As I get close to the day of the procedure, I encounter more surprises. I received a call from my local pharmacy that my prescription was ready. I didn’t know what that was. No one had told me that I would be getting a prescription prior to the surgery. It turned out to be generic Flomax. I suppose this is good to have on hand for after the surgery, but as I mentioned earlier, I wasn’t having any urinary symptoms and hadn’t been given any instructions on this.
Then I got an email from the hospital with a link to a website. It requested me to go to this site to view their “emmi” program. This turned out to be a series of four audio/video clips. They provide a long numeric password for my privacy. I’m not sure what they were trying to protect since the videos provided nothing but the most basic information. There was nothing in them identifying me or specific to my procedure. One of them was about “my hospital stay”. It took ten minutes to say that my medical team cared about me, washed their hands, and that I should ask if I have any questions. Another one was on how to prepare my skin for the surgery. It made two important points: 1) wash your skin thoroughly before the procedure, especially the area of the body where the surgery will take place; 2) but do NOT do this for the genital area. Hello – the area of my surgery is the genital area. Do I wash it or not? The narrator for all of them is a woman who sounds exactly like she’s reading a story book to four-year-olds. It’s very demeaning. They even assure the viewer that it is very easy to use a computer to watch the videos, which the viewer can only hear if they have already begun watching the videos on the computer. The unit on anesthesia begins by telling me what surgery is. Do I really need that? Again the emphasis is all about how much everyone cares about me, yada yada. Then it lists 11 risks of anesthesia alone and point out this does not include all the risks of anesthesia, and none of the risks of the surgery part itself. It’s pretty scary, actually. I don’t know why they want the patient to view this unless the lawyers want them to force it onto the patients for liability reasons. The last one was about Advance Directives. My wife and I just had our estate plan updated and have new Advance Directives, and the hospital and our family doctor have copies, so this video is totally unnecessary for me. If they’d bothered to check or personalize it they would have known this, but obviously they didn’t. Altogether these pointless videos take almost an hour. I found them patronizing almost to the point of being insulting, although for some very young or very poorly educated patients I can see how they might be appropriate. Watching them all was harmless enough, I suppose, but irritating and I came away feeling that I was just a checkbox item they had to check according to their lawyers. They seemed worried about their skin, not mine.
A few days before the scheduled surgery I got a call from Dr. K. He began by introducing himself and saying he worked with Dr. N whom I had met. Dr. K didn’t even remember that he had examined me and measured my prostate, much less his promise that he would coordinate with Dr. A (which I already knew he had not done). The good news is that he and Dr. A had been talking and had decided that the EBRT was unnecessary. He described it as overkill. So he would be ordering seeds for the brachytherapy at a stronger level. If the brachytherapy is to be followed by EBRT, they have to reduce the initial dose from the brachytherapy to avoid an overdose of radiation. I was glad to hear this, of course, since the whole thing is over much sooner, and because there are a few side effects from the EBRT that are not present, or not as often present or in the same strength, as with brachytherapy alone. I don’t want to expose my body to any more radiation than is necessary. The reduction was also reassuring in that it signified that my biopsy results were not as serious as previously thought and that there was no evidence cancer cells had escaped the prostate to the surrounding tissue. It was very disturbing, however, to find that my treating doctor had no memory of me. What else didn’t he know? Did he see the note about the bad Cipro reaction that I had called in to his office?