Thursday, October 23, 2008

Life with Testicles

I just fixed my testicular torsion:

"In testicular torsion the spermatic cord that provides the blood supply to a testicle is twisted, cutting off the blood supply... Prolonged testicular torsion results in the DEATH of the testicle...!!"

It was an interesting experience. Now I'm going to tell you all about it... :D

It'll be a little weird, so don't read if know... if you think that you may feel uncomfortable and don't want to feel uncomfortable... Here it goes:

Yesterday morning I woke up and noticed a weird pain around my testicles. It wasn't a constant pain but it made me aware of itself every once in a while. I took a look, but didn't pay that much attention since it wasn't so bad. There was only some slightly intense pain when my body was in certain positions, dependent on the angle of my legs and so on... I mostly ignored it, assuming it probably is nothing and will go away by itself. I also went to see "Hellboy II" yesterday, it was a nice and entertaining piece of work, could've been longer. I had to avoid certain positions while sitting to not to feel any pain...

Anyway, today morning, as I woke up I noticed that the pain was still there. This was an unpleasant surprise, I had wished that it would simply disappear. So now really interested in what's going on down there, I began to examine it closely: It was only about my right testicle. Applying minimal pressure from many directions resulted in an intense pain, it was therefore pretty hard to touch. I also noticed that the right side seemed to be hanging higher than usual, so I began to consider that it might have something to do with the testicle slipping from its correct position. But I wasn't sure and I kept looking. After spotting a soft and little (smaller than a pea) roundish thing, I got close to concluding that it was testical cancer.

Now it might sound insane to most of you, but the idea of having cancer was sort of exciting for me because it would give me the chance to test the New (German) Medicine myself, which is generally dismissed as pseudoscience. According to the New Medicine most(if not all) testical cancers are caused by a conscious or unconscious desire to have a child (i.e. after having lost your child in an accident, or maybe even after a divorce where you don't get to see your child as much). It's sort of like the body is sending extra support to the testicles so that they're more effective, the number of cells in that area start to increase and that's what cancer is all about, according to the New Medicine: An attempt of the body to adapt and fulfill the emotional needs of a person. While looking up more about it online I found a story of a guy who claims that his testical cancer was cured as he only followed this explanation of the New Medicine, no meds no chemo. I briefly checked out this guy's story and at the same time I was also trying to figure out if and why I was feeling the need for a child somewhere deep inside me.

Then I slowly realized that the description of testical cancer wasn't really fitting to my own experience. Around that time the situation seemed to get more serious, perhaps due to what I had done during my amateur examination. There was really an intense pain, not always in all positions, but whenever I moved some pain was sure to come. While walking, the pain was so intense and so sharp, a few times I got pretty dizzy. Once I got pretty close to fainting I think, when my vision blacked out for umm... 80% and I've gotten really pale in a very short while after that. I also had a bad stomach because of the pain, I felt like I was going to vomit. Letting my head cool down under cold water helped me pull myself together.

Cancer seemed to be the result of a slower process and with less pain. Knowing that I don't really know much about how testical cancer really feels, as much as I wanted to have it(?), I was inclined to look for other explanations. I googled this and that and jumped through various links and websites, trying to find something closer to what my experience felt like. Epididymitis seemed to make sense for a while. But reading things like this was what rang the bell for me and helped me realize the situation:

" The spermatic cord shortens as it twists, so the testis may appear higher in the affected scrotum. "

As I earlier said, my right testicle seemed to be in a position higher than I thought it previously was. So I started to look deeper into the testicular torsion possibility and realized that other people's descriptions of their own pain was basically identical to mine. I was convinced at that moment. (And what I earlier perceived as a little roundish thing was probably nothing more than a part of my epididymis.)

This is where it began to get a little scary(er). Because this is what you'll read about treatment of testicular torsion online:

* "Immediate surgery - ideally within six hours of the pain starting - is the recommended treatment. The torsion that has tightened the blood vessels is removed and the failed blood circulation to the testicles is brought back to normal. In order to prevent torsion happening again, the testicles are sewn to the innerside of the scrotum (testicular fixation). It is usual to fix the opposite testicle at the same time."

* "If treated within 6 hours, there is nearly a 100% chance of saving the testicle. Within 12 hours this rate decreases to 70%, within 24 hours is 20%, and after 24 hours the rate approaches 0. Once the testicle is dead it must be removed to prevent gangrenous infection. "

*"Surgery must be performed within 24 hours to ensure the health of the affected testis. During the procedure, the surgeon untwists the cord and secures the testis in place so that it cannot rotate again. The other testicle should also be secured to deter future testicular torsion."

etc. etc....

So... Shit! After getting this first impression about the treatment, I found myself in panic. I realized that my heart was beating really fast and I had this fuzzy feeling overall, too much adrenaline. One reason was that it was already more than 30 hours for me. So losing my testicle seemed very likely at that moment. The other reason was that this meant that I had to go to a hospital as soon as possible and get surgery. This was a whole lot of work and a very time-consuming, complicated thing with various unexpected consequences, like having my testicles sewn. Who knows what that feels like? * And as someone who doesn't like to have to rely on others in life, the thought of not being able to solve this problem myself was pretty annoying to me.

But I also didn't like to panic since it was preventing me from acting efficiently and rationally. So for the next 5-10 minutes or so I just laid in my bed and listened repeatedly to a relaxing song. This helped me clear my mind and I went back to a more rational state. I could've probably done it without the song too, but it wouldn't have been as quick and effortless I suppose.

One thing I realized after that was the significance of my pain not being constant. So only certain positions caused the spermatic cord that provides the blood supply to get dangerously twisted. Which meant that if I remain in a position where I don't feel any pain, then there was no reason to worry about my testicle not getting enough blood and dying. This was possible through experimenting a little with how I sit and stuff like that. Noticing this was comforting.

After focusing on if and how it's possible to solve this problem myself I started to find things like this:

So there was hope after all. As someone who already has sufficient distrust towards authorities I decided to fix it myself. All I have to do was to reverse whatever happened down there and return the testicle to its former position.

I spent the next 20 minutes or so under warm shower where I hoped that things would loosen up a bit. (I'm not sure if the warmth made it easier or harder.) It was like trying to solve a puzzle and you're immediately made aware by an intense pain if you take a wrong step. So the pain makes it both easier and harder to solve. :) Plus, most of the feedback you get is through subtle sensations instead of visual or audial, which makes it more interesting. In the end, after playing around enough with it I was able to untwist it.

It still wasn't perfect though, and it was indeed inclined to get twisted again for a relatively long while, but there was nothing left to worry about since it was under my control this time. But I had still doubts if the problem was completely solved or if my solution was only a temporary one: Although this event took place on 23.October, the date I'm publishing this blog post is on 31.December. Initially I decided to wait a week or so to make sure that it's really over, because as I started to write this on 23rd I was still feeling a little pain down there every now and then. (It was getting drawn back up again and I had to keep it down where it really should be. And I was pretty careful in the next few days.) But after I was completely sure that I don't have a problem anymore then I was too lazy and delayed finishing this blog post to publish it. Now at the end of 2008, I wanted to get rid of this burden. :)

One final note which should actually be obvious: I would've accepted surgery without thinking if the pain I felt were constant and if I were unable to relieve the pain even temporarily through manual detorsion. Temporary relief was a sign for me that permanent relief is also achievable with more effort.

Also to quickly sum up the lessons I learned:
  • Avoid wearing underwear that is too tight. I think that was the reason in my case. It was a really tight one. I'll never wear something as tight as that one again. That in combination with whatever activities took place during the night caused me to wake up with testicular torsion one morning. Beware guys... :)
  • Informed distrust against authorities is a good thing. If I had obeyed all the advice experts give online, then I'd need to go through surgery. I don't think anyone would've really tried to avoid surgery and untwist it manually if I had gone to a hospital, only a few sources even mention such a possibility. ** And even if they did, I would probably still be in surgery. Because they claim that even if the torsion is fixed without a surgery, the testicle should get permanently fixed through surgery. This is just not so smart. It's obviously not always necessary to go through a surgery if there's no more an emergency, there can be easier ways to deal with it and stabilize it after the correction. After a while it's possible for it to return to a completely normal state anyway -as it proved to be the case with my testicle. But all this depends highly on the patient, too, probably. Naturally I'm talking only about my own experience.

So that's it. Maybe this helps somebody in the future.

* : This guy knows what that feels like: Lovely butterflies, rainbows, flowers and sunshine!

** : This is the best info I could find about manual detorsion. It would've been better if I had found this at the time when I still had the problem: Testicular Torsion: Treatment & Medication

P.S. I updated the Wikipedia entry and added some info about manual distortion, also a link to this blog post.

Update: The link to this blog post was removed from Wikipedia in April 2009 due to me providing "dangerous advice". I tried to contact the editor who made the decision for clarification to no avail. I think I was rather cautious with my "advice", as evident in my final note. I don't think I even gave any advice, I just shared my own experience. I suspect that this edit was more a result of a bias against alternative theories/treatments (e.g. New Medicine). I restored the link in May 2009.

Update 2: They removed it again. More info at the article's discussion page.


Chris said...

Kind of an old post, but I have $.02 for it anyway. It may be beneficial to get it surgically fixed because once it happens once, it may start to become an on-again-off-again issue. I'm currently contemplating surgery because I will get a case of torsion every 2-3 months, and honestly if you have medical insurance, it's not worth waking up to the feeling of getting punched in the balls every 90 days =]

sadunkal said...

Hehe, thanks for the advice. It has been more than 3 months for me now and it doesn't feel like it's going to happen again though. So surgery doesn't seem necessary, but I'll consider it if it ever happens again I guess. I'd speculate that the longer you can hold on, the unlikely it'll become.

You should consider training your testicles if you know what I mean... Actually I don't know what I mean. :) Hehe. Perhaps you can tape them to stabilize..? Or training the other muscles around may help? PC muscles?

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