It was a terrific opportunity he really couldn’t pass up. Todd Chamberlin had been invited to fill a last-minute spot on an eight-day raft trip in June 2022 through Grand Canyon National Park. Yet, The Sopris Sun’s executive director hesitated.
For several years, he had been suffering from urinary issues. “The doctor thought I had kidney stones,” Chamberlin told The Sun, but by May 2022 he knew he had a condition known as urinary retention (UR). Most people with UR experience a variety of symptoms involving difficulty urinating, but, in Chamberlin’s case, when it flared up, his urinary tract was completely blocked, necessitating a trip to the emergency room to medically empty his bladder.
Chamberlin was on medication to control the symptoms and had been given assurances by his urologist at the time that he should be all right. “Besides,” he said, “the first day of the trip was happening on my birthday.” He agreed to join the group.
By late afternoon on the first day out on the river, however, the worst was happening: Chamberlin was experiencing severe UR. A former ER doctor was on the trip but could do little for him. Fortunately, because it was a chartered trip, the guide had a satellite phone and could call for help.
They were on a small sandbank along the river in the narrow and remote southern Marble Canyon section of the national park. Chamberlin would have to be airlifted out by helicopter, but it couldn’t get there until after nightfall. “Last year, out of about 130 helicopter evacuations, only a small percent were night rescues,” he noted. And this was in an especially challenging and dangerous location to access.
He said that he endured the long, excruciating wait by watching and after nightfall listening to a herd of bighorn sheep high on the steep cliffs above the campsite. “That kept me going.” Then like a UFO the helicopter finally descended quickly at about 10:30pm and evacuated him to the hospital in Kingman, Arizona, where he was treated. “They drained two liters [almost 70 ounces] from my bladder. It was instant relief, but another seven days on a catheter awaited me.”
Seeking treatment
Back home in Carbondale, it was clear that more had to be done. “Had the guide not had a satellite phone, I would have died, a very painful death at that,” Chamberlin stated flatly. He saw his new urologist, Dr. Jamie Lowe, at Valley View Hospital’s Rocky Mountain Urology Center (RMUC), who determined that he had noncancerous benign prostatic hyperplasia (BPH; enlarged prostate).
UR is very common in older men, and typically is a symptom of BPH. In addition, his prostate specific antigen (PSA) level — which can indicate the presence of cancer — was “off the charts.” The fact that he was in his early 50s meant that his condition was quite rare and of concern given his age and medical history.
For a number of years, the most common treatment method for BPH was a surgical resection (tissue-removal) procedure that removes some or all of the prostate. Although it cured UR, it also resulted in irreversible loss of sexual function. In addition, if only part of the prostate is removed in younger patients (like Chamberlin), it is likely that tissue will grow back and again have to be resected. As Dr. Lowe told The Sun, “The prostate continues to grow during adulthood.”
A much less invasive treatment, with the trade name UroLIFT, has been in use at RMUC for several years. It involves implanting tiny devices that force obstructing prostate tissue away from the urethra, and does not affect sexual function. Chamberlin discussed this option with Dr. Lowe. A major drawback, though, is that the procedure is only effective for mildly enlarged prostates. In his case, his prostate was already too large — more than three times normal size, as it turned out.
New treatment
As Chamberlin was weighing his options, a new treatment was about to come onboard at RMUC that was showing great promise. Lowe’s colleague, Dr. Aashish Kabra, had been monitoring the development of a procedure with the trade name Aquablation. Kabra told The Sun, “I had been following the progress on [Aquablation] for over five years … did a lot of due diligence [on it] … and presented it to the hospital in June [2022].” By early fall both he and Dr. Lowe were performing the procedure, the first physicians to do so on the Western Slope.
Aquablation is unique in a couple of basic ways over other methods. First, it utilizes 3D ultrasound imagery to precisely pinpoint what tissues need to be removed. Second, the procedure is done with a precision robotic device (as opposed to the manual methods of surgical resection procedures) that is guided by the images and uses a small high-powered water jet to remove the obstructing tissue without damaging other parts of the prostate necessary for sexual function.
A decision, a snag… and success
Given his options — standard resection surgery or Aquablation — Chamberlin chose the latter. “As a gay, single male,” he explained, “I wanted to stay sexually active in the hope of finding a partner again. My last relationship ended a few years ago because of another unrelated medical issue and I didn’t want this surgery to affect my ability to have a future relationship.” The procedure was set for October. It turned out, however, that there was a big problem: Chamberlin’s health insurance provider had denied coverage, claiming that Aquablation was still an “experimental” treatment.
The facts, however, contradicted that assertion. The procedure was first described in 2015, and over several years of trial studies proved it to be a safe and effective treatment for BPH with minimal side effects. Medicare approved Aquablation for coverage at the end of 2020. Dr. Kabra noted that, in general, “Insurance is getting on board; 90 to 95% of people [now] have no problem with insurance.”
Despite numerous appeals, Chamberlin’s carrier continued to refuse coverage, even arguing that he was “too young” for it. “I was so bummed and was in a big depression,” after being denied, he recalled, noting that there was no way he could personally cover the cost of the procedure — several tens of thousands of dollars. His only recourse was to switch to a carrier that did approve coverage, but that couldn’t happen until the first of the year. Meantime, he had to endure more painful UR episodes and trips to the hospital.
Finally, in mid-February of this year, he had the procedure. He admits that the first weeks of recovery (out of about eight) were “uncomfortable, teetering on painful,” but given all the pain and ER trips he had to endure leading up to the procedure, “it definitely is worth it.”
He noted that he is watching what he eats and drinks, “trying to figure out what caused the enlarged prostate,” since the treatment may last “only 10 or 15 years,” and “[scientists] don’t know what causes the prostate to enlarge.” He is off his medication, sleeps better (getting up one or two times per night, as opposed to four or five before) and thinks his sexual function is “actually improved” now. He is also back to the gym and all the sports and outdoor activities he loves to do.
The bigger picture
Dr. Kabra pointed out to The Sun that “Urinary bladder health has emerged as an important issue,” adding that it has become a “paradigm” in recent years. He emphasized that it is especially important for men in our region to become aware of this, as they have the highest rate of male longevity in the state. “You don’t want to live with BPH,” he continued, “as the bladder can deteriorate” and lead to a variety of serious health problems. “The sooner you do something, the better,” he added.
Both he and Dr. Lowe commended Chamberlin for his willingness to share his story publicly. “Getting the word out is important” Kabra noted, “and a success story like Todd’s is very helpful for encouraging other men with BPH to seek medical care.” Information on BPH and treatment options can be found on the RMUC website: www.bit.ly/VVHRMUC