Cancer, Stress and the Search for Doogie Howser

By Dr. Arlen L. Smith

I sat one night, recently following my surgery, watching a cable TV presentation of "Thelma and Louise" and thinking of how things just seem to happen (just so you aren't confused, Doogie is tied in later). The movie, consisted of two women, whom while on vacation became fugitives due to circumstances which dictated questionable defenses. Consequently, they were wanted by the law, and because they didn't think anyone would understand, they ran. Basically, they were victims of circumstance, but because of how the system is designed, they chose to die rather than face possible imprisonment. Some people would refer to this as "shit happens".

I have become a firm believer in this little adage over the years, mostly because it seems to peak it's ugly little head out at the most inopportune times. It has been my experience that business, relationships, personal life, politics and most other aspects of life can, given an opportunity, screw up. Some of these "screw ups" have little, if any effect. Some however, can really make you stand up and take notice. Which brings me to the point of this article. I was diagnosed with testicular cancer.

This one little "screw up" brought my life to a screeching halt. Things that had been of prime interest were now nearly frivolous. Things that had been previously taken for granted, were now of utmost importance. I was thirty five years old, and for a time, viewed myself as a dead man. Retrospectively, I have realized that for a brief moment I was able to stand face to face with my own mortality and I didn't especially like the feeling. It was interesting in that, for the most part, you usually don't know when your life will end, especially as a young person. I now visualized being told "we've done all we can, but the best you can hope for is two years". Well, this is it, your terminal, outta here, kaput, finished, soon to be pushin' up daisies. The metaphors just poured out. All of the sudden, I felt like a statistic. Hell, I was a statistic. So much for the initial panic.

I must confess, that initially, the greatest difficulty, at least for me, was not dealing with the reality of the disease, but in breaking the news to my family. I have never been married, so I was spared the anguish of having to tell my wife, kids, dog, etc. However, the most traumatic, as would probably be with most first born sons, was to break the news to my mother. She did what I suppose most mothers would do, she cried. Then she developed amnesia for the rest of the day. I can't say as I blamed her in that at this point, amnesia would have been a quiet relief. As it was, I had to settle for my younger sisters limited bartending ability, which was more than adequate.

There are various things that quickly go through your mind. Will there be much pain? Will I lose my ability to think? Will I no longer be self sufficient? How much of a burden will I be on my family? How soon will it be before I lose all my dignity? When can I expect to no longer bathe, dress, feed, or use the bathroom by myself? All are valid questions. All should be considered. But they need consideration at a later time.

The amazing thing about my type of cancer is that, if detected early, there is over a ninety percent cure rate. This ratio increases if certain protocols are followed, which result in ninety five percent and greater cure rates. The down side is that you are now a statistic, and usually become somewhat hypersensitive to testicle jokes and crotch humor, although I must admit, that I have created a few jokes of my own as a result.

Being a physician, one of the things you take pride in is the ability to recognize when there is a problem. I can do this with extreme regularity. Also, because I am a male of the species, there is an inborn characteristic that says " if I ignore it, it will go away". These two traits are not in any way compatible. As a consequence, one will eventually win out, and luckily, my inborn character lost. However, this is not universally true with all men. There seems to be a feeling of invincibility, especially in young men, where this disease is most prevalent. This is tragic, especially given the cure ratio. Ignoring the signs only lower your chances for life. The other sad part is men don't examine themselves. If it were possible for me, I would have a sign in every men's bathroom that would convey this message. It's very simple, act like a squirrel, CHECK YOUR NUTS !

I need to back up a little, to bring you up on the actual chain of events and how I found my "Doogie Howser". I initially noticed that something was not quite right when my three year old nephew ran up to give me a hug. He tends to be slightly aggressive at times, and because we are buddies, feels free to attack without provocation. His head is also just crotch high. As a result, I was greeted by a happy child who nailed me in my privates. The strange thing was however, that instead of the normal seven second delay before the beads of sweat pop out and you slowly double over, there was an immediate sharp pain that subsided slowly to a deep ache that didn't stop. I later went home and "nosed around" a little and discovered that there was a very small area of acute tenderness at the very top of the testicle about the size of a bee-bee. Knowing what I know (or at least thought I knew), I felt a deep feeling of sickness in the pit of my stomach, similar to when you accidentally swallow a bowling ball.

The next day, I went to my office and began a short information search. Because my normal field of healthcare is that of a chiropractor, my day to day dealing with cancers is basically limited to recognition and referral to the appropriate specialist. I do however, have access to statistical information that can be extremely distressing if it happens to be about you. For example, I referred to my faithful copy of Robbins-Cotran "Pathological Basis of Disease" and looked under testicular tumors and cancers. In each section I read, the statements were basically the same. The first paragraph would describe the symptoms and morphology, and the second would begin with "sadly enough", and give the not so encouraging rates of survival. My heart continued to sink. At this point, I may have been my own worst enemy, in that I was reading the worst possible scenario and thinking that was me.

My next step, was to find out for sure. My mind was quickly thinking of who could I trust with my future at this point. In dealing with medical professionals, you sometimes discover that there are as many theories of the proper treatment as there are doctors. That was something I didn't need. I wanted results not theories. So, to the phone, and begin getting referrals. My goal was to get some names of reputable urologists, and hopefully, some of the names would refer to the same doctor. As luck would have it, one specialist was referred to me by three separate doctors. I had found my Doogie!! I called to set up my appointment and was told I could be seen in two days. Good, lets get this damn thing over with.

I reported for my examination and was given a multitude of paperwork to fill out, wanting my vital personal statistics such as what kind of insurance do I have, who is going to pay for this and have I met my deductible yet? I filled out the paperwork, trying to preplay in my mind what was about to happen. My tension was diverted when the nurse took me in back, gently put her hand on my shoulder and asked me to pee in a cup. That was thoughtful, but I hadn't even seen the doctor yet. Oh well, if it's urine they want, it's urine they'll get. The only problem was I had just gone before I got there, but still managed a few drops for them to play with.

She then put me in an exam room and told me the doctor would be in a few minutes. Now I know why there are "People" magazines. A half hour later my Doctor-to-be came in and introduced himself. He was friendly and personable and I was comfortable with him. A good beginning. He asked what I thought was the problem, and I told him, along with what I had read and my concern that I would soon be fertilizer. He acknowledged that I was more informed than the average patient, but that I may being over-reacting at this point. I felt mildly relieved, hoping that my "Doogie" wasn't giving me false hopes.

He then asked me to drop my pants, to which I replied,"only if you drop yours first". He was not able to see much humor in this so I complied without further argument. He then examined me for what I felt was inordinately long period of time, at which point I told him that I had relationships that hadn't lasted this long, and again he remained unwavering. He told me he was unsure at this point what it was, hopefully, it may only be a cyst on the cord, but we need an ultrasound to make sure. Great, more tests. I made an appointment for the ultrasound for the next week. Five more days of uncertainty and emotional goofballs. I thanked him for having warm hands and went home.

The following week I reported for the ultrasound. This was done in the hospital, so I was required to fill out more paperwork, but basically the same questions. I silently hoped that the tech. doing the ultrasound would be a grumpy old man. No luck. I disrobe, put on a gown and lay on the table. In comes attractive young woman. I thought of an actor I had once read about that when doing a nude love scene with a beautiful young actress apologized in advance by saying "Please accept my apology if I get an erection, and please accept my apology if I don't". I spent the majority of this exam staring at the ceiling and trying to keep certain aspects of my anatomy under control. I was also able to see the ultrasound screen and was not pleased with what I saw. Without getting technical, it appeared that my initial fears were coming true. I thought I saw tumor and not a cyst. It was definitely in the testis and not the cord. My heart sank again. So much for the erection. I told them I would call my doctor the following day.I went home feeling sick.

The next day, the doctor calls me first. That was nice, shows concern. I was trying to be upbeat and friendly. He then confirms that there is definitely a tumor, but he doesn't know if it is malignant. He wants to do a biopsy to find out for sure. I get evasive and ask what would happen if I chose to do non-invasive care and megadose vitamins and antioxidants. He tells me he will drive to where I work, handcuff me and personally take me to surgery. So much for non-invasive. He was also loosening up a bit, which was better for me. He then tells me the testes would be removed through my abdomen, and that he would take a section, have the lab tests done, and if it was benign, try and salvage as much as he could. My logic kicked in at this point and I told him I knew the statistics showed that over 90 percent of testicular tumors were malignant, which he agreed, and also that there was a higher chance of contamination of the field by stray cells if the biopsy was taken while still attached to the cord (and to me), to which he also agreed. I envisioned a stray nasty little cancer cell being accidentally released and leisurely doing the backstroke towards my lymph nodes hoping to find a comfortable place to nest and have more nasty babies. No thank you. I told him I would prefer to have that bad boy removed, placed on a tray, and taken about twenty feet away before any slicing was to begin. He agreed, saying that was both easier and safer for him. Preliminary one was now out of the way.

We next discussed the possibilities of a prosthetic (or rubber ball) that could be implanted to replace what was taken. He asked if I wanted one. I asked what they were made of. He says they are silicone. Fantastic, now I can get cancer from the implant. I tell him I doubted I would be dropping my pants on main street to show passers-by my new addition anyway, so the implant is decided to not be implanted. I ask him that because there is going to be an empty space if we might consider putting something there I could use, like a Sony Walkman. He wasn't sure, but suggested a better alternative might be a brass bell so I would always know what time it is. I told him I would take it under advisement, and get back to him. I asked him if I was being too light hearted about this whole thing, and he basically said it doesn't hurt to have a sense of humor. We set the surgery date for four days later. Mild panic is now setting in.

I was not able to continue to work that day, so I cancelled my patients and went home. On the outside I was trying to be strong and lighthearted. On the inside I was dying, literally. This was the day I told my mother and she developed amnesia. This was the day my littlest sister bartended. Overall, not the best of Fridays.

The weekend was spent mentally preparing for what would happen. The surgery was scheduled for the following Thursday, so there was not much time to prepare. That might have been good, in that you have less time to reflect and psych yourself out. The week passed quickly, and "D-Day" arrived.

Having been involved with the medical community for quite some now, I have come to realize a few things. First, hospitals are for sick people. Second, if your not sick and you stay in one, there is a good chance you may get sick before you leave. This may be a personal bias on my part, but because of this I chose to have the surgery done as an outpatient in what is known as "day surgery". I felt I could convalesce better at home, in my own bed, and with my own TV. Some people would view this as anywhere from insane to macho. To me it was common sense. Besides, I'm fairly tall, and those damn beds are always too short. I told "Dr. Doogie" my feelings on this, and although he said it isn't normally done that way, he agreed as long as I promised to stay off my feet. Problem number two was now dealt with. I was soon getting calls from the hospital in preparation for my arrival as well as calls from the anesthesiologist to find out if I wanted a "local" or if I wanted to go completely under. I opted for the latter, due to the fact that I didn't feel I needed to be awake if someone is going to be yanking one of my testicles out. Somehow, being awake for that seemed a little masochistic. I had made arrangements with my bartending sister (hereafter referred to as Gwen.... mostly because that's her name) to shuttle me to and from the hospital, and take care of my basic needs- like getting ice to put in my crotch. She was an enormous help in my hours of need. Everyone who goes through something like this needs a Gwen in their life. Everything was now ready.

I was to report to the hospital fairly early on Thursday to get ready for the surgery. I made sure to wear loose fitting clothes as I presumed that I wasn't going to feel much like getting dressed up when this whole thing was done (which was interesting to me because the hospital didn't make any recommendations on what to wear for comfort following the operation). I was told to not eat or drink for twelve hours before coming to the hospital, which I was able to do easily.

Upon arriving at the hospital, some interesting, almost comical things began to occur. The lobby of this hospital was quite large, and in the middle was a large well designed desk with a young woman sitting behind it to check you in. Standing around the desk were various people (five to be exact) talking and laughing quietly. I walked up to the desk, and the young lady asked my name. I gave her my name, and she looked down at the intake book. She apparently couldn't find my name and asked why I was there. I told her I was scheduled for day surgery. She looks again, and still can't find my name. I was dreading the next question, as she was talking fairly loud---"What kind of surgery are you having?". I answered her softly, "I'm here for a radical orchiectomy". Again she looks. Again no luck--damn, here it comes, "What's an orchiectomy?". I lean over closer to her whispering (by now everyone is listening, it was almost like--"My brokers E.F. Hutton"), "I'm getting one of my balls removed". She looks again-"Oh, here you are, you're scheduled for one o'clock". I look at Gwen, somewhat surprised, and ask her if she thinks that my name was actually listed under "ball removal". She says she wouldn't be surprised.

We are then whisked away to a small cubical with a woman who is bubbling over with happiness. "So, your here for day surgery!!", she exclaims, Gwen looks at me and whispers that the woman is acting like I just won a trip to the Bahamas. Then "Bubbles" looks at me and says "What are you here for?" Oh God. Here we go again. "I'm here for a radical orchiectomy". "Oh,-- what's that?" I look at Gwen with a distraught look. She is actually getting a mild kick out of this, and is smiling a little. "I might have cancer, so I am having one of my testicles removed", I reply. The woman is now fidgeting a little and gets right down to business. We go through the financial information (again), and another person, this time a male of the species, takes us on the long walk to day surgery. Talk is light, and I try to avoid any further discussion of "why are you here?". We arrive into day surgery, and are lead into a room with six beds. A nurse greets us and asks my name. She then asks "what are you having done today?" I look at Gwen, and she is now visibly entertained. I decide that this topic has been beat to death and there is no-one who bothers to read the files, so I look at the nurse and reply "I'm here to get my IUD removed". The entire room stops. Someone giggles. I look at the nurse and tell her my file should be here somewhere, and it will tell her all she needs to know. She smiles and I knew she got the picture.

She leads me over to the bed by the wall. On the bed is a gown and a pair of socks with rubber bottoms. There is also the standard plastic cup, small bed pan and various other possible necessities. I figure I'll get charged about $30 for the cup. God only knows how much the bedpan will set me back. I change and lay down on the bed. Gwen and I are talking about various things, trying to stay upbeat, and actually doing a fairly good job. The nurse comes by, takes my vitals and then proceeds to hook me up to an I.V. drip of saline. I find it interesting that they want to dry me out the night before, and then pump me full of water just before the surgery. I lay there for the next two and a half hours drinking water through my arm, when another nurse appears and says that they are ahead of schedule and can take me in fifteen minutes. Uh-oh. Heart skips a beat. Silently I say, "look guys, it's been fun, but I've changed my mind". They aren't listening. I remain calm (I think). I start rationalizing in my mind. "Really I feel fine. I know I'm going to be a hurtin' duck when I come to. Am I out of my mind?" I can't move. The nurse comes in and starts to wheel me towards pre-op. We roll in and they take my blood pressure again. "Seems a little high". No shit.

At this time, things get very interesting. The nurse starts to insert another I.V., but discovers that she doesn't have all the required paraphernalia (mainly the needle) to do the job. She lays my chart on the bed and walks away to get the needed needle. Being the inquisitive character that I am, I reach down, open my file, and begin reading my chart. What I read basically terrified me. The chart listed the tumor on the wrong testicle! All through the chart it read left, left, left when it should have been right, right, right! I continued to read through the chart, and when I reached the end I read the primary diagnosis-- which said "Prostate Carcinoma". This was really squeezing the begeezus out of my adrenal glands, because my prostate was never examined or addressed in any way. OK, WE NOW OFFICIALLY HAVE PANIC. I was definitely at a ten on the sphincter scale. I read the entire file, and then went back and checked to see if that was actually my file that I was reading. Yup, sure was. There was my name, and address right where it should be, but they definitely were not talking about my particular problem. You must understand the reason for my concern. Under normal operating situations the surgeon will generally only perform the main portion of the surgery. The prep work, opening and closing is often done by someone else. The only information that these people have to work with is the information in the chart. Also, once you are under anesthesia, you are on your back with a hose hanging out of your mouth, tape over your eyes and a shower cap on your head. You look pretty much like any other Tom, Dick (no pun intended) or Harry. So even the surgeon may not recognize you as who you are. As a result, if your chart says "left side" or "prostate" that's the surgery you're prepped for. I thought of the story of the man who had gangrene in his leg, but accidentally had the wrong leg removed. Naturally, the other leg had to be amputated also. He sued but lost---he didn't have a leg to stand on. From my standpoint, I felt my future family was greatly at risk, and I wasn't at all pleased about the thought of spending my remaining life as a eunuch.

I closed the file and waited calmly for the nurse to return. She came back, needle in hand and started preparing to stab me when I very politely told her that if she did so much as touch me, I would "be out of this bed, and all over her like a bad suit". She was quite surprised by my apparent hostility towards her (especially since we had been getting along so well), and asked why I was so angry. I told her that I wasn't angry, but I was not going any further until I had the surgical team out here for a little pow wow, because I had read my chart, and it was completely wrong. She had no explanation of why the chart was wrong and consented to go get "Doogie" and the rest of the team. The team came out, and I explained why I was "mildly" concerned. The Doctor looked at me and said "it's the right testes, correct?", much to my relief. I said yes, but the chart says "left". He looks at the chart, and has a quizzical look on his face, but has no explanation. I look around at the team. "The tumor is on the right side", I raise my right arm-- "this is my right side", I wave my hand-- "it's on this side, do we all understand?". The group slowly all nod their heads while maintaining blank looks. Good. Now we can go ahead. I am a little more at ease.

In the meantime, the anesthesiologist has slipped me a mickey. I start feeling a little woosey, and look right in his eyes and say clearly for all to hear, " you ghave hme sommmthmgg didmm't myou". He looks at me and tells me to relax. I feel the vague sensation of being shaved (not my face, mind you), but right now I really don't care. People are now very busy. The anesthesiologist puts a mask over my face, tells me to "breathe deep, it's only oxygen". The sucker lied to me, I was out after the third breath......

I wake up in the pre-op room, which now can be called post-op, for the obvious reason. Apparently, I should have woken about fifteen minutes after arriving in post-op. I however, chose to sleep in and didn't wake up for nearly an hour. This gave them cause for a little concern, and given my luck, they were probably worried that I had slipped quietly into a coma. When I woke up, I had the definite feeling of just having been on the worst drunk of my life. My head ached, my mouth was dry and my crotch was on fire (and the anesthesia hadn't completely worn off yet).

I was wheeled back into the day surgery room and moved to the bed by the wall. Gwen was there and I looked at her and mumbled something like "Ah'm hmreally shmashed" and went back to sleep. Another small annoyance in this escapade is the fact that you cannot leave a hospital after surgery unless you can prove that your kidneys are working. They are real sticklers about this one, so as I became more aware of my surroundings, I requested fluids--apple juice--- bring a lot, in fact bring the whole tree, I want to go home. What they did offer were those little cans of juice with orders to drink slowly. OK, fine. Then bring me ten of 'em. I figured them to be about eight bucks apiece. I drank my juice and waited for that lovin' feelin'. Nothing happened. Drank some more juice. Still nothing. I decide to get up and try anyway. I head to the bathroom, all the while bent at a 30 degree forward angle. I then discover that I can't sit yet because of the incision. Great. Well, I'm a guy, we were designed to pee standing up. True, but peeing while bent at a 30 degree forward angle is something else again. I manage nothing (maybe a drop), flush the toilet and leave the bathroom. I shuffle about ten feet and get an accurate grasp of how gravity really works. I lean on the wall to get my balance. Gwen, in her innate wisdom, looks at the nurse and says, "he looks kinda sick". They both came quickly over to help me and the nurse asks if I was able to pee. I looked at her, and with the most pious look I could muster, said "yes".

With that little job taken care of, I should now be able to leave. They bring me my clothes and I begin to try and get dressed. I feel like such a dork. I can't bend far enough put on my shorts, pants, socks or shoes. Truly a "James Bond" and every woman's dream. About the only thing I can do myself is put on a hat, which is fine if your in a nudist colony. How degrading. I imagine I will probably make a terrible "feeble old man". I'm looking real swift too. Five pounds of ice in my crotch and ready to boogie. Gwen leaves to get the car and I carefully ooze myself into a wheel chair. Mentally, I'm still a few french fries short of a full-meal-deal.

I get in the car, and we proceed home. Gwen does a good job at avoiding most of the really big bumps in the road. We get home and my main objective is to be horizontal. The remainder of the day and night is spent making sure I have ice and the occasional pain reliever.

I wake up early the next morning and feel surprisingly good. Still quite sore, but not as bad as I had anticipated. I get up and wander around (still at 30 degrees), wash my face and brush my teeth. I even get a little adventurous and try to look at the incision, but chicken out when I discover how sticky the tape is. I also find that I cannot remain standing for very long, because the inflammation tends to return at a fairly quick rate, and I need to lay down to get the fluid to drain. Also, I almost feel the need to undergo a lesson in "alternative toilet training" as this is still a very awkward task to perform. The remainder of the weekend is spent mostly lying down and answering the phone or talking to friends who offer their concern and best wishes for my recovery. I discovered how the concern that others give can actually make you feel better and help you speed your recovery. There's nothing like good old fashioned sympathy and warm fuzzies. I also became aware of how many references there are to testicles in the movies. We rented "L.A. Story" for example, and there was an exhibit in a museum which contained "Beethoven's Balls" as well as a man whose testicles made sounds like little bells when he walked. Maybe I am a little hypersensitive, but I was literally astounded at how often this area is talked about, referred to, hinted at, grabbed and kicked. It was like male chauvinism in reverse.

I returned to work the following Monday and discovered that for the most part, all I could do with any accuracy and consistency was talk on the phone. I did manage however, to see a limited number of patient's and get through the day. My "forward angle" is now decreased to about 15, and you can hardly tell I had anything done. The next day I schedule my follow up visit for the end of the week. I also talk to my Doc and find out that I had a malignancy known as "seminoma". The news leaves me a little numb. I still can't believe that I have actually had cancer, and given the chain of events, I feel I am doing quite well for the most part.

I report for my next visit, which is basically a check to make sure the incision is healing correctly. I now have a raised ridge along the incision which is not very comfortable, and tends to have a burning sensation. Also, things are beginning to itch. I am checked, and apparently everything is healing normally. The Doctor gives me a copy of the lab report which gives the dimension and diagnosis of the tumor. I read it and quite frankly am amazed that something so small can be so deadly.

After the initial shock subsided, I then asked my Doctor if the testicle had been disposed of. He told he suspected that it was still in the pathology lab, and wanted to know why I was interested. I told him I thought I may want to keep it as a memento of what had happened, and also that some day if I ever had to use that saying of "you know, I'd give my right nut if...", and actually be able give it if the need arose. I told him that would probably really set someone back if they knew it was actually mine. Besides, I figured it would make an interesting conversation piece for my mantle. He looked at me and laughed, saying that if anyone else had asked, he would have thought it morbid and would have said no, but knowing the way I am, he said I could have it if I wanted it. I never went to get it, deciding that if I really needed one, I would get one from a pig and lie about it being mine (pig balls are really huge).

Next, I am told that I need a C-T scan to rule out any metastasis to other areas (great, we're still not done yet). We then discuss the next possible phase of treatment which is radiation. At this point, this therapy is not required, however, according to most recent studies (whatever that means) the survival rate increases about 10 percent if the radiation is done as a preventative measure. This would increase my odds to around 98 or 99 percent. I figure that you can't even get those odds in Las Vegas, so I decide to go ahead. "Doogie" hands me a business card for a referral to the radiation department. I then asked him something that was concerning me strictly due to my knowledge of the male anatomy. My entire right side of the groin was quite sore and I knew that the testicle had to have been taken back up through the inguinal canal. Knowing this, my question was simple. "What do you use to get something about the size of a walnut up through a canal only the diameter of a pencil?" His answer was equally simple--"What do we use? We use force". My face must have drained a little of color as I imagined how much force actually was used. I was again thankful that I had been in La-La land when all this had happened. With my last question having been answered, I scheduled my next appointment, leave and head downstairs to the bowels of the hospital still amazed at the "force" comment. None of the doctors are available in radiation, so I make an appointment for a later date. I go home and call to make an appointment for the C-T scan. My life continues to look like a series of medical appointments.

I report for my C-T scan the following Tuesday, and again, fill out more paperwork. I am then brought three (count 'em, three) 16 ounce glasses of an orange flavored drink which contains a contrast media for the scanner. I am told to drink one every half hour until they are gone (that's an hour and a half, if you aren't good with math) to allow them to get into the system. So, back to the magazines and the juice. When I am ready, an assistant comes and takes me to change into a gown. I change and go into the scanner room with my butt cheeks flapping in the wind (yet again). I lay on the table and a radiology tech. whom I will call Suzie (her name has been changed to protect the innocent) comes in and inserts an IV needle in my left arm. Suzie tells me that I will begin to have a warm sensation like I am wetting my pants, but not to worry, that is normal. I fail to see how it can be normal to feel like you have no bladder control, however I offer no rebuttal. As predicted, I do get the feeling of wetting my jammies, but I actually stay dry and maintain my composure. The scan takes about 45 minutes, and by now my bladder feels like it's about the size of a beach ball. The orange juice has reached it's final destination and wants the exit ramp. I finally am allowed to get off the table and I motivate myself quickly to the john. The results of the scan will be sent to my doctor, the results of the orange juice go down the drain.

My follow up with the surgeon is fairly short. The C-T scan has shown no spread to any area. This is great news. However, this doesn't rule out the theory that one of those nasty little bastards aren't still around. He tells me to schedule for another scan in one year. I am slightly concerned that a year is an awfully long time between checks, but he assures me this is normal protocol. OK Doc, if you say so. He then asks if I had been seen to start the radiation yet, which I hadn't, but was to go in two days. A new topic is covered which deals with possible sterility, due to the radiation (I envision mutated sperm cells with heads but no tails-- terrible swimmers). He suggests that I may want to consider the andrology center to increase my chances should I ever want to have children. He gives me the name of a doctor to contact if I want to pursue this further.

I contact the andrology center (commonly known as a sperm bank) to find out procedures, cost, success and failure rates for sperm saved in these types of facilities. The procedure is relatively simple-- your on your own, just you and your choice of erotic magazine. You need to fill at least five, but preferably ten vials for them to freeze and save. It generally takes two "sessions" to fill a vial, but that also depends on what your volume of ejaculate is. Jeeze Louise, these guys get down and personal. I calculated in my mind that this could conceivably (pardon the pun) consist of around twenty times of whacking off in somebody's office, not including times that you may miss the container (This was the first time I ever had to consider the possibility of aiming at something during this activity). The success ratio for this type of fertilization afterward is not the greatest either, although I doubted that I would be able to move too fast if I had been frozen solid for an extended length of time. Finally, it's not cheap. Total cost varies between $2500 and $5000 to allow you the chance to freeze your gametes. I considered the pros and cons and the fact that there is less than a ten percent chance that I would be rendered sterile anyway, and opted to forgo my relationship with the test tube.

I next went for my initial interview to the radiation center, to be evaluated and begin my preventative radiation therapy. I filled out the paperwork (yea,yea, I know) and was put in a room to wait for the doctor. Shortly following, the doctor came in, introduced himself and explained what the procedure was going to be. First I would be X-Rayed in the lumbar spine and pelvis to determine exactly where my lymph nodes were located. Next, I would be tattooed with little dots so it would be easier to aim the X-ray consistently at each session. I wasn't sure how big the dots were to be, thinking I may end up looking like a target or a refugee from a motorcycle gang. It turns out they are very small, in fact I still have a hard time finding them. Everything was now ready for the next phase.

I was to begin the radiation on the following Monday. There were fourteen treatments in all, everyday for about two weeks, with weekends off for good behavior. I was to receive a total of 2500 rads, which by radiation standards is pretty low. I was told I would probably lose a little hair (but not off my head-- you can guess where). I was also told I would have about a 50/50 chance that I would be sick (nausea) after the treatments. I took into account that I can tolerate just about anything and not get sick, so I thought this would be a cake walk. Wrong again. This turned out to be the worst as far as residuals from treatment. My days ended up being something like this:

1. 7:30 am. Report for treatment. Remove pants and put on pajama bottoms that never fit.

2. Radiation technologist takes you into room with great big X-ray and has you drop your drawers. (no modesty allowed)

3. Radiation beam is centered on tattoo markings.

4. Therapy is administered to both sides (front and back), for about 11 seconds a side.

5. 7:50 am. Leave hospital for work.

6. 10:00 am. Begin feeling a little nausea. (This actually didn't start until after about the fourth or fifth treatment).

7. 10:05 am. Whatever is in your stomach now leaves.

8. The rest of the day is spent feeling fatigued and sick to your stomach.

9. About 4:00 or 5:00 PM, you begin to improve and by about 9:00 in the evening, I was actually able to eat something.

10. Start over the next day.

This scenario went on for the next two and a half weeks. Consequently, I was not the happiest of campers during this little ordeal. I also gained about 10 pounds during this time, mostly because I was only able to eat late in the evening and I could not do much exercise due to the surgery still healing (not that I was previously known for my Jack LaLaine tendencies anyway). I must admit that I really didn't feel too attractive while all this was going on.

After the final radiation treatment, I still found that I remained quite fatigued during the day, and would try and sleep at any opportunity. Weekends were definitely used for rest, and my social life was for the most part in the dumper. I did use this time to reflect and come to grips with my own personal philosophies on everyday stress, personal stress, life, death, future and that all important question of "why are you here"?

During this whole ordeal, I found certain things very interesting, both in how I viewed myself as well as how I coped with what may happen in the immediate future. I had read that the "normal" chain of events for people involved with this type of physical problem usually occurs in this order. First there is denial, in which the person refuses to believe they have a problem. Second comes depression, which should be obvious as I can't believe anyone would feel "uplifted" when dealing with a situation such as this. Third comes anger, where you are pissed off that you were "singled out" to have this little problem. The final stage is acceptance, where you realize that fact's are fact's and you had better calm down and face the music. I didn't follow these guidelines. I started at terror (mostly due to my background), and had a brief discussion with Mr. Depression that may have lasted a day. I apparently accidentally skipped over anger and went directly to acceptance. It was sort of like "go to jail, go directly to jail, do not pass go, do not collect 200 dollars". Part of this may have been due to the speed that needed to occur in dealing with this. I really had no initial time for contemplation or reflecting. Also, I feel anger can be such a waste (Depression is a waste also, but sometimes you can't help but wallow in your feelings and hold your own private "pity party"). This whole series took about two days. Don't get me wrong, acceptance does not necessarily constitute strength. You can accept the facts, but it's still legal to be scared out of your gourd. Fear of the unknown was one of my major problems (The other was wondering if my underwear would ever fit right again).

It was this time, after the surgery, and during the radiation, where I really had the chance to think. I still didn't have all the answers as to longevity. I would have to wait at least a year. I began to feel detached from my physical being that was identified as my body and viewed myself more from the "essence" of what I thought made me what I am. For the first time in my life, I saw my body as a vessel which contained "me" in a confined space that was easily identifiable to others, but that vessel, for whatever reason, was breaking down. It was analogous to a car that your friends recognize you in, but breaks down occasionally for whatever reason. The difference is you can trade the car for a better one when you want. Your body is a different story. I am not a "religious" type of person, and have a tendency to view things from the scientific perspective. However, I also have to believe that whatever it is that makes me "me", can't cease to exist because my body chooses to take a hike. Some people view this as "religion" or "spirituality" or whatever you want to call it. I just refuse to believe that my "essence" is merely more that a series of chemical reactions (My associate, Brian, who I work with, says my outlook is very "Zen", whatever that means). I also came to grips with death. I realize that sounds a little morbid, but it is true. I wasn't necessarily comfortable with it, but I had come to grips with it. I was sad that there would be things that I would never get to see or experience, but the same can be said for anyone, anytime they are about to die. There would always be those things that you would have like to have done but didn't, would have like to have seen but couldn't. I was sad about my failures, and wished there was more time to set things right. Later, I came to grips with mind and realized that I probably had done about the best I could with what I had to work with. I had never intentionally hurt anyone, and although I have made some stupid decisions in the past, I had not done them with malice. As a result, I became more comfortable with myself, and it was a very good feeling.

I realized that a finite existence is necessary if not essential to the humanistic point of view. This may sound silly, but if you lived forever just as you are, what would you have to live for? History of the past and memories of people not forgotten are what the future is based, and there have been some phenomenally wonderful people in my life. But, what would be the point of progress or technology or making a better life for your kids, if this was as good as it would get? If you could live forever as you exist now, could not die or have a threat of death, the ethics, morality, respect, desire and need of improvement we hold for each individual would be gone (not to mention most of the food and real estate). At least that is the theory that gets me through. I just felt my time may have come a little early. The other thing of interest is that everyone will at some point in their life deal with everything I just said. It has to be that way. Your solution to the question may be different from mine, but if it satisfies your needs, then it's worthwhile.

In a way, this "philosophy" has helped me to deal with the portion of my life that may well have been the major contributing factor to my cancer, which is the stress. I have always been the type of person that attempts to maintain my composure, not lose my temper and hopefully keep a level and objective outlook on whatever is occurring around me. In the process of doing this you can sometimes suppress and internalize feelings that can literally eat you alive. I never imagined that these feelings would eventually settle in one of my testicles as a possible avenue of escape. Further, I have never been overly impressed by people who fly off the handle at the slightest provocation (although, these type of people probably live well into their nineties, because they have no stress--everyone else carries it for them). Consequently, stress can be, and probably is the single most contributing factor in these types of cases.

I have been accused by people in the past of not taking life seriously enough. I have also come to the understanding that people who say that probably don't understand my humor. Whatever the case, I believe that humor, and happiness are in direct opposition to stress, unless of course you're a comedian and it's your job, then obviously humor is your source of stress. So to those people who thought I needed to take life more seriously, and to those who have given me undue stress, I respectively give you the finger. To the rest of you, I give you very simple advice.

Relax, be happy and seize the moment.

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