August 30th - Right goes Night

Last time, we told people about nuts... 

A week ago, if you had asked me how I would have spent my Wednesday, I wouldn't have said "Getting up at 4:30 AM to check-in at a surgery center promptly at 5:30 AM to have a radical orchiectomy" but that's what was going to happen. It was written in the scrolls. Righty had become too ambitious and begun taking territory beyond its given purview, Lefty was terrified of being lumped in, and the insurrection had to be stopped to save the Sacred Kingdom of Scrotanium.  

After check-in, I was shown into a personal waiting room with my father (who had the... balls to accompany me WHAM! PUNS!) and asked to put on a hospital gown. After gowning up, they took my vitals and a steady rotation of staff began to come through the small room. 

First was the on-call nurse who went through a checklist of items to confirm why I was there, any prior surgeries, any medication I was taking, the pain I was feeling, etc. 

Next was a relatively goofy surgical nurse who would set up my IV and explained that next in would be the anesthesiologist to explained the process of being put under.

The anesthesiologist was a lanky, goofy looking guy who had a quirky sense of humor, which I appreciated. 

Paraphrasing him: "Ever been put under before? Great. So, here's what's going to happen. We're gonna wheel you into the operating room and get you up on the special table for special guys. Then I'm gonna ask you if you're ready to be put under. I'm not going to wait for a response and then you're gonna wake up back in this room with one less testicle. Sound good?"

Hard to argue with calculating logic of that process. It was nice hearing a joke or two in such a sterile environment. Shortly after the sleep-doctor left, my Urologist showed up for his final consult. 

After a little banter, he got down to the surgery (which again, I appreciated his forthrightness on). 

"So, Michael, here's the deal. The surgery should be a breeze, but your blood work and your CT Scan came back. The blood work is... Okay, not great, but okay. The concern is that the radiologist saw a nodule in your lung which we are assuming is evidence of metastatic spread from the tumor." 

It's hard to describe how you can feel "lower" than knowing you're about to lose a testicle, but I found it. My heart dropped out and I felt a little faint at that notion. Not knowing much, all I heard was "Lung Cancer". 

"So, here's what that means. In my experience, you're looking at 3 rounds of what's called BEP Chemotherapy. Each round is 3 weeks long. Basically, we're going to knock you down for a week, you'll feel better and then we're going to knock you down again. The good news is that at the end, the objective is that you'll be cured. I called a friend of mine to see if he could fit you in for your Oncology Consult, he's one of the best I know. So I don't want you to worry. We're going to make this go away. Any questions?"

I wasn't quite sure what questions I could have, so I tried to reassure myself the way I always do.. Making a joke, "You know it's the right one that's defective right?" 

You can Google your own results to see what a Radical Orchiectomy is or what it looks like.  In the meantime, here's something else that needs radical removal and is radical.

BUT DID YOU TRY THE RADICAL HOT SAUCE!?!

Fast forward an hour and a dull pain in my groin for August 30th to count as the second time I've woken up wearing a jock strap I didn't fall asleep with. As a note, they use that as a "support" for surgery recovery. So that's a fun fact for you.

There wasn't much pain, but I was also still coming out of anesthesia and an IV painkiller. As soon as I had my wits about me, I checked. I bet everyone checks, to be honest. Who wouldn't? Upon checking myself, three things occurred to me: 1) Huh, that's a jock strap; 2) My whole groin seemed like it had lost a bet and was half shaven; 3) Lefty was still there, the Kingdom would survive!

After an hour and 30 minutes of recovery or so (some still sedated, some conscious), I was released. After a 5:30 Check-in I was out of the surgery center and on my way home by 10 AM. Let that sink in. That is how easy it is to radically remove something. 

I spent the balance of the day doped up on pain killers, sleeping and making liberal use of an ice pack. There wasn't a lot of pain to be honest and movement, while stiff, came relatively easy.

During one of my more lucid moments of recovery I phoned my sister who, as I have suggested earlier, is a Doctor in Ireland. She was understanding and likely knew more about the condition than I did. She was helpful in suggesting that she could operate as "Doctor Advice" or "Sister Advice" and I just needed to tell her which one. We made a few jokes about it to help with recovery and she reiterated she would be back in town for Thanksgiving. 

I would later find out out after my consultation with the Oncologist that, by Thanksgiving, I should be almost back to par and, if all goes well, Cancer free.

Next time we take a trip to see the Cancer Doc!

August 29th - Telling People is Fun

A (hopefully) quick post on telling people.. 

Operator? Please connect me to Bali.

So as a bridge between the the diagnosis and surgery date, I decided I would start telling a limited number of people outside of my parents. This was a difficult and conscious decision on my part. The rest of my family and friends knew I had an infection of some sort and it had kept me from several events, including a trip to Denver for a Bachelor party. I knew telling anyone would be hard, but I figured who to tell and when would come naturally. 

My parents gave me one piece of advice on the subject, "This is yours to tell. Tell everyone or tell no one. It's really up to you."

Mentally, I began to compartmentalize a list. Though the surgery wasn't major, the implications were more broad. I decided I would need to tell my brothers and my sister before the surgery. With a limited amount of time, my sister became an impossibility given her living in Ireland so I started with my older brother. 

I thought I was prepared for the conversation, to be honest. I had gone through it in my head enough times to have it down pat, cold and medical. When he picked up my call I asked him if now was a good time to chat. I cracked a joke I don't recall and then I told him. His initial response was, "Are you serious?" and that is when my voice cracked. I continued to border on tears as I explained to him the ultrasound, the consult and the surgery I would be getting early the next morning. It was hard and still, as many times as I went through it in my head, I don't know why. He had a few questions about the implications and I made sure he understood we would know more after the surgery. Before we disconnected, he made sure to tell me he, his wife and the kids would say a special prayer that night and into the week for me.

After hanging up, I broke down. It took me a few moments to get myself back together, clear my nose and breathe. It wasn't sadness or fear, I don't think. It was more like exasperations and exhaustion. There was no good way to break the news to someone that cares about you and who knows even less than you do about what's going on. Most times, I would pour myself a Jameson to calm the nerves but that was a pre-op "no-no". 

The next call was to my younger brother who was on vacation. That call was easier after the first. He was calm and supporting and wanted to know as much about the prognosis as I could tell him. I reiterated we would know more coming out of the surgery, but that initial signs were all good, all things considered. I made a joke about being much more like Lance Armstrong now and we agreed to touch base after the surgery. We agreed telling my sister, a Doctor in Ireland, as soon as was possible the next day was best as well. 

That was about all I could take that night. As I suggested in my previous post, as early as surgery was, sleep was difficult to come by. I had done everything I thought I could to prepare but the mind still races with ridiculous ideas and far off possibilities.

Luckily, there was a great staff to help me through.

August 28th - URLologists Fix Websites and Me

In case you're coming in mid-stream: Previously on "GI Junk"...

Over the weekend, I became an anxiety riddled hermit with an internet research and vodka addiction. I absorbed as much information I could on the potential for testicular cancer, the possible prognosis, how they might narrow it down and whether or not I would die from a faulty ball. It's amazing what the mind does when it doesn't have answers. When I wasn't researching different types of cancer, I was marveling at some of the stories that people told about their similar struggle. It made me feel good and it made me feel prepared for my consult.

I was told that the Urologist at Urology Associates fit me into his schedule late on Monday. As I arrived at 4:00 PM, two things occurred to me:

1) I was the youngest one in the waiting room by at least 30 years and it felt like everyone was wondering who I was there to console; 2) Oh god, oh god, oh god, oh god.

Dr Peregrine is known for his sight, not his hands (source: Internets)

Apparently, there was an emergency surgery just prior to my arrival so there was a long-expected delay. That gave me plenty time to research my doctor and browse Reddit. While I was already told all the doctors at this clinic were top notch, it appeared to me like mine was great. Internship at Mayo, Director of Urology at Abbott, lots of experience, seemed top notch. That made me feel better. So did the daily ridiculousness of the internet.

At around 5, I was finally asked back for my consult. Right out of the gate, I liked my Doctor. He was to the point but not overly blunt. We brought up the ultrasound images and he explained what was going on in my coin purse. Medically speaking, the ultrasound showed a 2.5 cm growth on my right testicle. As far as tumors go, "It looks good, unbroken, etc. That's all good." 

(Here's my ultrasound. Fair warning, it's a sonar image of my cancery gonad.)

He then turned to me to explain the score, "Michael, if you could have a meeting with god, he'd tell you he has some bad news and some good news for you. The bad news: You're going to have cancer at some point in your life. The good news: you can choose which cancer. Might I recommend testicular?" 

That made me smile. At least it was unorthodox. 

He continued on, "No, seriously. Testicular Cancer is extremely treatable and ultimately curable in most cases. We won't know for sure until we're able to get the pathology done but you're going to have to go through a procedure called Radical Orchiectomy"

Spoiler alert: you don't leave the hospital with sunglasses and a skateboard. In layman's terms, they're going to take the tumor out with the testicle and then biopsy it. So I have that going for me. Would have preferred skateboard feet, to be honest. 

The surgery was scheduled for August 30th at 5:30 AM for Check-in. On Tuesday, I would have to get a pre-op physical, blood tests and CT Scan to see if the cancer had spread. That was a whirlwind of a day, at the end of which I packed a bag for a few nights at my parent's place for recovery. 

I didn't sleep much that night. It was too difficult thinking about the implications of the surgery. 3 hrs of sleep or not, 5:30 AM rolled around very slowly.

But first, a brief note on telling people from earlier that night.