Tuesday, September 20, 2011

Testicular Cancer - A Journey (and other overused metaphors)

Well, I’ve gotten a lot of questions about my “cancer thing,” so in order to share information with long-lost friends and avoid the awkward phone calls with very little information (“Old buddy from college? It’s Greg. My tumor markers dropped a little! OK, I’ll see you at VEISHEA in five years!”) I decided to start this blog and share my overly personal experience of losing a testicle to cancer. Just imagine…before blogs, this would have taken hundreds of overly-personal Christmas cards.

Anyways, it was August 15 when I first noticed something was amiss. I was sitting in a city council meeting when I noticed that one of my testicles was hurting (that was a fun sentence to type knowing fully well my grandmother will likely read this…HI NANA!). I’m not one to put off pain because I’m scared of hospitals at all. I’ve got health insurance, so I’m going to use it if there’s anything I’m worried about, but this situation was unusual. I had rode a horse the day before (the first time I had done this since I was small enough to be lifted on top of one), and not being used to being jostled up and down, I figured I had landed weird while the horse was galloping and had bruised one of them. “I’ll give it a day,” I thought.

The next day I noticed a fruity sensation. This was entirely attributed to the Fruit Stripe gum I was chewing, however, and the pain in my testicle was gone. I completely forgot all about the pain and my reference to a chewing gum popular in the mid-90s and went on with my life.

It wasn’t until two weeks later that the pain returned, same testicle. I made several jokes with my wife, including a few about it being cancer, and made the same promise: if it’s still there tomorrow, I’ll get it checked out.

The next day the pain remained, so I called up a local physician. I hadn’t been to the doctor since moving to Boone except for a physical for the fire department, which was paid for by the city. When I inquired about returning to the doctor I saw that day, I found out my insurance didn’t cover that provider. My wife, however, had received a tetanus booster from a doctor that did accept our insurance – Dr. Mehlhaus.

This leads to something that is a new subject all in itself…small-town life. When I had my fire department physical, I was holding a urine sample when I passed my next-door neighbor, who thanked me for the cookies my wife and I had made for them a few weeks earlier (tip: if you don’t own a snow blower, but your neighbor does, learn how to bake). It also turns out that I’m in Rotary Club with Dr. Mehlhaus (typing that sentence, I feel like a 90-year-old telling a story that they are making purposefully long). Eating lunch every week with a person that you make an appointment to look at your testicle is difficult, but I’d heard good things about him, he was a very nice guy in Rotary and I had a high opinion of him. To summarize, living in a small town is funny...chances are if you're holding a container of urine or having a bulge on your nut examined, you're going to run into someone you know, so modesty is something you learn to live without.

My opinion of Mehlhaus being a decent guy nearly changed when I was led to his Iowa Hawkeye-filled patient room. I felt like I was being recruited and wondered silently if any patients were offended by this. I reminded myself that Iowa State didn’t have a medical school and waited for the doc. (Note: Despite his Hawkeye allegience, I now view Mehlhaus as the best doctor in the world)

Mehlhaus showed up and we spent about five minutes shooting the breeze about a recent bond issue, which was cut short by him asking me to drop my pants…an odd conversation shifter. He inspected, had me pull my pants back up, and immediately hopped on the phone trying to set me up with an ultrasound at BCH. Apparently everything in the city was booked up that day because he left the room and spent 15 minutes on the phone, using his skills of negotiation to get something set up.

He came back in the room and didn’t mince words: he was worried. It was either very severe epididymitis or testicular cancer. He told me if it was epididy-whatever I’d take some pain medication and they’d monitor me. He said if it was testicular cancer, survival rates were 95-98 percent and I’d have surgery. He said he had set me up with someone he knew in Des Moines and wanted me to drive down there now. Not in four hours, not tomorrow…go get in your car, tell people at work not to expect you today and leave.

This was an unexpected turn, but I nodded along with him as if I was given a cancer diagnosis all of the time. I asked about the epididymitis, as if he were a mechanic telling me my car had either a chipped windshield or a blown transmission and I had responded with, “Oh man, does it look like the crack has started to spread at all?”

I thanked him, left, ran home to swap cars with my wife and share the news, which I actually gave her over the phone on the way home. I stressed the high survival rate, told her not to worry and met her at home looking for my iPod. She asked if I was in shock, and I told her not really…I fully understood the risks, and I absolutely did. I was more concerned with making a 45-minute drive to Des Moines without my 160 gigs of music (as usual, on any given day, 98% of my music is crap, but I have to skip through it all).

I stopped at work and gave them the news, which is not easy. Telling a newspaper staff that the person who usually does all of the layout, writes a couple of stories (I had two I was in the process of writing for the next day) and alters the photos that instead of doing that today, he’ll be leaving, eight hours before deadline is…tough. Obviously the possibility of cancer is a flawless excuse, but I still felt bad.

I showed up in Des Moines and was told to meet my urologist. I showed up at the lobby, was given my sign-in stuff and delicately asked a question to the clerk. “I need to use the bathroom. I assume, with this being the urology department, you’ve got, like, 50 of them. Can you point me to one of them?”

They only had two, but one was unoccupied. In there, with it being urology, I noticed a tray of urinalysis cups. A sign prompted visitors to leave a urine sample if they could. “Wow, just like a fancy hotel,” I thought to myself. “Why not?”

I left the bathroom, and my urine sample in the metal cabinet, and went back to the paperwork. I had filled out quite a bit of paperwork that day and was getting tired of it all. This paperwork was ridiculous…all questions focused on my urination habits. Do you have trouble urinating? Nope. Get up frequently at night to urinate? Nope. Reason for visit? Cancer. Allergies? “Cats, but I do not ingest these orally,” I wrote.

A nurse came out and got me and we went through the routine – she takes my height, weighs me, I make the same stupid joke I’m sure all patients make about how the patient questionnaire I’m holding must weigh 10 pounds, and I’m led to a small room.

My urologist was awesome. He checked me out, said the same thing Mehlhaus told me, sent me to an ultrasound tech in the same building, and it was there that I started to get slightly nervous. I walked into the ultrasound tech place, signed in, and sat down amongst a crowd of about 25 people. Not two minutes later, a nurse came out for me…not a good sign.

I threw on the gown, laid down and looked around at all the maternity pictures of mothers with their babies as the tech put ultrasound gel on my nuts. I’m sure it was awkward for the both of us, but it gave me a chance to leaf through the latest copy of Parenting magazine while she went over my testicles with something that looked like an airport security wand. I resisted the urge to ask her if it was a boy.

From there, she left, leaving me in the room for about 15 minutes and I was sweating a bit. It wasn’t until this point that I started thinking about how this might be somewhat serious and asking myself if Mehlhaus and my oncologist were simply telling me the best odds and not the most practical odds of beating this. Fifteen minutes in a room normally reserved for people excited to find out the sex of their baby when you’re facing a diagnosis you’re still unsure of is an eternity.

When the tech came back in and told me to go back to my urologist, I was nervous. When I got back to the crowded urology department, signed in, and my urologist came into the waiting room to get me himself, I knew.

Sure enough, there was a mass. The urologist was 90% sure it was testicular cancer, and said there was a 10% chance it was just a mass. Surgery was scheduled, I was given no options on time, I was to show up for surgery the next day at 8:30 a.m. I immediately called my wife, who understandably was freaking out, but kept it together very well in front of her daycare kids. Next I called my parents and brother to let them know, which is an interesting experience. “Hey, mom? What’s going on? Oh, really, Amy’s doing good in cross country? That’s awesome! Anna’s doing well also? That’s great. Anyways, not a big deal, and I don’t want you to freak out, but I’ve got what looks like testicular cancer and I’m having surgery tomorrow.”

Obviously, my parents freaked out. Anybody hears cancer and they think the worst, but I honestly wasn’t all that worried at the time. I had asked questions, and based on the odds and the state it was in, testicular cancer to me was like the Detroit Lions of cancer (post-written edit Sept. 27: I'm starting to regret typing that looking at their record so far this season). It’s this reason why I don’t really look at myself as “battling cancer,” a term that’s used a lot these days. It’s difficult to describe, but being a huge fan of metaphors, it’s like when top clothing designers do a line for K-Mart. “Is that Gucci?” “Technically, yes.” That’s how I feel with my testicular cancer. “You have cancer?” “Well, technically, yes.” That might be the most non-heterosexual metaphor I could throw out there, but I preceded it with a football reference, and I only have one testicle, so cut me some slack.

My favorite part of this was telling a couple friends, who reacted exactly how I needed them to react in that circumstance (and I knew they would). Robson told me it sucked, but now I could make “I would give my left nut for…” statements with more validity. Vize matter-of-factly asked me if I had heard of the song “Half a Man” by Stephen Lynch. This is precisely the reaction I needed…the last thing I wanted was sympathy or people acting as if I’d been given horrible news. The odds are unbelievably high…do you tell somebody going in to have their appendix removed, “I’m so sorry, you’re going to be OK. You’re in my thoughts and prayers.” It’s a sweet thought, but not entirely appropriate.

Hanging with my wife the evening before surgery is an odd experience. I felt like my left testicle was on death row, but I didn’t know the best way to give it its last meal. We both joked about it (mainly me…this entire process has been hell on her, as it would be for me if she was going through it), had some Ben & Jerry’s ice cream and went to bed. Surprisingly, I slept like a baby that night. I’m unusual.

The next day, more of the same. Same paperwork, same joke about ingesting cats, thrown into a gown and put on an IV. Lauren had the difficult part…she had to actually be conscious through the surgery. I went into huge room with a bunch of people, debating whether or not it would be appropriate to ask if they could put a Junior Mint in my sack to help balance out the weight so I wouldn’t steer right when I walked. I felt the timing was inappropriate, so I put that one away to use later (apparently here).

They put the good stuff in my IV and told me they were starting the knockout stuff. I started to ask them if they wanted me to count to a certain number or if I should just…holy crap, I’m waking up in recovery.
My eyes were heavy and I struggled to regain consciousness. A nurse noticed and asked me how I was doing. I asked for a late checkout and where continental breakfast was…a horribly lame joke that seemed even lamer with how exaggeratedly they laughed at it.

I was given pudding…hardly a consolation to losing a testicle…and two packages of crackers. This seemed like an odd combination, but I was hungry. They didn’t have coffee there, so I settled for a Sprite. I still feel bad for this, but my wife hadn’t eaten all morning and there were no vending machines in the lobby. She ate one of my saltines, to which I jokingly accused her of pilfering my “surgery crackers,” which prompted a nurse to bring my wife a package of them. They sat untouched, my wife embarrassed. I still feel horrible about that…I don’t think she had eaten for 18 hours at that point, and wouldn’t until we got home.

I was disappointed that they didn’t give me my testicle so I could have it stuffed and put on a keychain, but apparently they needed it for a biopsy. My wife drove me home and I slowly worked my way upstairs and into bed. Ice, Playstation, mini corndogs and Percocet got me through the next two days, although the pain wasn’t bad at all. I was off pain killers and drinking wine at my in-law’s house three days later. Four days afterwards, I was at my parent’s house in Omaha hanging out with them for Grandma's birthday.

Biopsy came back – it was cancer. However, the cancer was contained to the testicle itself – a four-centimeter long growth on my left testicle. People from Canada are gasping right now…for Americans, that’s about 1-1/2 inches long. Oh yeah…my testicle grows cancer better than teenagers grow crops on Farmville.

I went through a CT scan, which was interesting, and waited for the results. Everybody was optimistic. For the first time, I wasn’t, and I don’t know why. I think I was worried that with everyone else assuming it was done, I should be wary. Results of the CT scan came back…once again we went to my urologist who told us that I’d be going through three rounds of chemo. The odds of success with the chemo for the type of cancer I have are good, he said, about 95-98%.

So, that’s where I’m at right now. My wife and family has understandably been freaking out about this, as I believe I would be, too. If Lauren was going through this, even with odds near-perfect, I would freak out. Me, however, I’m not worried.

I’ve never seen the point of worrying about stuff like this. At this point, there’s nothing I can do about this except to move ahead. Worrying isn’t going to do a thing about this other than freak myself out, freak family and friends out and completely ruin what would otherwise be a good day. Besides, looking at this, it’s kind of a funny situation when you want it to be. I’d rather laugh about how bizarre and funny this entire process is than sit there and reflect on the process. Besides…95% odds? Chances are better that I’ll get in a car crash on the way to chemo than for my treatment to not be effective.

I look at chemo the same way I do as watching “The Deadliest Catch.” If offered the chance, would I work on one of those crab boats, without pay? Hell no…but part of me wonders what it would be like and how I would handle it. It’s the exact same way with chemo…it’s not something I would voluntarily sign up for, but I’ve always wondered what it would be like and how I would handle it. It’s completely messed up, but I’m kind of excited to get it started.

So, that’s where we’re at. I have Stage 2 K-Mart Cancer, I’m going through three rounds of chemo (which may leave me bald around Halloween…something that opens up all new worlds of possibilities for costumes) and I find the entire process oddly funny. Sure, it’s somewhat serious…any disease is…but it’s not anything that people haven’t gone through before and with cure rates as high as they are, it’s not anything that I’m going to worry about.

Going from pain in a testicle to removing that testicle within 24 hours, and then learning I’d need chemo two weeks later…that can seem either kind of scary/sad or really pretty funny. It all depends on how you look at it, and I will always look at that type of situation from a humorous viewpoint…it just doesn’t make sense to do it any other way.

So, for family and friends that have read this far, take the fun route…joke about me winning the Tour de France, tease me about being half a man and laugh when I say, “Man, it’s hot in here…I’m sweating my ball off.” This isn’t a scary situation…I don’t think people freak out about doing anything else with a 98% success rate (did you know it’s the same success rate as having Lasik eye surgery?).

Finding humor in situations where others find sadness is going to make your life a whole lot more fun. Believe me. I’m not entirely crazy, I’m only half-nuts.


  1. "I was given pudding…hardly a consolation to losing a testicle…"

    that was quite possibly the funniest thing i have ever read while sitting on the can at work. i pity the poor soul sitting next to me....oh well.


  2. This is great! Very similar to what I'm going through, minus the hot Russian nurses offering to shave you. Keep that attitude positive!

  3. I love your testicular cancer metaphors. You're so right. It's a shitty thing to go to, but it's not the same as "cancer" as most people envision it. My husband and were discussing this today in the oncology waiting room. Although a native of Detroit, he does take some issue with your Lions comparison. =)

  4. Thank you for this. Your post, metaphors really impressive for many peoples. Good luck!

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