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My sister wrote an article about diagnosing autism. I would recommend the read. It’s great, and maybe important.
2 votes 
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Autism Diagnosis
February 1st, 2010 2 votes Loading ...Vasectomy
November 13th, 2009I have been asked to share my perspective on vasectomies, and not simply because I have had two of them. I also got an infection following the second one, which made for a funny story, but I narrowly averted loosing one of my testicles. Then my wife and I changed our minds, and decided to have kids, so to secure my sperm a doctor extracted it with a needle. I have lengthy and unique experience in the area, is my point.
My road to a vasectomy started just like everyone else’s, with sex. “The Pill” reduced my wife’s libido to a point where birth control became superfluous, so we eliminated those, and our haphazard use of condoms felt like gambling. The list of solutions to avoid pregnancy is not long. Abstinence is not on our list, and the rhythm method works really well as long as you are comfortable having up to eight children. That left surgical options, and quite simply, those are less complicated for men, with fewer risks. So, I decided to get a vasectomy.
It’s a simple procedure. I don’t want to be flippant about this, but if you are able to be clinical, there’s not much to it. A local anesthetic and about twenty minutes in a doctor’s office. It takes longer to change the oil in my car.
Here’s the rub; low risk, is not no risk. In a minority of cases problems develop. Infection, inflammation, and chronic pain are all potential consequences. Not to mention that men with vasectomies have been known to father unexpected babies. However, in the majority of the cases, once you’ve calmed down from having someone cut open your scrotum, the only result is tenderness for a few days, and of course, sterility.
It seemed to work just like that for me, at first. More than a year after the operation I developed a complication. I’ll avoid medical terminology, what am I a doctor? The only detail that is relevant to my story is that sex became uncomfortable, or rather, I was unable to perform my “big finish” without some accompanying pain. Unless you are into some pretty specific fetishes, testicular pain during ejaculation is not desirable, so I was intent on getting that fixed.
The remedy was to cut out the old vasectomy and do another one. This was a more involved operation requiring general anesthetic, still low risk, but once again I won the “kicked in the nuts” lottery. I developed a serious infection following the surgery that put me in the hospital with a fever and very specific swelling. I made it to the other side of that sterile, without pain, and thankfully, with everything still in place.
Then I decided I wanted to have children. Which I can’t adequately account for, but that’s what happened. A friend recently asked me about my inexplicable change of heart. “Well,” I said, “no one has ever accused me of being indecisive.” In whichever direction I’m going, I’m running, like Forrest Gump.
My road to sterility was definitely more harrowing than most, but I’m not unique in wanting to change paths. Vasectomies are reversible, with a good success rate, but it is not something I looked into. As you might imagine my internal debate about further surgery anywhere near my entertainment equipment went something like this, “Not a fucking chance.”
Instead, I elected to have a needle inserted into my scrotum to extract sperm from the source, which I know doesn’t sound any better. My wife and I agreed to try In Vitro Fertilization (IVF), for which the doctors need sperm, and more than a plastic cup and happy thoughts were required for me to participate. I’ve written about this elsewhere, I almost passed out, but other than that, it went fine.
To the poor guys who have been cringing since paragraph one; I’m done talking about terrible things that can happen to your balls. I have a bunch of sperm frozen, awaiting the chance to unleash my progeny on the world, and my reproductive equipment can go back to being entirely recreational, which was the point when I started this whole debacle. All’s well that ends well.
Would I have the vasectomy again? Probably. It was the right decision at the time. If I had all the above information in advance, or had an inkling I was going to change my mind, clearly I would have made better decisions, but you can say that about anything.
Bad luck magnified an error in judgement, twice, but hell, it’s a risk every time you get out of bed, and sometimes you get the short straw. Thankfully, I’m not a typical example. My only advise is to consider your options, perhaps more carefully than I, then pick a direction, and start running.
This article was written after prodding by Angie, one of the ladies at ivfdiaries.com, who asked me to write about my experiences, and opinion, on vasectomies.
4 votes Loading ...Universal Health Care
September 14th, 2009People come here from the U.S. to our fertility clinic. The clinic and the staff are excellent, but primarily it is the cost that brings people here. In many cases it is cheaper for couples to spend money on meals, hotels, and travel to come to Victoria for IVF treatments than it is to pay for it in the United States. That is unfortunate.
Dear neighbours1 to the South:
Universal Health Care is an idea that most developed nations have adopted, and we love it, honestly. It’s not perfect, but if you get sick here, you will be taken care of, which we consider our collective right. You may come to see it that way too.
Don’t let insurance lobbyist scare you by shouting “Socialism.” Your government gave billions to bail out auto companies. It is too late to label government involvement in the economy as evil. That ship sailed a long time ago. You should at least get something for your money.
Most of you want to see changes in your health care. It seems like you have a big battle ahead of you. I hope you win. You deserve it. Until then, come up to visit Canada for your fertility treatments. We’d love to have you.
Good Luck,
Dirk
P.S.
I almost hate to mention it, but the Metric system, seriously, it’s here to stay. Every nation except Burma, Liberia, and the United States use it. That’s embarrassing.
In summary, Universal Health Care, it’s a good thing, and the Metric System, not a passing fad.
Resources
- A cartoon argument for Universal Health Care
- CBS Poll & Angus Reid Poll – most Americans favor Universal Health Care
Footnotes
- Yes, that’s how we spell it. We like to throw useless u’s into the middle or words. I don’t get it either. [↩]
No Votes Yet Loading ...Gynecology
August 10th, 2009
There is more to your reproductive system than your vagina. That is the title of a chapter in a fertility book I flipped through today at the clinic. Turns out, it’s true.
On ancient maps, mariners would mark uncharted areas of the sea with pictures of serpents, mythological creatures, and the warning, “Here be dragons”. It’s much the same way that I view the female reproductive system. I mapped out my favorite vacation spots, and everything else is veiled in mist.
We have spent hours reading information and speaking with professionals at the clinic about the entire process we are undergoing. I have been present for dozens of ultrasounds to view the state Michelle’s ovaries. Despite all of that, this morning I asked her how her uteruses were feeling. We will have a kid in college before she lets me forget that.
4 votes Loading ...OHSS
August 7th, 2009
Doctors have installed gauges and levers into Michelle. She is currently an egg factory, and factories have schedules. My calendar has dates labeled, “Extraction”, “Fertilization”, “Transfer”, and “Pregnancy Test!” We know the precise moment that things are happening, which may reduce the romance, but it certainly adds to the drama and anticipation.
The doctor routinely performs an ultrasound of Michelle’s ovaries. The objective is to count the number of follicles developing and measure their size. Once the follicles reach a target size they can be triggered to mature the eggs. Last visit they counted eight per side, but the number jumped dramatically to 12 and 10, and once again, Michelle is an overachiever.
One of the risks of inducing ovulation with drugs is Ovarian Hyper Stimulation Syndrome (OHSS). Michelle’s estrogen is high, which contributes to the large number of follicles that are developing, but it also puts her at risk. There are serious potential consequences of the condition, but it usually corrects itself. Onset is characterized by a build up of fluid, which the doctor combats by restricting Michelle to one can of V8 and a Gatorade a day. She’s the first patient that has ever told him that she likes V8.
1 votes Loading ...Cooties
June 3rd, 2009
Chicken Pox never goes away, it lays dormant in your spine. It can reactivate and travel from its hideout along a nerve until it gets to the skin and makes you itchy and miserable, just like it did when you were a kid. This fascinating information I learned after the doctor informed me that I have a case of Shingles.
“Don’t put cream on it,” he said, which is a small victory because I had refused Michelle’s tube of put-this-on-anything cream. There is no question I lost the war though. If I had listened to her, and seen the doctor a few day earlier, I could have received the treatment that is effective within the first 72 hours.
This disease of the young and the old hitting me at my apparent prime of life is tough on the ego, but most painful is that I must admit that all those little girls of my youth were right, “Dirk has cooties!”
1 votes Loading ...Do Not Resuscitate
May 19th, 2009“Oh, not too good man. They can’t treat him with chemo and they think radiation will kill him.” This is how the conversation begins.
I am sitting by myself on a patio enjoying a beer in the sunshine. The speaker is also alone having lunch when he receives a call. His side of the conversation provides a sad glimpse into his life as he relates the condition of a loved one to the caller.
I never learn who he is speaking about, but believe it is someone from his immediate family, because his mom “is not as upset as he thought she would be.” Perhaps his mom has reached the same stage he has. He relates the latest information like someone who has come to accept a situation to grim to contemplate.
His loved one is dying and there is little hope. Cancer has ravaged his lungs. He is on a breathing tube. The disease is spreading rapidly. “The doctors are not too confident” about his treatment. This morning the dying man asked to have an order signed that prevents any extraordinary measures to continue his life. Hospital lingo for this is DNR, do not resuscitate.
My own battles are trivial in comparison. It is a powerful antidote for feeling sorry for yourself. Many have said it more eloquently than this, but if you have a full belly, a roof, and your health, then you have everything. Take a deep breath and enjoy the sun while it shines.
Be kind, for everyone you meet is fighting a hard battle. – Plato
4 votes Loading ...Eight Glasses A Day
April 7th, 2008When the twenty year old swimsuit model is asked to pass on beauty tips you are likely to hear the benefits of drinking lots of water to keep you skin looking great. Or some other bullshit. What is she going to say to the interviewer from Teen Beat magazine? I started with the freakish genetics of an Amazonian Princess, plus I smoke a lot of cigarettes and do a lot of blow, which really keeps my appetite in check.
That so many calls for consuming water as a catch all health tip come from sources like the one above, or in women’s magazines in connection with advise on how to look younger, or prettier, or lose five pounds, is probably one of the reasons women seem more likely to be toting around water bottles everywhere they go.
The benefits of drinking, when your body gives no indication of being thirsty, are questionable. “Drink water”, is not health news, it is advise easily proscribed by any fool, and it usually is.
Five Myths About Drinking Water – NPR
Evidence wishy-washy for health benefits of water – Reuters
No Votes Yet Loading ...Shooting And Stabbing
January 23rd, 2008What is the difference between shooting pain and stabbing pain? I am reasonably intelligent and have a passable command of the English language but I have no idea what the answer to that question is.
I have a history of being annoyed with the medical profession (see here and here for examples why), but am I alone in lacking adjectives to describe my pain. When asked I struggle to answer if my pain is radiating, tingling, aching, sharp, burning, stinging, twinging, or throbbing. I filled out one of those forms you do on a first visit today and it asked me to circle where I hurt and check off the boxes that described my pain. Stabbing and shooting were separate boxes. When you keep poking that spot it makes me want to punch you right in your stupid face. So not shooting or stabbing. I would describe my pain as punching. What does it say about that in your desk reference?
No Votes Yet Loading ...Brain Injury
November 15th, 2007I opened up the mail today to find a letter from the hospital I was at on halloween night. The opening sentence of the letter stated: “You were recently treated for your injury in which you sustained a concussion.“. The letter went on to offer assistance in my recovery and the envelope included a pamphlet entitled Facts about concussion and brain injury. The letter was an interesting surprise, mostly because I had no idea I had sustained a concussion.
Write stuff down for people with brain injuries. That should be the title of a class in med school don’t you think. They could have a discussion about how communicating verbally with the guy that has two eyes swollen shut and blood coming out of his ear is not recommended. I might make the mistake of presuming that general medical knowledge would allow you to suss out that fact, but I could be forgiven my error in judgment I suppose because, as it turns out, I have a brain injury. The letter in the mail notifying me of potentially serious danger signs to watch out for fifteen days after my hospital visit is a nice touch though. Had I suffered a stroke brought on by a blood clot it probably would have been a real comfort to know someone cared. It’s sweet really.
No Votes Yet Loading ...The Worm Turns
August 30th, 2007Bilateral. That means two sides. It is the term that was added to my consent form prior to my surgery. I was initially scheduled to get one side done, but there were minor concerns with the other. “Might as well get both while we are at it and you are under anesthesia” says my surgeon. “Yep, might as well I guess”, says I. It was that easy. Fucker up-sold me like I had just bought a big TV and he was throwing in some extra cables.
A three-year-old little boy was examining his testicles while taking a bath.
“Mum,” he asked, “are these my brains?”
“Not yet,” replied his mother
When you are talking to a doctor they tell you a lot of stuff, but never quite enough to reassure you completely. I can attest that you develop very selective hearing during these conversations. In discussion with my surgeon and his resident we went over a lot of information about my condition and treatment. Out of all of that only a few things really dug into my sub-conscience and stayed with me: “chronic pain”, “atrophy”, and “removal of the testicle”. There were a bunch of words that surrounded those phrases, and really, those other words were key in maintaining the context of the phrases, and had I kept them in mind may have provided some reassurance. Laying in bed at night I have to tell you that it was those few nuggets that really stuck out though.
I am happy and relieved to relate that I am no longer quietly freaking out. I now have no part of my anatomy that resembles a purple Nerf ball trying to eat a hot dog, so things are definitely on the up-swing.
No Votes Yet Loading ...Medical Advise
August 25th, 2007I have no medical training. I am just a laymen patient like the rest of you. Regardless, I have some advise to dispense that is the culmination of a few minor run ins with medical problems: Man That Guys Got Balls, Brain Injury
Ask to see a specialist
A General Practitioner (GP) knows a little bit about a lot of stuff, but for anything even mildly serious you want someone that knows a lot about your specific problem. If you have a snotty noes or hypochondria see a GP, for all else see a specialist. I have experienced radically different advise between the GP and the specialist I have eventually seen on a number of occasions.
It will depend a little on how often you see a doctor. Personally, I hate waiting rooms, so if I see a doctor its because I am pretty sure I have a problem and it does not seem to be fixing itself. Under those conditions I would estimate I ask for a referral to a specialist at least 50% of the time. Even if you are not too sure that your problem is serious enough, ask for a referral. Unless you are bleeding from the ears it is going to take some time to get into see a specialist, sometimes months. By asking for a referral and setting up an appointment at the first sign of trouble you are at least starting that lengthy process. If things get worse you will be happy you are in the queue. If you get better it is really easy to cancel the appointment.
If your doctor gives you any resistance push back or get a new doctor. Their role is not to play gatekeeper between you and other advise. You know your body and you should decide when you want to speak to someone about it.
Never trust your doctor
What do you call the guy that graduated from the bottom of his class at med school?
Doctor.
This is true of any profession. There are good ones and bad ones. The difference is that if your tax accountant gives you bad advise it is not likely to kill you.
It is astounding but true that most people are happy with their doctor, accountant, and dentist. This is because laymen are not really qualified to judge an expert in any field. I do not know a thing about medicine, accounting or dentistry, so anyone with a first year education in any of those subjects can impress me. By the time there is a problem it is too late.
Most people would say they have a “good” doctor, but that judgment should not have much weight. Never trust your doctor whether it is your regular doctor or some specialist. A healthy dose of skepticism is important when it comes to your health. I have had personal experience with a specialist that made a diagnosis that did not really make sense to me. A little research on my part and some prodding questions influenced him to change his diagnosis. Doctors have opinions but there are often multiple solutions to these problems. Understand your options, and if you are at all unsure, get another opinion and do research of your own.
Take Notes
If you have followed any of the advise above this next point becomes crucial and it is a valuable tip. Take a piece of paper and a pen with you to your doctors visits. Take notes.
This becomes particularly important if you go to see specialist. You will wait a long time for an appointment and then you will receive a bunch of information in five minutes. The doctor will ask if you have questions, and you won’t be able to think of a single one, but as soon as you are out of the office you will think of dozens, but now it is too late.
A friend of mine had an experience with an orthopedic surgeon that helps emphasize this point. He described finally getting into see this guy and during the appointment the doctor talked a lot about the procedure and ligaments and recovery and threw out a lot of terms, answered my friends couple of questions and the next thing he knew he is on his way home. As I said he eventually had a bunch of questions and concerns but the next time he was scheduled to see the guy was five minutes before he was going to cut into his knee.
I have found it very helpful to be able to type a procedure, a condition, or a drug name into google and get answers to my questions. The internet makes it so easy for you to informed about what is going on with your body, but if you do not write down the basics in the office you are going to have trouble remembering it all by the time you get home.
Take responsibility for your own health
Given my own experiences I think the above three points are very helpful. Now you just have to be aggressive. Taking a passive role in your treatment can come back to bite you in the ass. Be skeptical, do research, be informed, and do not be afraid to speak up if you do not like how things are going. Almost without exception medical professionals are genuinely interested in your well being, but in the end no one is more concerned about your health than you are. If you end up with a bum shoulder that always gives you trouble your doctor is unlikely to lose much sleep over it.
2 votes Loading ...