My contribution to Movember

Whether it’s “No-shave November” or “Movember”, there’s a lot of attention given this time of year to men’s health in general, and cancer in particular.

I don’t take part in either of these events, partly because I don’t like the way a beard / moustache feels, but mostly because I already spend my November extremely aware of men’s cancer issues.

So, let me tell you, on this International Men’s Day, how my right testicle tried to kill me. Warning – rude words ahead, including the dreaded “c-word”.

Here we go gathering nuts in May

A little over fifteen years ago, I was living a fantastic life.

A wife, a six-year-old son, a house in a nice suburb of Austin, working from home on my own projects, and making enough money with those projects to justify doing so.

As anyone who’s ever watched any “funny home video” shows on TV will tell you, the purpose of a six year old is to throw things at your crotch, or to swing things at your crotch, or to hit you in your crotch, or to head-butt you in your crotch.

OK, so that’s maybe not his sole purpose, but that year it seemed like this was happening more often than usual. It wasn’t, of course, but it was noticeable that I was … feeling the impact a little more keenly than usual.

It takes balls to go see a doctor

I checked, my wife checked, and we concurred – something was definitely not as it had been. I mean, everyone knows that a man’s testicles aren’t the same size and shape on each side, and I’d been blessed with a particularly disparate pair from my teenage years.

But this was something new – swelling that just increased gradually, and a firmness that was inappropriately placed.

It was time to see the doctor.

Even knowing this, and reading about how badly – and how quickly – testicular diseases can impact men, it was extraordinarily difficult to face the task of picking up the phone, calling to speak to a doctor’s [female] receptionist, and tell them exactly why I wanted to come and see the doctor. Nonetheless, I girded my loins as much as I could, swallowed hard, and made the call.

The key is to remind yourself that this is probably the fifth call that receptionist has received this week on the same topic, and that she wouldn’t be working in a doctor’s office if she weren’t ready to hear medical terms briefly describing anatomical parts. I’m surprised how quickly I came to this conclusion, given how many decades it took me to learn that when a doctor asks “so, how are you doing today?”, they actually want to hear the details, rather than “oh, fine, thanks, and you?”

“Good luck”

The doctor’s visit was quick and clinical, just what you’d hope for. A flashlight applied to the nether regions, in much the same way you might check a hen’s egg for occupants, a little uncomfortable palpation, and a quick inspection of nearby things while you have your underpants down.

“You’ve got a hydrocele,” he said, doing that thing with the rubber gloves where you snap them off, startling an already nervous patient. “A short surgery should fix that.”

Relief. Nothing quite as horrifying or scary as I had expected.

“I’ll set you up with a urologist, and we’ll get that taken care of in the next couple of weeks. Good luck.”

I’d never had a doctor wish me “good luck” before, and it quite chilled me.

You’re never ready for the C-word

I visited the urologist, got set up for surgery, and discussed plans with my wife.

It was always in the back of my head that this could be something more than merely having a little extra fluid to drain.

So we talked about the C-word. I think of it that way, because on all the forms since, this is the one word the medical establishment goes out of its way to avoid writing in full. There are long words, foreign words, culturally taboo words, and all of them are written in full on some or other medical forms. There are abbreviations, but no word more than this one results in hardened medical professionals ceding to decency and refusing to name it in full:

Cancer

You kind of guessed that was going to be the result, right?

We kind of did, too, and had discussed the idea that if there was any cancerous signs, that quite frankly I preferred being a living eunuch, if that was necessary, to being a dead, but otherwise intact, cancerous corpse. It seems such an obvious decision to make, but it’s still a very hard one to bring to bear.

And my wife did so on her own.

Because the only way to tell if the testicle looked cancerous was while I was under general anaesthetic in the operating room.

And sure enough, the doctor came out mid-surgery, while I’m away with the fairies, to talk to my wife about the situation at hand. I can only imagine how that conversation went, so I shan’t try to replay it here. I can only express how truly grateful I am that my wife gave consent to do what we had already discussed – to remove that cancerous nasty thing and send it to a lab for study.

So I woke up to a woman looking unutterably upset at the prospect that she’d had to make life-altering medical decisions, for which I have always been truly grateful. There literally isn’t a day that goes by that I wish she’d made any other choice.

And yet even to this day, it still bothers her – that’s how upsetting it is to be on the outside of this disease.

It wasn’t much fun on the inside, either, to be honest, and that’s my story which I can tell.

Time to hulk up!

This was all in the week before Thanksgiving, 2002, a year when the first movie  featuring an all-CGI Incredible Hulk was being advertised on the TV.

Poor Bruce Banner, strapped to a table, unable to move, while gamma rays coursed through his body under the control of a malfunctioning computer, turning him into the hangriest super-anti-hero ever.

After a trip to San Antonio, during which I felt every pothole on the I-35 from Austin, to have Thanksgiving dinner with my inlaws, we returned home and started observational and preventive treatment as follow up for good ole “testicular C”.

First, the tattoos. I have five tattoos now, each one a single dot, in the shape of a cross.

For targetting.

I wasn’t exactly strapped to a table, but I was unable to move, while gamma rays coursed through my body, laser cross-hairs ensuring that the focused radiation hit only the right parts of my intestines. They call it radiotherapy, and when you go to an oncologist / radiologist to get radiotherapy in Austin in 2002, you sit in a waiting room surrounded by inspirational photos of Lance Armstrong. Whatever you feel about his drug use while winning the Tour de France competing against others who almost certainly used most of the same drugs themselves, he continues to be inspirational to many cancer survivors like myself, simply for having survived enough to be able to ride a bike.

Testicular cancer doesn’t travel across, it goes up – so the process is, remove the testicle, fry the intestines lightly, and monitor the chest with ongoing X-rays just to make sure. Removing the testicle is called an “orchiectomy” – true story, the orchid plant is named after testicles, because that’s what the plant’s bulbs allegedly look like. This is why testicular cancer awareness pins are orchid-coloured.

Insurance companies make me sick

One of the side effects you think of with any cancer treatment is serious nausea, and this is definitely the case with radiotherapy. It makes you feel uncomfortably unwell. American medical care being run by insurance companies, I was given leave to have fifteen anti-nausea pills. For 25 days of treatment. During which I’d need multiple pills per day.

The only thing to do – snack on saltine crackers, and where possible actually cook some meals at least for my son. Bland food was really pretty much all I could manage. To this day, he quite rightly refuses to eat chicken and rice.

Because my wife had to return to work, and was travelling as a result, I drove myself to appointments, and that’s probably my biggest mistake in all of this – the American Cancer Society offers free rides to patients attending hospital and doctor appointments, and has many other services besides. Take advantage of them, I donate to them specifically for you to use their services.

Cat scans and pregnancy tests

After that, every six months to a year, I’d get a CT scan of my abdomen, and a blood test every month. CT scans are not the most comfortable of procedures, particularly with the iodine contrast dyes.

Once in a while, the person administering the blood test would question whether the test was really for me. On my doctor’s advice, I would ask them to re-check the form. It turns out that I was basically being given a monthly pregnancy test, to ensure the cancer wasn’t coming back.

More surgeries, and more insurance

Still more surgeries were in my future over the next year – apparently, skin likes to stick to skin in unusual situations and in uncomfortable ways.

The insurance company raised our rates – presumably in line with regular price rises, but to the point where it was difficult to afford. After all, even back before the ACA, it wasn’t right to raise insurance rates just because someone got sick. However, what WAS legal back then was the ability of other insurance providers to call the cancer a pre-existing condition, and to use that as reason to either refuse to sell me a policy, or to jack up the rates. Personal insurance policies are expensive to begin with, but when you can’t shop around (or threaten to do so), you’re really out of luck.

And that’s why I took the Microsoft job, and jacked in my personal business for the most part. Because American health insurance kills the American dream more often than it deserves to.

And now, the lesson

So, the final lesson – and there always is one – is that if you are a man, aged between twenty and thirty-five, or you know someone who fits, or will fit, that description, know that it’s important to check your health – actually touch and feel your body, particularly your ‘man parts’ – on a regular basis. When things change in a way that isn’t expected, it’s really important to give your doctor a call. That week. Perhaps even that day that you notice it. The person who takes your call has heard it all before – and if you aren’t comfortable talking to them, you can actually ask to speak to a nurse, a physician’s assistant, and even specifically to a man, if that’s what you need to feel comfortable to cover this.

Your doctor will tell you if it’s important, or something not to worry about. They’ll give you advice on what to watch for in future, and wish you good luck if you need it.

Above all, don’t literally die of embarrassment.