shit!

But…nothing. I FELT NOTHING! And then it was out. Big phew! What a master.

Okay, says Bob, gently sit up. He held a pad beneath my willy. Nothing leaked.

Okay, now sit on the edge of the bed. Same. No leakage. “Excellent.”

Now stand. Just a drip or two.

Okay, here’s the bottle. He turns on a tap to run water, and he and the student retire behind the curtain. I think to myself: ‘It’s okay, Bob. I’m not piss proud any more.’

I pee. “Listen to that,” says Bob. “That’s a very good stream.”

Exactly 150 mills in the bottle. Splendid.

pads2Next, he fits an absorbent pad to the inside of my Dan Carters.

It’s there to take any “accidents”.

It has a sticky side which adheres firmly to the material of the underpants. Ingenious.pads3

The pad he uses is bulky and I immediately think of Elizabethan gents and their cods-wallops.

Later I discover that pads come in various sizes.

I’m able to switch to slim versions that are barely noticeable.

pads1I also discover by accident just how clever the mechanics are.

I drop one into the toilet pan and when I fish it out, there isn’t a drop spilt as I transfer it to the rubbish bin.

Now that’s absorbent!

Women readers (if there are any) will be smiling, I guess, since I now realise their knowledge of absorbent pads is a lot greater than that of me and my male peers.

Next, Bob runs through the exercises.

Exercises? Yep, I will need to learn to flex my pelvic floor muscle.

Let’s give it a try. Yep, I’ve got it straight away: feels like tightening the rectum, while the willy gives a little twitch.

Practice at this will be needed over following weeks so the sole remaining sphincter (valve) at the foot of my bladder isn’t required to do all the work when it comes to damming things back.

A well-trained pelvic muscle will complement the process, and stop me peeing myself at the wrong times, such as when I cough, sneeze or get up suddenly from a chair.

It will take about three months, apparently: clench and hold for up to 10s, do it 12 times, with rests between, and keep breathing. Then 12 short ones.

Takes about five minutes a day, and later I find myself doing it on walks, sitting in the car, lying watching telly.

Back home, I get the urge to have my first try at freelance peeing.

The result is a shock.

I’m used to hunching above the pan with my left forearm leaning on the wall, but now it’s an entirely inappropriate stance – my urine emerges in such a rush of fire hydrant power it hits the back of the seat.

I reel back and find I can get it in the pan from a metre away.

I let out a whoop that has Lin running into the bathroom in panic. Wow, the sheer joy of it, after years of struggling to get a stream.

A friend told me before the operation he had seen men in tears at the urinal of his club, desperately trying to have a leak. If any of them are reading this, think about it.

If this is “quality of life” change, then I’ll take it, thanks.

NEXT: Bloody disaster!

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Part 1 of My PC Adventure: a Kiwi male’s brush with prostate cancer

NZ TV current affairs host Paul Holmes said it on his show during one his monologues: “Got trouble with the wee-wees – get it checked out.”

It was the 1990s, I seem to recall, and he was taking us through his experience of prostate cancer: discovery, treatment, aftermath, and advice on how up-tight Kiwi blokes should have regular medical checkups to catch the devil early. He said it all in a dramatic sweat, the perspiration running off him under bright lights and the effects of whatever chemo/radiation treatment he was getting at the time.

It resonated, but only slightly, in that “yeah-better-get-checked-but-not-because-I’m-a-hypochondriac” way men have.

I’d had a gradual slowing of piddle flow from about 1994, and eventually mentioned it when I was talking to my GP on Waiheke Island where we lived at the time. I asked the doctor – an old school colleague called Barnett Bond – whether I needed a blood test (I’d heard about it, vaguely) and his response surprised me: “I’m not giving you the test.” 

In his opinion, the PSA test was as yet inexact: it could pick up five different enzymes (I think that was the term he used), only one of which was a cancer indicator. A positive test had a good chance of being a false alarm, needlessly putting the patient through further testing that was not very pleasant.

Meantime, he said, a digital exploration would do. My first, it revealed nothing untoward.

Ah, I hear you say: the old “finger-up-the-arse”, the dread of every red-blooded Kiwi male, a wellspring of homophobic fear and tasteless “jokes” along the lines of “I’m bloody glad I’m not gay”, etc.

Actually, it’s no big deal. The doc gets you to lie on your side, underpants down and knees drawn up. He puts on a rubber glove (in my experience, without any snapping sounds) and before you can blink inserts a finger (I’ve never seen which one) deftly up the back passage and has a quick feel of the prostate gland, a walnut-sized organ attached to the bottom of the bladder, and through which the urethra (the tube taking piss from the bladder) passes on its way to the penis.

The prostate can be easily felt up through the wall of the colon. My only advice is, have a leak before the examination, because prodding against a full bladder is uncomfortable.

By 1998, I’d moved to New Plymouth, where my new GP, Hiran Fernando (who later ended up in jail for offences against some of his female patients), did both the digital exam and a PSA blood test, about which he had no qualms. Both showed a benign result, so at the age of 56, I seemed in good shape to avoid the prostate cancer discovered in my father at the age of 83.

Or so I thought. I now know that most men develop it or at least an enlarged prostate as they head into old age (I’ll put that at 80), and the chances you’ll get it if your father did are probably enhanced.

Meantime, what was causing the gradual loss of flow? Why was it becoming something of a joke to stand in a public urinal taking several minutes to leak a weak stream, while two or more young men could come in, let fly with what sounded to my increasingly sensitive ear like a horse slash and leave well before I was finished?

Odd thing is, I didn’t ask my New Plymouth GP. I was happy with the negative test results for prostate cancer, so thought it was just age creeping up gradually. Turned out, I was right, but more on that later.

There was another reason not to push it. In my adolescent years and up until I was about 30, I suffered a “condition” sensitively dubbed by a mate I confided in as being “piss proud”. Basically, I couldn’t go in public. Even one other bloke standing at another urinal at the far end of a line of 20 was enough to stop anything happening.

This led to some fairly stressful experiences, the most memorable at the age of about 12 when trying to go during halftime at a Ranfurly Shield match at New Plymouth’s Rugby Park. Finding myself at the head of a 1000-man queue for what seemed like the sole male lavatory and being told in no uncertain terms it was “three-at-a-time”, I froze.

Full bladder notwithstanding, all I could do was aim a maddenly dry dick – shrunk by fright to the size of a peanut – at the filthy white bowl for what seemed like hours, ever mindful of a howl of impatience and derision rising behind me. My comrades in micturition changed constantly, until, at a point when two new ones stepped up at the same time, I feigned shaking the drops off and stepped away. The capacity of a full bladder to stay that way for a long time was cruelly demonstrated that day.

Eventually, I found a way to overcome the problem – by counting the tiles in the loo. I would start at the roof of the wall before me and count the tiles (or screws, or individual letters in the graffiti, whatever) and freeze my mind with distraction until a tentative piddle began. By 30, this ridiculous affliction simply vanished and now I can piss it out with the best of them.

Except, of course, I was past my wall-conquering best. That hydrant flow of the 18-year-old had matured into a respectable stream that was able to be directed clear of the shoes, but which never again approached the cataract qualities of the stallion. Not that I gave a bugger, given that just to be able to piss on demand was triumph enough.

Then, in the late-40s, the arcing stream, though still intact as a single body of water, began ever-so-slowly to weaken. I put it down to nothing more than the psychological aftermath of my youthful brush with piss pride and apart from my half-hearted alert to Barnett (his response escapes me now) said nothing during annual medical checkups, which I’d started getting after an accidental discovery of raised cholesterol in 1991 (that’s a whole different story).

So, that’s the rundown on some of my internal plumbing, the bits relevant to this tale. Read my next blog to see where it all began to add up.

For information about prostate cancer,  go to the Prostate Cancer Foundation of NZ

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