Meeting my doctor in person

A few days after my first boold and urin test, my doctor's secretary called me and gave me an appointment to see my doctor in person on March 6th which is today.

I have been thinking about this day since my urine test. I am expecting some bad news. I am also mentally preparing to discuss about my phimosis. I have a good feeling from our phone conversation that this doctor has a good listening ear and will be open to discussion non-surgical solutions. At least I hope, circumcision for me would be the very last resort. I have been replaying my speach in my head almost every night while trying to go to sleep.

I have about half hour to drive to the doctor office. I am thinking about that speach and I am a bit stresses. But this stress has morphed from stress into hopeful excitement. Then the other instant i think about how dark my urine was and the stress moves into preparing for bad news. I just can't wait to arrive there and one way or another end that stress. Hopefully for the best.

I brought a book (The Annotated Turing) to read while I wait. I take a seat in the waiting room and open the book, I re-read the same paragraph a couple of times but my concentration is really not there. I was waiting about 15 minutes and the doctor calls me.

We get in her office and she again has a bit of small talk before even opening up my file I like that, I feel welcome and feel like it's a friendly relationship more than a doctor that I still fear a little bit. She then opens my file and confirms my information. She takes my temperature and weight and height and blood pressure and pulse. She mentions I have slightly high blood pressure and pulse. I tell her I am a bit stressed and scared of doctors. She tells me it's normal to be more stressed in such situations and it's not rare to have much higher values in the doctor office than at home. She aked me if I had a blood pressure machine at home. We do have a couple of them, my girlfriend is a nurse and my mom has one too. We talk a bit about where my girlfriend works, etc. She then says that for my homework, I will have to take my blood pressure at random times of day for multiple days and bring her those results on the next visit to have an idea about the real world values. She says, we have a couple of things to discuss, my tests are not very good.

I was kind of expecting that honestly. She starts with my blood test and asks if there is history of cholesterol problems in my family. I was expecting she would have started with my urine test as that was what was worrying me the most. So I tell her that yes, on my father side, the whole family had some mix of cholesterol and diabetes problems. She explains to me that my cholesterol levels are extremelly high for someone my age and she is not surprised about the genetics in this. We discuss a bit about exercise and diet. I explain to her that I think I have a good diet if I compare myself to the rest of the family but I do lack exercise, I do office work every day and work from home. I mainly stand up to go eat or go to the bathroom. She recommended me to try and have more light exercise like taking walks ideally at least half hour per day.

Then since my diet is not too bad, she would like to prescribe me pills to lower my cholesterol. But she would like to start me directly on massive dosages and those pills have possible side-effects that can in some individuals be quite strong. Nothing crazy but muscle pain and weakness and some such. It's a combination of two complimentary piils, one acts on the blood to eliminate cholesterol and the other acts on the digestive system to limit cholesterol absorbtion. The second one can cause diarhea, gases and some such. She asks me if I agree with this course of action and patiently waits for my comments. I am not surprised with the high cholesterol levels, I knew that was in the family. I am a bit surprised on the interaction and her asking me my opinion about it. I like that. So of course I agree and tell her I can handle some pain if it helps me live longer of course. She then tells me that this is one very effective drug but if the side-effects are too strong that she has others and to not attempt too hard to live with the side-effects. But she want's me to start each of those two pills 2 weeks apart so that if I don't tolerate them, we can know which one it is. (In the end I had absolutelly no side-effects, which is awesome).

Then she asked me if I had any questions about this before moving on to the urine test. I did not have any. On the urine side of things, I had very high micro-albumin levels and above average protein levels. The main concern is the micro-albumin, they are not bad per se, but they indicate bad kidney filtration. It means that other things that the kidneys should filter are also passing down the urinary system. But it's hard to know exactly why without more investigation. Here I am thinking about a camera up my penis again. But she quickly continues on. She said that it can be something as benigh as simply high blood pressure (which can be caused also by the high cholesterol levels) or something as bad as kidney failure or anything in between, so we'll cross that bridge when we cross that bridge. She asked me if I ever had an abdominal ultrasound. I said no. She then explained to me that this the the least invasive first step to have some clue and eliminate some obvious possibilities. It's a totally painless process, it's just like a pregnant women having an ultrasound, they move a probe around my body and take pictures. She would like to do a full abdomen ultrasound and not just the kidneys because it might help us on the urinary traction infections history to also be able to see the bladder and the spleen. I am totally stumped, why did no other previous doctor prescribed me this totally painless non-invasive investigation and scared me with cameras up my penis and circumcision!

I have a great feeling and I am totally ready to now go ahead and tell my story as I see she is starting to wrap up on paperwork.

So I go ahead and tell her that I have something else to discuss. I explain I am sorry to only mention it at this point but that I was really scared of doctors and she made me feel at home and it's only now that I am feeling ready. I go ahead and explain that when my parents immigrated to Canada we had to all have medical exams to get our citizenship. And that the doctor who examined me saw my foreskin was not retratable and force it. She immediatelly frowned very strongly in disaproval and said this should never be done and that she guesses now I have phimosis. Wow she got it totally and she is not of those doctors that think this is right. I feel like a huge weight just came off my shoulders, a weight I have been carrying alone for so many years. I exhale all the air I had in my lungs and take a short moment to sit back relax, I feel good now.

So I proceed with telling her that circumcision for me is really a last resort solution and that I know that some people can cure it with prescription steroid cream and a lenghty regimen of stretching. That I would like to try that if she can prescribe it or would like if she could refer me to a urologist that she trusts to not be too strongly biased towards circumcision. She says she can totally do it but needs a few moments to look into some references for dosage and such. She goes on the computer and I tell her I have been doing research and she probably won't find much serious documentation with scientific studies on adults doing this, it's mostly individuals talking about their process and story online. I had this great forum but it closed, now one can only find a few blogs about it here and there. She confirms she does not find much info on adults but that it can't hurt to try.

She then tells me that she totally understands my fears with the context of what a doctor did to me but if I would allow her to take a look so we can monitor progress in future visits and to rule out any obvious other problems. I tell her I have trust in her now and as long as she explains her intentions before any act, I won't freak out. So I get on the table and proceed to drop my pants and show her. She is really surprised at how small the orrifice is and that I did not get more urinary tract infections. She explains that this may actually be the only cause for those infections and the indicators in my urine tests. The urinary system is just pipes and if there is not a good flow through them, then these things happen.

So she prescribes me Betaderm 0.05% cream for 6 weeks and then we will talk again. That we will also keep circumcision off the table for as long as possible and re-asses after trying this. And I am the patient and the person deciding anything, she is there to give advice only, nobody an force anything I don't want done to me.

I thanked her so many times for everything she did, she made me feel confortable, she agreed with my opinions and I feel she is really more helpful than imposing. I got out of that doctor office almost dancing and I ran to the drugstore to pick up my cream. Unfortunatelly someone made a mistake and sent my prescription to a different drugstore, so I had to wait the next day to go pick it up.

As soon as I came home, I told my girlfriend the whole story and she is happy but certainly not as much as I am. I would schedule a party if it was not such a private matter.

In my next posts I will actually start my treatment and discuss each step along the way.