Why wait? To scan for kidney stones. Result? I'll know in about a week, but to my amateur eye, there was no mineralization in the obvious spots, and no calcifications in the testicles, either. The last bit's consistent with the ultrasound, at least.

kristoff wrote: Wed Feb 25, 2015 8:21 pm Doing injections and trying to maintain a fairly steady level without peaking and dropping, you'll want to do injections weekly. For the period I was injecting a few years ago when I temporarily lost my insurance, I would do 1cc a week. A vial was good for 10cc and cost 75$ plus supplies. Sometimes nursey roomy would shoot me up, other times I would put it in my leg. Fortunately, insurance resumed and I am on daily Androgel. Works well for me.

Most of the folks I have talked with over the years who have dealt with testicular pain have done it for several years. Progress was usually only made when doctors were fired, replacements found, sometimes a few times, and folks became very direct, assertive, and at times insistent. Be well informed and logically lay the situation out for them step by step and bring them to your conclusion.

Good advise--I hope. It makes the most sense to me. That's how I intend to make my case to my urologist. Strictly on a rational, unemotional medical need basis. I will refuse any treatments or band aid surgeries that only put off the inevitable. The only thing I plan on consenting to is castration, and not just one but both of them.

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nvrgag44 (imported) wrote: Wed Mar 18, 2015 9:03 am Good advise--I hope. It makes the most sense to me. That's how I intend to make my case to my urologist. Strictly on a rational, unemotional medical need basis. I will refuse any treatments or band aid surgeries that only put off the inevitable. The only thing I plan on consenting to is castration, and not just one but both of them.

I wish you luck with your urologist, who is inevitably going to need some convincing.

Dr. Arnkoff, meanwhile, was booked well into the future, so I'm really not putting off the inevitable with a few cheap and noninvasive tests at this point.

ZeuterMe (imported) wrote: Thu Mar 19, 2015 12:09 am I wish you luck with your urologist, who is inevitably going to need some convincing.

Dr. Arnkoff, meanwhile, was booked well into the future, so I'm really not putting off the inevitable with a few cheap and noninvasive tests at this point.

I hope I don't have to travel to Detroit. There has to be a skilled willing surgeon somewhere in the Chicago-Milwaukee area. I'm going to tell my urologist that, "I want them gone, period. You're young, smart & a skilled surgeon. I'd like you to do the surgery but I will find will find 'someone' to do it." I'd never go to a cutter but I won't tell him that.

Oh dear GOD! What's wrong with you wannabes? Detroit isn't that far from Chicago and I drove only 30 miles less to get my castration done when I did it.

This insisting your help be immediately local is crazy. If you truly want it, you'll go to Detroit. Sheesh!

And who do I go to if there's post-op complications? Drive back to Detroit to the guy who has already pocketed my $$$$$$? Or walk in to the local ER and explain I had my nuts cut out by someone in another state who, by the way, is the only doctor I've ever seen get below average ratings in every rating category.

TL;DR: Money or opsec.

I presume the local requirement has something to do with operational security, and keeping knowledge of the surgery on a need-to-know basis.

Failing that, going out of town means getting a hotel for the follow-up, and we're already talking about three large for the surgery itself. A few nights of hotels and restaurant food, plus a hundred bucks of gas, plus the opportunity cost of missing a few days of work, will quickly drive the total cost up to something resembling a nice used car. Most Americans can't buy a nice used car with petty cash. Actually, most Americans would have to fly, probably one-way, since they can't be quite sure when they'll be fit to fly home. Privacy is a problem, (http://arstechnica.com/tech-policy/2015 ... rvey-says/) and lots of people are probably pretty sure that an elective castration showing up on a background check might make you unemployable (whether or not it's true).

There's also the family support network to be considered, as well as the opposite - some members may have family responsibilities they can't shirk on until their kids go away to college. And if you thought the thousands of dollars we were already talking about was bad, a week's worth of babysitter bills may just double that.

Me, for example - I'm glad I got a price quote from Dr. A, because he told me that he was confident that his surgical approach would help my pain. Sure, it's not signed and notarized, but it's a second opinion that may be useful in discussion with someone who my insurance will cover. My hope is it'll get them to test promptly, fail quickly (if in fact they are going to fail), and move on to a surgical solution and skip the part where they offer me long-term opiate prescriptions.

ZeuterMe makes all good points. In addition to what I said in #16 I have family to consider. I enjoy the luxury of a loving family with grandchildren that think the sun rises and sets on their grandfather. I would never do anything to burst that bubble. It's also a major reason why I keep my sexual preferences in the closet. As Zeuter also points out there are the myriad travel expenses and time away to consider. Medicare and my supplemental policy will never cover Dr. A and elective surgery. But they will cover just about everything if my urologist says it's a medical necessity.

nvrgag44 (imported) wrote: Fri Mar 20, 2015 6:12 pm Medicare and my supplemental policy will never cover Dr. A and elective surgery. But they will cover just about everything if my urologist says it's a medical necessity.

I shudder to think of the actual sticker price of all the diagnostics, failed treatments, drugs, scans, &c. of all the attempts to treat my chronic pain. Fortunately, insurance means I don't have to think about any of that. Assuming I didn't have to pay for gas or hotels, the surgery itself would be the least expensive portion of this whole escapade - there's a vet next door to my urologist who has a sign suggesting that they'd do it for $50, but the urologist wants $3000 - which I totally can't afford unless the insurance is going to knock it down to a $200 co-pay. (The way Dr. Arnkoff prices, I think I'd just have the co-pay to cover!)

To answer my own question: Why wait? To build a stronger case for my insurance company, and to make sure that those damned testicles are actually the source of my pain, and I'm not blaming them for a totally unrelated health problem.

If it's not them that's the problem, I'll put off elective surgery until the technology has improved. Or, at least, until it's cheaper, or perhaps until this sort of technology is available to human patients. (http://thearabianmagazineonline.com/iss ... -structure)

If you go on vacation and have a heart attack, are you going to wander back to Chicago for treatment or are you going to seek help where you're at?

The point is this - It's 300 miles from Chicago to Detroit and for what you seek that distance is nothing. I do sense hesitancy. My point is Detroit isn't that far away, you're going to have to rest up after it's done regardless where it happens, likely nearby. Being so concerned you're going to have complications, and worrying about where you'll seek help if you have complications, etc. means that roadblocks are being placed to a successful outcome. Doctors when presented with a situation are going to treat that condition no matter how it happened. Complications could come up, you could also get hit by a bus walking across the street tomorrow. Watching someone profess this is something they want, have wanted for some time, and who has help that close to them, say that they will not seek it is quite confusing.

Frankly you're quite lucky. Most people do not have a licensed surgeon that close to where they live that is willing to provide this service.