Tuesday, July 22, 2014

Another Lump? I'm Running Out Of Balls... Or The Nutless Wonder?

For better or worse, going through testicular cancer once makes you a little gun shy.  Losing one testicle isn't too bad, but you quickly run out of testicles to lose after that.  I have sometimes wondered if having to carry a personal cell phone AND a work cell phone may have put out too much radiation and caused my cancer.  So to be safe, I wear cargo pants all the time and carry the phones lower.  My friends make fun of me, because I am still being exposed to twice the radiation of one phone it's just on my leg now, but I remind them that I still have TWO legs.
Anyway, at my last urology appointment, I mentioned I found a lump.  Having the health issues I have, I regularly see five different doctors, four of whom have a great sense of humor and I can joke around with.  However, my urologist, who is a great doctor and ultimately responsible for saving my life since he caught the cancer when a nurse practitioner dismissed it as nothing, he is all business all the time.  No joking, nothing but the facts.  I mentioned the lump to him, and kneeling down for my yearly check he was able to locate it as well.  He stated he was fairly certain that it was nothing, but if I wanted to get an ultrasound done to rest easier, I could.  I stated, I was probably just scared from finding the lump the first time (that ended up being cancer) and was paranoid about finding lumps now.  Still kneeling down and checking out the lump, he looks at me with a serious look on his face and says "When you feel something, I want to feel something."  Now, I know what he meant by that.  He meant, no one knows your body better than yourself, so if you notice a change you need to report that to your doctor.  It just seemed a little funny to me hearing that with someone kneeling down and holding my testicle in his hand.  And knowing that this very good doctor would not see the humor in what he just said, made the whole moment funnier.  I felt like a kid sitting in class in grade school trying not to giggle at "Guess what?  Chicken butt!"  I came pretty close to biting a hole in my tongue to suppress the laughter.
Fast forward six months later, and I kept feeling that lump with my regular checks, and it kept making me more and more nervous that it was "something".  I finally called the office when I could take no more to schedule an ultrasound.  The day they found my first lump, my ultrasound was scheduled for as soon as I could drive to the other office.  Last week's scheduling took days.  When the scheduler finally did return my call, she said, "When did you want to come in?"  I just told her, "Tomorrow!"
I went to the office and was relieved to see the same old lady that had performed my ultrasound last time.  Now there is probably more than a few males that would read this that are thinking to themselves, "Old lady?  No!  I was some hot young thing fresh out of college!"  And those males haven't thought this through all the way.  While the testicle may feel like this finely crafted orb, it is kept in the most hideous, unattractive container.  I am not much on trying to figure out what the fairer sex finds attractive, but I would imagine that is pretty low on the list of alluring male body parts.  And you are going to force someone to be up close and personal with it for some period of time since, to do it right, they have to scan the area from two different angles.  You want someone that you aren't trying to impress, that knows what they are doing.  You want to walk out of that office with some peace of mind.
And speaking of peace of mind, I explained to the lady where I felt the lump and she felt the area too.  This is where years of experience come in, because not only did she find the lump, but she described the area better than I could, which made me comfortable that we were both focused on the same spot and that she would get good images of the area I was concerned about.
First, she went ahead and checked "lefty" and put me at ease by saying, no matter what they found, he was going to stick around because the lump was not affecting him at all.  That was my main concern, I admire the "flatbaggers" because their journey is much more difficult with testosterone replacement therapy and other issues.  I didn't want to go down that road.  I did mention to her that last time, I could tell it was cancer, even though we had to wait for someone else to read the images, just by the look on her face.  That was a mistake.  She put on her best poker face this time, making sure I had no clue as to what she saw on that screen.  Do NOT play cards with that woman!
Feeling confident that at least I would get to the bottom of things so to speak, I went home to wait for the news.  Unfortunately that was Friday, so I had to wait through the weekend.  Each night, scanxiety was a little worse, and I slept a little less.  Finally, last night (night four), I think I slept for all of about an hour.  My wife had enough.  She told me to call the doctor.  I told her I was going to wait, because they were supposed to call me.  In my mind, if you call too much and irritate the doctor, they make the incisions twice as long, make you wait longer in the waiting room, or leave the blinds open during your screening.  She said "OK", then went to work and called the doctor anyway!  The good news is, apparently it's no big deal.  She didn't find out what it was, because she just wanted to hear it wasn't cancer so that I would quit tossing and turning all night long.
So, what is the moral of the story?  I don't freaking know anymore.  How about, when in doubt check it out!  Yeah, that works.  But seriously, there are two reasons for checking out anything you find suspicious.  First it could save your life (like it did the first time I noticed an odd lump) and second, you will be able to relax because you aren't worrying about it anymore.  And remember the words my doctor said to me, that if you feel something, he wants to feel something.

Saturday, July 19, 2014

Testicular Cancer Top 10....or I Am Not A Doctor, But You Are Still Going To Tell Me About Your Nuts...

In the breast cancer community, there are a lot of sources for finding information on how to do self exams, what treatment options are, and how to cope afterwards.  And while there are certainly many sources of information and non profits for so called "men's cancers", we aren't as open about discussing them.  It is ironic that the same ones that like to boast about being so well endowed that they make donkeys jealous are the same ones afraid to ask anyone how to do an exam.  I am not real sure what the reason for the disparity between the sexes is.  Maybe it's because breasts are right up front where you can see them and testicles are hidden, except in European bathing suits.  Or maybe how the great masters would always view breasts as these perfectly formed pieces of art that they would spend days sculpting into marble, while at the same time, the artists would make a guys junk look like a wadded up piece of paper with some concrete slapped on it.  At any rate, the public perception about the two are not the same.
After I went through my fight, and if you have read any of my posts you know that I have no shame in discussing what one experiences with testicular cancer, I cannot tell you how many times friends, colleagues, and random strangers have pulled me aside and asked, "How did you  know?"  I certainly don't mind answering that question.  I can explain how I found mine and then I usually refer to a website like http://www.testicularcancersociety.org/testicular-self-exam.html to get a more clinical and better explained way to do exams.  Then the feeling of dread comes over me, because I have been through this enough to know what is coming next.  The person will then describe, in great wrinkly and hairy detail, why they are asking me that question.  So far, they have always stopped short of actually showing me, and I would like to keep it that way.  Let's face it, they are not a very attractive piece of anatomy.  One of the few good things about having a nutectomy (orchiectomy, if you want to get technical), is there is one less of those ugly things that you have to look at in the shower, and bump into random stuff with...oh, and you can do your self exams in half the time.
So in the spirit of changing the stigma of testicular cancer and breaking the silence, I will post before and after pictures of my...OK, not really, but I will answer some of the questions here, that I normally get asked in a hushed voice in the corner of a crowded room, or outside around the corner out of ear shot of the smokers, or in late night phone calls with heavy breathing...OK, that person never actually says what they want, but always hangs up after I tell them to do a self exam.

1. How to do a self exam?  There are several sources for how to do a self exam including the one from the Testicular Cancer Society I mentioned above.  Some places even offer shower cards just like some breast cancer foundations do. There are two things to remember.  First do exams consistently.  You will notice something changing down there long before anyone else will.  I don't care how often you go to the doctor or what odd pastimes you may have, you will still notice first if you do regular exams.  And the earlier you catch it, the less it spreads to other parts of your body.  Second, we all know about shrinkage, so the boys have to be warm to get a good exam.  That is why it is generally suggested during a bath or shower, rather than right after taking the Polar Bear Plunge.  After all, you want things loose to feel details, cancer starts small and grows, you don't want things cold and shriveled like trying to feel two acorns stuffed in a leather wallet.

2. What if I find something?  It's probably nothing, but do you want to take that chance with your life?  Go to a doctor to be sure.  You would be amazed of the things that hang out with two nuts such as hydroceles, spermatoceles, cysts, drummers (sorry, musician joke), most of which don't hurt anything.  In my case, harmless hydroceles were found, but the issue is they can mask cancer, so I was taught to do an illumination test, where basically shining a flashlight behind the boys GENERALLY causes the harmless stuff to glow and the bad things to be dark.  However, let your doctor determine that for you.  That is not always the case and if done wrong, you can have cancer growing for months without realizing it.

3. If it is cancer, will they take my ball(s)?  Most likely yes.  That is why you want to catch it early so you only lose one.  But ultimately, what is the big deal?  I assure you that in the almost four years since "rightie" was removed, no one has noticed.  I get just as many compliments down there as I always have.

4. Will my testosterone levels drop with only one nut?  Maybe, but probably only slightly.  My doctor put it to me this way, if you lose one lung or donate a kidney it doesn't mean you are running on half power.  Usually both don't work at full power anyway, so the remaining one just works a little harder than before.  My testosterone numbers are well into the normal range.

5. Will my sperm count drop?  See above.  The fun part is with testosterone testing you give a blood sample,  but with sperm count testing there is no needle but there are dirty magazines.  Even if you drop in half, you will still more than likely have enough to get the job done or get you in trouble, however you view that situation.  Just a word of caution, I don't think the girl downtown offering to check your sperm levels for $5 dollars has had any medical training whatsoever.

6. Will I be able to have kids?  God I hope so, because I had one, so if you can't then someone has some explaining to do!  Yes, either the natural way or with frozen guys.

7. What is the first thing I should do after being diagnosed?  Ask all of your hot female friends if they want to say "goodbye".  OK, obviously that is a joke and probably wouldn't even work.  But I would call an organization like livestrong.org especially if you are interested in having kids.  They can tell you about certain grants that will pay for collection and storage of frozen guys, but the catch on some of them is you have to apply BEFORE you go to get the collection done.

8. Can the cancer come back?  Yes it could, but that is why you talk to an oncologist to see what your options are.  I opted for chemo for the peace of mind of not having to worry as much about it returning.  A few weeks of feeling sick was more attractive to me than a lifetime of worry.

9. Do they just slice open the bag and take out the groceries?  No!  They go in from around your waist so they can take all of the plumbing too, just in case it has started spreading.  So you can show people your scar without being obscene...unless you want to.

10.  Do you miss it or have any phantom pain like an amputee would?  No, and the good thing is, say hypothetically, you have a two and a half year old that runs at you full speed with a plastic Mike the Knight sword, the chances that he will hit your tender spot have now been cut in half (although he still manages to get me on the tender side EVERY SINGLE TIME!  I am throwing that damn sword in the trash!).

So there you have it.  The top ten (legitimate) questions I get asked in whispers and darkened corners.  If you have anymore (legitimate) questions I will answer them like I did here, based on my own experiences or direct you to a trusted source.  I am in no way a doctor, and I in no way want to see pictures, diagrams, or even very accurate descriptions.

Saturday, July 5, 2014

Old Feelings Die Hard

Four years ago this week, I first noticed my lump.  My wife had went on vacation with her mother and I stayed home alone to take care of work projects and watch the dogs.  The past three years, I never really paid any attention to this date.  After all, it's the date I just noticed something.  It wasn't the date I was diagnosed.  It wasn't the date I had my surgery or went through chemo or anything.  But that is the weird thing about cancer, it seems you are never really completely free.
This year we had planned to take my two year old to my parents to watch fireworks for the 4th of July.  From their house, they can see most of the fireworks.  And we thought if we take him there, and he doesn't like the loud noises, or the bright lights, or he just starts being...well, a two year old, we could just take him in the house and not have to deal with traffic or crowds or that one guy that has to describe every firework loudly.  After we had made these plans, my job made other plans, and my wife offered to take my son without me.  It was a plan that was seemingly perfect, my son could experience the fireworks for the first time and I could keep skittish dogs company in the country.
That is when it hit me last night.  I have been passing my scans without any problem, and my scanxiety has dropped to almost nothing.  I only have to go to the oncologist twice a year now  Even my dermatologist told me that she could tell I was really making a good effort to avoid skin cancer.  So I haven't been thinking about cancer much at all.  But last night was different.  I was back to that place four years ago, just me and the dogs.  The weird thing is, I didn't feel a lump, but I did have that feeling, a feeling I can't explain.
Most of us when we are diagnosed, aside from the shock of the "C" word, you get this "icky" feeling that something is growing inside of you that wants to kill you.  The surgery can't come quick enough, you just want that stuff out today.  That is the feeling I had last night.  The feeling that I was all alone again.  The feeling that something icky was going on.  What made last night even freakier, was without thinking, I picked up that PRS guitar I bought four years ago today to play with while they were gone.  It's not one I normally play, but it's what I grabbed last night.  The only one that was light enough for me to play after my surgery.  The one that got me through cancer.  Just as my mind flashbacked to the bad time four years ago, I also subconsciously reached for the one thing that helped me get through it too.
As I approach what I consider my fourth cancerversary, I have been thinking about when I am done.  Is it five years?  Is it ten?  Is it when you quit going to the oncologist...I hope it's not that one, because I think he has been saying "just a few more years" since my second visit.  As far as my health is concerned, I think I am done.  I have been getting clean scans.  I have finally been dropping the weight I gained while I was sick.   And for the most part, I feel better than before any of this happened.  But I guess it's harder to gauge the feeling that we are done mentally being affected by cancer.  Because last night, I sat alone and scared and realized I wasn't as done as I thought I was.  Or maybe I am, because I grabbed that PRS, just like I did after my surgery, and played until I didn't have cancer anymore.