Archive for the ‘dogs’ Category

I pictured you walking backwards and that you were coming back home...I pictured you walking away from me and hoping you were not leaving me alone...

I pictured you walking backwards and that you were coming back home…I pictured you walking away from me and hoping you were not leaving me alone…

Chapter Two-A dog shows up at the lake
John and Karen had two other dogs, Oscar and Tootsie, both of whom they loved dearly, but there was an emptiness around their home without Meg. The couple felt her memory and presence everywhere in and about the house. The couch, the trampoline, the backyard, the bedroom, the children’s rooms, the porch, and years and years of pictures with members of the family framed throughout the house, served as a constant reminder of Meg. The two remaining dogs were dachshunds; Oscar was the grouchy father, and Tootsie, a high maintenance daughter. The female dachshund next door had been Oscar’s wife and Tootsie’s mother. It had been an “arranged” marriage.

“I miss having a big dog around here John,” Karen said.

“I miss having a dog that likes being in water,” John replied. He thought, “Dachshunds are like cats, they do not like water and don’t swim.”

John and Karen had a small piece of property on the lake near their home. They rarely spent the night at the small cabin on the site, but very much enjoyed going there for “day trips” and always got home before the time the street lights came on.

John and Meg could easily consume a Saturday at the lake with cutting grass, fishing, and working in their small garden there. They often visited the big box stores for stuff needed for whatever they would be doing that day. Meg loved riding in John’s truck, ambling around the property, and dipping into the lake for a swim from time to time as John worked.

“John, what on earth do you and Meg do all day out there?” Karen often asked.

John and Meg looked at Karen in unison and agreed that Karen just did not “get it.”
“Well Karen, Meg and me don’t have nothing to do out there, we got all day to do it, and we may not get but half of it done,” John answered. He wasn’t sharing any of their secrets.

With Meg gone there was a void on Saturdays, not only at home for the couple, but also for John at the lake. John attempted to make the dachshunds his “lake dogs,” but they did not like water and just made a mess out of his Saturdays. Oscar hated it at the lake preferring the warm and known confines of their home and being a lovable grouch on his turf. Tootsie loved riding in the truck to the lake and she loved to cuddle in the warmth of John’s jacket during the ride however, Tootsie was always doing something meddlesome. She explored to the extent that John spent the majority of his time looking for her or keeping Tootsie out of trouble.
On one occasion John lost Tootsie for about two hours though it seemed like an eternity. During the time she was missing, he frantically searched the shore of the lake, the cabin, and the surrounding area. He envisioned Karen chastising him for not “taking better care of Tootsie.” All of his worst fears as to her safety ran through his mind only to find her on top of the boat dock. Tootsie had no problem climbing the steps to the top of the deck, but once there, she would not come back down. He found her accidentally because he saw the silhouette of her small head on the horizon of the dock flooring. His fear of finding the more worrisome silhouette of her body floating in water hence relinquished, John commenced to chastise her under his breath. (Tootsie’s head is small for her body. John’s head is small and Karen often made fun of him for it. John’s mother said her first memory of John as a baby was that he could, “cover his whole face with his hand.” On his high school football team in LaGrange, Georgia, he wore the smallest helmet. It was a size 6 and 7/8, and was specially ordered for him. Karen told John, when she perceived he was gaining weight, “John, you need to be careful about gaining too much weight or you’ll start looking like Tootsie. Your head won’t match your body.”)
On another fateful day at the lake, Tootsie chased a mouse or some other rodent under the cabin, which had only a six-inch crawl space, and it took several hours to determine where she was. Once found, she would not come out and there was no obvious way to get to her or to get her out. Complicating the situation and intensifying the anxiety for John, it was not clear if Tootsie was trapped or just would not come out. Exasperated and about to give up, John found a neighbor with a skill saw to cut a hole in the cabin’s kitchen floor to “rescue” her. The sawed out square of flooring replaced the hole in a patch-like fashion serving as a constant reminder of that day’s three-hour ordeal to free Tootsie from the confines of the cabin crawlspace.
“Karen, I am not taking Tootsie out to the lake anymore. She is a good truck dog and likes to ride, but she is way too much trouble for me out there. I can’t get anything done with her. She gets into stuff. “Dachshunds have a Napoleon complex and that’s her problem,” John thought. He, however, did take her again. It would be a mistake to do so, and it would be the last trip to the lake for Tootsie.
The “last” time Tootsie went to the lake with John, she played the “Napoleon role” that only a foot-long dachshund can do with the great dane puppy which lived next door. She barked and taunted the dog until it grabbed her like a pillow, shook her, and then threw her about thirty feet. All of this transpired in a matter of seconds right in front of John to his amazement and chagrin while he was raking leaves and listening to a Georgia football game. Tootsie’s run in with the great dane resulted in a trip to the vet, a V-neck T-shirt soaked with Tootsie’s blood, ten holes in Tootsie’s abdomen (but no damage to her intestine), two hours of surgery in which John assisted the vet, fifty stitches, and another ruined Saturday at the lake. No Tootsie was not to be another Meg and she would not be going to the lake anymore, period. To make matters worse, on the day Tootsie came home from the hospital, John was holding her in his arms, and was about to give her cheek a kiss when she snapped up and bit him on the tip of his nose. He dropped her to the floor out of shock and a bit of anger, only to find her running to Karen. Karen now became the “good-guy” and Tootsie’s savior in this unprovoked attack, which further aggravated John. Karen then laughed uncontrollably at the situation and particularly at John clutching his nose. John’s nose was now bleeding profusely and when he checked it out in the mirror there was an inch long scratch which was deep and devoid of skin. The area subsequently scabbed over and for two weeks was a painful and visual reminder of the little ungrateful troublemaker that was Tootsie.
“Dr. McHugh, what happened to your nose?” John was asked a thousand times over the ensuing weeks.
“My dog bit me,” he answered. Having to respond to that question in light of the history of the event was “salt on the wound” to John. He did, however, forgive Tootsie.

Several months later after blowing leaves at the lake, John alone and without a lake dog, was resting on an old spring swing left at the lake by the original owner of the property Jessie Jewell. He saw a small puppy walking up the gravel driveway. The lake property is at the end of a road that has a cul de sac. His first thought was that someone had dropped off the dog and left it. As the puppy approached her gait and color made John think that the visitor was a golden retriever puppy and probably one of a neighbor’s dogs. She walked nonchalantly to where he was sitting and sat down right next to him. It was as if she was already his dog and that what she was doing now was what she was accustomed to doing naturally and often.

“Well, what’s your name, cutie pie?” John asked somewhat taken aback by the level of the “make yourself right at home” nature of this stranger.

The dog’s tail began wagging as it looked up at John contentedly. John confirmed that the dog was a female, and as best he could tell, she was a thoroughbred. He figured that someone was probably missing her pretty bad about now. She had no collar. It was unknown to John at the time that this was a foreboding sign. He picked her up, held her in his lap with her belly up, legs open and apart, and began to rub her. To John, a dog that will let you rub its belly is an “at peace” dog and a prerequisite characteristic of one you’d want to have. Oscar would not let you do that, but Tootsie would. This dog was as laid back as you please to be on her back and be rubbed, particularly behind her ears.

“I think I’ll keep you my little friend. Do you like the water?”

When John and the new dog arrived home that evening, he said as he entered the house, “Karen, guess what showed up at the lake today?”

Karen immediately said, “She’s pretty. Look at her tongue; it’s got a black spot on it. That means she has chow in her.”

“You don’t know that Karen. A black spot on the tongue? Are you kidding?”

“It means she has Chow in her. I bet she is a Golden-Chow.”
Karen was right about the puppy having Chow in her as evidenced by the way her bushy tail always was curled up over her back. None of the neighbors near the lake cabin reported losing a dog and so the family adopted the golden retriever looking puppy with the bushy tail and black spotted tongue as their own.

Bess, their middle child who was in sixth grade at the time, named the new pet Chloe. The new dog was the same color as Meg and since Meg was named after the spice, nutmeg, Bess wanted to name her after another brownish colored spice. She thought chloe was a spice as well. That chloe was not a spice was something that John and Karen did not note, but would not have corrected it even if they had noticed the error. John, a poor speller, the next day went to PetSmart to make a tag for her collar, but spelled her name “Clohe” much to the sarcastic delight of his family who never let him forget that he spelled her name incorrectly. Named for a spice that wasn’t, and having to wear a tag with the wrong name on it may have very well been a glimpse into Chloe’s unpredictable future.
The couple and their family fell instantly in love with the gentle intruder. As John’s mother would say, “One man’s loss is another one’s gain.”
The “gift” and the coming saga that was Chloe then commenced; the extent and complexity of which was unknown to John or Karen at the time. Chloe on the other hand, knew exactly what was to come and the role she’d play in the lives of John, Karen, their family, and more importantly, other lives.

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i can tell you a lot about you by knowing who you love.....

Had to get that “moustache dreadful picture of my hair off the main page of the previous post. A nurse of mine asked,” Are those plugs?”

The answer to the question posed above: Drum roll please……

  • Yes you can have sex the morning of a prostate biopsy
  • Yes sex before a PSA will make it higher
  • No a rectal exam won’t make the PSA higher
  • Yes you can have sex after a biopsy
  • No it won’t hurt your wife
  • Yes there will be blood, to what degree varies
  • Yes, when the color of the semen turns rusty looking (old blood and iron) it is about to stop
  • No, repeated biopsies of the prostate hurt it or “make it leak”
  • Yes…to all the wifes out there….good try on another reason to postpone sex but having had prostate biopsy isn’t one of them….no extra charge to all the men out there

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seeing is believing?....you have to believe to see my frin....

First of all…how does Amazon know when an individual who has a Kindle marks something as a highlight? I saw these highlights today for the first time on the Kindle page for my book. I go there from time to time to read comments and check ratings. I want to comment on the highlights. Before I do, I’ll share with you a conversation I had with my wife after my discovery.

“You know how sometimes you are reading a book and you read something you like…you’ll take a pencil or a yellow highlighter and underline a passage or sentence. That’s what they are doing, they are highlighting but on their Kindle.”

My wife who is a traditionalist when it comes to reading and books and doesn’t get why anyone would prefer a Kindle to a book says, ” How does Amazon know when someone highlights something? I don’t like that. I don’t want Amazon knowing what I am doing with my book. This is odd John.”

I read the “Popular highlights” explanation three times. I guess Amazon is wirelessly searching you Kindle when you download the next book. Did you know they could do that? It is a bit ” Orwellian.”

Anyway, most of the quotes from my book have to do with radiation issues. I mentioned in another post that my most negative comment on Amazon had to do with me, a urologist surgeon, being biased toward surgery. On the surface and on one’s initial impression, based on the following highlights, I’d agree. But there is more…and this is the truth and how it happened.

What has impressed me over the years in figuring out why certain patients decided to do what they did about their prostate cancer was how little they knew of the potential “down the road” side effects of radiation. In making those “effects” know in great detail comes across to some as being against radiation. Nothing is further from the truth. Radiation wasn’t for me, but for the guy who is afraid of surgery and the complications, the patient whose life can’t tolerate the recovery of surgery, etc etc….radiation is a wonderful alternative.

But…that guy that brags to me and his friends that he’s smarter than the next guy because he has been on the internet and “cure his cancer without surgery” not knowing the full ramifications of radiation…well it bothers me a little. Or the guy that from the get go feels that the urologist who diagnosed his cancer will recommend surgery because he’s “out to get a buck,” I just feel there needs to be some clarification. As I say in the book, ” When it comes to prostate cancer treatment decisions, you pick your poison. There is no free ride.”

If I had a nickel for the times that a patient who has radiation complained of urinary irritative symptoms or sexual dysfunction after radiation and indicated that it was a surprise to him…well I’d be a rich man. Somebody did not tell them the whole story, or they were so “clever by half” they did not listen. “Someboddy got some splaining to do,” as Ricky Ricardo used to tell Lucy. So…It ain’t biased, these highlights ain’t biased….they are making known to the radiation type patient (whether seeds, external beam or yes even Proton) what you are get”in to.

So…read the following with that grain of salt…. if the risks and benefits of radiation (after a knowledgeable review) trump surgery…or vice versa…go for it………

I ain’t trying to talk you out of nothin….I just want you to know…….

Popular Highlights from Kindle readers who have purchased “The Decision”

 (What’s this?)

Once you have chosen radiation, you have limited surgical options to correct any worsening of your ability to void. You are” attached at the hip” with it, both from the standpoint of surgical intervention of any urinary symptoms that occur as well as for curative measures if your PSA rises, indicating return of the cancer. &quote;
Highlighted by 5 Kindle users
In my opinion, the fear of total incontinence resulting from removal of the prostate should not be viewed as the major issue in the decision. &quote;
Highlighted by 5 Kindle users
(You can do radiation after surgery, but it is difficult to do surgery after radiation.)You &quote;
Highlighted by 5 Kindle users
This differs dramatically from radiation, in which baseline function is not affected initially but deteriorates to an unknown level over time and stays at that level. &quote;
Highlighted by 4 Kindle users
If you choose radiation treatment, your surgical options for dealing with any of the complications associated with radiation, particularly obstructive voiding symptoms, are also limited, which will be discussed in more detail later. These factors, more than the ability to cure, are the caveats of radiation therapy that I feel are most often overlooked by patients choosing seed therapy. &quote;
Highlighted by 4 Kindle users
As I inquired more about seeds, I was advised that the quality of the placement of the seeds was paramount to getting an adequate treatment and hence cure. There was room for error. It concerned me that if I did not have a procedure with good placement, then my cancer was likely to return due to my young age at diagnosis and my years at risk. &quote;
Highlighted by 3 Kindle users
Regardless of the treatment you choose, you will have one or more of the following voiding issues. How long they will last or how severe they will be for you is an unknown. &quote;
Highlighted by 3 Kindle users
If a patient makes a decision without careful consideration of his underlying voiding pattern and how it will potentially be affected, neither he nor the doctor has done his due diligence. &quote;
Highlighted by 3 Kindle users
I felt then as I do now, that surgical removal assures that all the cancer in the prostate will be gone; radiation of the prostate cannot assure you that all the cancer in the gland will be killed. &quote;
Highlighted by 3 Kindle users
Ask intelligently, “What was your Gleason’s score, baseline erectile function, how old are you, what is your current voiding pattern and what are your other medical conditions?” &quote;
Highlighted by 3 Kindle users

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a little knowledge is a dangerous thing

Orvis is having a dog cover contest. I sent one in of Chloe the other day and my daughter will be sending this one in for her dog, Brother, and our other dog, Penelope.  There is no  way they won’t win something.

Since I have used them so often on this site, maybe I should call the picture….Prostate Pups

Or maybe…prostate cancer sniffing pups—-remember the article about prostate cancer chemicals getting into the urine and that dogs would be able to sniff for cancer.

Pss…the comment and response on the previous post is fun and a hint to the topic for my next book…take a look.

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when you say your are sorry...stop right there....no need to say "but.....

What makes my book special ( I think ) is the attention that only a urologist who has been through the prostate cancer process and treatment could make of the voiding issues. That’s what urologists do…we are human plumbers. We understand how men void, the difference between obstructive (slow stream) and irritative (frequency, urgency, getting up at night) and the medicines and surgeries used for each. It is confusing. In my book there is a very large chart showing the differences in each and how all the treatments affect each.

I once wrote on a prescription pad the symptoms and the meds for each for another doctor. A year later, he pulled it out of his wallet to use to treat a patient in my presence and said, ” John, you just would not believe how many times I have used your little cheat sheet!”

Back to the question. Obstructive…i.e. an  enlarged prostate, slow stream, secondary frequency and nocturia, stop start stream, no pressure, small caliber…….”You can’t piss and run under it.”

If you have obstructive symptoms and want to do radiation you had better beware!

If you want radiation and you have obstructive voiding symptoms…you can fix the symptoms before but not after. Things don’t heal well after radiation.

So….you have big prostate and obstructive symptoms and you want radiation, particularly seeds….

  • Microwave therapy
  • Laser prostatectomy
  • TURP
  • Maximum medical therapy if with very good response

After the above…then seeds…in most cases of prostate cancer with favorable pathology, the delay of a month or so is not a medical issue.

When  it comes to obstructive voiding symptoms and a male that want to do radiation…..

“It is better to cure at the beginning, than at the end.”

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it is amazing what can be accomplished if it doesn't matter who gets the credit


So…A dream I had as a child was a pool with a lap lane. I love to swim and when I  was younger , I was actually quite the swimmer. I rarely lost a race in any stroke. There was a boy in Columbus, Georgia who regularly beat me…but no one else. I ruled the swimming world when I was eight in Columbus, Georgia. I remember winning every event in every stroke at the Green Island Country Club on a day when there was a total eclipse. We were swimming and at the same time looking at these tin foil card board boxes that allowed one to see the eclipse without looking directly into the sun. I remember it as if it were yesterday.

So, I get to be a doctor, I chose to be a urologist and then with some success, I get to build a new house with a swimming pool with a lap lane. My dream come true…right? Well…. what if the pool turns out to look like a penis? What?  All these years and hopes and dreams and a pool that looks like a penis?  Tell me it isn’t so.

It was. A regular oblong pool with a lap lane looks like a penis and a scrotum.  We also had two dachshunds and so I became the urologist with a dick pool and two weinner dogs. Who’d thought? My kids got ribbed about it all the time. I thought I was successful but now this?

I will say I love my pool. I love my chocolate lab chasing balls and sticks in it. I love taking pictures of her chasing balls and sticks in it and swimming in it. I absolutely love my lab in the pool.

Now the question. Can a man with prostate cancer “spread something” to his wife by having sex?


So….good try girls….be more creative next time…you are not getting out of it for this reason or this time…………….have at it.

Guys…You are welcome….no charge.

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salt doesn't say its salty.......

Dogs making the diagnosis of prostate cancer. Could a urologist be taught to sniff as well?

And to think…I have been posting  pictures about dogs on a prostate cancer blog site for a year now. Who’d a thunk it?

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