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Posted 6/11/2008 9:34 PM (GMT 0)
Dear wiggyann,

I am a former hospital quality manager and I was appalled and angered to read your husband's experience when he went for his biopsy. Last year I had to file a HIPAA complaint. Here is a link to information in case you're interested in filing a complaint http://www.hhs.gov/ocr/privacyhowtofile.htm
The Office of Civil Rights also provided me with a phone number for my State in which I could report medical professionals.

Maria Teresa
Posted 6/12/2008 4:49 AM (GMT 0)
Dear Maria Teresa,

Thank you so much for your post and for all of the information for filing a HIPPA complaint. I do think the time frame for doing this has passed though. My husband does feel that the nurse handled things very poorly that day. However, when his biopsy came back positive, our main focus at that time was on his cancer treatment options and getting him well. After his treatment was completed, I did prepare a letter to the urologist which explained the nurse's actions on the day my husband had the biopsy. However, my husband would not let me send it as he was concerned that the letter might cause a problem or worse that the urologist might drop him as a patient.

I shared his biopsy experience with the members because I wanted to get their thoughts about what had gone on that.

Again, I really appreciate your response and I hope that everything turns out good for your husband :-)

Wishing God's Best Blessings to both of you,
Wiggyann

Husband 68 at diagnosis in December of 2006
PSA 6.6 at biopsy, the one before that was 7.2
Gleason 7, stage T1c
eight out of twelve cores positive for adenocarcinoma
Bone scan and CAT scan of pelvis and stomach in December 2006.
Treatment: 25 IMRT (radiation treatments) and a 90 seed Pallidium
implant on April 25, 2007
psa six months after seed implant was 1.7
psa eleven months after seed implant 0.5
Posted 11/1/2008 8:54 AM (GMT 0)
I feel really bad for all you poor guys that have to go through that. I personally would NEVER undress in front of a female nurse, no matter what my illness. They have no right to assume we will bear all everytime they snap their fingers. I would wait for them to leave to undress, keep myself completely covered when they are in the room and never allow them to remain in the room if I have to expose myself to the doctor. They have no right!
Always be polite at first but if they continue to give you problems then just insist they leave. I welcome and appreciate any kind of care they could give me as long as my privates are covered. The way some of you have been treated is simply disgusting. Speak up, you don't have to let them push you around. In my experience, when I politely tell them how I feel the majority have been very accomodating and respectful. I have had several that I really like and they have always treated me with respect and I look forward to seeing some of them when I go in.
I'm sorry if I sounded harsh and disrespectful at the beginning of my post, but although the majority have been great, a few bad apples get me so steamed up it just infuriates me. To any nurses out there - if you're kind and understanding, as I'm sure the majority of you are, you have a good friend for life. If you insist on depriving me of my modesty and dignity (unnecessarily), look out!
C
Posted 11/1/2008 1:43 PM (GMT 0)

I have had 3 Prostate biopsies in the past 15 months, each time, I was sent to a small, private changing room, similar to trying on clothes in a department store.  Recently, while undressing for the bone scan and ct test, same thing, a small private changing room.  The only problem was putting on the "3-arm" gown.  I am the most left handed person you will ever meet, so the picture on the wall made no sense to me!  A nurse outside the waiting room had to help me figure out what to do with the extra arm (blush).

Posted 11/1/2008 3:01 PM (GMT 0)
Many thanks Clay and Purgatory for your posts and your kindness
and understanding :-) I hope everything goes well for you when you have your surgery, Purgatory.

May God Bless You Both,
Wiggyann

Husband, 68 at diagnosis
PSA 7.3
8 out of 12 cores positive
Gleason all 3+3, except one which was 3+4
Treatment: 25 IMRT ( radiation treatments )
plus a 90 Pallidium seed implant in 2007
last psa 0.5
next one coming up this month
Posted 11/2/2008 5:44 AM (GMT 0)
In my earlier comment I was pretty serious and forceful about what I believed but I don't want anyone here to think I don't respect those that aren't as forceful as I am.  I realize with my attitude I may end up ticking some healthcare workers off which possibly endangers my future visits.  Those of you reading this that just take it easy and accept what I would call abuse from doctors and nurses are actually acting much smarter than I do, and I really respect that.  Wiggyann, I think your husband is acting the smart, common sense way and I hope he doesn't think (if he reads this) that I have any disrespect for him or believe he doesn't handle the situation correctly.  My best to him and I hope he has better experiences in the future.

C

Posted 11/2/2008 8:18 AM (GMT 0)
Hello Clay,

You don't have anything to apologise for. It is better to say something than to accept behavior that humiliates, degrades or otherwise indicates a lack of respect for the dignity and worth of an individual.

My husband was anxious the day he went to have the biopsy and just wanted to get through it. It was about a week later when he told
me everything that had happened that day and and he also said that he thought the nurse handled things poorly. I wanted to write a letter to the urologist and tell him how my husband had been treated, but
he was concerned that if I wrote the letter, it might cause a problem and he didn't want to do that.

I appreciated your email very much.
Wiggyann
Posted 11/2/2008 9:06 PM (GMT 0)

clayjensen said...
I feel really bad for all you poor guys that have to go through that. I personally would NEVER undress in front of a female nurse, no matter what my illness. They have no right to assume we will bear all everytime they snap their fingers. I would wait for them to leave to undress, keep myself completely covered when they are in the room and never allow them to remain in the room if I have to expose myself to the doctor. They have no right!
Always be polite at first but if they continue to give you problems then just insist they leave. I welcome and appreciate any kind of care they could give me as long as my privates are covered. The way some of you have been treated is simply disgusting. Speak up, you don't have to let them push you around. In my experience, when I politely tell them how I feel the majority have been very accomodating and respectful. I have had several that I really like and they have always treated me with respect and I look forward to seeing some of them when I go in.
I'm sorry if I sounded harsh and disrespectful at the beginning of my post, but although the majority have been great, a few bad apples get me so steamed up it just infuriates me. To any nurses out there - if you're kind and understanding, as I'm sure the majority of you are, you have a good friend for life. If you insist on depriving me of my modesty and dignity (unnecessarily), look out!
C

No offense is intended but what a peculiar attitude. I guess I'm going to have to learn to be more "forceful".
Bill
Posted 11/3/2008 6:59 AM (GMT 0)
No offense is intended but what a peculiar attitude. I guess I'm going to have to learn to be more "forceful".
Bill

What part of my attitude do you find peculiar?

Posted 11/3/2008 8:02 AM (GMT 0)
clayjensen
The tone of your post comes across as we who have NO objection to, nor any problem with, being semi naked in front of health professionals are not as "forceful" as yourself. That's what I find peculiar. "Deprived of modesty and dignity"? Have you had a DRE or rectal ultrasound. Have you had a catheter inserted and/or removed from your bladder? Have you had you urinary flow measured? In this cancer journey the somewhat silly notion of keeping your "privates" covered while you are being medically assessed IS peculiar. Is that pair of young 20 something nurses lusting for a glimpse of my naked somewhat wrinkled 60 year old body?.................I should be so lucky.yeah Tell me......... you have not mentioned your prostate problems. Why are you here?
Bill
Posted 11/3/2008 10:38 AM (GMT 0)

Quite some time ago, I realized that I have no "private parts" any more. Doctors and nurses have seen it all before and aren't fazed by it, and nor am I, now.

BillyMac didn't mention one other "indignity" that we prostate patients suffer. My first penile injection, was done by a female nurse, who then 10 minutes later returned to inspect the resulting erection. All done with no embarrassment on my part, or I'm sure on her part.

I appreciate that those of us who are undergoing these procedures for the first time do have a sense of modesty, which in my experience is respected by doctors and nurses. However too much modesty can get in the way of the treatment, and those of us who have been through the mill tend to lose the modesty.

Posted 11/3/2008 2:04 PM (GMT 0)
I understand the feeling of privacy and dignity, but I was lucky enough to have a urologist and staff who were mindful of my privacy. That being said, some things you just have to get used to, the DRE, biopsy, cath removal, and many things since have caused me to be less concerned with personal privacy issues. The first penile injection comes to mind, the nurse pulled me out, prepped the side of my penis, injected, at least she let me hold pressure on the site !!. Ten minutes later, she comes back, grasps me, checks for rigidity by pressing, pulling, squeezing, etc. However, at this point in my journey, I realized she was just doing her job, still I was in a place/position I never imagined myself being. I guess what I am saying is that we all have needs for privacy and tact, some offices just are less sensitive to this.
Randy
Posted 11/3/2008 2:52 PM (GMT 0)
I’m probably as modest as the next guy.   I have problems undressing in front of hunting buddies at a campsite and friends at a pool party that turn into a skinny dipping party after a few too many.   Being “seen” by medical professionals is a non issue for me.   “If you’ve seen one, you’ve seen em all.”   All of the nurses that have seen me in my birthday suite have treated me well. I’m certain this is due to them having had more then one visit to a Male Gynecologist. Talking about getting up close and personal with your privates…   I had one funny encounter a female radiologist. I was on my third weekly cystogram and was use to the ritual. They’d have me get on the x-ray table – cover me with a large towel and then have me slide my britches down to my knees. The young woman said: “Hold on there sport. I’ve seen enough to last me a lifetime. Give me a second to leave the room.”   And then there’s my little sister that was having troubles getting pregnant. According her: “there nothing more fun in the world then having sex with your hubby in the morning…Standing on your head for thirty minutes and then rushing to the docs office to show him what you’d had just done.”  
Posted 11/3/2008 4:03 PM (GMT 0)

Steve, that's funny.

I lost my sense of embarassment many exams ago.

However, speaking of upsetting encounters....

I was at a Urologist before my RP for a second opinion. He also had a female fellow MD in the exam room for training. (As an aside, I wonder why a female would be studying to be a urologist with a specialty in prostate problems.) At some point he asks me to drop my pants for a DRE which I do while she's in the room - I have no problem with that. However, after he's pulls out, I feel another entry and I'm thinking what's that all about? Can it be she is being trained for this and she is practicingon me? Without asking me first? Anyway as soon as it's done I quickly turn around and see her taking off a glove and throwing it out. At this point I am pretty upset and I feel violated. Why would the Dr allow this without my permission? This was not necessary medically since he already did his exam.

I felt uncomfortable saying anything since he is a very well-respected doctor and I might need him in the future but I still feel wronged. So life goes on but it still bugs me.

Posted 11/3/2008 4:47 PM (GMT 0)
I too would have wanted to be asked. BUT, ya gotta speak up. Your well restected Doc didnt' stop to ask you cause he didn't think it was necessary...Once you make em aware that it's necessary.....
Posted 11/3/2008 6:04 PM (GMT 0)
hangin-in,
That is a case where you were violated. But some institutions do say these things may happn in the documents that you sign when you walk in. Was this at MSK? As a world reknowned center, I would expect that they are aware of what's appropriate and what isn't. It was inappropriate for these doctors to not ask if it was OK if another doctor could examine you, for training or any other reason. It may even be inappropriate to have them in the room during such an evaluation. I don't have a problem with female doctors at all, but I would have a problem with anybody in training taking an active role in my treatment and diagnosis without my consent. This is why we have HIPAA laws. Privacy matters!

Tony
Posted 11/3/2008 11:43 PM (GMT 0)
My doctors nurse prepped the biopsy probe while I sat in the room.  She told me "dont worry, he doesnt put the whole thing in".  To which I replied "not without dinner and a movie he wont".  She got a kick out of that and it helped chip some of that anxiety away.  By the time my Rad Prost. was done and I got back to the doc for the cath removal, I really didnt care who saw me naked.  I lost my modesty early on.

Posted 11/4/2008 12:03 PM (GMT 0)
Hi Meister,

What a good sense of humor you have. Neither my husband nor I are particularly good at witty comebacks. I read a saying once that fit me perfectly which went, "Ah me the wise and witty sayings on ice within my brain awaiting opportunities that will not come again."

Thank you for posting :)

May I ask a question? You mentioned sitting in the room while the nurse prepared the biopsy probe. Did she have you remove both pairs of your pants in front of her and then direct you to sit down in the chair next to her while she lubricated the probe using both hands? She also commented to my husband, " Oh this doesn't all go inside of you, only about this much does" and she indicated a place along the probe. I know my husband was embarrassed and ashamed to be in a situation like this. I'm certain he had not wanted to see the instrument which was going to be used to do the ultrasound and biopsy as he was already dreading the procedure enough as it was. I had a urologist tell me that having a prostate biopsy could be quite painful and I was very anxious for him that day, also. Thankfully, his urologist had state of the art equipment.

Wishing you 00.0 psa's from now on
Wiggyann
Posted 11/6/2008 2:07 AM (GMT 0)
I remember one procedure (but I forgot what it was) where the nurse had to shave my pubic area prior to the procedure.

So, I'm laying there on the table and she's "holding" my manliness out of the way while she's shaving with a razer in the other hand.. and she asks, "So what do you do for a living?"

It showed me that she wasn't bothered by it and, as people here have posted, she is so used to it that she didn't think twice about starting up a conversation with a patient while she worked on him.

I agree with the others here who have posted they've been seen naked so many times, it no longer bothers them. (Well, there was that ONE time when I started biofeedback after my surgery to learn where my pelvic muscles were -- where the nurse had to place a sticky lead on a wire in between my cheeks as I bent over -- that was my most embarrassing moment)
Posted 11/6/2008 4:33 AM (GMT 0)
Hi Anglophile,

Thanks for posting :-) This was my husband's first prostate biopsy and he had never had an invasive sugical procedure
before.

For example: After the biopsy his urologist immediatly left and the nurse ask my husband if he was okay and then told him he could get up. He was standing there with soiled tissues and blood all over his hand and didn't know what to do with the tissues. The nurse was right there watching him. He kept looking around and finally saw a small waste basket in the corner of the room. He tossed the tissues towards the waste bin, but they fell short and landed on the floor next to it. He was getting ready to take more tissues and continue to clean himself, but decided instead to retrieve the tissues on the floor. He bent down to pick them up and when he stood back up, he fainted and fell to the floor. When he came to and opened his eyes, A urologist who shared the office, another man and the nurse were all bending over and staring down at him. Another woman and another nurse had also come into the room and my husband heard the woman say that she had heard the crash from out in the hall. The urologist asked my husband if he was all right. Of course he wasn't, but said he was and told me later that he was never so humiliated and embarrassed in his life lying there half naked in front of all of these people and there was blood all over everything.

As the urologist helped him to get up, my husband told him that he just wanted to get out of there, so he just hurried to get his clothes and then had to dress with everyone still in the room.

Aside from the nurse having him undress and sit in the chair next to her without any pants on while she put a condom on the probe and lubricated it using both hands. And his experience after the biopsy. I don't think the issue was his modesty, but a total disrespect for him as a person that day.

Preparations for all urology procedures should be conducted in such a manner that is as free of stress as possible and which maintains the dignity and respect of the patient. And as much privacy as can be should always be afforded to the patient being careful never to subject them to embarrassment or humiliation, always being mindful of their state of undress!

Wiggyann
Posted 11/12/2008 5:35 PM (GMT 0)
The biopsy is an all-around negative experience - tollerable, but anything but fun. I guess there are several ways to look at all of this - some of it requires a sense of humor. On the other hand, I do think there is a type of insensitive hardness demonstrated and almost expected in these situations. Obviously, the person who is about to undergo the procedure is under stress anyway and doesn't need someone treating them as less than human. Additionally, the amount of money the biopsy cost is staggering, and I would think those receiving benefit from it financially could fine tune their courtesy.

In my experience I had a very bossy and insensitive middle aged woman who commanded I remove all clothing from the waste down and yes she just stood there while I complied as though I would not do it unless she was standing over me observing. I was thinking "I am a 62 year old man, not a child." Thankfully, I had a long shirt on with tails so I covered most of her direct view and this helped me deal better with the embarrassment. I thought at the time - this is very obnoxious. Now, since then I have had multiple situations like this including two young nurses standing over me at the hospital after surgery discussing my cathedar. I realize they have all seen the moon and stars, but they are still people and I can't help but wonder how they can be so removed from putting themselves in the patient's shoes. At any rate, I think the lack of professionalism with such people whether intended or not is inappropriate.

Thankfully, most of my experiences have been very professional, but there always seems to be a few flys in the ointment who for what ever reason have lost their professional concern for the dignity of the patient. I sympothize with your situation, and suggest you kindly let the good doctor know your concerns about the experience so hopefully they will treat the next guy with more dignity and respect.

Age 61 (now 62)
Original data - pre-operation
PSA: 5.1
T1C clinical diagnosis, Needle biopsy - 10 cores, Gleason 7 = 3+4 in 1 core (40%), 7 cores Gleason 6 = 3+3 ranging from 5% to 12%
All scans negative
Lupron administered 4/9/2008 for 4 months (with idea I would undergo external beam radiation followed by seed implants - then I changed my mind).
Robotic DiVinci surgery - Dr. Fagin (Austin) May 19th
Post operative - pathology
pT2c NX MX
Gleason 3+4
Margins - negative
Extraprostatic extension - negative
seminal vesicle invasion - uninvolved
1st Post PSA <.04
2nd Post PSA <.1 10/30/2008
Posted 11/13/2008 6:23 AM (GMT 0)
Hi RBinCountry

Thanks so much for your post. I copied several of your sentences
below and I think the way she treated you was very degrading. There isn't any excuse for that kind of behavior. She sounded like a prison nurse checking you in :-)

(In my experience I had a very bossy and insensitive middle aged woman who commanded I remove all clothing from the waste down and yes she just stood there while I complied as though I would not do it unless she was standing over me observing. I was thinking "I am a 62 year old man, not a child.")

I sure hope you never have to see her again.

Husband 68 at diagnosis
psa 7.3
biopsy 12 cores, 8 positive - seven 3+3 and one 3+4
Gleason 7
stage T1c
25 IMRT (radiation treatments) and a 25 seed pallidium seed impant
April of 2007.
last psa 0.5
next one due this month
Posted 6/13/2012 4:47 PM (GMT 0)
Well, This was all new to me but it was no big deal being naked in front of a female nurse.The equipment was on a small table and I actually wanted her to explain it all to me before the Dr came in because it is good to be informed. I kind of turned it around though and I think the nurse felt funny. After the biopsy the Dr. said " I don't want you to be concerned because you will see blood in your urine and semen for up to 3-6 weeks. Since it was the week of Valentines Day I just couldn't let it go. I had to say  " Good timing Doc"     He looked at me as to say" huh"?  The nurse was writing something on the papers. I said    "It's Valentines Day on Tuesday and wife will get a big surprise."      The nurse was trying not to laugh and the Dr. let out a chuckle and said "Incredible."  He left and I just cleaned up with the nurse in there naked from the waist down for a few minutes.

When I went back almost a month later for the gold beads that was even better. Different nurse ( Younger 40 ish ). After the beads (which were a little more uncomfortable being put in than the biopsy) I said to the same Dr., " It's St Patricks day this week Doc and I was racking my brain trying to figure what goes with red to get green."  This nurse said OMG.  lol     Also I said to the Doc,  You may have put that probe in with one hand  but if you had tried to take it out while you were inserting those beads you would have needed two hands and  a knee. Matter of fact you better check that for dents"

Now they both laugh. 

I guess it is all in how you look at things. Everyone is different and I respect each persons feelings. Also I have had a Primary Care Female Doctor for 35 years so being naked in front of a nurse or female Dr. doesn't bother me.

56 years old

PSA 2011   3.3

PSA 2012   4.6

Gleason  3 / 4

1 plug from 10 -  20%

Just finished IMRT on 5/18.   42 days.

Been almost month and side effects are slowly going away.

Posted 6/13/2012 4:55 PM (GMT 0)
I don't think undressing is worse getting a trans rectal biopsy in front of the nurse.
Even worse with a transperenial biopsy I'm scheduled for the 25th in front of a nurse.I've heard you're propped up spread eagle like a woman is at a check up by a gynecologist.
Posted 6/13/2012 5:00 PM (GMT 0)
During my proton treatment, I had a rectal balloon inserted everyday prior to actual treatment. This was done with me laying on my back with my knees up, and was usually done by a young radiation tech, usually female. All thoughts of modesty or embarrassment were quickly vanquished in the knowledge that everyone was going through the same thing. My worst concern was that some of them were better than others in 'inserting" the balloon.

You cannot be worried about embarrassment or modesty when you have PCa!!
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