So apparently most guys aren't experiencing pain anymore by this point. Wonderful. Apparently most guys have reduced or resolved pain from this surgery overall, too, but I don't know if I believe that... it's certainly not in line with MY experience. Maybe my pain was just less severe than most guys' to be begin with, so that my pain level now WOULD be an improvement if I was most guys. But I don't think so - judging from what I've read from other guys, most of them don't talk about things like needing to keep wearing special underwear after this surgery, except for the rare exceptions. I seem to have more in common with the exceptions than with the rule. Of course someone has to make up that 11% that they say won't experience pain relief, so I'm not truly alone. But apparently not only did I win the genetic lottery for the crappy infertility diagnosis to begin with, I'm a bonus winner of increased pain. It doesn't inspire a lot of confidence going forward - I've continued to defy odds and expectations in a bad way at every step of the road thus far. I realize that's the pessimistic view - there HAS been some good news & positive results mixed in along the way, and I've still got some sort of chance that this pain won't be permanent. I AM grateful for that. But, again... emotions aren't rational, and that's not how I FEEL right now.
That's all for now, I guess. Just a bit of venting today.
Thursday, March 8, 2012
Monday, March 5, 2012
A Mixed Victory
So this morning was the fateful, long-dreaded three-month follow-up to November's surgery. I never heard last week the results of last Wednesday's new semen analysis, so we'd find out those results this morning, and the future course of action that would go along with it.
Of course the Fertility Clinic wouldn't actually have the results READY for us this morning, after assuring me last week that they would, so we went through the entire appointment with the urologist without having any results to talk about that were supposed to be the whole point of the appointment to begin with. That was frustrating. The doc was friendlier today than any previous time I'd seen him, but he was visibly disappointed when I gave him the news that I'm still more painful now than before the surgery. Then of course I had to drop my pants for him again, and the exam this time was actually more painful than it was in December (because he wasn't very gentle at all this time), but at least it didn't uncover any new complications. He did observe that I've still got swelling, which explains my continued pain. He mentioned that if the pain does not improve any further, we may be looking at another procedure to deaden the nerves. But then, lacking any new numbers to discuss, we did what we could to talk about immediate next steps.
The nurse said that if my count had not improved since the surgery, he'd want to talk to us about HCG hormone treatments, since my testosterone is low and you can't treat "low T" for infertility with testosterone directly, or else you'll actually make the semen parameters WORSE. So the doc did indeed bring this up, but he admitted up front that it's expensive and not covered by insurance - $500-$600 a month. There's no way we can afford that on my current salary; there's not nearly enough budget left to squeeze. Fortunately that was not his recommendation yet, though, and he actually suggested that I try taking a specialized "Infertility for Men" vitamin/dietary supplement. This still isn't cheap - $180 for a three-month supply - but $60/month versus $600/month is WAY more palatable, and more feasible. He did say that the vitamins actually work, too. So, as much as I might like to have the "low T" addressed, it looks like that's not gonna happen. But at least I won't be screwed up with weird side effects from hormone treatments (yet), so I suppose that's good.
So we left the doctor's office this morning with the directive to start the vitamin treatments, then do another semen analysis three months after whenever I start that, then come back to the urologist two weeks after that analysis. Okay, fine. I f*cking HATE semen analyses by now, but at least it doesn't mean more high-dollar medical bills right away, and at least it doesn't hurt (like surgery or this morning's exam). At least it's another 3-4 months out. But we still didn't have the results of the analysis I did last week.
The nurse tried to get the results while we were there, and the Fertility Clinic did send over a set of results we hadn't heard yet - but what they sent was the results of the second semen analysis we did back in November, before my surgery. That... hurt more than the physical exam did today. I thought I was screwed up before - the first analysis had a count of 4.25 million (only 21.25% of the 20 million LOW end of normal), and 0 morphology (meaning ALL of my sperm were misshapen), but at least the motility was normal/good. The second analysis made the first sound like GREAT news by comparison - a count of a whopping 0.25 million, or 1.25% percent of the 20 million LOW end. About 0.17% of the 150 million HIGH end. They found a whopping ONE living sperm on the slide for the second analysis. "Firing blanks"? Yeah... apparently I am. I would have expected the second analysis to have been better than the first, actually, given than I gave that sample on five days' abstinence, versus three days for the first. But apparently that expectation was very, VERY wrong. I did read somewhere that a semen analysis should never be done on MORE than five days' abstinence or else, oddly, the semen parameters start dropping again. So maybe five days is just too long for my body... that's the only difference I can figure that would have made the results so dramatically lower. The doc's parting words for me this morning were, "Keep moving them through regularly. Whatever that means," with a smile. I'm going to take that as being on doctor's orders to never wait more than three days between release now, however that needs to happen.
But that made me even more worried about the latest semen analysis results - because I did that one on five days' abstinence, too. The doc said they would call me with the results whenever they got them, and about 90 minutes after I got to work, his nurse did. And... therein lies the "mixed victory" of the title. Count is still down from the first analysis - 1 million versus 4.25 million before. And motility is down - 44% (50% is normal), versus 60-something% the first time. But morphology is now a 1, versus 0 before. 8 is considered normal for morphology, so going from 0 to 1 is a bigger step than it sounds, and it means that at least I have SOME normally-shaped sperm now. The motility drop is disappointing, but she did say that the large majority of that 44% were in the highest category for motility, meaning they were exceptionally strong swimmers. And the 1 million is DEFINITELY disappointing - that makes the original 4.25 million seem like an unattainable goal - but at least it's four times better than the second analysis taken before the surgery. Comparing to the second analysis may be the more accurate comparison, given that they were both taken on the same five days' rest. It's also important to remember, to me, that this was an analysis of the sperm that I produced back in December, when I was still fresh off the surgery, VERY swollen and VERY sore. Hardly under ideal circumstances. So, all things considered... I'll consider this the modest win that we were hoping for. Thankful for that.
But how am I feeling? Well... pretty much how I felt after our October appointment with the OB/GYN. When he told us that the situation was not nearly as bleak as we feared after first receiving the "infertility" label. But when we also found out the exact numbers on that first sperm count, and I found out that I'm even more screwed up than I thought. Today I just found out that I'm even more screwed up than THAT, so while I'm grateful that things seem to be on the right track (albeit slowly), it's hard for me to be cheerful and upbeat. I'm angry and frustrated, honestly, that I'm still dealing with pain keeping me from living in my body as I got used to for the first 31.9 years of my life. Angry that I've gone through all of this pain and worry and stress, and that I don't have more to show for it yet. Still upset and kicking myself over all of the pain and worry and stress this has put my wife through. Back again to all of the self-loathing, self-blaming, "how screwed up am I?" thoughts. The nurse sounded like she was trying so hard to put a positive spin on the results when she called me this morning, but the fact that she was obviously trying so hard belies the fact that she knew this was not good news that any guy wants to hear, which doesn't make me feel any better either. I realize, rationally, that this is going back to the "too much, too soon" expectation following the surgery, and I need to continue to be patient. Things ARE improving. It's just that emotions are not rational, and dealing with all of this leaves me emotionally drained, which tends to tear down the rational filter and leave the raw emotions exposed on the surface.
I AM grateful for the good news that we received today. But I need to vent, and need time again to work through the emotions and thoughts stirred up again today after three months reprieve. Looks like we'll do it again in three months, and I'll do everything I can between now and then to make sure it will be a better result next time.
Of course the Fertility Clinic wouldn't actually have the results READY for us this morning, after assuring me last week that they would, so we went through the entire appointment with the urologist without having any results to talk about that were supposed to be the whole point of the appointment to begin with. That was frustrating. The doc was friendlier today than any previous time I'd seen him, but he was visibly disappointed when I gave him the news that I'm still more painful now than before the surgery. Then of course I had to drop my pants for him again, and the exam this time was actually more painful than it was in December (because he wasn't very gentle at all this time), but at least it didn't uncover any new complications. He did observe that I've still got swelling, which explains my continued pain. He mentioned that if the pain does not improve any further, we may be looking at another procedure to deaden the nerves. But then, lacking any new numbers to discuss, we did what we could to talk about immediate next steps.
The nurse said that if my count had not improved since the surgery, he'd want to talk to us about HCG hormone treatments, since my testosterone is low and you can't treat "low T" for infertility with testosterone directly, or else you'll actually make the semen parameters WORSE. So the doc did indeed bring this up, but he admitted up front that it's expensive and not covered by insurance - $500-$600 a month. There's no way we can afford that on my current salary; there's not nearly enough budget left to squeeze. Fortunately that was not his recommendation yet, though, and he actually suggested that I try taking a specialized "Infertility for Men" vitamin/dietary supplement. This still isn't cheap - $180 for a three-month supply - but $60/month versus $600/month is WAY more palatable, and more feasible. He did say that the vitamins actually work, too. So, as much as I might like to have the "low T" addressed, it looks like that's not gonna happen. But at least I won't be screwed up with weird side effects from hormone treatments (yet), so I suppose that's good.
So we left the doctor's office this morning with the directive to start the vitamin treatments, then do another semen analysis three months after whenever I start that, then come back to the urologist two weeks after that analysis. Okay, fine. I f*cking HATE semen analyses by now, but at least it doesn't mean more high-dollar medical bills right away, and at least it doesn't hurt (like surgery or this morning's exam). At least it's another 3-4 months out. But we still didn't have the results of the analysis I did last week.
The nurse tried to get the results while we were there, and the Fertility Clinic did send over a set of results we hadn't heard yet - but what they sent was the results of the second semen analysis we did back in November, before my surgery. That... hurt more than the physical exam did today. I thought I was screwed up before - the first analysis had a count of 4.25 million (only 21.25% of the 20 million LOW end of normal), and 0 morphology (meaning ALL of my sperm were misshapen), but at least the motility was normal/good. The second analysis made the first sound like GREAT news by comparison - a count of a whopping 0.25 million, or 1.25% percent of the 20 million LOW end. About 0.17% of the 150 million HIGH end. They found a whopping ONE living sperm on the slide for the second analysis. "Firing blanks"? Yeah... apparently I am. I would have expected the second analysis to have been better than the first, actually, given than I gave that sample on five days' abstinence, versus three days for the first. But apparently that expectation was very, VERY wrong. I did read somewhere that a semen analysis should never be done on MORE than five days' abstinence or else, oddly, the semen parameters start dropping again. So maybe five days is just too long for my body... that's the only difference I can figure that would have made the results so dramatically lower. The doc's parting words for me this morning were, "Keep moving them through regularly. Whatever that means," with a smile. I'm going to take that as being on doctor's orders to never wait more than three days between release now, however that needs to happen.
But that made me even more worried about the latest semen analysis results - because I did that one on five days' abstinence, too. The doc said they would call me with the results whenever they got them, and about 90 minutes after I got to work, his nurse did. And... therein lies the "mixed victory" of the title. Count is still down from the first analysis - 1 million versus 4.25 million before. And motility is down - 44% (50% is normal), versus 60-something% the first time. But morphology is now a 1, versus 0 before. 8 is considered normal for morphology, so going from 0 to 1 is a bigger step than it sounds, and it means that at least I have SOME normally-shaped sperm now. The motility drop is disappointing, but she did say that the large majority of that 44% were in the highest category for motility, meaning they were exceptionally strong swimmers. And the 1 million is DEFINITELY disappointing - that makes the original 4.25 million seem like an unattainable goal - but at least it's four times better than the second analysis taken before the surgery. Comparing to the second analysis may be the more accurate comparison, given that they were both taken on the same five days' rest. It's also important to remember, to me, that this was an analysis of the sperm that I produced back in December, when I was still fresh off the surgery, VERY swollen and VERY sore. Hardly under ideal circumstances. So, all things considered... I'll consider this the modest win that we were hoping for. Thankful for that.
But how am I feeling? Well... pretty much how I felt after our October appointment with the OB/GYN. When he told us that the situation was not nearly as bleak as we feared after first receiving the "infertility" label. But when we also found out the exact numbers on that first sperm count, and I found out that I'm even more screwed up than I thought. Today I just found out that I'm even more screwed up than THAT, so while I'm grateful that things seem to be on the right track (albeit slowly), it's hard for me to be cheerful and upbeat. I'm angry and frustrated, honestly, that I'm still dealing with pain keeping me from living in my body as I got used to for the first 31.9 years of my life. Angry that I've gone through all of this pain and worry and stress, and that I don't have more to show for it yet. Still upset and kicking myself over all of the pain and worry and stress this has put my wife through. Back again to all of the self-loathing, self-blaming, "how screwed up am I?" thoughts. The nurse sounded like she was trying so hard to put a positive spin on the results when she called me this morning, but the fact that she was obviously trying so hard belies the fact that she knew this was not good news that any guy wants to hear, which doesn't make me feel any better either. I realize, rationally, that this is going back to the "too much, too soon" expectation following the surgery, and I need to continue to be patient. Things ARE improving. It's just that emotions are not rational, and dealing with all of this leaves me emotionally drained, which tends to tear down the rational filter and leave the raw emotions exposed on the surface.
I AM grateful for the good news that we received today. But I need to vent, and need time again to work through the emotions and thoughts stirred up again today after three months reprieve. Looks like we'll do it again in three months, and I'll do everything I can between now and then to make sure it will be a better result next time.
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