At 43, prostate cancer was not even on my radar. My regular doctor had done my annual exam, and then called back a week later to tell me she wanted me to see a urologist.
"It's probably nothing," she'd said, "it's just that your PSA has been going up. It's not high, but it is increasing steadily, and I want you to get followed up."
I'd said okay, but it took me a couple months to get around to making the appointment. I mean, I googled PSA right away, and it didn't seem to be a big deal as my number was just under 5, not the kind of numbers I saw online that might be reason for concern. But Doc Ameilia was thorough and I trusted her, so I made the appointment.
Dr. Flores was a pretty gruff older guy, not much on pleasantries. As I sat in just a gown he looked over my chart and asked perfunctory questions.
"I agree with Dr. Villanueva, we should get this checked," he said looking up at me over the rim of his readers. "I'll have a nurse come and take you into the procedures room. It'll only take about fifteen minutes and you can be on your way."
Those fifteen minutes are not pleasant, and the results were life-changing. The great news is that though I did indeed have prostate cancer then, I am now officially a cancer survivor, and I didn't need surgery. External beam radiation and "seeds" took care of the cancer without any continence issues. On the other hand, the radiation did have a side effect that I am now dealing with six years later.
"It looks like everything is going great, Mr. Harrison," said ARNP Susanne Faircloth. Again I'm just in a gown, but at least this time I'm in the Survivor's Clinic at the regional cancer hospital, and the woman in the room to do my exam is rather attractive. "PSA is below zero point 3, everything else is perfectly normal. I'll just check your prostate and, if there are no concerns, we'll call it good until next year," she continued with a smile.
"I'm wondering about the meds," I kind of stumbled. I'd told myself to just ask, they're medical folks, they probably get these kinds of questions all the time. I didn't know ahead of time that I'd be speaking to a woman. A woman with a lovely smile, bright eyes that stared straight into you, and who was about to have me bend over to exam my prostate.
"Oh, do you need a refill?" she smiled.
"I need something else," I blurted out. "I mean,.." I slowed myself down, taking a breath. "The Viagra isn't..., it's not always working. And the side effects are really uncomfortable, all my joints ache something fierce for hours and I get super congested. Then half the time I don't even get an erection, and it's not like I can just go down on my wife if I can't breathe 'cause of the damn congestion." I rambled in my frustration. "And having to take this stuff an hour ahead of time is a pain," I finished.
"I see," she answered. Her head was down, the eye contact gone.
"I apologize, I didn't mean to be..."
"No, I understand, Mr. Harrison," Nurse Faircloth answered, looking me in the eyes again and smiling. "You're frustrated. You've beat the cancer, but now it's still causing you and your wife problems. I understand that. We can change you over to Cialis and..."
"No," I shook my head. "I had my doctor switch me over six months ago. I'm on the daily regimen and..." I laughed. "Nothing," I shrugged my shoulders in resignation.
"At all?" she asked with concern.
"Not as much joint pain, and the congestion seems a little less, but... no. Maybe half hard at best," I admitted. "I've even pooped a couple extra of the 5mg pills on a Friday night hoping for a little boost...." I trailed off.
It was quiet, Susanne on her rolling chair looking at the chart on her lap. I noticed her fiddling with her wedding band.
She reached out and put her hand on my knee and looked up at me. "I can imagine how difficult this is for you and your wife. You're not even fifty yet, sex is not something that should be absent in your life," she said with sincerity. "This is really beyond my scope of expertise, but I have heard good things about Dr. Cavallos. He's a urologist who specializes in sexual health. Let me get you his number," she said standing.
"Okay," I answered.
"You can get dressed, I'll be right back," she said, stepping to the door.
"What about...?" I couldn't believe I was asking about the rectal exam.
"You're numbers are great, the physical exam is just a verification. Let's get this taken care of first," she said opening the door. "However, I will see you back here in six months. I'll be back in a couple minutes."
So this is how I came to be sitting in Dr. Julio Cavallos' office two weeks later, my wife Liz pretending to be interested in a game on her phone. Dr. Cavallos' Nurse Practitioner, an attractive brunette probably not even thirty had come in and reviewed my record with us, asking about my cancer treatments, and then about our experiences with my ED problem. Liz and I were here because we really wanted help, so though the topic wasn't something normally discussed outside our bedroom, we both answered nurse Kaitlin Reyes' questions.
"Let me assure you that we can help you with your ED issues," Kaitin said with assurance. "The practice is focused on sexual health and we have a very good track record. There is nothing in your records to indicate any problem other than the effects of the prostate cancer treatments, and ED is really a quite common post-treatment issue," she continued. We both nodded.
"What I'd like to do is to exam you, to make sure there are no other issues, and then do a penile ultrasound to make sure there are no hidden anomalies. Does that sound good?"
I shrugged. Liz asked, "An ultrasound? What will that show?"
Kaitlin shifted her focus to Liz. "While a manual exam can detect some issues, the ultrasound lets us check blood flow, to see if there are any strictures, insufficiencies, and leakage. The erect phallus will tell us a lot," she finished in a rather clinical manner.
"Ah, that's ah..." I said, glancing down at my crotch.
"Oh, not to worry, we induce an erection," she smiled.
"How?" Liz asked, one eyebrow raised. There wasn't an edge in her voice, but real curiosity. After nearly twenty-five years together, she knew my penis well and had tried lots to induce an erection; always successfully until the last couple years.
I could swear there was a little smile on both Liz' and Kaitlin's lips, some sort of woman-to-woman thing.
"Medication," Kaitlin replied. "An injection. It's an option many couples chosen if oral medication does not work or is too inconvenient."
"A shot?" I asked.
"Yes," Kaitlin answered. "A small injection at the base of the penis. It induces an erection in about ten minutes," she said turning to me.
I'm pretty sure my hands were over my lap at the time, instinctively protecting myself. "How big a needle?" I wanted to make love to my wife again, often, but suddenly the joint ache of the oral medications seemed tolerable.
"It's a 31 gauge. Very tiny," she responded, trying to reassure me. "Listen, let's do the physical exam to start. After that, you'll have had a few minutes to consider the ultrasound. It is the best way to make sure there are no unseen problems with circulation. It's all about blood flow. But if you say 'no' we'll try another route. We want you two to be happy with the results and regain your intimacy. It's what we're about."
Liz and I looked at each other. I kind of raised my eyebrows and she sort of nodded. "Okay," I said to the nurse.
"Great," said the twenty-something nurse, standing and turning to wash her hands at the sink. "Mr. Harrison, if you'll take off your shoes and pants, then stand next to the exam table and drop your shorts, I'll get some gloves and be right with you."
I let out a long breath, Liz seemed to stifle a smile.
It was ignoble, and I was actually even more perturbed at my cock's inability to rise to the occasion. It's some sort of fantasy, I suppose, of every guy to have a genital exam by a lovely young nurse. We all imagine that she'll turn and find us magnificent, then coo 'oh, my' or something equally flattering. At forty-nine, mine was a fairly typical dad bod. No pooch, but no rippling abs either and more loose than firm. As to my nether parts, I'm a grower, not a show-er - and right now it seemed that my manhood was being shy. Not knowing what to do with my hands, I crossed my arms on my chest and just focused on some poster on the wall.
Kaitlin finished her hand-washing and pulled a couple gloves from the box on the counter. As she pulled them on, she faced me. "If I recall your chart, you had a torsion when you were younger? Which side?" she asked taking a seat on the rolling stool and sliding up to me.
"I was nine. Left side, but they pinned both sides," I responded.
"Hmm," she said, talking to my flaccid dick. "and a hydrocele?"
"Right side," I said staring at the poster and not seeing it.
"Hmm," Kaitlin said. "I'm going to touch you now, alright?"
"Yeah." Please, god, let something happen! I'd always been so responsive, and while I am not a porn star even in my imagination, no one had ever complained about my size, which was perfectly average. I chuckled inside, recalling how during the prep when I started radiation, I had to get tattooed. It's to align the irradiation device; they place a tattoo dot on each hip over the trochanter, and then one more equidistant between those. Yep, right above the base of my penis. The young woman doing it had started on my right hip, then the left. Before she even got to the left side, my cock was standing straight and proud. She didn't say a word, she just placed the heel of her palm on my erection and moved it aside, then proceeded to place the last marker on my body. She lifted the needle, and took the tattooing device in her other hand and let the hand already on me rest on my then throbbing cock. All she had said was "We're all done here. Thanks for being such a good patient."
Six weeks of external beam radiation had been just as adventurous. Every day, five days a week, for six weeks I went to the center for my eight-thirty appointment with my team in treatment room five. Come in, change into my sexy hospital gown and wait to be called. My team was Alexis and Sheila, both of whom had to be fairly new nurses, cute and bubbly. The first week, I would be called in and take my place on the exam table. They would cover my pelvic area with a towel, one laying the towel over me as the other lifted my gown to my abdomen. It seemed stupid, as they would then uncover me as they aligned the (I speculated) laser beams with the three tattoo dots on my body. Some of it was moving the machine controls, and some of it was moving me up or down, or to one side. The first few days, one or the other would apologize and let me know they had to 'reposition' my erect penis to find the tattoo, and tentatively use two fingers to hold it to the side so they could see the tattoo for alignment. Once set, the towel was set over me again, and they would leave the room while the machine did its work. All I got at the end of each session was one of their voices over the intercom saying thank you, and to have a nice day. By the second week, the towel wasn't even unfolded until they had me all aligned, then they would drape it over me. And there was no more tentativeness on either Sheila or Alexis' parts about my ever erect cock. One or the other would simply wrap a hand around my shaft and lift it straight up, align the machine and then lay it back down. After the third week, I guess we were all pretty comfortable. I do recall 'swelling' or flaring my cock a few tines for each of them as they held me. I think it was Sheila who said 'stop that' one time (with a smile!), but they did continue to hold my cock in their hand as they aligned the machine for the rest of my time there.
Kaitlin cupped my scrotum in her palm and lifted slightly. She then took each testicle in turn and thoroughly felt it for any bumps or knots. Now, six years later, there wasn't a twitch.
"All right, can I have you get on the table and lay back, please?" I did as she requested, still resting my hands on my chest and now staring at the ceiling. Kaitlin stood on the side of the table opposite Liz, so my wife could see all she was doing. Kaitlin took the end of my penis between two fingers and stretched me lengthwise. She then began to gently squeeze along each side of it, I guess to see if there were any problems. I began to feel a little arousal and glanced over at Liz, worried. To my surprise she didn't even acknowledge me, but was focused on what Kaitlin was doing. Kaitlin now took the head on my still mostly flaccid cock and raised to toward the ceiling, really pulling on it as if trying to lift me by it. It hurt, but in a good way.
"Any bends or curves?" she asked. Liz answered in the negative, watching Kaitlin hold me taut.
