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14 Feb

              Lucky me; it seems I have been given the opportunity for a second dance with my old friend, testicular cancer.  For those that aren’t familiar with my story, when I was 22 I was diagnosed with testicular cancer the first time.  I permanently lost one testicle, temporarily lost my mind, and went on sort of a destructive binge until I figured out what I needed to do to pull out of the nosedive I was in.

              Fast forward 25 years, and on what would have been my last follow up (had everything gone well) they found a growing lesion inside my remaining testicle.  After further review, considering I was already on testosterone therapy and wanted no more kids (already have two bundles of love, and that is enough), the doctor recommended that my remaining testicle be removed.  I consulted with a second doctor, who also recommended that my remaining testicle be removed, and so I decided that all doctors were out to get me.

              Later on, I calmed down and agreed that maybe it was a good idea for my remaining family jewel to be removed before it tried to kill me.

              I will admit that when they took the first one out, I was appeased by the fact that I still had one left.  As you can imagine, this time around was not quite so comfortable; most people, me included, do not start with three.  But at my age, considering the circumstances and hormone replacement therapy available, I was (ultimately) ok with the decision.  It took a while, but I got there.  It also helped that unlike last time, when I had about two hours’ notice, I had closer to six weeks to prepare, study, and investigate options. 

              So, here I went again, back in pre-op, going to get my remaining testicle removed.  I was very impressed with the care I was receiving, but there were a few things I wish they had done better.  I was given a pair of booty socks, but unfortunately all they had left were XXL socks, which in addition to being entirely too large were so brightly yellow they were visible from space.   I was also indeed impressed with the number of times I was asked my name, social security number and birthday.  Apparently, a LOT of people wanted to get neutered, and they really wanted to make sure that no one snuck in and cut the line…

              As I lay there in pre-op, saying my goodbyes to my remaining testicle, I began to hear a conversation from the next bed.  While patient privacy is of course a priority, it is only a priority in as far as they surround your bed with the thinnest curtain possible in hopes that it somehow can keep everyone else in the ward from hearing what is about to happen to you in great detail.  In the next bed was a younger female veteran who was getting ready to undergo a breast reduction.  There were several people around her bed, and they were discussing making sure that things were even, confirming how much tissue to remove, and a remarkably detailed discussion about the direction, orientation, and overall fate of the nipples. 

              Two things occurred to me at this point. 

              First, I wasn’t sure which was more uncomfortable to hear; my neighbor’s discussion about her soon to be decreased bust size, or (from her point of view) my soon to be emptied scrotum (even though for my part I really tried to whisper).  Second, with all this push on reducing waste and “going green,” what did they do with the removed breast tissue?  It occurred to me that she was getting something removed, and I had already elected to get a prosthetic testicle and was therefore getting something inserted.  Was it possible that this was a zero sum game?  Would her removed boob soon be replacing my diseased fun nugget?  The more I thought about this, the more nervous I became, and my blood pressure monitor chirped as my BP crept up from concerned to anxious.  It was decided that they would start my drugs early to calm me down.

A short time later, I was a bit more relaxed, and I found myself in bed surrounded by several people.  There was the attending doctor, the doctor actually doing the procedure, three resident doctors, a nurse named Apollo, a nurse anesthetist who had access to amazing drugs, and someone else they seemed to just randomly pull in from the hallway.

The lead doctor, after once again confirming who I was for the sixth time (who would WANT to me be me at this point), asked me if I knew why I was there.  “Yes,” I replied confidently.  “You bastards are going to neuter me.”  They all laughed (I wasn’t kidding!), and then the doctor asked me if I knew that they were putting in a prosthetic testicle.  I confirmed same, and immediately remembered that I still wasn’t sure what it was going to be made out of. 

Why just one?  Well, I had my first one removed at age 22, and now I was 48.  That’s 22 years with two testicles, and the last 26 with only one.  I figured I was more used to uniballing it, so I only asked for one.  Besides, as I later found out, they are $3K to $5K a pop, and who wants to spend that on a second non-functioning fake testicle?

Anyway, the attending physician looked at the nurse and asked, “Is the prosthetic here?”

Apollo the nurse answered quickly and with confidence, “Yes, Kevin is here.”

That got my attention off my recent neighbor’s boob residue and back into the present.

I had to ask. “You guys named my prosthetic testicle ‘Kevin?’”

Apparently, there is a whole career field dealing with prosthetic testicles, and Kevin was the name of the person who transports the testicles, probably in some armored briefcase handcuffed to his wrist.  They come in different sizes (I didn’t know this), and they don’t know which one is going in until they see the one that comes out.  Still, in deference to him, I named the prosthetic Kevin, and now realize that I am the amalgamation of he and the original Rob, and now go by R(pronounced “R sub K”) to reflect same.  At least I knew it wasn’t recycled from a breast reduction…

              I fell asleep, my testicle was removed, and Kevin was installed.  I healed up, and then headed in to see the urologist for my follow up.  Imagine my surprise to find that 1) the pathology confirmed that I indeed have cancer in the now-removed testicle, and 2) it was a completely DIFFERENT type of cancer and unrelated to the type I had before.  Being a math guy, I immediately began working out what the chances were of that happening; one guy getting two DIFFERENT strains of testicular cancer.  It was a whopping 1 in 62,500.  Imagine my delight.  And, oh by the way, there was a bonus award too.  THIS strain came with a recommendation of chemotherapy!  Hooray!

              And the news got better.  Without subjecting my 48 year old and already abused body to chemotherapy, my chances of recurrence of cancer was 15-20%.  Because I was out of testicles to be attacked, the cancer (if it decided to come back) would reappear in my stomach or chest, both of which are rather vital to survival, so I was not amused.  With the preventive chemo being recommended, the recurrence rate drops to just less than 10%.  That means that if I have the chemo, there are 9 chances out of ten that it won’t come back.  That sounds good, except that I had just “won” a lottery where I had one chance in over sixty thousand, so excuse me if I hold off on a victory dance.

              In the meantime, Kevin has invaded my subconscious.  I had several dreams where I experienced a problem with Kevin.  For example, I recently had a dream where, while I was sleeping, Kevin FELL OUT.  Obviously this was upsetting, so I picked him up and called the VA Hospital that did my surgery.  Now, I have had virtually nothing but positive experiences with the VA, but we all know the reputation, and so did my subconscious. In my dream, the VA told me that they could see me in two days, so I spent the rest of the dream trying to keep Kevin clean and looking for a stapler to close the hole that he had slipped through in my scrotum. 

While dealing with Kevin dreams, I had also been trying to set up my chemotherapy.  Chemo is a great way to kill cancer cells in your body.  It’s also a great way to kill a lot of other cells in your body, including ones you might want to keep around.  Apparently the chemo was going to go through my immune system like a fat person through a casino buffet. 

I arrived early at the infusion clinic, to get a head start on cell death.  Going by looks, I appeared to be the youngest patient in the room.  However considering chemotherapy drugs are basically poison, it was entirely possible that some of the elderly looking vets were the same age as me, just on their second or third treatments.  My trepidation was not abated.

I checked in, sat down, had my vitals taken and signed my consent form.  This basically waived the hospital’s liability for anything that might happen to me over the next four hours, up to and including death.  Then a nurse inserted the intravenous line in me, and started pumping me with fluids, lest I become dehydrated before the lethal injection.  And then I…waited.

I waited for quite a bit.  Finally, the boredom overtook me and I found out that one of the meds I was due to receive hadn’t been located yet.  Because they hadn’t located it they couldn’t put it in my arm, so I was just to sit there until they found it.  Finally, it magically appeared and my infusion continued, but the entire thing took closer to 4 hours than the two and a half hours for which I had been told to allot.

I tried really hard to stay awake, but I had been somewhat nervous several nights previous and hadn’t slept well.  On top of that, some of the pre-chemo meds they gave me can make a patient drowsy, and I can attest, they did.  Finally, I was in a warm chair with a warm blanket.  I fell asleep the last fifteen minutes or so, and only woke up when they took the needle out.  I drove myself home, had a light dinner, told my wife I needed to lay down for a bit, and promptly passed out for 13 hours.

              The next few weeks, to be honest, sucked.  I was tired, but I couldn’t sleep for more than two hours at a time.  I had to drink a LOT of fluids to flush the meds through my system to avoid kidney damage, so I was constantly running to the bathroom.  The chemo screwed up my stomach so that for about two weeks straight I was nauseous and had a headache every day, starting some time in the mid to late afternoon.  Some days I got winded just walking up the stairs.  And because my immune system was trashed, I couldn’t really be around people for fear of getting sick (this was during the COVID-19 pandemic, so I was even more afraid than the average population).  Thankfully I timed it so that this was over my Christmas break from work, so I missed very little time.  I watched a lot of TV and just sort of laid down a lot.  Sometimes I groaned.  I was pretty not fun to be around, but my family was awesome and took care of me and we all got through it.

              Slowly, my body recovered, though for a several weeks after I could tell that my body was still impacted by the poisons pushed into it in the name of good health.  Just as I started to feel better, it was time for a follow up scan. 

              I had to arrive two hours early so I could drink “contrast.”  This would help my stomach light up like Cincinnati during my scan.  After drinking the contrast, which sort of tasted like cow urine strained through a dirty sock, I was led into the room for the scan.  A very accomplished, experienced, confident person named Raphael was in the room.   I felt immediately at ease, as he just oozed competence. Unfortunately, he would not be touching me in any way. 

Also in the room was Jordan, who wore a labcoat resplendent with the insignia of “Long Beach Radiological Imaging School” taped crookedly above his pocket. It was also on backwards when I walked into the room.  I jokingly asked if it was his first day (although I wasn’t really sure how much I was joking).  Another person in the room who I hadn’t noticed before told me in a somewhat serious manner that it was actually his second day.  Later I would wish that were true.

It WAS Jordan’s first day.  He would be in charge of starting my intravenous line, injecting me with more contrast, and removing my IV when done.  Off we went, and Raphael tried to talk him completely through the procedure, after which Jordan tried to put the needle completely through my arm. 

Eventually, the IV line was started, and my only real contribution to the event was bleeding.  The procedure was completed without further incident, and it was time to take out the IV line.  Apparently, this hadn’t been covered in Jordan’s classes yet, because he looked at my arm a bit quizzingly and then just started pulling and yanking on things that may or may not have been attached to my arm hair or perhaps still stuck in my veins.  Raphael stepped in before major damage was done, and I was free to go.

Through it all, I felt pretty lucky.  I had cancer twice, and was still alive.  As cancers go, this was the best one to have if you are a guy, because it was very treatable (albeit in a personal and embarrassing sort of way).  True, as the saying goes, it’s always routine when it’s on someone else, but still, it’s time to pray gratefully and focus on the positive; one more pothole on the highway of life.

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