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bfleish (imported) wrote: Tue Dec 09, 2008 10:04 am Everyone,

Thank you so much for your replies. This really is a special place and the support is the best!!!

The doc hit the nail on the head on what was making me so darn sleepy. The only reason he knew what was wrong was that he had another patient who experienced the same problem. I'll try to keep it brief:

The problem was a drug interaction with 2 drugs when taken at the same time. I am taking a statin (My cholesterol is just fine but my father died at 60 with terrible vascular disease so I've been taking it preventively for years) and a very low dose hypertensive drug for the same reason. I had just switched the statin drug to the generic because you can get 6 months worth at Costco for $16.00 (and 6 months of the hypertensive drug for $18.00). I don't want to say the names of the drugs (don't need lawyer's caroling at my door right now) but when you take them at the same time they interact (at least with me) and turned me into a sleeping zombie.

The doc suggested stopping the Statin drug till I felt better and then taking the statin in the evening and the hypertenstive drug in the morning and see how that does.

He was still concerned that there might still be an infection so they stole some of my blood (and they even charged me for stealing it) and he wrote a script for an antibiotic just in case.

The drainage from the drain hole is essentially gone. I would say it is maybe a drop or two a day. No more gauze and paper tape!!!

As for what MRT mentioned about applying Androgel. Here is how I do it. At $18/day I try to maximize my dosage. I put on vinyl gloves first. Androgel will not stick to vinyl but sticks to skin very well. I use the tubes instead of the pump. I squirt one tube into my left gloved hand and smear all of it on my right upper arm, shoulder and chest. I rub until the glove runs into friction. That means all the Androgel has been rubbed in or has evaporated. We're talking maybe 20 seconds. Then I repeat with my right hand. When I'm done I take off the gloves and put the empty tubes inside the gloves and tie it off. This way my curious cats can't (or at least they don't) bite into the empty tubes of Androgel in the trash can. The best part is that I don't have to wash my hands when I'm done!!

So my next quandary as the swelling goes down is boxers or briefs? I'm not into commando, sorry. Opinions?

But are you hairy? If so shave shave and shave again! Re underwear there is NO question. My vote are briefs. Preferably made in China from silk...

Boxers are so 1940 US Navy...

First, BF, congrats on finally losing the testicle. It's a great change, believe me. I'm sorry you had such a tough time with A**hole docs, but sadly, that's not unusual. Seems that they put you through hell trying to save a testicle that you were happy to lose. This was not about you, it was about their inability to empathize with your wants and needs.

Best of luck from here on and I hope things heal up soon.

Falcon

Day 24 followup:

I am over the crazy drug interactions so sleeping all the time is over. In fact it kind of reversed and sleep became difficult for the last couple of nights but I figured I slept so much for the last week I needed to catch up on staying awake.

The stitches still have not fallen out but I go to the doc next Wednesday and I'm pretty sure if they haven't fallen out by then he will coax them out.

The antibiotic seemed to do the trick and I seem to be infection free.

I realized today that it feels good to feel good.

I'm looking forward to another good and maybe some great days by the end of the weekend. I am BEYOND ready to close this chapter and move on to healthier sperm free times.

Congrats from here too.

It really boggles my mind why the Dr went to such excessive pains to try and save what was obviously a doomed and probably non functional organ from your description and in the process put your well being and possibly your life at risk. All this in spite of your clear desire to have it all done with.

Maybe it had something to do with fears of a malpractice suit or something if you went home sterile. I guess the message is when you encounter a situation like this is to move quickly to change to a more sympathetic Dr. What have other people experienced in similar circumstances ?? Surely you should be able to make these kinds of dcisions yourself and have those decisions respected whan such medical conditions occur. GRRRRRR

I'll respond to several things. First off underwear. As a recent eunuch myself, I found that even my tiny nuts made for a loose bulge in my underwear once they were gone. I started out with all new, and love the cotton/lycra blend briefs from the swedish company H&M. The support and even enhance the firmness of your butt, as well as having a very small pouch , which fits best on guys without balls.

As to the feeling better thing. After nearly 30 years of troubles with my testicles, I really had no idea how much the pain was dragging me down. Once they were gone, I suddenly had this new energy , that could only be described as miraculous.

To all who are reading this, doctors seem to just "not get" the idea that a man would have testicle issues. The think that pain is "all in your head", or they flat out refuse to discuss any options other than medications. I saw at least 20 urologists over the years to try to find a cure for my testicle pain. I have been on HRT since my late teens almost totally. There was no reason why a sterile gay man with achy testicles should have been subjected to what I was, but the medical community has a knee jerk reaction to the idea of making eunuchs.

Ray

Very informative and useful information. Thanks for sharing your experience. I desire removal of testes due to painful chronic recurring epididymus but doc says after epididymus is removed infection and pain will be non-issues. But after having epididymus removed from left testicle years ago I know what such an operation does; the testicle will be soft, squishy, small, numb, sterile. Not wanting to be a host to 2 such deformities I would prefer to have them removed and just use replacement hormones instead. A life of using such hormones, and their varying effectiveness, is something to consider. Your experiences are not heart warming. Once my surgery is over I guess I will revisit my desire, and consequences, and alternatives to removal.......which as I have learned is a virtual impossibility anyway as your case illustrates.

Consider using bioidentical hormones. I use a compounded testosterone cream and I don't shave off any hair, rubs right in and works great. I low dose the "t" so it also lasts a long time and only costs me $30 bucks a month, though my insurance pays another $30, but that's still only $60 a month. Cheaper than a lot of meds.

http://www.bodylogicmd.com/bioidentical-hormone-therapy

Francis (imported) wrote: Fri Dec 12, 2008 3:08 pm Congrats from here too.

It really boggles my mind why the Dr went to such excessive pains to try and save what was obviously a doomed and probably non functional organ from your description and in the process put your well being and possibly your life at risk. All this in spite of your clear desire to have it all done with.

Maybe it had something to do with fears of a malpractice suit or something if you went home sterile. I guess the message is when you encounter a situation like this is to move quickly to change to a more sympathetic Dr. What have other people experienced in similar circumstances ?? Surely you should be able to make these kinds of dcisions yourself and have those decisions respected whan such medical conditions occur. GRRRRRR

The reason the doc went to excecessive lengths to try to save my very much doomed testicle is actually pretty simple. Training. You go to med school and have drilled into your head to "do no harm" and "do everything till the end" and that is exactly what my urologist did. My urologist is in his early 50's and is extremely conservative in his thoughts and processes. He felt that my wishes "of just getting rid of it" to end an infection was extreme for my thoughts and processes. After a very INTENSE conversation we somehow met somewhere in the middle.

After listening to him explain his reasons for doing everything he could to salvage what was left was for fertility I clearly explained to him that fertility meant nothing to me and there was no other reasonable reason to go through the time and don't forget about the expense of Hospitalization and

bfleish (imported) wrote: Sun Nov 23, 2008 2:06 pm IV antibiotics to try to salvage

something that wasn't doing anything any more.

I watched the gears turn inside his head and realized that he had run out of reasons that his training had taught him to keep a testicle. Next thing out of his mouth was "You know this will be permanent, No second chances". I said "Where do I sign doc?"

I was trembling when I finished speaking with the doc. Honestly I did not have a plan B at the time.

I am not absolutely sure but I think I was the first patient my doc had ever castrated and it was not for cancer. And it definitely bothered him. Alot.

But in a strange way it made me respect my doctor even more. He stood up for what is right about medicine. But he also listened and was able to step out of his comfort zone and see that I was a real person, with a real problem and I was really asking for his help. And he absolutely helped me.

Hash (imported) wrote: Sat Dec 13, 2008 8:00 am Consider using bioidentical hormones. I use a compounded testosterone cream and I don't shave off any hair, rubs right in and works great. I low dose the "t" so it also lasts a long time and only costs me $30 bucks a month, though my insurance pays another $30, but that's still only $60 a month. Cheaper than a lot of meds.

http://www.bodylogicmd.com/bioidentical-hormone-therapy

Hash,

I will consider biodentical hormones at some point in the future. Right now my goal is to heal up 100% and not mess with my hormones (or any other drugs) until everything has settled down and life is absolutely normal and starts to become boring again.

I do have insurance so the Androgel is not a killer for me right now. But since it is so expensive I have a sneaking suspicion that in the future the Insurance Company might start pitching a fit about it. Another fight for another day.

One month followup:

Actually it is 2 days early but here goes.

No pain, no drainage, feeling fantastic and good to go.

Then I went to the doctor today. He was alarmed that the infection in my scrotum had not gone down as much as he liked. It still feels & looks like there is a large testicle in there. The doctor assured me that he absolutely removed the testicle and what remains is the abcess and infection that surrounded my doomed testicle. He wants me to go back on antibiotics and if it doesn't start looking much better within a month he might want to go back in and see what's going on.

It took the wind out of my sails. I walked in feeling fantastic and ready to put this nightmare behind me and I got sideswiped by the doctor. I walked out kind of upset.

I guess I had it in my mind that once the testicle was gone and I healed up that would be it. Not so fast.

Oh well, that's how the ball bounces (or did it go spat when it came out?). I am in zero pain and feeling great on repacement hormones. Things could be a lot worse.

I guess my body is really weird. I have been on shots that took my peak T levels over 1300. I have been completely off HRT for periods of time and am currently off. At levels of 800 or so I had problems. I feel better, have as much energy, lose weight (15-20 lbs.) each time I get off HRT. I am married and my sex life is active off HRT. I have no depression, memory issues, bone density issues, or any of the problems that most talk about. The only change is in my attitude towards sex. I am able to perform especially with levitra or prostaglandin but really don't mind if I go longer periods between sex. It is also much more difficult to orgasm but I don't mind that either. My testosterone level is down to 13 ng/dl or basically none. Below 50 is considered castrate level by most Drs. Certainly below 20 is castrate level. I have not had cancer. I am curious if there are others that really do not see much life change off testosterone completely.

bfleish (imported) wrote: Sat Dec 13, 2008 11:31 am The reason the doc went to excecessive lengths to try to save my very much doomed testicle is actually pretty simple. Training. You go to med school and have drilled into your head to "do no harm" and "do everything till the end" and that is exactly what my urologist did. My urologist is in his early 50's and is extremely conservative in his thoughts and processes. He felt that my wishes "of just getting rid of it" to end an infection was extreme for my thoughts and processes. After a very INTENSE conversation we somehow met somewhere in the middle.

After listening to him explain his reasons for doing everything he could to salvage what was left was for fertility I clearly explained to him that fertility meant nothing to me and there was no other reasonable reason to go through the time and don't forget about the expense of Hospitalization and

[quote="bfleish (imported)" time

bfleish (imported) wrote: Sat Dec 13, 2008 11:31 am =1227409560]
IV antibiotics to try to salvage

something that wasn't doing anything any more.

I watched the gears turn inside his head and realized that he had run out of reasons that his training had taught him to keep a testicle. Next thing out of his mouth was "You know this will be permanent, No second chances". I said "Where do I sign doc?"

I was trembling when I finished speaking with the doc. Honestly I did not have a plan B at the time.

I am not absolutely sure but I think I was the first patient my doc had ever castrated and it was not for cancer. And it definitely bothered him. Alot.

But in a strange way it made me respect my doctor even more. He stood up for what is right about medicine. But he also listened and was able to step out of his comfort zone and see that I was a real person, with a real problem and I was re
[/quote]
ally asking for his help. And he absolutely helped me.

Thats similar to my experience. The issue of "possible" fertility is very strong and needs to be talked out at length. You may think you have no one to impregnate or that your wife is past the age of being capable but a doctor thinks ahead. Maybe you will remarry a 20 year old or whatever. Getting out in the open the concerns that you might not be worried about but the surgeon IS, seems to be the right path. And yes, pain is relative. A Urologist is not "into" this very deep so thats why you really do yourself a favour by talking to a doctor who does pain. And if he/she can resolve it without removing your Testicle(s)? Thats a good thing! No, lifetime of HRT and REAL sterility.

Two month followup:

It seems like its been a long time since my orchiectomy but in reality it has only been 2 months.

There still is a grape sized lump in my scrotum which is a remnant of the abscess that caused the failure of the testicle. It is a strange feeling to have something in your scrotum that feels like a small testicle that is slowly getting smaller and will one day be gone.

Hormone wise I am using Androgel and my latest T-level was 651. I have much more energy and my mind seems so much sharper. Morning wood and erections are "approriate" for someone my age. While I wish the sexual desires were reduced I really enjoy the other benefits of increased energy and mental clarity even more. Body hair has increased significantly. My chest and belly were hair free when taking androcur and now it has filled in almost completely.

Another benefit of replacing the hormones is that I am losing quite a bit of weight. It seems to just fall off with little effort. I feel much better 20lbs lighter. I've got another 20-30lbs to go.

So for now I have made the decision to continue the Androgel at the current dose. It has had such a positive effect on me that I can't imagine going back to my low energy, clouded mind state.

I guess I am one of those people that wanted eunuchism so bad and when I finally achieved it I realized that I couldn't live with the low energy and clouded mind. Please, please consider this before making the final cut. The energy loss was significant for me and even simple tasks like taking a shower became exhausting.

They say there is nothing like your own produced testosterone. But in my case whatever my body produced wasn't compatible with me. I did everything I could to remove it from my system via Spiro/Androcur/Depo Provera. After my orchiectomy I started Androgel and it seemed like it was a better fit. Very hard to explain but the replacement drug seems to work better than what my testicles produced.

I realize that as a enunch I can manipulate hormonally what I want. If I change my mind and want to return to no erections/desire all I have to do is reduce the dose of Androgel. If I want to be a horny SOB I can increase the dose of Androgel. If I wish to be more female then I can stop Androgel and take estrogen. In my case I don't think I would go the estrogen route, but I could.

Speaking of a horny SOB when I was trying to figure out what the right dose of Androgel should be I purposely tried a very large dose. Acne flourished, I snapped at everyone, and road rage became way too much. The biggest problem were the erections that would not go away. At first it was interesting and different. But after a full day of a raging hard on my penis would become very sore. Not fun.

The one thing that is still bothering me is my scrotum. It has not shrunk up at all. As a result it sticks to my thigh and can get very uncomfortable when it twists & stretches. I have found that trimming the hair on my scrotum helps but it still seems to be in the way more than I like. I have decided to give it at least a year to see if it will shrink up. If it doesn't then I'll look at getting it removed.

So after years of trying to become a eunuch my desires became different once the deed was done. I hope that this is a learning experience for the wannabes out there. The manipulation of hormones in your body is truly life changing in more ways than you can imagine.

Your post was quite interesting. Perhapes the Testosterone that your testes were making was going in doses too low or high or perhapes they were giving you strong cycles with way too little then too much or some combo? Androgel is like a rock. You get a peak and it slowly goes down. Nothing in your body will really change it much and perhapes thats why your satisfied with it?

In regards to too much or too little. YES! There is a "sweet" spot that you may spend months to years figuring out and when you do? NICE!

Anyway, glad you got rid of the pain and good luck with the swelling going down. It will eventually. Use hummm... Talcum? Powder in the shorts to keep your scrotum from catching and sticking to everything. My wife has a big bottle of this that I dump in my shorts to avoid the hot and stickies... The kind of underwear you wear can be a factor as well but I've got implants so part of it is to lift them up a tad.

Almost 4 month followup.

Not good news. An abscess has formed from the stump of the cord that was left in the scrotum. The abscess is much larger than a normal sized testicle and does not hurt. But where the abscess has attached to the scrotum it is extremely painful. Back on pain pills and antibiotics.

When I had the orchiectomy 4 months ago I asked the doc to take the testicle out inguinally so that there would be no chance of a problem in the future. He chose to do it scrotally after I was knocked out due to the testicle being huge in size and he didn't want me to have to go through another inguinal recovery. I wasn't real happy when I woke up but I hoped for the best.

So here I am 4 months later discussing with the doctor about going back in again and having the remaining cord removed inguinally. I'm not exactly happy.

Mr.T has mentioned it many times on this site and now I join him in absolutely demanding that if you have a doctor do an orchiectomy make sure it is done inguinally.

The inguinal approach means not taking the testicle out through the scrotum but an inscision in the groin which removes the testicle and most of the cord.

Removing the testicle and the cord prevents the cord from causing all sorts of problems when disconnected within the scrotum. I've read of the nerves in the cord attaching the the scrotum and creating all kinds of pain issues. And there is my problem of an abscess forming from the stump.

On another note it is interesting to have gone a few months with an empty scrotum and then very suddenly having a very large "testicle" back in there. It seems like I used to walk with my legs a little wider apart pre-orchiectomy. I'm readjusting again.

I'm truly sorry your having problems. Having balls too large to pull up the inguinals was really NOT my problem! Mine had atrophied and were already shoved up there more often then not. However I think I understand the problem as my new parts (Implants) just would never go up there without using dynamite.

I did a lot of reading of medical papers before I opted in for surgery. Trying all the various pain treatments etc. One thing I came away with was that Scrotal Orchiectomy seems to go bad way WAY too often. A real crap shoot. And for guys who have pain issues?

The pain doctor I was working with was a great resource. He also knew this Inguinal vrs Scrotal biz and he btw was the one who suggests that its important to inject the cords / testes with nerve blocks before they are removed to avoid later problems with phantom pains. As with any "amputation" there is thought that knocked out or not trauma to the removed part(s) priot to the actual cut equals phantom pain issues later.

There is a member here who had his cords cut through a small incision (Laproscopic?) and this resolved his pain.

I had my testicles removed through the scrotum by Dr. Kimmel almost 4 months ago. The cord ends have vanished. At least he did that part of the job right. I do still have a large crevice in my scrotum where he everted the skin with his too tight sutures.

I haven't seen this thread before so it really caught my attention because there were many parallels to my situation. My physician discovered my testicles were small and hard at my physical last July. He sent me for an ultrasound and then to a urologist. He did a testosterone test and another ultrasound. The T test was 97 (280-1080 normal). So he decided to do a biopsy. I told him that if the testicles looked bad, he should remove them then. He also wanted to use a general anesthetic while I thought I could endure the procedure with a cheaper local anesthetic. My insurance would cover the general but I would have been happy to go with the local. So much for keeping medical costs down! Anyway, we did the biopsy and when he talked with my wife while I was still out of it, he said the testicle he cut a section out of appeared to be infarcted. He sent that piece to pathology as well as sample of a needle biopsy done on the other testicle. I was disappointed when I heard that, thinking he had the opportunity and reason to remove my testicles then. The pathology report came back that the testicles were infarcted-dead in ordinary words. But he wanted to wait 3 months to see if there would be any regeneration. After going through the 3 months suffering from low testosterone- weakness, hot flashes, etc, I got another T test that came back at 44. So now I'm scheduled to be castrated next week and have already started with TRT- Testim 5gm/day. I felt more energetic after the first day on it, especially after the 3 month delay.

But I've had to endure a needless 3 month delay and another surgery and the related pro-op physical and blood tests, that could have been avoided if he would have just removed them when he was doing the biopsy. My urologist has said the bi-lateral orchiectomy is simplier than the biopsy so he has at least agreed with me to use a local anesthetic this time. I'm not sure a local would do so well with bfleish's situation, but his extraordinary circumstances should allow for an insurance exemption if he makes a large enough stink about it.

Maybe they (doctors) can say they are tring to save natural tissues but at the same time every delay results in more office visits and more future surgeries. Its sort of a guarantee of future business for them. It frustrates me in the same way bfeish is frustrated, but what power do we have? Not much!

BTW, I was sent home from the hospital after my biopsy with just a jock and wad of gauze for a dressing. It worked well but I found one of my wife's control briefs worked even better to firmly hold the gauze in place.