What's Wrong With This Picture?

A) This woman's bustier is too tight

B) This woman has a bad dye job on her hair

C) This woman forgot to put on her nail polish

D) This woman is SMOKING

A) This woman's shirt is too short

B) This woman needs to go on a diet

C) This woman's upper arms aren't very toned

D) This woman is pregnant and SMOKING

A) Grandma has dirty fingernails

B) Grandma needs an eyelid lift

C) Grandma is not sharing

D) Grandma is SMOKING

A) Penises do not have arms or eyes

B) Scrotums do not have legs

C) Scrotum legs do not wear boots

D) The penis is SMOKING

The correct answer in each case is of course, D. Smoking.

Smoking has been positively linked to bladder cancer. Not possibly, definitely.

And smokers who continue to smoke after a diagnosis of bladder cancer have a very large risk of developing metastatic disease within 2 years. Once bladder cancer has become metastatic life expectancy is usually less than 3 years.

Many bladder cancers start as superficial lesions that can be treated if caught early. Unfortunately, bladder cancer isn't always very obvious so if your doctor tells you that you have blood in your urine even if you can't see it, follow your doctor's recomendations to have it checked out.

Common risk factors for bladder cancer are age (over 40), being male and smoking.

If bladder cancer is caught early before it becomes invasive, treatment is much simpler. If it is invasive, then the discussions change dramatically to options such as removal of the bladder and/or radiation and chemotherapy.

People often fear quitting smoking for fear of gaining weight.

You can lose weight. It is much harder to lose cancer.

Other people fear becoming irritable if they stop smoking. There are lots of good ways to help cope with this, though.

There is hope and help if you want to quit.

And each time you try to quit, one day you really will.

The saddest part of Christmas this year was going to the funeral of one of my favorite patients who died of bladder cancer. She never stopped smoking.

Please try. For everyone who loves you but most of all for yourself.

We can help. Talk to us.

Mea Culpa - the blog has grown stale

Mea maxima culpa

It's not for lack of time

Since most of my last three months have been spent like this outside of work

Let's see if we can bring this thing back to life, shall we?

Happy Holidays 2010!

Whether it is Christmas

Or Hanukkah

Or Kwanzaa

Or anything you celebrate this time of year

We wish you all the peace, love and happiness in the world.

(Our favorite Christmas present was Obama signing the bill that prevents any further Medicare cuts to physician payments for one year.)

We look forward to helping you achieve optimal urinary and sexual function in 2011.

Post Op Vasectomy Advice

Hear me now and believe me later!

The second hardest part about having a vasectomy is doing what you are supposed to do for the first week afterwards.

(The hardest part is deciding to have it done.)

(Unless you were not the one who made the decision)

But if you do the following things that Dr. Roesel recommends, your recovery will be much smoother than if you insist on "doing it your way".

Dr. Roesel goes over these things with you before you leave, and you also have written instructions that you are given. But when you are in a pleasant Valium haze you may forget what she says or where you put those instructions.

So let's go over them.

1. Wearing supportive underwear for the first week is a MUST.

This is an example of supportive underwear. Yours do not have to be so extreme.

Regular "tighty whities" are fine. Just don't buy them too big. Remember, we are talking support.

Boxers, boxer briefs, sweatpants, pajama bottoms and longjohns are not supportive. Put them back in the drawer.

2. Take it easy for 2-3 days after the procedure

Remember, you have had surgery and things need time to heal.

This means lying around and keeping your scrotum protected from the forces of gravity.

I like to tell my patients to only do things that they can do wearing a pair of bedroom slippers.

I have never seen anyone playing tag football or moving a big screen TV in slippers.

This is a really bad idea on many levels.

3. Use an ice pack as needed for comfort. We give you a gel pack but frozen vegetables work well, too.

4. Do not suffer.

You are not a "girlie man" if you need to take painkillers.

Be careful about taking too many, though.

5. Abstain from ejaculation for the first 7 days. If you have wet dream, you get a pass. You can't help that.

6. Stay out of the pool or the hot tub until your incisions heal.

7. And don't hesitate to CALL with ANY questions or problems.

Top 10 Reasons Why People Like To Come To Our Office

1. We do not weigh you

2. We give you candy if you would like some, or a rubber mouse or frog if you prefer

3. We absolutely don't believe in causing pain

4. We have quiet pets in the waiting room, not fish with running water sounds that make you need to urinate

5. We always have a smile for you

6. Our magazines are up to date

7. We have warm baby wipes for clean up, not cold scratchy paper towels.

8. We have toilet seat covers and grab bars in the restroom.

9. We make you laugh

10. We can give you an appointment SOON, not weeks from now, and even SOONER if you are in pain.

Our office is more fun than a ride on a piglet. Come see us!