Free Confessions of a Male Nurse by Michael Alexander

see him.
    I didn’t want to palpate the bladder, especially as I could see it protruding up from his lower abdomen, so I left that part to the doctor . . .
    ‘What the hell was that for!? I could’ve told you it’s full.’
    Mr Riley nearly went through the roof as Dr King gently pushed on his lower abdomen. It wasn’t really Dr King’s fault – he was just doing what he had been trained to do: a complete and thorough assessment. He was a bit shaken, but he was new and probably hadn’t seen someone in this much pain from a blocked urethra before.
    ‘Perhaps we could catheterise him now,’ I suggested.
    The doctor readily agreed and we got started.
    I don’t have words to describe the look of relief that swept over Mr Riley’s features as the catheter was inserted and the pressure finally released – but I’ll try anyway. Imagine spending a night out on the town drinking and waking up in the morning in urgent need of a pee. Now imagine that no matter how hard you tried, you could not pass a drop. Every minute, every hour the pressure keeps on building, the sensors in your bladder overloading with pressure, they’re screaming out at you to do something, but there is nothing you can do. Then suddenly . . .
    ‘I can’t believe it. It’s no wonder I was in agony,’ Mr Riley said, as two litres of urine drained from his bladder.
    You might think it impossible for a bladder to hold two litres of fluid, but what happens in cases like Mr Riley’s is that over time the bladder slowly stretches . . . and stretches. It took ten minutes to completely empty.
    Mr Riley was now on the prostate surgery list; he was entering his prostatic golden years.
    Unfortunately, the waiting list for urological surgery is often long and there are many older men sitting at home with a tube of their own because their plumbing has blocked up. Some of these men have spent longer than twelve months like this. Mr Riley didn’t have private insurance and he now had to adapt to this new stage of his life.
    It is unfortunate that we often have patients coming in to hospital because they have acquired an infection that has crept up this tubing and into their bladder, or patients whose catheters had blocked up because their urine was full of foul smelling lumps of dead tissue and bacteria. It seemed to me that more time and money was spent in the long run from these complications. And if anyone is going to get a complication it is most likely to be the elderly.

The veteran
    Tom, Simon, Daryl and Joe were four patients who put a lot of trust in their urologist. At 75, Tom was the oldest of the men. He was a prostate veteran; this was going to be his second operation in three years. The rest of the men were virgins – all in their sixties and about to have a trim.
    Being four men in the same room, all about to have the same operation, enabled the men to share notes and generally have a laugh (albeit a nervous one) at the situation.
    ‘You gotta drink lots of water, that’s the secret,’ Tom would repeatedly tell the others. He enjoyed being the expert – although this was almost all the advice that he could remember to give.
    He was right though – plenty of water to flush the blood away. The prostate can bleed a lot when it is cut, and you don’t want it to clot and block off the urethra. Drinking plenty of water helps produce more urine, and reduce the risk of clotting.
    I was just relieved that none of the men had heart failure. Heart failure means your heart is struggling to pump the blood around your body. If you add more fluid, you put more strain on the heart.
    There was only one other piece of advice that Tom managed to remember – and it was a tip I wished he’d forgotten. Tom had the other men so in fear of me that they were distracted about their operations the following day.
    As the men spoke about what I was going to do to them, I stood outside their room, hidden. Timing was everything: at the height of the discussion,