Wednesday, July 12, 2017

PCL9: No Time for Excuses

Self-exams of Testicles Save Lives and Detect Testicular Cancer Early. Period. End of Story.

Do not pass Go; do not collect $200. (Although if you skip doing the exams, you’ll wish you had collected that $200. Cancer is crazy expensive.) I was told by my doctor many years ago to do them monthly, and luckily, I did them regularly and discovered the lump on Lefty.

Thanks to Fighting Cancer Takes Balls
for my new shirt!
Zig Ziglar once said, “Put all excuses aside and remember this: YOU are capable.” I’m assuming he forgot to fully articulate his thoughts, probably because he was doing a self-exam. What he meant to say was, “Put all of the following excuses aside and remember this: YOU are capable... of doing regular self-exams.”

Excuse #1: I didn't know I was supposed to do a self-exam.

Well, you clicked on this page, so now you do. Self-exams should be done monthly. If you haven’t been doing them regularly, start now. Pick a day of the month and stick with it. You have two testicles - maybe do a check on the second of each month (or remind the man in your life to do one). I guess that means I have to do it on the first now.

Excuse #2: I don't know how to do a testicular self-exam.

Ever checked a grape for anything wrong before eating it? If yes, you’re halfway there. If not, you should really slow down and look at your food before eating it.

Your scrotum is relaxed in the shower, and you’re hopefully already naked too, so that’s a good place to do a self-exam. The process is easy: just place your index and middle fingers under the testicle with your thumb on top. Firmly but gently (no need to squash the berries), roll the testicle between your fingers. Any weird lumps or bumps should be checked out by a doctor. If you’re doing it monthly (LIKE YOU SHOULD BE DOING), pay attention to any changes from month to month.

My lump was on my left testicle towards the bottom. It felt like a pea-sized pebble, and there was another mass that felt like a baby jellyfish was hugging my testicle. Trust me - it wasn’t that cute. When in doubt, schedule a doctor’s appointment.

Excuse #3: I don't have time.

Stop reading this post, and do one now. I promise I’ll wait.

Seriously, it takes about a minute. (Although it now takes me half the time.) Skip that last Tweet, don’t watch the full Netflix credits, or do one less swipe on Tinder. You need to make the time. Taking care of your health is one of the most important things you can do.

Excuse #4: A self-exam is an uncomfortable way to examine my testicles.

You know what else is uncomfortable? Losing your hair, low white blood cell counts, constant nausea, and never-ending fatigue from chemo. In many cases, if you detect a lump early enough, removing the testicle is enough to treat it and you won’t need to endure chemotherapy. Yes, it might suck to lose a ball, but early detection is key. The earlier you catch a lump, the better your prognosis will be, which means you’re less likely to need intense treatment.

Furthermore, it’s your body. Not to be crude or vulgar here, but chances are you’ve gotten familiar with that area of your body a few times before. I can’t think of a better reason to touch yourself than for your health.

Excuse #5: I get checked once a year at the doctor.

There’s a couple points to be made here. First of all, do you really visit your doctor once a year? If you’re like me, my last regular physical was in 2014, although I’ve definitely made up for that with the nearly 100 doctor visits since November.

Here’s another scenario for you to consider. My annual check up was always scheduled in July, since that’s my birthday month. I discovered my lump in October. Had I waited the nine months until my next regularly scheduled appointment (which I probably would have skipped again), who knows how far my cancer would have spread? Paying attention to your testicles once a year just isn’t going to cut it.

Excuse #6: If I do have it, isn't it treatable?

While testicular cancer is among the most highly treatable cancers, I would still rather avoid chemotherapy and further treatment. Cancer of any kind has long-lasting physical and mental impacts and isn’t something I would recommend.

That’s also a weak excuse. It’s like saying, “Well I don’t need to wear a seatbelt because if I crash, I can have some surgeries and a long hospital stay and be fine eventually.” Guys, you’re not invincible.

There’s also a somber point to consider here. While testicular cancer is curable in over 90% of cases, that means it causes death in around 10% of men who develop it. Those aren’t odds you should be willing to bet on.

Excuse #7: If something's wrong with my testicles, I'll notice on my own.

Watermelons are slightly larger than the average testicle,
but work well for demonstrations
False. I had no other symptoms that pointed to a health issue, aside from feeling the lump, which I wouldn’t have caught without a self-check. While it’s true that some people who are diagnosed with testicular cancer have pain, physical swelling, or other signs of something being amiss below the belt, symptoms vary from person to person. Self-exams are the first and easiest line of defense to catch early developments.

Excuse #8: Cancer is for older people.

Also false. 50% of men diagnosed with testicular cancer are between the ages of 15-35. If you consider that old, you’re probably in my fourth grade class (in which case you probably shouldn’t be reading this page until you’re a few years older - but you should come back then!) Testicular cancer can hit anyone at any age, so don’t just chalk it up to something old people have. However, if you’re not vigilant with self-exams, you could look like an old person, walking with a cane and having your hair fall out. I have personal experience with both.

So there you have it.
Eight common excuses for why you might not do a testicular self-exam - and eight reasons why they’re excuses that you should stop making. If you can think of more, let me know in the comments and I’ll update the post. Be sure to go forth and discuss testicles on a regular basis; here are some helpful tips! Author's Note: Check out Ken Lane's #Takea2nd4theBoys campaign for a simple way to set automatic reminders. 

Deadpool supports testicular self-exams

If you’re still unclear about the importance of self-exams, maybe my friend Mr. Deadpool (who also had cancer but got some pretty sweet superpowers, which I regrettably have not gained… yet) can convince you. This is slightly vulgar, so consider yourself warned.

A self exam is how most cases of testicular cancer are detected early. Click the image for video directions or click here for a larger version

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Saturday, July 1, 2017

PCL8: Six Months Later

Six Months After Finishing Chemotherapy for Testicular Cancer, I Reflect on My Physical Healing and Mental Health

June 30th marked six months* since I finished chemo and rang the bell. In April, I wrote about my recovery two months post-chemo. Six months is another significant milestone, so I decided to write another update.

Physical differences as a cancer survivor

The bachelor party crew, pictured here in 
our natural savage state
In April, my nausea and fatigue were nearly all gone, but I still had some slight issues. Today, I am completely free of both symptoms. I have not felt nauseous for at least three months, and my energy level is way up. I’ve completed about six weeks of P90X, which is a more challenging strength-building regimen than I had done in the year or two prior to diagnosis. I have also been running more regularly, cutting over three minutes off of my mile time since April. I just returned from my bachelor party with my groomsmen, which involved three days of camping, hiking through a state park, exploring a Civil War battlefield, successfully completing an escape room, and playing paintball and dozens of rounds of Kan Jam. Am I exhausted? Yes - but I am glad I had the energy to do all of that.

Another big change from where I was in April was that I recently had my port removed, which is freeing. I constantly find myself touching the spot where it was to remind me that it’s really gone. The actual incision site is still covered with medical glue, but it appears that the scar is healing nicely. The scar on my hip from my orchiectomy (which was nine months ago) has faded into almost nothing.

Hair regrowth post-chemotherapy

Another physical difference is that my hair has completely regrown to its normal length. I even had to get a haircut recently since it was getting too long and ratty. While losing my hair helped me to realize that my outward appearance is not the only thing that makes up my identity, it definitely helps me feel more like myself when I’m able to spike it up again.

While the color and texture of my hair initially seemed to be completely different, it’s getting back to normal. Before chemo, I used to have one strand of hair in the back of my head that was frizzy and curly. No matter how many times I cut it, it always grew back that way. However, since chemo, that strand has not reappeared. Some people get chemo curls; I got chemo straightening.

Haircut selfies
Despite these positive changes, some latent negative side effects are still lingering. Water still tastes funny to me, but adding lemon helps tremendously. I’m not sleeping as well as I was before chemo, but I have also been going to bed later and later. I think I’m resisting going to bed early since I was basically forced into bed by 7:00 during chemo, and I want that time back. I have some minor memory issues and am still going strong with Google Keep to-do lists and random stickies to help me keep track of what I need to get done.

Mental health after facing cancer

However, the latter two effects may not be due to chemo at all - they may be related to my ongoing struggle with emotional healing. As I outwardly regained my sense of self after chemo, I found that the internal battle to heal continued to rage on.

I’m not the person I was before chemo. I’m not the person I was during chemo. I’m not even the person I was directly after chemo. I am a changed person. While many lessons learned from cancer were for the better, I really find myself struggling to stay upbeat and positive at times.

To be honest, I am terrified of a recurrence. While I am not performing self-checks daily like I was in April, I still find myself habitually starting to perform one. Just recently, I thought I felt another lump. Sometimes I feel pain in my scrotum. Are these symptoms real concerns, or are they the paranoid thoughts of a cancer survivor? I don’t want to be the Boy Who Cried Wolf, but I also want to have constant vigilance. Finding that balance has proven more difficult for me than I thought.

I also struggle to stay even-keeled in my attitude. I often go through drastic mood swings. One moment, I will be totally fine, and the next, I’ll become very sullen and agitated about the smallest things. I know that it’s hard on those around me, and I don’t mean it to be. It’s something I’m aware of and still working on.

Port removal scar
A lot of these side effects might seem like the typical issues that most 20-somethings deal with, but for me, it’s different. I don’t expect someone who has never had a life-threatening diagnosis like mine to understand what it’s like to battle cancer, nor do I expect them to cater to me as I process and heal. My whole life was uprooted in one fell swoop. As I said in the second post on ABSOT, 2016 was my year - engagement, new house, new job, tons of professional growth opportunities, a new puppy, etc etc. When I got my diagnosis, it all came grinding to a halt. It’s hard to come to terms with this major disruption in my life and move on. Life after cancer isn’t easy, and much like PTSD, its effects sometimes take me by surprise. You don’t know what it’s like until you’ve been there. I wouldn’t wish this experience on anyone.

Looking forward into 2017

Though it has been tough at times, 2017 has brought a lot of good, too - remission, a new car, another new job, a second clean scan, and our upcoming wedding. But at the same time, it’s much tougher than 2016 was. The physical difficulties brought on by cancer are now pretty much gone, but my experience continues to be hard on my internal self. People tell me I should be happy and excited because I am in remission and survived, but I find it hard to be at times. I don’t really have a real reason for it other than the internal healing is much harder than the physical.

I suppose there is no real timeline or recommended course of action to help overcome this. I was in therapy for a few weeks, but I never seemed to talk about cancer during sessions. The thing is, my downward spiral about cancer isn’t something I can talk about at a regularly scheduled time. It comes and goes as it pleases, announcing itself unexpectedly, much like the cancer did.

I struggled with mental health in high school to the point where I was in weekly therapy and on anti-depressants. I don’t think I’m quite at that stage yet, but I’m also not ashamed to ask for serious help if it gets there. I know that having depression at such a young age gives me a higher likelihood of experiencing it later in life, and I imagine a traumatic event like having cancer further raises the risk.

When I am fine, it seems trivial to talk about. When I am experiencing an episode, I don’t want to talk about it. When I need it most, I can’t bring myself to verbalize what I’m feeling. I know, that’s such a cop out. I tried to talk about how I am feeling with Mallory a week or two ago, but I broke down in tears. When she asked me why I was crying (which is an extremely rare occurrence), I said I didn’t want to talk to her. One of the few people in the world who loves me unconditionally, and I was shutting her out. The next morning I was fine, but we still never discussed why I was so upset the previous evening. This is the cruel irony of cancer remission. I want to talk about it, but at the same time, I don’t.

Writing as a cancer survivor helps more than just my readers

Have some pizza for enduring this post
I’ve heard from many people how ABSOT has helped them, but I think running this blog has helped me tenfold. I can let words I will never say out loud flow when I’m writing for the blog.

I’m well aware that this post started as a “hey, these are some great changes” and took a hard left into “my psyche is shattering” and that I’m not providing any real action steps for myself or for others. I don’t think I have any action steps right now; I just need to ride this out until I figure out what to do next.

My next post will most likely be more aligned with the generally witty/happy theme of ABSOT, but I do want to make it a point to always share the full truth of this journey. It’s not always a ball (pun intended) to be a cancer survivor, and I think it’s important for people to know that. For now, I’ll try to keep my spirits up, but I also recognize that it would be more damaging in the long run to always try to mask how I am truly feeling to people who care about me.

Well, that’s a really cheerful post. I’ll end on a positive note. Here’s a testicular cancer joke I found on the web:

“A testicular cancer patient sees a urologist to schedule an orchiectomy. The doctor tells him the operation will cost $4,000. The patient asks him if there's any way he can get a discount. The doctor answers, ‘Well, I could do two for the price of one’.”

* Turns out - that was five months. Oh well, close enough. Thanks, chemo brain. 

A self exam is how most cases of testicular cancer are detected early. Click the image for video directions or click here for a larger version

Click the ABSOT logo below to subscribe to the mailing list for the new blog posts, latest testicular cancer information, and self exam reminders!

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ABSOT is endorsed by the Laughter Arts and Sciences Foundation, a registered 501.c.3 charity. To make a tax-deductible contribution to help help continue ABSOT's work with testicular cancer awareness and men's health, click the image below.