I have been an appreciative reader (I dislike the term lurker) of this
newsgroup for about three years. Thank you to all who have shared their
experiences and wisdom wrt BPH.  I have gained much from your experiences
and would relate my own.

I am 68, and have had diagnosed BPH for about four years, and during that
time experienced three or possibly for episodes of prostatitis.  After the
first or second prostatitis the urologist (the first of four) pressed to do
a TURP, like, next Tuesday.  I had some knowledge of PVP thanks to this
group, though it was still rather new and problematic wrt insurance
coverage; however, this was not offered, and I ran for the exit.  I found
uro number 2 who had experience with PVP, and was with him for several
months until he relocated to Florida (I am in the Denver region).  So, on to
uro number 3, also with PVP expertise; we did the watchful waiting thing.

On Thursday, August 14, I experienced the onset of prostatitis, sudden
unexplained strong muscle ache and pain, chills & fever, headache, and
diminishing urine flow.  Quickly called for an urgent appointment with
urologist number 3, but only Physicians Assistant was available on Friday.
(I say at the outset, AVOID PA's IF AT ALL POSSIBLE.)  The PA confirmed
prostatitis, but arbitrarily changed the antibiotic from doxycycline to
cipro.  By Saturday it was clear the cipro was raising terrible havoc with
my stomach and bowel.  By Sunday I was bloated, miserable, and barely able
to pass urine.  Early Monday I requested an urgent consultation with the
uro, but was told variously by the PA and nurse that the urologist was not
available.  After several iterations of this, the nurse and PA asserted I
was having a separate gastric upset problem unrelated to prostatitis, and
should therefore consult my general practioner doctor!  I replied this was
obviously not credible, would cause more delay, and would cause confusion on
medications and responsibility.  More delays of the same nature until
mid-afternoon when the PA finally acknowledged the possibility of reaction
to cipro, and advised going to the nearest Quest Diagnostics to give a stool
sample!!  He had no idea how long it might take to get results. Urologist
might be able to call after 6 p.m.

At this point my bloating was pronounced and I was in acute pain. At my
wife's insistence we abandoned all hope with this provider.  We made a
terrifying rush to the Emergency Room; I was in agony. Now I began receiving
competent, timely, medical attention. I was given an injection for pain, a
blood sample taken, underwent a CT scan, and was catheterized, which
resulted in the release of 1.2 liters of urine. High levels of creatinine
and bun were shown in my urine sample, indicating my kidneys were at some
risk of shutdown. I was then hospitalized.

There never was a call from urologist number 3 (I learned later that he
probably was not even present.)  I subsequently refused to be seen in
hospital by number 3; this caused no end of concern among hospital staff but
I was eventually transferred to another temporary provider.

After release from the hospital I transferred to urologist number 4, and had
PVP surgery, which I will relate in another message as this is getting
rather lengthy.

The take-home message here is, I think, avoid PA's.  In my view and
experience they are not adequately supervised, in this and other experiences
of mine they are playing doctor without adequate training and experience,
and can do serious damage.  Another take-home is: strive to avoid delay in
getting treatment.  Get assurances of availability from your provider OR
locate and use an Urgent Care center near you OR a hospital emergency room.
I endured considerable unnecessary suffering because I tolerated delay and
worse from my uro, and hesitated to use the emergency room because of the
outrageous cost (even though it's not directly my money).

Charles