Med recovery question: orchiectomy [Archive]

Jason E

07-18-2009, 08:11 AM

Things are happening fast with this here and Monday is my op. I'm a little ansy, but nothing bad. It's nothing until it's something, right.

I'm going on a limb asking if anyone here has had one, but if so, can anyone answer real world recovery questions?

Not that I don't care if it is 6 days or 2 weeks before I can ride the bike, but it's less important then, you know, walking, showering, going back to work, hanging out with my daughter, etc....

I am looking at the positives; I get to take off Tuesday to watch the tour live.

Alright, thanks.

JE

CNY rider

07-18-2009, 09:05 AM

Don't want to ask you to divulge personal details, so feel free not to, but are you having an inguinal orchidectomy (typical cancer surgery)? Trans-scrotal? Unilateral or bilateral?

Jason E

07-18-2009, 09:12 AM

No, I'm offering, or would not have said anything. I know this forum can be cruel about bike opinions, but gentlemen when necessary.

Inguinal orchiectomy. We'll find out what it is exactly afterwards, and if it leads to Chemo or Radiation, so be it, but I'd like to know If I'll be laid up for a few days or week, or anything else anyone can offer in the immediate.

I'm telling Mrs. E. that the doctor is suggesting a tub of beer pretzels and sour cream.

CNY rider

07-18-2009, 01:45 PM

You are having a fairly minimal surgical procedure.
Would expect to be up and around, albeit sore, the day after surgery.
Back on the bike in a couple of weeks, tops.
I wish you well.

thwart

07-18-2009, 04:08 PM

Certainly wish you well!

And hope that you have a surgical 'cure'.

bob the nailer

07-18-2009, 04:31 PM

As someone who performs them I would not rate an inguinal orchiectomy as a fairly minimal procedure. A wise man once said "There is no such thing as minor surgery, only minor surgeons". Another wise man said "Minor surgery is surgery on someone else." Not intending to scare you but what I would tell you is no cycling for three weeks. To remove your testicle an incision will be made into the fascia, or covering, of the abdominal muscle in your lower abdomen, this needs time to heal before you begin stressing it by biking. Good luck with your procedure, let us know how it turns out. You will likely have multiple choices as far as what to do next depending on the pathology, this is an instance where a second opinion may be a good idea. Lance got one and saved his cycling career and maybe his life.

SoCalSteve

07-18-2009, 04:39 PM

I love this Forum!

When we need tax advice, people help us... Same with medical advice...when we decided it was time to lose weight, we set up a spreadsheet to help us with that...

This is a great place which is made up of a whole lot of "Menshes" ( Yiddish for people that do good deeds).

Collective group hug and a big pat on the back to everyone!

Just sayin'

Steve

CNY rider

07-18-2009, 05:36 PM

I love this Forum!

Steve

What I really love is that the urologist goes by the nickname "bob the nailer"! :p

malcolm

07-18-2009, 06:47 PM

What I really love is that the urologist goes by the nickname "bob the nailer"! :p

As long as the hands/fingers are small all is good

SoCalSteve

07-18-2009, 07:27 PM

As long as the hands/fingers are small all is good

And has clipped fingernails!

Just sayin'

Steve

BumbleBeeDave

07-18-2009, 09:18 PM

. . . but I wish you the very best of luck. I had a cyst in 1987 and was totally scared when the doc said they would biopsy it while I was under and if it was malignant I'd wake up with one--or TWO less testicles. I was scared silly. I'd been married less than a year. Fortunately it was benign, but the memory lingers and the very best oif good luck to you!

BBD

bob the nailer

07-18-2009, 09:52 PM

Certified size 6 1/2 gloves- that is small to you non-knowers of glove sizes.

Jason E

07-18-2009, 10:00 PM

I appreciate all of the input and encouragement, thank you. I'll let you know how it goes Monday evening, maybe Tuesday if I'm wiped out.

thx

JE

MattTuck

07-18-2009, 10:06 PM

Best of luck. My thoughts are with you and hope you have the easiest path back to health possible.

As far as getting back on the bike, take it easy. Don't rush. Better to heal up a little extra than over do it and cause other problems.

Also, if you have any prescription narcotic pain meds, remember they can be constipating. I feel like Doctors forget to "mention" this. A stool softener or fiber supplement and plenty of water may be in order to keep things moving down there. I know it isn't exactly the same street, but maybe the same neighborhood... and it can't hurt to keep stuff moving.

Dekonick

07-18-2009, 10:07 PM

Good luck.

soulspinner

07-19-2009, 05:41 AM

Heres a prayer fer wellness. :)

TimD

07-19-2009, 09:05 AM

Twenty-nine years and counting. Two naturally-conceived kids. YMMV.

Nick H.

07-19-2009, 04:23 PM

bob the nailer

07-19-2009, 04:38 PM

I had sex the day after mine! I really wanted to test the equipment. The stitches meant that the only comfortable position was kneeling by the bed but it was a great success.

I had two secondary tumours which took a year to sort out. But the treatment was so successful that after 3 years I stopped having check-ups.

Hope everything works out well for you.
Both of those maneuvers, the sex and the stopping the checkups may have worked for you(depending on how long it has been since the end of the checkups) however neither is the recommended course.

Nick H.

07-19-2009, 04:48 PM

Stopping the check-ups wasn't my idea. But my oncologist was very upbeat. Maybe it's a British thing - our view is that we undertreat and you guys overtreat.

e2a: this was 15 years ago.

As for the sex, I wasn't given any guidance and never thought to ask.

Birddog

07-19-2009, 06:37 PM

As for the sex, I wasn't given any guidance and never thought to ask.

Demonstrating once again that nookie is where you find it, not where you look for it.

Birddog

mls

07-19-2009, 07:12 PM

Its been 6yrs since mine and it took about a wk or so b4 I felt comfortable
standing tall . I think I was on the bike in like 4 to 5 wks . I was lucky just
follow ups w/dr after that no chemo or radiation . Best of Luck !

Jason E

07-21-2009, 09:12 AM

Well, I'm back.

Got home last night around 7:30, ate some dinner and passed out until 4:30/5 this morning. I feel fine, even without the Vicodin. I'm icing and such, but it went well.

It is/was a tumor. I was out but the Doc told my wife it had overtaken a good part of the testicle. We'll have pathology back later this week.

He is considering it Stage II, but there are positives. He says he sees a slight increase in size in some of the area nodes, but considers it "junk" that can be cleaned up with Radiation, not Chemo. Again, we will know more later. Also, there is an HCG level that I still need to go read about, but he says normal is sub 3, and that full blown cancer is closer to 500 or more. Mine is 11.

Most importantly, I feel good and my attitude is good.

Thanks again for all the feedback and encouragement.

1happygirl

07-21-2009, 10:36 AM

My thoughts and prayers are with you and your family.

Louis

07-21-2009, 10:37 AM

Well, I'm back...it went well.

Jason, good to hear back from you. Get everything sorted out with the treatment and good luck getting back on the bike. May your return to cycling be as successfully as you know who... :)

Chad Engle

07-21-2009, 10:38 AM

Sounds like good news! Wishing you the best of luck on your recovery.

Chad

Jason E

07-21-2009, 10:40 AM

May your return to cycling be as successfully as you know who... :)

Grrrr. I've stopped counting how many times I've heard that reference since yesterday! :crap:

The sentiment is appreciated, I'm just kidding.

Louis

07-21-2009, 11:01 AM

Grrrr. I've stopped counting how many times I've heard that reference since yesterday! :crap:

I figured that. I said it kind of as a joke and that's why I didn't name your co-recoverer.

rockdude

07-21-2009, 12:25 PM

Get well soon buddy.....

bob the nailer

07-22-2009, 04:22 PM

Jason-glad you are doing well. I am not sure how he can tell you if either radiation or chemo is indicated next without the pathology. If your pathology indicates a pure seminoma, then the usual next stage of treatment would be radiation, although some people think that chemo instead of radiation is a less morbid course with fewer long term side effects. The other pathology is what is called a mixed germ cell tumor, much more common by the way, and the treatment for that with an elevated marker and questionable lymph nodes would be either chemo or surgery, what is called a retroperitoneal lymph node dissection, to remove the lymph nodes, followed usually by chemo if the nodes are positive and observation if they are negative..

Jason E

07-22-2009, 05:43 PM

Bob,

I don't know. Maybe he was being positive, not that Radiation is positive, but he said everything telling me emphatically he'd know nothing until they got the pathology back. Perhaps it's me projecting positiveness into his vagueness.

I'm definitely hoping it is not going to require RPLND.

Jason

PS, no idea how that guy was doin' it the next day. That is the last thing on my mind! Well, maybe not the last, I'm a guy, but I'm not doing that yet.

TimD

07-22-2009, 08:19 PM

Try not to cough or laugh.

I was followed up monthly at MSKCC in New York, as part of a trial program run by Willet Whitmore. No chemo, no radiation, no lymph node dissection nor removal. Monthly blood tests and abdominal X-rays; twice-annual cat scans; twice-annual lymphangiograms. Pretty advanced at the time and definitely not the conservative approach. This continued for several years.

I would hope and expect treatment would have become more sophisticated since then (1981).

Ahneida Ride

07-22-2009, 08:24 PM

God Speed my friend ... ;)

bob the nailer

07-23-2009, 05:09 PM

Jason. Hope you are feeling well. You don't say where in NC you live, but if indeed a RPLND is required, consider looking for someone who does in with the laparoscope and or robot. Certainly Duke University Med Center would have that, Duke is one of the major urology centers in the US.

Jason E

07-23-2009, 06:54 PM

I'm right there. We are in Raleigh. Thank you. Pathology tomorrow.

bob the nailer

07-24-2009, 04:31 PM

So are you a golfer Jason? Man I would love to live that close to Pinehurst, actually in 1989 had sort of an opportunity to move to New Bern, but it didn't work out. Hope your recovery is going well. Keep us informed.

Jason E

07-24-2009, 05:45 PM

I'm not a golfer. I don't dislike it, but it has just never clicked with me.

Went to the Doctor this morning. It was an 8cm mass. The good news is that is was a "pure" seminoma. Nothing weird or mixed. Didn't realize they could be, but I never looked into it before.

My lymph nodes are slightly enlarged, his words, but thinks radiation will clean it up. I am speaking with the oncologist monday and I'll understand more then. From what I am getting though, this is one of the best outcomes I could hope for so far. We shall see what comes next.

I can tell you I am exhausted by 3pm everyday this week. Left work early again and took a 2 hour nap. I'm at a desk, and enjoy being there; it is not stressful physically or really mentally. I like being there rather then home on the couch and I leave when I need.

Thanks again, everyone, for the forum and the encouragement.

bob the nailer

07-24-2009, 08:06 PM

Yes that is good news, no rplnd with seminoma. You should do well long term, best of luck. Keep us informed as it goes along.

bob the nailer

07-25-2009, 02:28 PM

Jason- I was rounding this morning and ran into one of my friends who is a medical oncologist, I was asking him questions about therapy for seminoma. He said there is a growing opinion that in low stage seminoma chemotherapy is a viable alternative to radiation, that it may have fewer long term side effects, and in addition if you have microscopic mets to the chest lymph nodes, chemo is treating that, radiation is not. He told me of a patient of his, a physician, who chose chemo for his seminoma and has done well. It might be worth your time consulting with a medical oncologist as well as a radiation oncologist. Hope I am not just muddying the water for you, but I think one cannot have too much information. Good luck.

Jason E

08-01-2009, 03:22 PM

Bob, I appreciate that.

I got my post OP HCG level, it went from 11 to 1. Everyone, including myself, is very optimistic.

I met with a medical oncologist yesterday, and he gave me three options.

1) monitoring, no treatment
2) Radiation (17 treatments, 5 days on, weekends off)
3) One whack of Chemo

1) The studies showed that only 20% of the people with what I had develop into some thing further post op. The thought is they can keep an eye on you, but that then 80% of the people would avoid the Chemo or the radiation.

I guess the Chemo just scares me. I am picturing all sorts of weight loss and baldness, whereas mentally, I am in a state of comparing the radiation with visiting the dentist.

I left there telling him I would consider this weekend and decide, but leaning strongly towards the radiation. I have more questions to ask about this on Monday.

My wife feels the radiation is the most.... fill in the adjective. It is what gets done. She likes that mainstream acceptance.

Thanks again!

CNY rider

08-01-2009, 06:38 PM

First, it sounds like you're already focused on the thing that matters most: The fact that your prognosis is excellent whatever you choose to do from here.

In making your decision, go over the follow up schedule for those electing observation carefully. Plenty of CT scans, Doctor visits, etc. It can be a difficult routine to follow, and of all the options you have the worst one far and away is to elect observation and then not get the recommended follow-up.

Also, try to talk to a Nurse or someone at your oncologists office again about the chemo. You're picturing something in your head that is a lot worse than the actual reality of a single dose of carboplatin. Have them go over the administration and side effects again so you have them clear in your mind.

And best wishes no matter what you do.

bob the nailer

08-01-2009, 09:43 PM

Tough decision for sure, certainly both treatments are effective and low risk but the observation option is tempting I know because it sounds so easy. The observation option, however also involves a significant exposure to radiation, the radiation dose from multiple CT scans over a period of years is not insignificant. I know what I would do I think, but you need to decide based on what you feel and what you onc doc feels, not what some goober on the internet 2k miles away with a semi-educated opinion feels. Best of luck, keep us informed.

Jason E

08-01-2009, 10:34 PM

Thank you, and all the goobers.

I am leaning more towards the Euro treatment, and plan on discussing the "One Bag of Poison" method, and understanding it further, on Monday.

Is it distasteful to try to take the meds that offer me a more clear path to a CERA prescription?

Yes, I'm joking.

night.

Jason E

08-16-2009, 12:24 PM

So I am starting on treatment later this week.

More importantly, I got out and rode yesterday. Going out again today in another 45-60min. Yesterday was a terribly low wattage 20 miles. But I was out, and felt better having done in it.