I have to confess that as a 63 year old male I have an ongoing concern about my pee rate. Yes it may appear strange but as many of you may know, a man’s prostate gland increases in size as he ages. And along with an increased size comes a logical counterpoint: an accompanying decrease in flow rate, as the gland presses against the urethra.

So I figured I’d have it looked at. The urologist I met with spoke nearly perfect English and was very professional. He placed me on a hospital bed in his office and fired up the ultrasound machine. Turns out my prostate gland is only moderately larger than normal.

But then I heard an “Hmmm…” and given the context that my guts are being observed in real-time, I became concerned. The doctor then showed me a large black spot next to what seemed like a small kidney (in the photo below the cyst obscures the kidney):

An email to my friend Bill:

Sorry for the delay but getting my results has been a comedy of errors. See attached screenshot.

I have an appointment with my urologist in 2 hours but this morning the radiology lab informed me that the results were available. They wouldn't tell me the results or take a photo of the results to email me. But it was perfectly ok for a strange GoJek driver (Uber on 2 wheels) to pick the results up. Go figure.

When the driver arrived at the hospital, the security staff would not let him in! I tried to call radiology but no answer!

So I made an appointment for later today. 

I went through my records and it turns out that 6 years ago I had met with a urologist, and one of the notes was that I had a "simple cyst" on my kidney. I had forgotten all about it even though it was 6cm. Now it is 9cm. Probably the size of a tangerine.

The online summary of simple cysts are that they cause no damage unless they leak, and that's not common.

Since my simple cyst was in fact a non-cancerous cyst 6 years ago, I'm assuming that it has remained benign. The literature online indicates that simple cysts do not convert to cancerous cysts. In addition simple cysts do not impact the functioning of the kidneys.

So overall I'm optimistic but I will be discussing the puncturing of the tangerine later today. Apparently there is a procedure for puncturing and siphoning cyst fluid.

Ah, old age...

Email #2 to Bill:

Great news! All of my cysts are benign. They did find a couple of cysts on my liver and so I have a condition called polycystic (means many cysts), which is inherited. Fortunately they are not dangerous as long as the numbers stay low.

The 9cm tangerine is going to be siphoned off relatively soon, just so it doesn't start or continue to stress other organs.

I asked the doctor from 1 - 100 how healthy am I, and he said 80. So all is good.

It is strange to see growths on my organs and realize that 30 - 50% of males over 50 have them, most without any knowledge of having cysts. And it's also strange that the science is so poor, although the default explanation is that there's probably no $ in it.

Now for some numbers:

The initial visit with the urologist (350,000 rupiah) and the ultrasound (500,000) cost: $60 USD.

Returning for a blood test cost (1,600,000 rupiah): $114 USD. I thought that was a bit high for 9 blood tests.

Next was the CT Scan. To my knowledge there are three machines in Bali. You may recall that the machine is so big you slide into them by lying on your back and having the nurse push you inside. There’s a camera that swirls 360 degrees around your body so that the end results are detailed 3D images of your organs. That was 6,400,000 rupiah or $454 USD.

So the total bill was $628.

I’m investigating the procedure for draining the 9cm kidney cyst. So far my hospital, Siloam, wants to charge me $1,525 USD. I was surprised, as I was hoping that the procedure would be less expensive . The urologist said it would take about an hour.

When I first came to Bali I had in-patient health insurance but since this is an out-patient procedure I would not have been covered even if I had maintained coverage. As I mentioned in a previous post, I set aside $250 a month for health care costs.

If I were to add all of my medical procedures for the last 12 months, including this upcoming kidney drainage procedure, I’d be at about $2,400 USD for the year, or $200 per month.

Overall my experience was a good one, even taking into consideration my troubles in getting my CT scan results. When I did come in to the hospital to see the urologist in order to discuss the results, I noticed that my scan results were sitting in a large pile. So I’m not surprised that there was a mess up when trying to get them ahead of time.

And frankly it did not go unnoticed by me that I waited 6 years with my 6cm kidney cyst and had no anxiety whatsoever, but all of a sudden I needed to see my CT scan results ASAP!

I feel fine and that’s the main thing. I hope this medical tale does not give you pause about having procedures done in a foreign country. You may have to wait a bit for non-emergency results but if you can relax and adjust your expectations it all works out.

Later,

Neill