How I Found Out

In July I had surgery for what the doctors thought was testicular cancer. This would have been my second case. I went through surgery and radiation and chemotherapy for the same thing in 1985. As it turned out, this tumor was not malignant.

This is the story of how I found out about the tumor.

Synopsis:

• 1. Recovering from Jet Lag
• 2. The Physician's Assistant
• 3. That's Sensitive
• 4. The Ultrasound Technician
• 5. Your Doctor Will Call You
• 6. A Complex Mass
• 7. The Doctors' Office
• 8. The Urologist
• 9. The Diagnosis

1. Recovering from Jet Lag [synopsis] [next]

I seemed to take it the hardest when we all returned from our trip to France. Trudy and Ben were back to normal in a couple days, but I was exhausted for a week. Finally, after about seven days, I started feeling human again.

So feeling normal, I did a little yard work, although my body was still used to the cool weather of northern France and recoiled at being thrust into the Texas swelter again. And I wrote a note about my grandmother, who had recently died.

Sitting down to write was, I think, the sign that I had finally recovered from jet lag: I was recharged enough to shed some energy thru my fingers and keyboard out onto the net. But when I logged off the computer that night and stood up to go to bed, I felt feverish. And as I got ready for bed, I noticed that I couldn't pee even though I really needed to.

2. The Physician's Assistant [synopsis] [back] [next]

I was up and down all night, from bed to bathroom, bed to bathroom, with no luck. By the time morning came around, I was delirious from fatigue. And I had a fever.

Trudy called our doctor.

The doctor was out for two weeks, they told her, but his physician's assistant, Ginger, could see me. Trudy asked if I was willing. She didn't say it explicitly, but it was obvious from the look on her face that she was wondering if I was willing to see a woman for male problems.

Yes, I said. I didn't have the energy to be shy or proud.

3. That's Sensitive [synopsis] [back] [next]

The nurse who took me to the patient room was young and cute and fit. I, on the other hand, am well into middle age, have gained weight since I stopped running almost a year ago, and hadn't been able to pee for 12 hours. The contrast between the two of us made me wonder if I should have held out for a male doctor.

However, when the physician's assistant came into the room, she immediately put those anxieties to rest. She was also trim and fit, but unlike the nurse, Ginger well into middle age, too. And her years gave her an air of experience and competence, something that I felt I could use.

She said the blood work showed I had an infection. But given my history, she wanted to do an exam -- actually two. We don't need to go into the details. Let's just say that they both seemed to go well, except that at one point I said to her (with a wince on my face), Ouch. That's sensitive.

I am conservative, she said when she was finished. Since you said it was sensitive I'd like to do an ultrasound.

She made the appointment for me.

4. The Ultrasound Technician [synopsis] [back] [next]

Al was the ultrasound technician. He took me into a room that was dimly lit and mostly bare. There was a humming computer next to the examination bed, and that was it.

We did the renal ultrasound first. I didn't have to pull my pants down very far for that.

Take a deep breath, Al said. Now don't breathe.

I did as he said. He seemed to take several images, but he never told me to breathe. At first, I thought how impressed he must have been that I could hold my breath for so long. But he never said anything. I finally let my breath out on my own.

Oh yea, he said. Breathe any time you like.

So that was how we did things. He would tell me to hold my breath, and I would hold it until I was blue or until it seemed (from the sound of things) that he had finished taking the image. And the testicular ultrasound went pretty much the same way, except my pants were down farther and periodically I winced in pain.

When we were done, he said a radiologist would come out to the lobby to see us in a few minutes.

5. Your Doctor Will Call You [synopsis] [back] [next]

We waited in the lobby more than a few minutes, although it wasn't long. Eventually, Al came out to talk to us. He had an apologetic look on his face that mixed in a strange way with his smile.

They weren't able to interpret the image yet, he explained, and he started to say something else. We told him that wasn't a big deal -- that we already had a follow-up appointment scheduled with the doctor in four days and we could just get the results then.

He said no, mumbled something about lunch, and said the radiologist would be able to call the doctor in about an hour.

We said we'd call the doctor in about two hours. Al nodded. His apologetic expression now just looked plain awkward.

6. A Complex Mass [synopsis] [back] [next]

We spoke to the doctor's office after we had been back home for a while. Frankly, I'm not sure who called whom. At this point I don't remember much of the phone conversation. However, I do remember Ginger, the physician's assistant, explaining that they found a mass: more than a cyst, a complex mass with calcifications.

Ginger patiently explained that the mass was of some concern to her and that I should see a urologist. She offered to make the appointment.

She asked if I had a preference on doctors. Not really, I said, but then my experience with testicular cancer in 1985 came to mind and I told her one doctor I did not want do see -- a kind of anti-preference.

She didn't ask anything else.

7. The Doctors' Office [synopsis] [back] [next]

I guess all the urologists in town are at the same address. At least the three I have seen in the last twenty years are. And Dr. R's office was not only in the same building as the doctor I had asked not to see, but it was on the same floor, behind the same door, and had the same waiting area and receptionists. So much for consumer choice, I thought, but frankly, I just needed to see the doctor.

In the event, the nurse and the doctor seemed quite pleasant. He was distinguished looking, and had a calm way of talking that was reassuring. She was friendly and understanding and radiated competence. She appeared to be the one who kept the place running.

The only distressing part of that visit was how they went about viewing my ultrasound images.

8. The Urologist [synopsis] [back] [next]

Do you have them with you? the doctor asked, wondering if I had brought the images.

I said no and mumbled something about how the radiology lab had talked to the doctor's office directly and never to me. I don't think he heard what I said, because shortly later he asked the same question and then added, We will need them.

I mentioned that I thought the images are digital and that the technician talked about sending them electronically. He walked out of the office to talk to one of the nurses.

What followed could have been a scene out of a comedy movie. The doctor and several nurses and staff and I shuffled from office to office trying to view the ultrasound images on various computers in various doctors' offices up and down the hall.

Every time we tried to look at them, we got some sort of permission error. (You know: bad password.) And every time, the admin who seemed to know the most about doing this would mutter, That's odd. I was able to see them from my machine.

Finally we all traipsed out the door, down a dark, narrow hallway, into the admin's office. It was small and cramped. It didn't have the fancy paneling and bookshelves and diplomas and licenses and photographs and artwork of the doctors' offices but did have a computer that successfully brought up the images.

9. The Diagnosis [synopsis] [back]

Dr. R pointed to the screen and explained. He said that the mass on the image was cancer. I've been through this once before, so the impact was not devastating, and I was able to ask some sensible questions to make sure that I understood what he was saying and had some sense why he thought he was right.

The doctor's answers to my questions made it obvious that he was virtually certain that it was cancer, and he did not want to give me any false hopes.

We scheduled surgery for the following morning.

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