Part 2: Black and Blue Balls: When is the treatment worse than the pain?
I was lying there on the table tilted to lower my head because I’d told the doctor I wasn’t always cool with needles. I was wearing only a t-shirt, socks, and a watch. I was thankful I’d worn the watch. The doctor told me he’d be back in ten minutes. Then he and the three other doctors and one nurse left me there, clutching a paper blanket over my genitals and looking at my watch.
I had one of those real “me and my maker” moments then. Tears filled up my eyes as I thought it’s just me alone on this table with my fucked up balls that have just been stabbed with a needle a half a dozen times. Me and whatever there is in the universe when you wonder about life. I held the tears in then and for two more days.
The doctor and his troupe returned. He grabbed my ball sac and said do you feel this? No. And this would normally have you in terrible pain, right? Yes. There it is! Twenty years in pain and now it’s gone. He slapped me five. Then he had the nurse fill another syringe with nerve block and steroid and proceeded to stab my ball another six or seven times.
Then they left me to get dressed and I removed the paper blanket to reveal the blood seeping out of my testicles. There it was. The reason they’d tilted my head back. The proof that it’s not a precise surgical treatment. The proof that sometimes you gotta bleed a few eggs if you want to fix a nerve. A young assistant returned and offered me some gauze.
My doctor is very confident that he has identified a neuropathy in my testicles which has caused twenty years of pain. He believes my inguinal nerve is sending false alarms through my nervous system causing the chronic pain. He has tested this by injecting a nerve block into the site, leaving it to work for ten minutes, and then not so gently grabbing my sac to see if that was indeed the nerve sending the alarms. The second round of injections included a steroid which should train my nerves to calm down.
Eventually. Over time. And not a time that he can predict.
My doctor is confident (hence the high five) and encouraged. I am wary.
My doctor has a team of doctors in his clinic who all collaborate on a diagnosis. I first saw the physical therapist. When I told her the story I’ve told everyone, her ears perked up at the mention of my first reported incident probably being constipation. Digestive issues. This could be a clue, she thought.
Then she examined me which was the first time I’d be pantsless that day. Physical therapists do a lot of probing which can be extremely uncomfortable but I’d had a very positive experience with physical therapists after a car wreck a year earlier so I was prepared. For most of it.
Part of her exam included testing my pelvic floor muscles in a very uncomfortable way. She didn’t like the response from my muscles. She also examined and worked on my right abdomen and pronounced somewhat mysteriously, “you’ve got a lot of things going on.”
She left me to dress and conferred with the physician who would see me next. When she led me to the physician’s office, he and a young assistant (also a physician) were studying an anatomy book discussing which nerve could be running up my back, lighting up my abdomen, and affecting my testicle.
I’ve never seen a doctor studying an anatomy text in front of a patient. But this clinic is absolutely different than any treatment I’ve had before and I am willing to see what they come up with.
The doctor introduced his team which included two visiting physicians from Alaska. He asked if they could observe and I said yes because I’m open source like that but during the testicle stabbing, I slightly regretted that permission.
He spoke with me about his team’s passion for their work and their desire to produce positive results and I felt in good hands. Then he turned his attention to my blood work.
“You have screwed up hormones. Did anyone ever tell you that? Your hormones are screwed up.”
No, no one had told me that. In fact, my primary physician had checked my testosterone twice in the last year and told me it was normal.
He wasn’t talking about my testosterone, he explained, which was low but in the normal range. No, the other hormones that wouldn’t be checked in a standard testosterone test were very low. He would be putting me on a drug that would encourage those levels to rise. My vitamin D was very low as well. I knew that and had taken a supplement on and off. Hearing it from him made me get serious about taking it daily.
Then he explained the nerve block and led me to the exam room.
The third doctor I saw was a psychologist. Knowing before I scheduled my appointment that part of the evaluation involved a therapist comforted me. I knew that meant this team were serious about treating the entire patient.
She had spoken with the others before meeting me and asked how I felt about the doctor’s diagnosis and treatment plan. I expressed my wariness that it could be so simple. This has gone on for twenty years. I’ve seen tons of doctors.
We spoke about my personal life and I told her how I’d felt this diminishing sense of self, less vigorous and desirous.
What I don’t believe I expressed fully was that my wariness is also informed by the statements that I have “a lot of things going on” and my hormones are “all screwed up.” If this is merely a neuropathy causing pain, what do these things mean?
The doctor told me the nerve block would only last a couple of hours. That gave me enough time to drive home from San Diego. I expected my normal pain and sensitivity to return. I didn’t expect what I received.
I fell asleep with my girlfriend around 10:30pm but was up about an hour later. I could not get back to sleep. I got my headphones and watched an episode of Mad Men. I lay there in the dark. And I realized it was the steroids keeping me awake. Whenever I get those steroid packs for sinusitis, I stay awake all night the first night.
Also I was in terrible pain. My back felt sore. My balls ached. I was extremely sensitive.
Around 2:30am, I realized what else it was that made me so wary of the diagnosis. I am afraid the treatment will be worse than the present pain.
Before I’d gone to bed, I’d taken a shower and noticed that my balls were bruised and there seemed to be a lump of liquid in them. The serum, I surmised.
The next day, my balls were bruised even worse. Though he hadn’t hurt me at the time, the doctor did have to have handle my ball sac firmly for the injections. It showed. They were black and blue.
I was sore all over. I walked like Frankenstein’s monster, stiffly but delicately. I took Advil for the pain and pressed on.
I read about the hormone treatment I was taking and unfortunately ran across articles about the seriousness of hormone depletion. It was a moment where I realized this is why I haven’t investigated too much on my own. I don’t want to read the dire hypotheticals.
I felt that familiar feeling that I can’t be anything. I am in pain. I ache. I have to move carefully. And the things that make me a man are broken.
My car was parked on the street sweeping side of my block. I threw on some pants while my girlfriend got ready for work and went to move it. When I returned to the house, I hugged her and finally succumbed. I cried heavily into her shoulder and then walked over to the bed where I delicately collapsed and shuddered and sobbed. My girlfriend curled up next to me.
My balls were still black and blue. I was still stiff, sore, and tender. What the hell was it going to be like doing this every six weeks?
I have been taking the hormone medication for two months. I return to the doctor in one week. I do not feel the revived virility he predicted. And I am still in pain and tender. The pain part is to be expected. This is a treatment that goes over time. The nerve blocks are only temporary until I’m healed.
I’ve been exposed to what I feared when I considered this drastic, radical treatment: everything feels worse.
Perhaps it is a function of having to acknowledge to so many people what I’ve been going through all these years. Talking about it makes me consciously consider it which makes me more aware of its seriousness. For example, I’ve often felt the pain shoot from a stiff back right into my testicle when I get out of a car. It’s an instant tenderness. But now, it happens and I feel a knife of defeat stab me. “This is still going on. It’s worse than you ever acknowledged.”
Perhaps this worsening feeling is really an indication that I went at the right time, that things were feeling more serious and I had to seek drastic measures.
I’ve had painful treatments and exams and tests before. I’m pretty good at being tough when it’s needed. But this is new. I feel empty. I don’t feel like myself. And I’ve had several disquieting moments alone these past few weeks.
I want relief and renewal but I don’t feel any energy towards that. So I’m writing and pressing on and feeling somewhat like I’m still on that table with my feet in the air.