Part 3: Needles and Tape (in case you were wondering how my balls were in June)
I didn’t feel the first few needles. I only felt a brief brush where he found his mark and then a tap. But after four or five needles were in my leg and foot, I suddenly felt an intense burn at the next spot. He removed it and tried again. The path my acupuncturist was tracing was to relieve some of the tension in my body so he can eventually work the areas where I’ve stored my stress for two decades.
He is restoring my immune system and releasing the nerve that is so aggrieved. That first visit was relaxing and reassuring. After he placed all the needles, he ran an electronic stimulation through two on my foot and left me in the room with the lights dimmed and soft music playing.
Monday, late June
I saw the physician — Dr. G — who is treating my twenty years of testicle pain with nerve blocks. He told me that my testosterone had rebounded. It was more than double the count in March and he was looking at labs from May.
When I or any of my friends wonder how I’ve lived with such a specific pain for so long, I say that I did what I thought I could do. Physicians and urologists examined me, thought I was otherwise healthy, and told me the pain didn’t indicate something worse. They gave me short term remedies: wear boxers, wear briefs, put a heating pad on your back, lie down. One of the common things I heard was, “does Advil help?” Yeah, Advil helps. “Well then take Advil.”
Perhaps they didn’t appreciate the pain. Or perhaps they were just following the accepted medical routine. The pain didn’t really affect my libido or my physical ability to have sex. Their exams didn’t show anything else wrong. So they just suggested ways to manage pain.
In 2011, when my new physician examined me, she told me I was more sensitive than testicular cancer patients. That worried me but it also let me know that a physician recognized this wasn’t just an occasional ball ache. She sent me to a new urologist who didn’t tell me anything new. It was the same situation: everything still worked, so just manage the pain.
Since then though, I’ve felt a real decline in my virility and desire. When I mentioned that along with my frustration at my continued testicular agony, my physician recommended this specialist in San Diego whom I’m now seeing.
After telling me in April that my hormones were screwed up, he put me on Clomid, a fertility drug for women that stimulates hormone production in men. Apparently, it worked in me. “Did I feel renewed virility?” the doc asked. No.
What that could mean is that the Clomid boosted estrogen in me which is canceling out the manly feelings produced by higher T, LH, and FSH. So he ordered more blood work.
We talked about options. Since it’s clear that the nerves in my testicle are badly affected, removing it is an option — albeit the last one. He wants to try two more injections. If they don’t work, he’d like to send me to a specialist in testicle pain in Chicago before he removes my ball.
He was troubled that I was put in so much pain from his first nerve block treatment and had thought up a couple of solutions. My black and blue balls were likely caused by them just dangling around — as balls do — after the injection, so this time he would bandage them with compression tape to hold them tightly to my body.
He left me alone in the exam room with an illustrated book on the nervous system while he and his assistant prepared the injection. I read this:
“Referred pain” to and from the scrotal region is of considerable clinical interest. It is questionable whether pain due to stimulation of the testicular parenchyma alone is ever perceived in the scrotal region. When the tunica vaginalis and overlying structures are anesthetized, stimulation of testicular tissue causes pain that is projected to the lower abdomen, above the inguinal ring. Pain perceived as originating in the scrotal contents is apparently caused by stimulation of the parietal or visceral tunica vaginalis, which is supplied by the genital (external spermatic) branch of the genitofemoral nerve, a branch of the second lumbar nerve. Pain as a result of painful stimulation to the tunicae, which are innervated by this spinal nerve, is perceived in the scrotal area, whereas pain in the testis proper is referred to its point of origin in the abdomen.
So I was sitting there, pantsless, thinking “wait is this all in my back?”
They returned. The doctor washed my groin with little sterile cloths and then quickly shaved me. “I’m doing some manscaping,” he said. “Make it into a lightning bolt,” I replied. He had a female intern with him and he showed her how the male genitalia are identical in layout to the female. He showed her how my penis and balls cowered from examination. Then he told me, “hold your dick out of the way,” and began the injections.
He targeted the nerve right at the top of the sack. It was extremely uncomfortable but not exactly painful — not in a shrieking there’s-a-needle-in-my-balls way that you’d expect. Unlike other injections which may have an uncomfortable prick and dull pain, there’s a deeper, sharp stabbing that I feel.
Then the doctor told me, “you can stop holding your dick. It’s too small to get in my way.”
The treatment itself definitely didn’t do anything for my virility.
They left me alone in the room for about ten minutes for the nerve block to take effect. When they returned he remarked to his female intern, “see how they expand when they’re relaxed? His penis is even bigger.” The nerve block, though, didn’t work exactly.
The first time I had the treatment, he injected me several times in different places and it successfully eliminated any feeling in the nerves all over my testicles. Since he’d targeted this injection, the bottom of my balls was still sensitive. He made a note that future injections need to be targeted right above my ball. He had to feel around to find the right spot and touched a place that put me in instant intense pain. I cried out and buckled. That’s been my experience for years. One touch is fine and another shoots intense pain right through me.
I put my arm over my eyes while he found the right location and gave me another injection.
That was it though. He’d included the steroid in that injection so he didn’t have to do another round. He and the nurse and intern set to dressing my balls. They built a padding of gauze and then stabilized it with an X of compression bandage tape from left thigh to right abdomen and right thigh to left abdomen. They left my retreating penis visible above the bandage so I could pee — which seemed like an hilarious prospect — and advised me to leave the bandage on all night.
The bandage lasted until about 9pm. Every time I went to pee, it shot out in three directions. And every time I sat down or stood up, I risked getting things twisted. The problem was that tape was serious about staying stuck. And the doctor’s shave didn’t extend to my legs. I faced a few issues.
So I got in the shower hoping the water would loosen the tape. Peeling it off my abdomen wasn’t bad. But then…
The X of tape hung down in the opposite direction. But the gauze didn’t completely cover my balls. Tape was stuck to my nuts and when I tried to peel it off, it stretched nut skin down. So I had to come at it a different way and get it off my legs. That involved peeling it off my hairy legs. The quick-like-a-band-aid method didn’t work because this was wide, very sticky tape. I had to alternate jerks and slow peels.
Once off my thighs, the tape easily came off my balls. But the trauma of pulling tenacious tape off my legs left my thighs in pain. The next day I had small bruises over them where hairs had been pulled out.
Dr. G, the specialist, had me see a physical therapist at my first appointment. She referred me to another physical therapist closer to where I live. (Did I mention I’m driving at least 2 hours each way for these appointments?) I had an appointment on the books with this new PT for the week after my nerve block. But two days after the tape situation, on Wednesday, the PT’s office called and asked if I wanted to come in that afternoon. They’d had a cancellation. I didn’t think anything of seeing a PT so soon after seeing the specialist. After all, I’d seen his PT as part of my first appointment.
Nevertheless, I wasn’t looking forward to it. I’d had a pelvic floor exam with Dr. G’s PT. Part of the pelvic floor muscles exam is…internal. For men, that means a finger in the rectum. Lest that sound like no big deal, let me clarify: I’ve had a lot of fingers in my rectum. I reckon I’ve had about 20 prostate exams in my life. I think I had 3 last year. I once almost had 2 in one night when an ER doctor didn’t know his colleague had already examined me. This was…so much worse.
A prostate exam involves a lubed finger going in a little ways and feeling the prostate. There is discomfort, then slight pressure, and it’s over. A pelvic floor exam involves a finger going much farther in (seems like it) and lingering there for a bit. The patient has to breathe regularly and not clinch. The therapist has to leave her finger there until you’re “relaxed” so she can examine and work the muscle. Then she rotates. Imagine a clock face on your rectum (just cause it’s hilarious). And then imagine a physical therapist doing this exam at 1 o’clock, 4 o’clock, 7 o’clock and 10 o’clock.
It is uncomfortable on the best of days. And this, as we’ll discover later, wasn’t my best day.
I went to my appointment and met my new therapist and explained the pain and she gave me her thoughts on it. I do not believe she rushed to judgement — though she was quick in her thoughts, she also needed to examine me thoroughly to confirm them — but isn’t it weird that I’ve been seeing doctors for 20 years about this and suddenly I’ve found 3 who each know what it is?
She examined and treated at the same time. She would notice a tension in my abdomen or a problem in my hips and go deeper, rolling my skin and probing until I was groaning in discomfort. This happened all over my body, front and back. Then the internal exam began.
When that was all over, she told me to get dressed and meet me in the workout room to learn some exercises. I put my shorts and immediately felt a sogginess behind me. The lube hadn’t been totally disposed of. Evidently, there was enough of a deposit that it stained through my shorts. Whatever. It couldn’t match the discomfort I already felt at that invasive exam but it did make me self-conscious. I did the foam roll exercises she prescribed and went through the seemingly interminable process of scheduling two months of appointments and left.
As soon as I got on the elevator, I just shuddered. I wanted to collapse. I felt violated and uncomfortable and exhausted and down. Just sad and down. I got in my car and decided I’d indulge in a frappucino (if I could find a drive-thru Starbucks) and settle in for the evening traffic. That’s when all the emotion hit me.
My GPS sent me in circles looking for two Starbucks locations. I was screaming at it, shrieking profanities. I felt angrier than I ever had at everything. At every driver who cut me off or turned too slow, I just unleashed a torrent of furious curses. I had texted my girlfriend from the parking lot and told her the exam was bad and that I was headed home. Stuck in traffic somewhere, I asked her to pick up the drink for me and told her I was headed home to take a shower “and probably cry.”
Home that night was her father’s house where we were house-sitting. I got there after an hour or so in traffic and went immediately to the shower and just broke down. I wasn’t crying. I was weeping, shuddering and gripping the wall. I was disturbed inside and out. And my body ached. I was sore all over and would remain that way for days. It felt like she’d shifted joints around all over my body.
Driving back to our house-sitting house on Thursday evening, while stopped at a light and feeling sore and hopeless, I had a graphic suicidal vision. Deciding whether or not to describe it here is what has prevented me from posting this for so long. It was a nightmare image that just flashed across my brain.
Then the light changed and traffic started moving.
What the fuck just happened? I immediately thought. I’ve had dark thoughts before but that was insane in its visuals and immediate onset. At the next light, I grabbed my phone and asked: “OK Google, what are the side effects of Clomid in men?” Once home, I looked in depth at the links that came up: depression, suicidal thoughts, intense emotions, anger to sadness on a dime. I was scared. I’d been on this drug for two and a half months. Usually, it’s prescribed in very short runs.
I headed to my acupuncturist for the second time. I wasn’t feeling any better but I knew that the thoughts were related to the drug. That didn’t make them disappear or make me any less depressed. I just consoled myself that it was temporary.
At this appointment, he targeted the nerve directly. One needle in particular needed to find the right location to ease the nerve. He would twist it and put me in pain. He moved it, changed the angle. Everything made me react. He kept apologizing. I kept telling him this wasn’t the worst thing that had happened to me that week.
I stopped taking the Clomid that weekend. I emailed Dr. G to ask if I could and having received no response, just didn’t refill my prescription. (They would respond the next week and tell me it was fine to discontinue.)
It wasn’t until my next acupuncture appointment (a few days later) that the doctor connected the dots for me. We spoke of how sensitive I’d been to those needles. “Of course, you’re sensitive,” he said. “You’re full of testosterone. It was 700 back in May. You’re probably over 900 now.”
I felt anger and hopelessness that all these invasive, violating procedures had happened while my hormones were so amped. The acupuncturist was the only doctor who was sensitive to how my hormones affected me. I couldn’t believe I’d had needles in my balls and a finger up my ass when I was a raw nerve. I just felt defeat.
That was how June ended.