And most likely a useless visit. As a child, I had a cryptorchidism on the right side. After an orchipexy at age 12, over the years it's atrophied and moved back up so in the inguinal canal so I'm unable to check it. Of course it's a higher risk for cancer but he doesn't want to remove it because of my weight. His answer was there are XX million people in this city so that means your risk is 1 in X thousands. Of course he's not the one with the cancer risk! Along with that I'm having orchalgia on the left side. A constant nagging pain with frequent occasions of much more severe pain. I'll see what he says this time and if he blows it off again, I'm looking for another urologist. Last time he was concerned about prostate enlargement, a PSA test and blood test looking for markers. The things he said had me REAL concerned so I kept waiting on them to call me my test results. After three weeks, I ended up calling them and basically begging for my results. As unhappy as I am with them, I'm probably going to look for another urologist anyway.

H1

Actually he took me a lot more serious this time. He has me scheduled for an abdominal and pelvic CAT scan Friday to insure nothing abdominal is causing the problems and to get a good look at the reascended testicle.

Plus he has me scheduled for a cord block (nerve block?) in three weeks. OK somebody tell me about the nerve block.

H1

Hopeful1 (imported) wrote: Thu Nov 12, 2015 1:16 pm Actually he took me a lot more serious this time. He has me scheduled for an abdominal and pelvic CAT scan Friday to insure nothing abdominal is causing the problems and to get a good look at the reascended testicle.

Plus he has me scheduled for a cord block (nerve block?) in three weeks. OK somebody tell me about the nerve block.

H1

I had one a week ago. The protocol is a combination of a powerful, long acting steroid, and a caine-family anesthetic in a 1-to-9 ratio. It stings like the dickens for the 30 to 60 seconds it takes to inject … I counted a dozen painful incidents as he hit different spots in the sperm cord, though the needle only went in in two places. The novocaine kicks in quickly, though, and each one of these spots stops hurting in under a second. The novocaine is there to mask the discomfort of the injection and the steroid, which can burn for a while after it's injected; the steroid will reduce pain and inflammation for a period ranging from hours to weeks. In similar procedures done for spinal arthritis, three injections at one-month intervals can give a year of relief; my GP and urologist have adapted this protocol for chronic orchialgia and we're halfway through the protocol, so I won't know the results for a long time yet. In the short term, it seems that it's reduced the severity of the low-level background pain, and reduced the frequency of moderate-intensity flare-ups. I can still count the most severe ones on one hand, so there's no pattern there. In the really short term, once the pain of the injection is done, which happens with startling speed, you'll have at least a few rock-solid pain-free hours if he hit the vicinity of where it hurts until the lidocaine wears off. I actually switched to marcaine with my latest injection, and it covers up the evening where other caines would wear off and leave me badly aching. Ask if he has a long-acting local anesthetic, because it's absolutely worth it (and there's no price difference, in my experience).

After the first report, I would have said "Find a new urologist." Some suck - my old one just offered opiates, and I'd rather not end up a heroin addict. Some are amazing, like my current one, who was part of devising a completely novel treatment plan specific to my unique needs. However, his response during your second visit seems to be redeeming him, so … good luck? Seriously, though, it seems like he's on the ball as of now. The CT is necessary to look for spinal nerve entrapment - pinch a nerve, and you'll experience phantom pain where the nerve ends, not where the pinch is. Odds are he'll probably give you broad spectrum antibiotics at some point to rule out infection, too. The prostate test is important, since that can cause radiated pain. I presume that went well, since he's still looking for a cause, and not ordering prostate removal, and I'm happy to hear that (at least by implication).

Good luck, remember you can get through this, and I wish you a speedy diagnosis and an effective treatment.

Thank you, that helps a lot. He did use the words long acting anesthetic. He didn't check the prostate this time and my PSA last time was like 1.3 or something close. I would assume (yeah I know ass/u/me) the CAT scan will also look at the prostate since pelvic is included and it's without then with contrast. Even though my GP put me on Cipro, he did say something about another antibiotic but they didn't call it in to my pharmacy today. May need to call them back in the morning. Oh yeah, some other good news. Microscopic hematuria or a microscopic amount of blood in my urine.

As I told someone by PM earlier, I started to tell him, "Hell doc, cut them off. I'm transgender. If I wasn't such a coward and could have afforded it, they would have been gone 40 years ago." But I didn't.

Hopeful1 (imported) wrote: Thu Nov 12, 2015 9:21 pm Thank you, that helps a lot. He did use the words long acting anesthetic. He didn't check the prostate this time and my PSA last time was like 1.3 or something close. I would assume (yeah I know ass/u/me) the CAT scan will also look at the prostate since pelvic is included and it's without then with contrast. Even though my GP put me on Cipro, he did say something about another antibiotic but they didn't call it in to my pharmacy today. May need to call them back in the morning.

Contrast? Better than they did for me. Still, they went from knees to belly button, and it got all the interesting features they needed to check. The only thing I regret is not having a nose-to-toes scan for - at least - a medical baseline. Standards posted by the Yahoo orchialgia group suggest "empirical antibiotics" to rule out syphylis, chlamidia, and anything else known to infect those regions, even opportunistic pathogens like E.coli.

Hopeful1 (imported) wrote: Thu Nov 12, 2015 9:21 pm Oh yeah, some other good news. Microscopic hematuria or a microscopic amount of blood in my urine.

Interesting, worrying, I don't know - it's hard to say, but it does suggest UTI. I'm a scientist, not a doctor, so take that with a grain ±5% of salt. It could be epididymitis or orchitis, but - like I said - not a doctor. This isn't medical advice.

Hopeful1 (imported) wrote: Thu Nov 12, 2015 9:21 pm As I told someone by PM earlier, I started to tell him, "Hell doc, cut them off. I'm transgender. If I wasn't such a coward and could have afforded it, they would have been gone 40 years ago." But I didn't.

Write a letter, if you must. It's what I did to screw up the confidence to get the nerve blocks. You don't have to hand it to them, but knowing that you can if you can't bring yourself to say it helps the courage, and the desire to walk things back slightly helps motivate you to have the conversation you want to have. Or give me the doctor's phone number and time, and I'll call him to discuss it for you, so chickening out isn't a viable approach.