The Gold Standard…….

Old men and old cars have much in common. As we age, the check engine light comes on a little more often, requiring the services of a good mechanic or doctor to diagnosis the malady and repair the problem. The latest trip to a doctor or to the mechanic for service on an old treasured car, or yourself, is the topic of conversation that inevitably dominates the first few minutes when friends meet for one of God’s greatest creations, a cup of coffee. So it is my friends, I am writing today about a “minimally invasive procedure” that greatly improves the quality of life for many old men. With tongue in cheek, let’s have a look.

It begins harmlessly as we age. A walnut sized male gland grandly named the prostate, decides to grow a bit as apparently it has less to do than in our younger years, and does not like to be ignored. This growth manifests itself, gradually, into a minor inconvenience, a little more urgency as you hustle to the bathroom and the selection of a smaller soft drink to be quaffed with your popcorn as you settle in for an epic movie (are there epics out there anymore?). Then the urgency becomes an issue, say when you are in the upper deck of Arrowhead Stadium on a freezing afternoon, twenty or so minutes from the closest bathroom, that must be negotiated through a hundred or so drunks standing and screaming as you pass. To top off the indignity of this situation, when you arrive at the bathroom, there are twenty or so folks standing in line to use the appropriate fixtures, some of which, like you, take awhile to get the pump primed, and the layers of clothing arranged to get the job done. Football, at this point, is the last thing on your mind.

Now as we enter this phase of life, television advertising promises the instant relief of a pill, super this and super that, along with generally accepted pharmaceuticals the docs can prescribe. I have used the medically approved pills, but the gland isn’t impressed over the long term. By now, the indignity of hurried trips to the facilities is compounded by our inability to accomplish much when we get there. It is time to locate and visit with a urologist who is experienced, compassionate and skillful. Time permitting, I never enter into a potentially life altering experience without the benefit of study, and I am talking published materials and not the internet. Over the last few years, I have relied on the Mayo Clinic treatise on diseases of the prostate for a bell clear, understandable assessment of this “growing problem” so delicately described on television. Enter the “Gold Standard” that is the subject of this piece. Hang on, it get’s better.

I selected a local urologist, Dr. Mark Walterskirchen, M.D., who works in the Mercy network. He embodies all of the attributes that I mentioned above and has become another wonderful addition to my medical team here in Springfield. He was instrumental in guiding me through the options available to manage my “growing” problem, welcoming my inquiring nature as I questioned him with book in hand. There are a number of ways that a benign prostate enlargement can be handled, from lasers to invasive surgeries for really large problems. My particular problem could be handled by a “minimally invasive” procedure that involves approaching the gland through the urethra, cleverly named TURP, or trans urethral resection procedure. At this point, most men will take a deep breath and quietly reflect on just how in the devil they are going to remove pieces of the gland through an opening the size of which the Master has provided. For me, it conjured up a new and deep respect for the miracle of childbirth. When I asked the good doctor how many of these procedures he had performed, he casually replied “over 800” and then I queried his complication rate and found it to be unbelievably low. The surgery was scheduled. I checked into Mercy Hospital mid morning, entered surgery around noon and was home the next day at noon. This procedure has been greatly refined over the years, and in the hands of an experienced doctor produces miraculous results. You spend several hours in bed with huge amounts of intravenous fluids being pumped in and subsequently drained through a catheter where the inevitable bleeding is washed out of your system, thus preventing post operative problems associated with pooled blood anywhere. Pain was easily managed with oral medications and I sit here writing, with zero pain, pushing liquids, and the ability to approach the bathroom with the casual indifference of an 18 year old. Medical science, with the guidance of the Master can produce tremendous results.

So why am I this open about such a personal thing. I know of a number of male friends who are struggling with this aging gland, some of which are associated with my female readers. The thought of this procedure is far more sinister than the actual surgery. This procedure has been around for a long while and the Mayo Clinic, as well as many other very reputable medical cathedrals still refer to it as the “Gold Standard” for BPH, benign prostate hyperplasia.

A final word. Dr. Walterskirchen embodies the essence of the practice of medicine. His work ethic is unbelievable and yet his patience is unlimited. He is a busy man, but will take the time to discuss this sensitive business with his patients and help them to arrive at decisions based on solid medical evidence in a collaborative environment. My care at Mercy was second to none, and I have been a serious patient at the renowned Cleveland Clinic.

Oh, and to the women who have given birth and endured other minimally invasive indignities with your feet in stirrups, my hat is off to you. I have seen the light!

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