My First Prostate Exam - Advice Please

[Antonymous]

30 minutes ago, JetSetFvr said:

Don't take this the wrong way but some massage places have woman there professionally trained in Prostate massage that DID clear up some trapped fluids I had in there.  Aside from that, selenium and beta prostate lowered any risk I had.  Consider it.  Ever since those "treatments" I have stronger erections, I don't wake up to pee etc.  I did them once a week for a month and my prostate declined in size. 

 

Just a thought and suggestion.  Besides, I would rather have a woman with a finger in my nether regions than a man any day but I digress.

Very interesting and I know you are being serious about this. I read up on prostate massage many years ago and there was a whole medically related forum on the topic (which I can't find now). Practitioners swore that it was the best way to shrink the size of the prostate.

 

May I ask, where did you get it done; and was the masseuse trained to perform this procedure?

[tomgreen]

First a thank you to Sheryl and every one else who offered a suggestion or advice .

 

So I made it to Korat and finally went to the Suranareen University of Technical Hospital and things went like this.

 

 

Arrived at the hospital at 8.00 AM , accompanying me were my expat friend who lives in Korat and his Thai wife .Just inside the hospitals main entrance was a patient registration desk at this desk I had to fill out an application form , and outline what my medical problem was and I asked to see a urologist .

 

Once I had completed the application form and the receptionist had checked all my details I was asked for my passport and told to take the completed form and passport to a second near by counter , here I handed in my form and passport , then a head shot photograph of me was taken using a computer . I sat and waited for around five minutes then I was handed a white card and told to take this card a check in desk further down the hall way.

 

Once at the check in desk I handed my card over which was then placed in a basket . Around five minutes later my name was called and I went over to have my blood pressure / height taken by a young lady . The blood pressure results was 169 / 74 ( Heart Rate 68 ). 

 

The young lady said that my blood pressure was on the high side and to go and sit down and she would call me over for a second blood pressure reading in 15 minutes. Five minuets later ( no second blood pressure taken ) a new young lady called my name and I was taken to the urologists office and sat out side while the young lady took my paper work into the doctor. The young lady came out and said that the doctor wanted me to take a blood and urine test before I actually went to see him. So off to have the blood and urine test done . I sat out side the blood test room for around five minutes and then called in to give blood and urine sample .

 

I was told to return to the urologists office in one hour when the blood / urine test results would be available to the doctor . I spent the next hour having some thing to eat and drink.

 

 

 

On returning to the urologists office I was told to sit and wait , five minutes later the light above the doctors office began flashing and the a young lady showed me in to see the urologist . Thankfully the doctor spoke decent English and I explained my symptoms ( getting up in the night to frequently urinate . ) He than asked me if I had any symptoms of not being able to finish urinating or a burning feeling or straining while urinating or any other symptoms relating to urinating , to which I answered no. He then asked me if I had any other medical problems or other symptoms or was I taking any medication , to which I answered no.

 

 

He then performed a manual digital exam , ( finger up the rectum ) . He said that in his view my prostate was enlarged, and then he said that this enlargement was very common in men of my age , and in his view based on his manual digital exam and the PSA result shown on the blood test results I had just done at the hospital , there was no signs of prostrate cancer. 

 

The urologists went on to say that he would prescribe a one month course of tablets , which should reduce the prostate size , and I should return to see him in one month’s time .

 

The doctor also recommended that I cut out all coffee and caffeine products. No other life style recommendations were offered  by the doctor.

 

 

Just a few thoughts on my experience

 

When I went in to see the urologists I did show him my recent previous blood test results that I had done at a privet test clinic , in my conversations with him , he did not mention or refer to these blood test results , ( some of those test results were showing H )

 

 

The doctor made no mention of my blood pressure ( high ) results taken at the hospital

 

I was some what surprised the doctor made the comment that in his view there was no sign of prostrate cancer , after only a simple manual digital exam and after seeing the hospital PSA blood test result .

 

 

From arriving at the hospital at 8.0 AM and leaving at 10.30 AM the whole experience felt professional well run and coordinated , the staff were all very helpful and spoke some English the buildings and consultation rooms were modern clean and tidy , apart from waiting for the blood test results and eating a meal the amount of time I had to sit and wait between each stage was approximately five to ten minutes , so over all a good experience .And at no time I felt like I had been abandoned or forgotten about.

 

 

 

 

 

 

 

 

 

 

The blood test results were listed as ( at the urologists request , I did no know what the blood test results would include ) or had the chance to request any separate specific blood test work .

 

1. PSA 0.898

2. Microscopy – 0-1

3. Mucous thread - Few

4. Creatinine 1.3

5. eGRF 66

6. Urinalysis ( as below )

Color – Yellow

Appearance – Clear

Specific Gravity ( Urine ) 1.025

Sugar – NEGATIVE

Ketone ( Urine ) - NEGATIVE

 

Urine Protien – NEGATIVE

Urobilinogen , urine – NEGATIVE

Bilrubin NEGATIVE

Nitrite – NEGATIVE

Blood – NEGATIVE

Leukocytes – NEGATIVE

Ascorbic Acid – NEGATIVE

 

I did ask if it was possible to walk into the hospital and request just a personal blood test without the need to see a doctor the answer was no.

 

I’m not to sure how the above blood test numbers seem in relation to my current prostate problem .

 

When we arrived back at my friends house my friend took my blood pressure with a portable blood pressure machine he uses him self , my blood pressure results from his machine were

 

116 / 63 ( HR 70 )

 

 

During my visit to this hospital I noticed on several occasions , what appeared to be groups of foreigners wandering about all wearing hospital white coats .

 

So over all not a long or stressful day , and its going to be very interesting to see what the urologist says in one months time on my next visit . To finish I think I am feeling some what better after this hospital visit , but being a born worrier ?     I’m still , well worrying ?

 

 

The total cost for every thing at the hospital  was 1,150 Baht

.

 

Any thoughts on my hospital visit and the outcome welcome .

 

The Drugs the doctor prescribed

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

[KhaoYai]

25 minutes ago, tomgreen said:

I was some what surprised the doctor made the comment that in his view there was no sign of prostrate cancer , after only a simple manual digital exam and after seeing the hospital PSA blood test result .

Tom, given your PSA results, I don't think you'd get a different result in the UK. However, keep a close eye on things, as stated before, PSA is not a definitive guide as to whether cancer is present or not.

 

You do have an option though, in the UK on the NHS you would be hard pressed to get a doctor to authorise a biopsy with your PSA level.  It would also be very expensive privately.  In Thailand you will be able to get a biopsy done much cheaper if you feel the need to be sure.  Personally I'd wait and see what happens after using the medication.  Sounds to me like Prostatitis.

Quote

 

 

Edited July 10, 2018 by KhaoYai

[Artisi]

Tom, unfortunately they didn't do the second BP test, although 169/74/ @ 68 could  just be "white coat" syndrome -  high because you are at the Dr. and a bit stressed there and then.

your friends BP monitor should be checked - 116/63  seems low - but maybe your lucky, but worth rechecking your BP at every chance you get to establish a pattern / log for future reference. Are you close to a clinic or friendly Dr. maybe they would oblige you in giving an occasionally with a BP test - or buy your own monitor. The one I have store data over a months and I can print out a chart showing high / low / heart rate and time. 

[JimmyJ]

I am not a doctor.

 

IMO - You have no need for medication.

 

You have no trouble urinating.

 

" He said that in his view my prostate was enlarged, and then he said that this enlargement was very common in men of my age"

 

You've gotten yourself stressed out over something very common in older men - a possibly enlarged prostate, and more frequent urination than when you were younger.

There were no indications of prostate cancer prior to seeing the doctor, and after getting his diagnosis there is even less reason to suspect it.

 

Read the side effects of the medication before taking it.

 

 

Edited July 10, 2018 by JimmyJ

[tomgreen]

14 hours ago, KhaoYai said:

Tom, given your PSA results, I don't think you'd get a different result in the UK. However, keep a close eye on things, as stated before, PSA is not a definitive guide as to whether cancer is present or not.

 

You do have an option though, in the UK on the NHS you would be hard pressed to get a doctor to authorise a biopsy with your PSA level.  It would also be very expensive privately.  In Thailand you will be able to get a biopsy done much cheaper if you feel the need to be sure.  Personally I'd wait and see what happens after using the medication.  Sounds to me like Prostatitis.

 

Thanks for the comment , I’m going to wait and see what happens in one months time and what the

urologist says . I’m going to check out ‘’ Prostatitis ‘’

 

 

 

 

[tomgreen]

13 hours ago, Artisi said:

Tom, unfortunately they didn't do the second BP test, although 169/74/ @ 68 could  just be "white coat" syndrome -  high because you are at the Dr. and a bit stressed there and then.

your friends BP monitor should be checked - 116/63  seems low - but maybe your lucky, but worth rechecking your BP at every chance you get to establish a pattern / log for future reference. Are you close to a clinic or friendly Dr. maybe they would oblige you in giving an occasionally with a BP test - or buy your own monitor. The one I have store data over a months and I can print out a chart showing high / low / heart rate and time. 

Hi , I was feeling stressed out in the hospital and the unknown results , so may be like you say the white coat syndrome was playing a part . This morning after getting up I checked my BP again using the same friends BP machine , this time the reading was – 114 / 61 HR – 62 .

 

I would be interested to know the make / model of BP machine you have .

 

 

 

 

[tomgreen]

9 hours ago, JimmyJ said:

I am not a doctor.

 

IMO - You have no need for medication.

 

You have no trouble urinating.

 

" He said that in his view my prostate was enlarged, and then he said that this enlargement was very common in men of my age"

 

You've gotten yourself stressed out over something very common in older men - a possibly enlarged prostate, and more frequent urination than when you were younger.

There were no indications of prostate cancer prior to seeing the doctor, and after getting his diagnosis there is even less reason to suspect it.

 

Read the side effects of the medication before taking it.

 

 

 

I was wondering about the medication having read some past comments here from different people about not needing to take any medication due to what seems my possible common low risk prostate problem. I have read the possible side effects of the prescribed drug and seeing them is another cause for concern. The thought of returning back to see the urologist in a months time and saying to him that I had not taken his recommended drug is some thing that needs further thought . You are right , in some ways I am beginning to feel a bit foolish as I may be over reacting to just a normal situation that occurs in men of my age,

 

 

 

 

 

[Sheryl]

Test results and exam result are consistent with benign enlargement of prostate. No indication if prostatitis.

Quite standard to base the diagnosis on digital exam and PSA. A biopsy eould not be indicated. The only difference in what this doctor said/did and what would happen back jome is a Western doctor would have been more circumspect re cancer snd just said mothing to indicate cancer at this time, probably just benign enlargement but we'll monitor your PSA annually just to keep an eye on things (or words to that effect) rather thsn the more definitive statement you report, but that's down to language and culture. No difference in actusl care.

Your frequent urination at night is because your bladder is not emptying completely. It win't be during the day either but less moticeable to you.

Untreated this can predispose to bladder infectionas well as of course disturbing your sleep.

Re the BP reading the machines at these hospitals tend to be very unreliable, plus it is common for BP to temporarily go up during a hospital visit.

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

[Artisi]

24 minutes ago, tomgreen said:

 

Hi , I was feeling stressed out in the hospital and the unknown results , so may be like you say the white coat syndrome was playing a part . This morning after getting up I checked my BP again using the same friends BP machine , this time the reading was – 114 / 61 HR – 62 .

 

I would be interested to know the make / model of BP machohine you have .

 

 

 

 

 

[khlongtoey]

18 hours ago, tomgreen said:

 

First a thank you to Sheryl and every one else who offered a suggestion or advice .

 

So I made it to Korat and finally went to the Suranareen University of Technical Hospital and things went like this.

 

 

Arrived at the hospital at 8.00 AM , accompanying me were my expat friend who lives in Korat and his Thai wife .Just inside the hospitals main entrance was a patient registration desk at this desk I had to fill out an application form , and outline what my medical problem was and I asked to see a urologist .

 

Once I had completed the application form and the receptionist had checked all my details I was asked for my passport and told to take the completed form and passport to a second near by counter , here I handed in my form and passport , then a head shot photograph of me was taken using a computer . I sat and waited for around five minutes then I was handed a white card and told to take this card a check in desk further down the hall way.

 

Once at the check in desk I handed my card over which was then placed in a basket . Around five minutes later my name was called and I went over to have my blood pressure / height taken by a young lady . The blood pressure results was 169 / 74 ( Heart Rate 68 ). 

 

The young lady said that my blood pressure was on the high side and to go and sit down and she would call me over for a second blood pressure reading in 15 minutes. Five minuets later ( no second blood pressure taken ) a new young lady called my name and I was taken to the urologists office and sat out side while the young lady took my paper work into the doctor. The young lady came out and said that the doctor wanted me to take a blood and urine test before I actually went to see him. So off to have the blood and urine test done . I sat out side the blood test room for around five minutes and then called in to give blood and urine sample .

 

 

I was told to return to the urologists office in one hour when the blood / urine test results would be available to the doctor . I spent the next hour having some thing to eat and drink.

 

 

 

On returning to the urologists office I was told to sit and wait , five minutes later the light above the doctors office began flashing and the a young lady showed me in to see the urologist . Thankfully the doctor spoke decent English and I explained my symptoms ( getting up in the night to frequently urinate . ) He than asked me if I had any symptoms of not being able to finish urinating or a burning feeling or straining while urinating or any other symptoms relating to urinating , to which I answered no. He then asked me if I had any other medical problems or other symptoms or was I taking any medication , to which I answered no.

 

 

He then performed a manual digital exam , ( finger up the rectum ) . He said that in his view my prostate was enlarged, and then he said that this enlargement was very common in men of my age , and in his view based on his manual digital exam and the PSA result shown on the blood test results I had just done at the hospital , there was no signs of prostrate cancer. 

 

The urologists went on to say that he would prescribe a one month course of tablets , which should reduce the prostate size , and I should return to see him in one month’s time .

 

 

The doctor also recommended that I cut out all coffee and caffeine products. No other life style recommendations were offered  by the doctor.

 

 

Just a few thoughts on my experience

 

When I went in to see the urologists I did show him my recent previous blood test results that I had done at a privet test clinic , in my conversations with him , he did not mention or refer to these blood test results , ( some of those test results were showing H )

 

 

The doctor made no mention of my blood pressure ( high ) results taken at the hospital

 

I was some what surprised the doctor made the comment that in his view there was no sign of prostrate cancer , after only a simple manual digital exam and after seeing the hospital PSA blood test result .

 

 

 

From arriving at the hospital at 8.0 AM and leaving at 10.30 AM the whole experience felt professional well run and coordinated , the staff were all very helpful and spoke some English the buildings and consultation rooms were modern clean and tidy , apart from waiting for the blood test results and eating a meal the amount of time I had to sit and wait between each stage was approximately five to ten minutes , so over all a good experience .And at no time I felt like I had been abandoned or forgotten about.

 

 

 

 

 

 

 

 

 

 

 

The blood test results were listed as ( at the urologists request , I did no know what the blood test results would include ) or had the chance to request any separate specific blood test work .

 

1. PSA 0.898

2. Microscopy – 0-1

3. Mucous thread - Few

4. Creatinine 1.3

5. eGRF 66

6. Urinalysis ( as below )

Color – Yellow

Appearance – Clear

Specific Gravity ( Urine ) 1.025

Sugar – NEGATIVE

Ketone ( Urine ) - NEGATIVE

 

 

Urine Protien – NEGATIVE

Urobilinogen , urine – NEGATIVE

Bilrubin NEGATIVE

Nitrite – NEGATIVE

Blood – NEGATIVE

Leukocytes – NEGATIVE

Ascorbic Acid – NEGATIVE

 

 

I did ask if it was possible to walk into the hospital and request just a personal blood test without the need to see a doctor the answer was no.

 

I’m not to sure how the above blood test numbers seem in relation to my current prostate problem .

 

When we arrived back at my friends house my friend took my blood pressure with a portable blood pressure machine he uses him self , my blood pressure results from his machine were

 

116 / 63 ( HR 70 )

 

 

During my visit to this hospital I noticed on several occasions , what appeared to be groups of foreigners wandering about all wearing hospital white coats .

 

So over all not a long or stressful day , and its going to be very interesting to see what the urologist says in one months time on my next visit . To finish I think I am feeling some what better after this hospital visit , but being a born worrier ?     I’m still , well worrying ?

 

 

The total cost for every thing at the hospital  was 1,150 Baht

.

 

Any thoughts on my hospital visit and the outcome welcome .

 

The Drugs the doctor prescribed

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Silosin is an alpha blocker, it isn't going to shrink anything, it may help with your symptoms almost immediately but keeping your bladder valve open to allow better bladder emptying

[Artisi]

21 minutes ago, khlongtoey said:

Silosin is an alpha blocker, it isn't going to shrink anything, it may help with your symptoms almost immediately but keeping your bladder valve open to allow better bladder emptying

correct.

Drugs for prostate shrinkage is a different story and comes with a few side effects -  one is - if sexually active you need to get your head around retrograde  ejaculation.

Edited July 11, 2018 by Artisi

[Jip99]

I had to Google that..

[tomgreen]

6 hours ago, Artisi said:

 

Thank you .

[tomgreen]

I did not think about checking out the name of the drug that the urologists prescribed , I just read the accompanying leaflet in the box . I wonder why the urologists said the words ‘’ reduce the prostate size ‘’ and I had it in my mind that on my next visit in a months time the doctor would again do a digital examination to assess any possible reduction in size of my prostrate . So really if the drug ( Siloslin ) is not going to reduce my prostrate size, but only improve / reduce the number of times I have to get up and urinate during the night , then how would an enlarged prostate be reduced in size , and why after the doctor said my prostate was enlarged , would he not prescribe as well as Silosin , other drugs that would in fact help reduce my prostate size ?

[Artisi]

13 minutes ago, tomgreen said:

 

I did not think about checking out the name of the drug that the urologists prescribed , I just read the accompanying leaflet in the box . I wonder why the urologists said the words ‘’ reduce the prostate size ‘’ and I had it in my mind that on my next visit in a months time the doctor would again do a digital examination to assess any possible reduction in size of my prostrate . So really if the drug ( Siloslin ) is not going to reduce my prostrate size, but only improve / reduce the number of times I have to get up and urinate during the night , then how would an enlarged prostate be reduced in size , and why after the doctor said my prostate was enlarged , would he not prescribe as well as Silosin , other drugs that would in fact help reduce my prostate size ?

Maybe wants to try Silodosin initially to gauge affect before introducing further drugs. 

Edited July 11, 2018 by Artisi

[Antonymous]

Tom, IMO you are worrying too much and your results are excellent.

 

White coat syndrome is very common. I get it badly. Even though my wife is a Thai nurse and I’ve been in and out of hospitals frequently (picking her up after work etc), I still get a huge blip in systolic pressure every time I have to have my BP taken in a hospital. It is caused by psychological stress, not any physical condition.

 

For example once when I went to have my eyesight tested (just to get a prescription for new glasses!) my BP at the nurse station was 205/85. Typically my readings for any hospital visit will average 180/85. A few hours later, once home and settled by BP will be around 122/75. I monitor my BP at home with an Omron machine daily.

 

So don’t worry about your 169/74 reading. Note that it was the systolic pressure reading that was elevated, not the diastolic, consistent with anxiety (and WCS).

 

The doc asked if you had any other of the symptoms that are typical for someone with BPH and/or a UTI or acute prostatitis. He had to ask this to be able to eliminate those conditions from the reckoning. You replied No and that was fine.

 

The ‘result’ of the DRI is typically vague too. OK, he didn’t detect signs of cancerous cells and that’s good, but his diagnosis of ‘my prostate was enlarged’ is frankly laughable. How large is ‘large’? How can you possibly monitor any future growth unless you know exactly what the dimensions and volume of the gland are now?! Answer, you cannot and the next DRE you have may be ‘it is still enlarged’ or something equally unhelpful. And also consider that another urologist may use another term like ‘slightly enlarged’ or ‘on the large side of normal’. Do you see where this is going?

 

I had another ultrasound recently and requested the doctor who performed it to study my prostate, bladder and kidneys. YOU can stipulate what it is you want to study Tom. It is sometimes called abdominal KUB (kidneys, uretas, bladder) ultrasound. Please note, you do not need to have a transrectal scan (which uses a transducer anal insertion).

 

Over the course of about 15 minutes he used the ultrasound ‘wand’ to explore the organs carefully, passing it over each organ outside my body. As he was doing this he showed me on the screen what he was seeing and he explained everything clearly to me. At the conclusion he printed out pictures and made a report that gave the precise dimensions length, width and depth of my prostate and the total volume. He was able to show me where my gland was growing (it could be uniform, or mainly inner core around the urethra, or on the periphery) and to conclude that no cancerous or abnormal cells could be detected (they show up as dark areas on the screen). He was able to show how much urine retention volume I had in my bladder and to comment on any abnormalities in the kidneys.

 

With these results I was able to compare the numbers with the previous ultrasound I had done a year ago and draw very meaningful, actionable conclusions from this.

 

You chose to go the DRE route so you have none of this critically useful information. If you are still concerned about your prostate I advise (again) that you have an abdoninal ultrasound. Make sure you keep a copy of all the results so you can compare at another test centre at a later date. Should cost around 1,000 baht.

 

If you go ask a barber if you need a haircut, what do you think he’ll answer? Well guess what, doctors here in Thailand are similar! So no surprise that your doc prescribed an unnecessary drug and furthermore wanted to see you again in ONE month. Ridiculous. He (thinks he) has you on the hook now. Tom, remember that you are in control.

 

Earlier in this thread I gave advice on taking herbs that will help with your BPH and LDL at one and the same time. I stick by that. Tried it and successful for me.

Edited July 11, 2018 by Antonymous

[Antonymous]

All drugs have side effects and personally I avoid them and choose nutrition, herbs and lifestyle changes to fix any emerging conditions. I don't take any drugs, even Paracetomol. Here's what I found from simple Google search about the drug the doc has given to you. If I was serious about taking it I'd do a much more thorough search of course, but here's the lowdown.

 

You could take it, or you could choose alternatives. It is up to you. You know what I'd choose?

 

URIEF (silosin/silodosin/silofast, etc):

Since silodosin has high affinity for the α1A  adrenergic receptor, it causes practically no orthostatic hypotension (in contrast to other α1 blockers). On the other side, the high selectivity seems to be the cause of silodosin's typical side effect of loss of seminal emission.

 

As α1A adrenoceptor antagonists are being investigated as a means to male birth control due to their ability to inhibit ejaculation but not orgasm, a trial with 15 male volunteers was conducted. While silodosin was completely efficacious in preventing the release of semen in all subjects, 12 out of the 15 patients reported mild discomfort upon orgasm. The men also reported the psychosexual side effect of being strongly dissatisfied by their lack of ejaculation.

 

Common side effects include:

dizziness,

weakness,

headache,

sleep problems (insomnia),

diarrhea,

stomach pain,

decreased amount of semen released during sex,

abnormal ejaculation,

runny or stuffy nose, or sore throat

 

Tell your doctor if you have serious side effects including:

feeling like you might pass out, or

an erection that is painful or lasts 4 hours or longer.

[khlongtoey]

6 hours ago, tomgreen said:

 

I did not think about checking out the name of the drug that the urologists prescribed , I just read the accompanying leaflet in the box . I wonder why the urologists said the words ‘’ reduce the prostate size ‘’ and I had it in my mind that on my next visit in a months time the doctor would again do a digital examination to assess any possible reduction in size of my prostrate . So really if the drug ( Siloslin ) is not going to reduce my prostrate size, but only improve / reduce the number of times I have to get up and urinate during the night , then how would an enlarged prostate be reduced in size , and why after the doctor said my prostate was enlarged , would he not prescribe as well as Silosin , other drugs that would in fact help reduce my prostate size ?

Tom: thats correct, it's really fairly simple, but there is lots of  1/2 truths and skeptical information attached to anything regarding a person's  personal "hygeine" areas; 

 

There are 2 classes of drugs  "the alpha blockers"  & "the shrinkers" (& sometimes one pill with be a combo of the two types) ;  If you were to look at a diagram of the anatomy , it should be easy to understand.

 

Bladder has to drain , 1st it must exit the bladder via a valve( which is where alpha blockers act on) ; Then the urine must continue along the ureter/urethrea( the pipe from your bladder through the penis in order to urinate)

 

The pipe goes through the prostate, hence size changes can reduce the diameter of the passage,  if this happens you get backflow, and the bladder doesn't fully empty , so one has to get up at night more often as the bladder refills faster.

 

I believe that's the general outline, probably some caveats or minor errors in my explanation .....  eg. what drives how long the bladder valve stays open

 

Prostate is a slow growing gland, my urologist says 6 months to decide how well a shrinker is working.

 

 

PS: WCH  in my understanding might raise your top (systolic) 10 points but not 40 ; I would keep an eye on it.   

 

There is a simi official method, to reduce the confounding factors, take it when you 1st wake up in the same position laying or sitting, before you start walking around , if it is high on the Left (L), take it on the R also,   whichever arm is highest , wait 5 minutes and retake it again on that arm,  keep a written record

 

you probably don't want to live with a SBP of > 130  IMO  ; of course ; YMMV depending on your other "risk factors"

[Sheryl]

That the doctor only told you "slightly enlarged" does not mean he did not record more precise information on your chary.

Thete is a definite advantage to having the same doctor do the follow up over time.

With your ckinucal picture and PSA I do not think scans or ultrasound indicated and obviously neither did the doctor.

Re medications, drugs that help shrink the prostate do have side effects and are not always necessary if the enlargement is mild. Likely the doctor wants to see first if the other medication is sufficient to ease your symptoms.

Please understand that benign enlargement of the prostate is a normal part of aging. What is important is to rule out an aggressive cancer of the prostate and to manage the BPH such that there is no significant urinary retention and symptoms aren't unduly troublesome. This is being done.

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

[mokwit]

True alpha reductase inhibitors like Finasteride have unwanted side effects

https://www.drugs.com/comments/finasteride/for-benign-prostatic-hyperplasia.html

- there is also something called post Finasteride syndrome

http://www.pfsfoundation.org/post-finasteride-syndrome-sexual-symptoms/http://www.pfsfoundation.org/post-finasteride-syndrome-sexual-symptoms/

 

Maybe your Doc is seeing if he can improve symptons without recourse to finasteride in the first instance.

 

[tomgreen]

 

 

First again a big thank you to every one who contributed

 

Now my update , after thinking about what the doctor prescribed for one month ( Silosin ) and the possible side effect , I rightly or wrongly decided to take a chance and follow the doctors advice and take the drug for one month's duration .

 

During the first four days of taking the tablets , when I awoke in the mornings I felt slightly nauseous with the feeling like I wanted to possibly vomit , but never did. During the rest of the day I had mild headaches , which subsided in the afternoon , but I was still having to get up to urinate during the night.

 

 

On the fifth day I awoke feeling generally better with no side effects , although I was still having to urinate more during the day time. The next night I did not have to get up to urinate at all , and again in the morning I felt no side effects when I awoke . From the seventh day on I did not have to get up to urinate during the night time. So for the rest of the time while I was taking the tablets my night time trips to urinate drastically decreased and the side effects were not really apparent .

 

So generally I was happy with the outcome and look forward to my next doctors appointment to report to him the results. So I sat in the doctors office and told him what had happened after one month of taking the drug and how I was feeling and that I was generally pleased with the results, I did describe my side effect symptoms. He then made this statement , You will have to take the same drug for the rest of your life , the problem you have is age related and there’s no medical cure , other than keep taking the same drug . I did say to him that I was not happy to be taking the drug for the remainder of my life , the doctor then said that to possibly ease my concern I could take a smaller daily dose of the drug ( ½ a tablet a day instead of 1 ) . The cost of the drug for ½ a tablet per day is 300 Baht per month .

 

I asked the doctor if there was an alternative option , and he said not really the drug I was taking is well known and will not have any damaging long term effects on my body.

 

Personally I am happy that while taking the drug I can get a good nights un interrupted sleep , and the side effects for me seem to be limited and some thing I can deal with , my concern is that taking the drug for the rest of my life could be damaging in some way , and I could end up worse off than I was before I started to take the drug. The other thing that is bugging me is this . What if I stopped taking the drug , could I find a safer alternative that would give me the same results . Would it be better just to stop the drug in fear of possible long term side effects , and learn to live with the inconvenience

of having to get up during the night to urinate . I asked the doctor if I could make an appointment to have a PSA blood test done , his reply was that I should only have the PSA tested once every 12 months.

 

Or as some posters here say , May be I'm worrying to much ?

 

 

 

 

[Sheryl]

Yes, you are worrying way too much, and being hypervigilant, often a sign of an underlying anxiety disorder.

 

As explained before, this is a chronic condition, the drugs only ease the symptoms, they do not correct it, so of course they have to be taken for life.

 

The only alternative is a surgical procedure, these carry their own risks and possible adverse effects and are not recommended unless medications prove insufficient.

 

A very high percentage of older men take this and similar medications for life. the safety profile is excellent.

 

As you grow older there may be other medications you have to start taking as well. It is a very rare 70+ year old who is on no long term medications at all.

 

 

[JimmyJ]

On 8/7/2018 at 10:31 PM, Sheryl said:

Yes, you are worrying way too much, and being hypervigilant, often a sign of an underlying anxiety disorder.

 

As explained before, this is a chronic condition, the drugs only ease the symptoms, they do not correct it, so of course they have to be taken for life.

 

The only alternative is a surgical procedure, these carry their own risks and possible adverse effects and are not recommended unless medications prove insufficient.

 

A very high percentage of older men take this and similar medications for life. the safety profile is excellent.

 

As you grow older there may be other medications you have to start taking as well. It is a very rare 70+ year old who is on no long term medications at all.

 

 

(The following is of course addressed to tomgreen):

 

Yes, you worry too much.

 

I currently consider my hobbies to be gaining weight and frequent urination.

 

As far as exercise, my primary source are those trips back and forth to the bathroom.

 

Get used to doing them with your eyes closed and soon you'll enter "Pro" category.

Edited August 9, 2018 by JimmyJ