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[page 14]
DRE (digital rectal exam): Prostate appears Grade II-III enlarged,
symmetrical and non-indurated, i.e., did not feel hard or nodular,
with no discernible bulkiness or unevenness.
Reason for Visit: Inquiring about prostate-shrinking drug treatment (currently given heavy press coverage and advertising) for
his BPH symptoms (up 2-3 times a night, some hesitancy when
bladder is full). Patient filled out the AUA Symptom Score* to
determine if he was a candidate/or Proscar, but his tally of only
"7" indicated urinary symptoms too mild to qualify for drug treatment.
Recommendation: If symptoms become more unpleasant and/or
more frequent, to call for an appointment.
Post Visit Thoughts & Observations: Initial impression: patient
is a New Yorker without a New York attitude, interested in hearing what the doctor knows rather than telling the doctor what he
knows - an all too common occurrence, not confined to New Yorkers. He is a critical listener with a seeming abundance of gray
matter, but chooses to hold back on the many aspects of life he
obviously knows about, staying inside his personal armor until
he s sure it s safe to come out.
At our next meeting on March fifteenth - the one I'd set up
when I left Doctor Dominguez's office - Doctor Mawn and I became
more intimately acquainted. His digital rectal exam was unlike any I
had had before. It was considerably more probing, and though supremely uncomfortable, was so seemingly thorough and focused, I
found I was being comforted by the thought that if any finger knew
what it was about, Mawn's did.
* Prepared by a select panel of specialists chosen by the American Urologic Association to quantify symptom complaints of men experiencing prostatism (the other medical
term for BPH), it consists of seven questions, each one graded from 1 to 5 in terms of
severity. The most symptomatic patients would score in the high 30s.
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