Dr. Ronald Benoit, a UPMC urologist, advised me yesterday during my "emergency" appointment that he was confident my most recent Prostate-specific antigen test or PSA does not indicate prostate cancer. Music to my ears. PSA levels, he said, can fluctuate dramatically, and he's confident that it was one such inexplicable fluctuation that sent my PSA from a September reading of 2.6 -- well within the normal range --- to 5.9 in October, which is almost two points higher than the 4.0 level that represents a level of concern.
He noted my previous trend of declining PSA from 3.9, then 3.2 last April, to 2.6, with no signs of cancer.
But the critical point is this: Only a biopsy of the rostate gland will convince the team at the Thomas E. Starzl Transplantation Center that I have no cancer. Understand that prostate cancer would prevent me from qualifying for a kidney-pancreas transplant due to the fact that immunosuppressants drugs, necessary to prevent organ rejection, would allow any cancer to thrive and jeopardize my health, my life.
That's to say there will be no transplant if cancer is present.
So I asked him to put me on the prostate biopsy fast-track. I'm scheduled to have the biopsy on Monday. It's an outpatient procedure but I'll be able to return to work on Tuesday. I will need to take antibiotics on Sunday through Tuesday to prevent infection.
So let the drilling begin.
Now the good news:
Nephrologist Dr. Cynthia West reported what I already knew, that my kidney numbers were "excellent." Her word.
I blushed and smiled.
They actually show a decline in my creatnine levels which means my kidneys might be functioning slightly more efficiently than perhaps doctors previous thought. While that number is positive, it's nothing to take to the bank. It's but one test. My kidneys just might have been having a splendid kidney day when I got the blood work done..
Dr. West also has taken me off my prescription of Zemplar -- an active vitamin D medication necessary to help bring my parathyroid levels, which can be adversely affected by kidney function, back into the normal range.. Apparently my use of over-the-counter levels of vitamin D at 5,000 IUs per day has brought my parathyroid numbers well within the normal range, making the Zemplar unnecessary.
I got a second star on my forehead for that result.
She also said my efforts to control my diet have succeeded in lowering my potassium and phosphorous levels into the normal range.
Don't tell my boss, but my numbers, save for the creatinine level, are all normal.
"Excellent," Dr. West said. "I couldn't be more pleased."
So two more stars on the forehead. Four big stars. I could hardly see to drive.
So the sole test necessary to determine my eligibility for a kidney-pancreas transplant remains the prostate biopsy. I should have results on that next week. That alone will determine my eligibility.