Chapter 42 – Surgery

A CT scan revealed cysts on Austin’s prostate gland that would most likely require surgery.

Amy and Austin Stevens in the Namib Desert. Photo by Austin J Stevens

Amy and Austin Stevens in the Namib Desert.
Photo by Austin J Stevens

The next morning, we received a phone call from Dr Thomas’s office with details for an appointment with a urologist on Monday. We were very relieved to have secured an appointment so quickly, and the weekend was made more bearable by the fact that we would soon have some answers.

Early on Monday afternoon, we arrived at the office of Dr Katelaris, the urological surgeon, with Austin’s CT scan results and a referral letter from Dr Thomas in hand. We were ushered into the consulting room and Dr Katelaris promptly reviewed the CT films and echoed that which Dr Thomas had so worryingly announced – he had never before seen cysts on the prostate gland either! It was indeed an extremely rare occurrence. Dr Katelaris proceeded to inform us that the films also showed a haematoma in the area that would require draining and that the cysts would require surgical removal. Although Dr Katelaris believed it was unlikely that they were cancerous, he scheduled the operation for the very next week at a private hospital in Sydney.

‘What we need to do is a trans-urethral prostatectomy, or TURP,’ Dr Katelaris explained. ‘It’s the procedure we use to treat benign enlargement of the prostate, whereby we hollow out the inside of the prostate gland to remove excess tissue. In your case, this should allow us to remove the cysts from inside the prostate. By accessing the prostate gland via the urethra, no incisions need to be made from the outside of the body and so the nerves around the prostate will not be affected, so there should be no permanent side effects from the surgery. You should function just as well in every capacity after you’ve recovered as you did before the surgery. We’ll send samples from the cysts to pathology for identification. This is not minor surgery. Cancer is still a possibility, and I don’t know exactly what we’ll find once we get in there. As you can see on the film, the larger of the two cysts shows evidence of calcification…’

‘As in scarring?’ I asked. ‘From injury?’

‘The haematoma is most likely the result of injury and the calcification on the prostate gland at the base of the cyst could be consistent with that also,’ Dr Katelaris replied.

‘I was stabbed five times in the lower back many years ago causing injury to nerves, among other things,’ Austin clarified. ‘Is it possible that all this could be a result of that, if the knife blade hit the prostate gland?’

‘That’s very interesting,’ Dr Katelaris mused. ‘It’s possible the knife blade injured the prostate gland and caused this problem. The cysts could have been slowly filling with fluid since that time and have only now reached a size sufficient to cause symptoms. There is a good chance the haematoma could have been caused by a fall that injured the area. Do you recall anything like that in your history?’

‘A few years ago I was filming in Komodo and I fell down a hole in a cave,’ Austin said. ‘I landed on my lower back and broke some ribs and injured my ankle. I also had a fall-astride injury many years ago that caused swelling in my groin area.’

‘That could explain the haematoma. It’s also possible that you could have been born with these cysts,’ Dr Katelaris continued, ‘although the calcification suggests they are more likely to be the result of the stabbing injury.’

‘How exactly do you ‘hollow out’ the prostate?’ I asked.

‘I will use a roller-ball electrode that will cauterise the tissue at the same time. It should completely eradicate the cysts.’

‘How will I be after the operation?’ Austin asked.

‘When you wake up you will have a catheter to drain urine from the bladder to avoid the urine passing through the prostate during the early stages of healing. Pain on urination after the catheter has been removed is not uncommon. For weeks after the surgery you can expect bleeding from the prostate, so during that time you will find you pass blood and scabs in your urine. A lack of control and problems with frequent urination are also normal for quite some time after surgery.’

Austin and I realised that this operation would result in a rather long recovery time, meaning that filming the rest of the series, and our return to Namibia, would have to be put off for a while.

‘To further help us to eliminate the possibility of cancer, I think you should have a colonoscopy done to check for evidence of bowel cancer before we operate,’ Dr Katelaris said. ‘Bowel cancer could also be responsible for some of the symptoms you’ve described. I will contact a local gastroenterologist who can perform the procedure. It will be conducted at his clinic. You will also need to report to the hospital in which I’ll be operating for your pre-operative check.’

Austin sighed and I squeezed his hand. This was not going to be straightforward.

‘What are the chances of the cysts coming back after the surgery?’ Austin asked.

‘I don’t think that’s an issue,’ Dr Katelaris said. ‘If you still have adverse symptoms six months after surgery, you could have another CT scan to make sure everything is okay, but I think that should be unnecessary. We should be able to remove the cysts completely.’

After we had asked every question we could think of, we thanked Dr Katelaris and left. I immediately phoned the hospital and made an appointment for Austin’s pre-operative blood test and heart check that very afternoon. While Austin was in the clinic I organised the pre-admission paperwork for the hospital.

The next day, we stopped by the gastroenterologist’s office and collected everything we needed to prepare for the colonoscopy in a few days. Austin had to be on a strict liquid diet until the procedure was conducted and I made him soups and jellies to try to curb his hunger. Our time was spent in our hired cabin, snuggling up on the couch together watching movies, and speaking with my parents on the phone about the impending surgery. Both were Registered Nurses at one time, after which my mother, Carolyn, had moved on to work for Medicare and my father, Glenn, had enjoyed a long career as a Forensic Technician. I availed them of their medical knowledge at every opportunity in an effort to assure myself and Austin that everything would be fine.

On the day of the procedure, I drove Austin to the endoscopy centre. We were not waiting long before his name was called, and I sat in the waiting room during the procedure wondering what the results would be. Austin emerged after an hour or so with a clean bill of health, and we smiled for the first time in a week. The next hurdle we had to face was the operation itself.

On the day of Austin’s surgery, we arrived at the hospital in plenty of time. There was more paperwork to fill out, and payments to be made. Austin would spend a few days in the hospital after the surgery and so I had moved my things from the cabin to my mother’s house. Staying there, I would be closer and better able to get to and from the hospital every day.

Austin and I sat together in the waiting area until he was called in. I then sat beside his hospital bed, waiting for the nurses to take him into the operating room. Our nerves were shot to pieces by the anxiety of our situation, and we couldn’t wait to see the end of hospitals and clinics. In the last eighteen months, we had come together from opposite sides of the globe, confronted dangerous wild animals, crossed deserts and bushveld, flown around the world and travelled in six different countries together, but this was the most difficult thing we had ever faced as a couple.

‘I’ll see you in a couple of hours,’ I said, squeezing Austin’s hand. ‘It’ll all be fine. Dr Katelaris is one of the best surgeons in his field.’

‘I know,’ Austin said. ‘I just can’t believe we have to go through this at all. I’m sorry to drag you into this my gorgeous. You’ve been so wonderful, taking me everywhere and looking after me.’

‘Just returning the favour,’ I said. ‘After all, you’ve saved me from charging elephants twice!’

Amy and Austin Stevens camping in the Namib Desert. Photo by Austin J Stevens

Amy and Austin Stevens camping in the Namib Desert.
Photo by Austin J Stevens

‘After first putting you in their path,’ Austin grinned.

‘That doesn’t matter,’ I replied. ‘You always got us out again.’

A nurse peered around the curtain and smiled reassuringly. ‘It’s time to go now,’ she said. ‘Here is the number you can call to check when the surgery is finished. You’ll need to go to Urology on Level 9.’ I took the card she offered with the phone number on it and thanked her. Then I leaned over and kissed Austin.

‘See you soon,’ he said. ‘I love you.’

‘I love you too,’ I said. We held each other’s hands for as long as we could, until the nurse wheeled Austin’s bed out of reach. I stood and watched as they disappeared around the corner to the operating room, wondering what I could possibly do to distract myself until it was all over.

To be continued in Chapter 43, in which the aftermath of Austin’s surgery isn’t quite what we expected…

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