Had A Urodynamics Procedure Today

Thanks, hon. By this time Wednesday I should be on a path forward.

 

It's odd. I got on this roller coaster because of some strange gastro issues (I had for many months when I lost my insurance) that magically cleared themselves up once I took the barium drink for the CT scan and then immediately did a colonoscopy prep (I think this was about 4 years ago.) But the CT scan found a bladder stone and a kidney cyst that had to be observed for a year before being declared a nothing burger. So it was me finally deciding to have the bladder stone removed (before I got older and it got bigger) that got me into a urologist that then got me on this path.

The upside that I keep reminding myself of is that the CT scan and the colonoscopy and the endoscopy and all the other tests pretty much gave me an in-depth clean bill of health (at the time), to include scans of my vessels, my heart and my lungs. So other than not being able to pee, there's nothing else wrong (that I'm aware of.) But visits to the urologists have been "eventful" and frustrating, and going on for a few years. I'm ready to get off of this treadmill.

This procedure I'm having wasn't even raised by my doctor. He gave me the choice of being always cathed or of doing it myself when I needed to pee (same 2 choices another practice presented.) I read about this other procedure on the web and I raised it with him. Apparently his practice has some number of patients who have had this done. I guess they save it for special circumstances (MS patients are the classic recipients of this procedure because of neurological problems and dexterity issues...plus being wheelchair bound makes the normal way of being cathed highly uncomfortable and tough to change every month.) I don't know why they push all other patients to self-cath just because those patients have the physical capacity to...this other procedure is so minor they often do it with a local anesthetic.

So I'm gonna do this. And I'm gonna catch one of the nurses at the right moment and ask her what the self-cath fetish is all about. I know I can charm the ugly truth out of one of them.

 

I was with my last GP for 25 years, even when he was "Out of Network" with my then-current insurance plan. After I moved, I still drove 200 miles round trip to have him do my annual physicals...until he retired. (I was sometimes able to coordinated them with business trips I was already making.) He was such a good guy. He and his wife (his nurse) came here from Belgium.

And you're right about nurses. Find the right one and they'll tell you who the good doctors are and who the butchers are. I got in an FDA pilot program for a new procedure when I had a cervical disc replaced because a nurse pointed me in the right direction. There's one such nurse I really like at this urology practice, but you cannot request a specific nurse when you make an appointment, although I've not tried to push it hard. This is a large practice...40 doctors and 6 locations...so it's more complicated than making an informal on-the-fly request made in a small practice..

 

I'm thinking a bottom-up approach might work. I need to be nice to whoever sits behind the keyboard (not that I'm not already nice to folks.) If I find a way to contact that nurse directly, I can ask her the best path to take. But I was really motivated to keep her when I thought my normal catheter was being replaced monthly and I had problems with an extraction done by others. Now that I'll have this one below my belly, they'll schedule me with the nurse who is experienced in changing that style catheter. They told me her name, and it's not the nurse I like. I imagine she'll be OK...and this is an entirely different process that I shall dread less. (Some folks actually change their own catheter of this style.)

I was told they get some number of "specific nurse" requests like mine. Their official story is that it's logistically impossible to accommodate everyone. I think the real story is that in these huge places, the nurses are the ones who are actually enacting the daily procedures on patients: inserting catheters, removing catheters, doing retention tests, etc. They are the front-line hands-on routine care providers, while the doctors are merely periodic technical advisors who do the situational high-end work. I've went in for my "cannot pee" emergency and then a week later for a retention test, and did not see my doctor before/during/after either procedure. He may have even been at a different office that day. Given the intimate nature of this stuff, I imagine that many of us would follow a favorite nurse from practice to practice before we'd have loyalty to a given doctor, especially when we're past the diagnostics phase and are into routine maintenance. And that's likely their concern.

You know, when I mentioned this stellar nurse to my doctor, he had no idea who I was talking about, and she has been there for 5 years! She actually started the same day my doctor's personal nurse did in 2017, and those two became personal friends...yet he would not know her if they bumped carts in Walmart. It's a huge practice.

 

I don't mind the process of aging. It's being aware of it that I find frustrating.

And I can't complain...I've had darned few health issues in my life.

 

Uh, that's not the right thing to say to a guy who's 68. I was hoping to get my arms around this bladder issue and try for an uptick in my state of being.