2005 to 2007: Visiting Doctor to Doctor

1) Urinary problems. I have to go numerous times a day – between 15 and 25 visits, most times with tremendous urgency and often leaking. 10-20 seconds of warning and that’s it. I also get little flow after many of these emergencies, usually an eggshell or two’s worth. Flow is weak 90% of the time. As a pilot, I have had to carry a relief bottle even for short flights, and have had as many as 3 or 4 urinary emergencies in a less than 2 hour flight. Leakage is common. Despite the heat in Las Vegas, I sometimes resist drinking anything for fear of another emergency. I also have to urinate sometimes at night which I never used to do, and in order to reduce that, I press on my stomach while urinating just before bed to try and empty it out. Most times when I pee in the morning it smells quite bad and is also darker. I have also lost control of my urine at night sleeping and wet the bed. First time was in October 2006, one episode. Happened again in February 07, and had episodes 4 of 5 nights. I couldn’t feel myself urinating in the bed but could then feel it on my leg, but then too late to stop it. I bought adult diapers to stop wetting the bed, but since buying the product have had no incidents.

2) ED. I am able to get a natural erection once every week or two, but cannot maintain it longer than 10 seconds. Natural sex is not really possible. I do get the pre-ejaculation fluid, and still get that from thinking about it. I seems there just isn't any blood going there. I haven't used any oral medications for this since January 2006. I began using an injection process of getting an erection in November 2006. I self administer, using insulin syringes, a mixture of

3) Occasional loss of control of the rectum. In June 2006 on a Sunday morning, I woke up and used the bathroom, ate breakfast, and then went #2. I got up and got ready to go outside and skin the palm tree in the front yard. Put on some shorts, knee pads, and grabbed a knife. I bent down on my knees, realized I had to poop more, couldn't hold it, and then had to go take a shower because I made quite a mess of myself. This happens once in awhile, maybe 3 or 4 times in the past year. It isn't diarrhea. Possibly softer than normal but not runny. Normal color.

4) Instability and weakness in my legs. I can walk, but I have issues trying to run or use one leg, such as stairs, or picking up something off the ground. Balance on one leg is difficult. On occasion, one leg or the other will give out briefly. I feel clumsy when I try to run, and I haven’t been able to play baseball or basketball or do anything that requires quickness and agility. I can hit, throw batting practice to the kids, catch and throw fine, but bending down to field a ground ball, especially to one side or the other, just isn't within reach anymore.

5) Saddle Anesthesia. There is a general numbness in the saddle area with a corresponding hypersensitivity in the feet. UCLA found this one.

Tests that have been done
All kinds of blood work has been done, including PSA now. All have been negative. All urine tests are negative, though my urine does smell in the morning. Rectal exams from 5 docs now have said nothing abnormal, with the exception that one urologist and a colorectal surgeon said my sphincter clamping pressure was fairly weak.
I've also had a rectal ultrasound, which indicated my prostate was 53 grams. It also revealed the day I had it that my bladder we completely full, yet I couldn't provide a urine sample right before the test. The Doc was going to catheter me, but I then drank some coffee and managed to urinate some. That doc figured I had BPH/enlarged prostate and prescribed Flowmax and Avodart. Flowmax helped for a week or so, mostly with morning urination, but didn't stop the afternoon emergencies. Avodart did not help. A month later I went to see that same urologist and he did an exam where you catheter a tube inside the penis with an eyepiece. That exam revealed no blockages or abnormalities. Doc said to stop taking the Avodart and use the Flowmax as needed.

August 2, 2006 I had an MRI, which revealed a massively enlarged piriformis muscle having a “mass effect” on the Lumboscaral nerve. Referred to a neruosurgeon and a colorectal surgeon. Colorectal (mid Sept 2006) said this wasn’t her area of expertise, and her exam noted the weakness in the sphincter muscle. Neurosurgeon (mid sept 2006) referred me to pain management Dr. for injections into the piriformis to see if there was any change in symptoms.

A secondary reading of the MRI suggests an "avariant insertion of the piriformis". This Dr. also said that lesion alone does not explain the incontinence or impotence. To work that up he would MRI the entire cord and brain to look for any demyelinating lesions in the brain. Also Normal Pressure Hydrocephalus or some variant might present like that in a younger person.

MRI’s of the brain, cervical and thoracic spine done at Desert Radiology in October 2006, all negative. MRI of the pelvis at University of Utah, 12/07, negative. MRI at UCLA of the Conus Medullaris area in 1/07, negative. CT scan of the head 1/07, negative.

Spinal Tap at UCLA 2/07, pending results.

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