Some would say cute, others would say funny looking. Make no mistake the Fugu or puffer fish is rather interesting to say the least. You are probably wondering what a puffer fish has to do with prostate cancer.

Well hold onto your hat and we will get there.

Said pufferfish just happens to be the among the most poisonous vertebrates in the world. It is over one hundred times more potent than cyanide, no less . Not something you want to accidentally put in your tea or spread on your toast. These fishy bad boys and girls are filled with a substance called tetrodotoxin, which is concentrated in the viscera. That’s a posh word for the soft inner organs.

In Japan the puffer fish is a traditional delicacy. It is prepared and sold in special restaurants where the celebrity licensed chefs, who have trained for years, carefully remove the viscera to reduce the danger of poisoning.

How would you know the chef has had a bad day or really does not like you?

Well the potent neurotoxin tetrodotoxin has a unique way of letting you know that it’s in town. You will feel a tingling, burning or numb feeling in the lips and tongue, followed by the same in the extremities, hypersalivation (love that word! – means serious hyper dribble),  sweating, headache, weakness, lethargy, in-coordination, tremor, seizures and eventual complete paralysis, including all internal muscles and organs. You will be fully conscious during all of this and dead within four to six hours.

Oh and did I mention that there is no antidote.

The chef prepares the Fugu swiftly and very, very carefully.

A single mistake, a cut or jab or prick in the wrong place, could mean death for a dumb customer.

First the fish is put on its stomach and the head is opened to removes its brain and eyes. The ovaries and the liver are the most poisonous parts and are gently removed. One by one all the poisonous body parts are all carefully put onto a metal tray. Each part has a special badge so everything is accounted for. The dangerous parts are locked away in a metal box and incinerated later. The edible parts are cut into delicate slithers and elaborately fanned out onto the best china plates for some nut who will pay a seriously premium rate in a top restaurant for the pleasure of dicing with death.

Yeah, yummy in my tummy as Joel would say.

Don’t worry I am actually getting there.

We were all sitting in the waiting room and four strangers were called into the small consultation room which normally only comfortably holds two people. Now I had waited a long time for this appointment as the previous one had been cancelled by the hospital due to supply problems with the drug. We sat in a semi-circle while the nurse went out and came back again and finally settled down.

“Welcome to you all for the erectile dysfunction class for the Viridal Duo injection. Just want to check that you are all in the right place?”

Just a side note here. You digest Viagra and it works from the bottom up, increasing the blood flow to the penis. The injection is basically Viagra injected directly into the penis. It will work on practically all patients regardless of if your nerves were spared during the operation. There are just a few medical conditions that prevent this happening.  There are also studies that indicate that early use of the injection after the operation can actually speed up the normal spontaneous function.

The two black guys to the left of me both nervously repeated the word ‘injection’ one after the other. The guy to the right of me never said a word for the duration. One of the guys was still muttering that he didn’t know. No-one had told him. You know when someone puts their Oyster ticket (bus pass) on the wrong bus and has an issue with the world because they cannot get a refund. That kind of whinging.  I’m not a sadist but I didn’t look away as I saw the colour draining away from the two of them. I have seen it happen before on this fun packed prostate cancer journey at other seminars.

Never fails.

Come on guys! You lot had ten or twenty years more than me before getting to this point. They really were not warned but I was on my best behaviour and I didn’t laugh or smile.

Not on the outside anyway 😊

As I have mentioned before the King has not quite taken back his throne yet so it could be a case of waiting patiently for full service to resume. Apparently, one happy go lucky nurse informed me, its ‘only a year’ and it could take up to two. Well sorry 70% is just that – I want the missing 30%. How about you give me 30% of your next months salary Ms Happy go lucky?

Nah! Forget that!

So here I am seeing if this can help in the interim. Happy to try anything.

“A mountain is there to be climbed, or it stays undiscovered.” That sounds like something someone famous would leave as a quote.

She went on with the seminar. “Don’t worry you won’t have to try this as a group in the seminar, I will be seeing you all one to one.” Note to self – fasten back up belt buckle before you stand up.

“Blah, blah, blah……”

“This bit twists into this bit, shake it. Make sure there are no air bubbles. Twist the needle in. Hold the head like this and inject into the side of the penis. It won’t hurt it’s only a tiny needle.”

“How tiny is the needle?” One of my friends on the left nervously asked.

I said a “Cluck, cluck” in my head.

“It’s smaller than the needle you would have used if you had the operation” That would be the needle for the twenty eight day anti-clotting injections. If that was meant to comfort him, I’m not sure, he still looked terrified.

“We will only be giving you a half dose of the drug today to see how you do”

I momentarily stuck my lip out. What the hell is half the damn dose going to do? I felt I was being cheated! I pay my taxes and national insurance thank you very much!

“Don’t put it in the head, that’s very painful. Don’t put it in the underside of the penis as it will just run out in your pee. Just stick it straight in its only painful if you hesitate or move it around. If your erection does not go down after four hours go to hospital immediately. If you have an erection longer than four hours and you don’t get it seen to by the hospital it will begin to die as it has no fresh blood flow. It’s called Priapism.”

die, Die, DIE, DIEEEEEEE!!!

She didn’t say that last bit but I’m giving dramatic strobe, shaking effect. There is of course the chance of penile angulation (where the penis curves un-naturally) or penile fibrosis (scar tissue – inhibits growth ) which she didn’t mention.

Don’t put the needle in the wrong place!

Really cheery seminar this one.

She went on with a few more admin type questions and then it was “Who wants to be first then? I will be back in a minute” and off she went. The three of them looked at one another, muttered under their breaths, shuffled about a little, looked at their feet and couldn’t decide who was going first.

“I am happy to go first. I have to get back to work” I piped up. Surprisingly there was no argument from the trio.

The nurse came back and went over some admin type questions. “You don’t have sickle cell or trait”

“No.” I answered.  A few more questions and then OK let’s hop over there on the couch and try it. Pants were down in seconds and she handed over the box.

I fitted it all together, screwed the needle on, tapped out the air, like the doctors do on TV. “OK, hold the head and straight into the side” she said.

Boom!

If you can imagine someone putting a power drill into your forehead and turning it on. That would be a fair description the sickening scream that came out from deep within me.

Nah. Not really. It was simple and painless as the nurse had said. A piece of cake. I did joke with the nurse though what if I screamed and made the other guys run off. She had the same dark sense of humour as me and we were both laughing away. She said it should take between five to ten minutes to work and I should just wait outside while she sees the next man. Jeans back up and off I went back into the waiting room. I sat next to one of the guys and he asked how it was.

I didn’t answer for a few seconds. I was wrestling with the inner me that wanted to say I needed to see the nurse again because something bad was happening. I was on my best behaviour, so I said it was fine no problem at all.

Then I saw my nurse friend and went over for a chat, while I was waiting for something to happen……