I was recently reminded of this brief period in my life so I had to go dig up the picture.

Similar to how I may or may not have gone to Nashville for a wedding as a potato, I may or may not have spent a few summers as a semi-professional gokart racer.

So it's been a while since posting, but here is proof you can, in fact, have fun when you have cancer and are going through chemotherapy. 

It's funny, I got the original diagnosis the day I was supposed to travel to Denver for my bestie Charles's bachelor party. Prior to that -- when the doctors thought it was an infection -- I was on the fence about going to Denver.

With Denver's elevation and a planned whitewater rafting trip, I had concerns about the potential for my testicle to explode. Was that irrational? Maybe. But I ask you, would you risk that?  An exploding testicle?! I'm not a doctor. But that seems like a rational thing to think. Like most of the thoughts I had about things at the time.

After some soul-searching, I'm glad I didn't go to Denver because I really needed to be here for support.

Charles was one of the first people I told outside of my family and he was very supportive. He made it clear that even on short notice, I had a place at the wedding both as a groomsman and partier. So if it needed to be a "game-day decision", that was fine.

It was a difficult decision about whether to go to the wedding. Ultimately I took Charles up on the offer to attend even after missing the bachelor party. It seemed like the right thing to do.

Against my Doctors' wishes, I got on a plane and flew to Nashville to attend the wedding.There were a lot of great pictures from the event and I thought this would be a great place to publish them. Here are some of the highlights. This is how you go to a wedding when you have cancer. 

The Big Day

The day started like many wedding days do. For the wedding party, it's important to look your best. You have to hit the "The Three S's" as soon as possible: a shit, shower and shave. The shave was easy since the chemo made most of my hair fall out, including my beard. 

Then you need to look your best. For most wedding parties, the attire was decided months prior so all you really need to know is how to tie a tie. And, occasionally, how to drink a PBR.

In the classiest weddings, such as those in Nashville, the wedding party wears a boutonniere. Mint Julips optional.

Mint Julips might be optional, bourbon is not.

Just make sure you don't overdo it too early. I tripped on my one of my oxford early on and nearly ruined the wedding.

Like the gentleman I am, I was asked to stand guard outside the bride/bridesmaids' suite to ensure Charles did not see the bride early.

On the plus side, standing guard means you get to meet all the Bridesmaids early.

"Thank you for your service"

Eventually, the party must get started and I am a party. Animal.

Got to make the rounds after the wedding ceremony. 

Eventually, you have to settle in at the table for dinner. A brief lull and respite from the approaching storm.

Who doesn't enjoy the wedding cake? Monsters. That's who.

I had some other duties to attend to but stopped by the dance floor for some quality time with the wedding party.

DJ Tater is spinning his new mashup. Guest DJing a wedding, even for only a few songs, was one of the highlights of my night.

Congratulations Cigar with the party and the groom. When in Rome (or Nashville).

Always remember to stay hydrated. Sometimes people have to remind me before I hit the dance floor again.

It's a wedding. You have to dance.

Dance like no one is watching... or on the dance floor.

I got a little too boozy and stole a drink. Don't remember whose drink... but I think the bartenders saw me.

Did I deserve to cut off just for sniping a drink? No. Had to sweet talk the bartenders to get back on their good side.

But how could they say no to this face? I received some good character testimony from the groom and one of the bridesmaids.

Whispering secrets..... 

Just checking in with one of the groomsman and the bride. Don't worry, they were sober.

Finally a picture with the Bride and Groom! Was trying to snag this all night, even with a photobomb.

Okay, one more beer before we hit the after party. No pictures allowed at the bar. 

The after-after-bar. What happens in Nashville... 

Stats on TC in a Nutshell

One of the things that has been interesting about this whole saga has been the lack of awareness, my own included, around testicular cancer and cancers in general. To that end, I've asked my good friend the Stats Monkey to talk a little about the numbers. Just please, do not make eye contact with him. It puts him on edge. 

The High Level

When not editorializing at my typewriter, I live most of my life in trees. As a result I have a high level view of most things. Cancer, my overly evolved friends, is no different. Fun fact: as a male chimpanzee, I also have testicles. Also as a chimpanzee, I, unfortunately, have no earthly idea whether I can get cancer in those testicles, but I can tell you they are round, slightly squishy and fun to play with, housed as they are in a similarly ridiculous skin-like enclosure.

While I realize the primate above referred to me as a Stats Monkey, let me assure you, I am, in fact, a Chimpanzee. I believe he meant to use this as a colloquial term of endearment due to my high functioning when it comes to statistics (specifically, and only statistics). But the hour grows long, and I yearn to retire for my evening banana, so I shall not digress again. 

Let us finally speak on my favorite subject: Statistics. 

Fun Monkey Fact: Estimates Suggest 260,000 in US with Testis Cancer

That is to say, my dear hairless simian, testicular cancer is not a common type of cancer as only 1 in 265 men will be diagnosed within their lifetime. Here are a few other fun facts about cancer to plague your amygdala in your sleep: 

1. There are roughly 9,000 new cases of Testicular Cancer per year in the US
2. Of these cases, 410 may prove terminal; commonly, this is due to late diagnosis or complications of age
3. 55% of overall diagnoses for testicular cancer occur in men aged 15 - 35
4. 72% of overall diagnoses for men aged 20 - 44

As the Stats Monkey, let me translate for your Homosapien brains: Testicular Cancer is the cancer of your young. I do not say this to scare you, dear hairless friend.  While I do not understand the term "Cancer" generally, I can sense your muscles tense and what little hair you have stand on end when hearing this term. Perhaps we should explore more? Would you like a banana? They are ripe and delicious.

Having the balls to catch it early and Staging

As I understand it, you enjoy puns. While we chimps cannot vocalize them, please know that puns are an average chimpanzee's favorite pastime. Lucky for you, cancer of your testis offers a chance to go -- as you humans might vulgarly put it -- balls deep in puns? 

You see, catching your Testicular Cancer early is very important. Catching it early -- by, for example, playing with your testis to check them monthly -- can dramatically affect what is known as the Staging of your cancer.

What is Staging? I am so enthusiastic you asked. 

Stage I: The cancer is confined to the testis only (68% of cases)

Stage II:  The cancer has spread "regionally" to the neighboring lymph nodes and tissues but not organs (11% of cases)

Stage III:  The cancer has spread to "distant" lymph nodes or organs, commonly the liver, lungs, bones and/or brain (21% of cases)

The stages are subdivided to increase diagnostic clarity, a term for which I have no good chimpanzian definition. Since the half-man asked me to talk about the subject of statistics, let us subdivide his particular diagnosis: Stage IIIA. 

You see, in later stages of diagnosis, the prognosis may vary based on where the cancer has progressed outside the testis proper, how much it has progressed and measurements of what is known as blood serum tumor markers. 

Stage IIIA:  Cancer has spread to distant lymph nodes and/or the lungs with moderate elevation to tumor markers (Editor's Note: As the monkey said, this is my diagnosis)

Stage IIIB:  Cancer has spread to distant lymph nodes and/or the lungs with at least 1 tumor marker highly elevated 

Stage IIIC: Both or One: Cancer has spread to an organ other than the lungs, at least 1 tumor marker is extremely elevated 

Your friend, if any human can truly be called friend, was diagnosed with Stage IIIA due to two very small "nodules" found in the lungs during a pre-op CT Scan. I have been assured nodule does not mean edible else I would have attempted to groom them out as we chimps are wont to do. With very low tumor markers to boot, your friend was given a strong prognosis of "Good Risk".

You see there are three risk groups for prognosis of later stage cancers. While we chimps prefer more cheerful terms such as "Your Risk is Bananas", the standing risk groups are simply "Good Risk", "Intermediate Risk" and "Poor Risk". Much like the Starbucks Coffee you enjoy so much, these provide very little clarity outside of very specific circles of humans.

Good Risk is Best Risk

While you might expect to call this "Excellent Risk", Good Risk is the best possible world in later stage diagnosis. Survivability remains high to the tune of 95%. Survivability drops significantly for Poor Risk to 50% - 60%. 

In case your large human brain has not "connected the dots", the staging is directly correlated to prognosis/risk. Which is to say: 

• Stage IIIA: Good Risk - 90%+ Survivability
• Stage IIIB: Intermediate Risk - 70%+ Survivability
• Stage IIIC:  Poor Risk - 50%+ Survivability (Editor's Note: Lance Armstrong was diagnosed here, riddled with tumors and was given less than 30%)

It is strange to a Stat Monkey like myself that your prognosis seems to discount the lungs so significantly. Have you evolved beyond breathing? Are your lungs not important any longer? We chimps still find ourselves in the stone age from an evolutionary perspective. Please teach us? Perhaps we could share knowledge of climbing trees to entice you towards enlightening us? 

Why This Matters

Okay Stat Monkey, back to your cage and typewriters or whatever the hell you do all day. If only the monkey knew how to graph this post would be much more visually interesting than just pictures of more frickin' monkeys. 

Anyway, why is this important? The general takeaway is to reiterate my survival rate is high (95%) and it was caught early, despite the Stage III diagnosis. My tumor markers were never very high and the spread to my lungs was/is minor. There was no detectable presence in my lymph nodes either (distant or regional). Taking all this together, I got lucky catching it in an obvious yet early way. 

Cancer is a scary word for everyone and sometimes the statistics support that. Other times, cancer is just a bump in the road and chance to take a step back to evaluate your life and mortality. That's what I've chosen to do with my time. It has provided a reset button for my mind and my health. It's an investment in my future. 

It is my hope for this blog and for posts like this, to destigmatize a severe diagnosis like "the Cancerz" and provide more clarity on the disease and the process to cure it.

Next time, as some have requested, I'll hit on more about my daily routine.

Week 2 & 3 (prologue)

Before I get into the actual treatment, let's talk about what happened the end of week 2.

Week 3 started off with an uncomfortable sensation of bone pain. What is bone pain? Well, imagine having shin splints but everywhere you have bones. It started with a shooting pain in my back, moving up to my shoulders and even behind my ear and into my skull. Go on, just imagine what shin splints all over your body would feel like. I'll wait.... 

It's worse than you think. 

Nope, probably worse than that. It's sort of a stop you mid-sentence-and-take-your-breath-away-while-you-shudder kind of pain. I believe that's the medical term for it anyway. Now, I would not fault you for thinking, That sounds kind of serious. Did you go to the doctor? No, I did not. Because I am a man. Not much of one, but a MAN! Also, I was sort of getting curious about whether or not I would see any severe side effects and that answered the question. 

It hit me on the Friday of week 2 and I sent a message to my Oncologist that night via the patient portal to document it. Doing a little bit of research on the interwebs for my symptoms, I found that it is a common side effect of the Neulasta white cell booster. 

Neulasta is a body injector that delivers a white cell booster over the weekend, 27 hours after chemotherapy for the week is complete. I got mine on the Friday of week 1, you can see what it looks like in the picture. Basically, at the end of treatment, the nurse injects that little beetle looking device with the drug and then adheres it to the patient. 3 minutes later, you feel a puncture (think a rubber band snapping your skin or a finger prick) to insert the catheter that will deliver treatment. 27 hours later, the device beeps and over the course of 45 minutes, it slowly gives you the Neulasta drug to boost your immune system. 

Am I stupid?,  you might start asking because you're lucky enough to not have Shinsplintitis [sic], Why would the white cell booster make your bones hurt?

Well, good news, you're not stupid. According to most of the resources I've found:

The nearest they can figure, bone pain is caused by some combination of histamine release causing bone marrow edema. (Editors note: This should not be confused with the metal band Adema though the effects on the human body are similar.) For the layman, which includes me if I'm being honest, edema is a fancy medical term for swelling. So basically, your body is mad you're asking it to produce more white cells, throws an allergic fit and the spongy stuff inside your bones swells. Being encased in bone, your marrow can do nothing but swell and scream at you, causing severe pain. Hence, shin splints. Everywhere. Did you think about it again yet? 

Luckily, you can take an allergy/antihistamine drug (i.e. Benedryl) to block the histamines and and a simple tylenol to help with the pain. Although I did not know that until well after the pain started so it was a fun thing to deal with for about 48 hours at the end of week 2.  

Speaking of week 2 (see how good I am at segueing between topics?), that one was a doozy...

Week 2 & 3 (Tuesdays, 1.5/2 hrs a day)

The once a week treatments aren't that bad, usually coming in around 1.5 to 2 hours on Tuesdays. The drug is Bleomycin, which is very caustic, in case you need a reminder. There is usually a good chance of a reaction in the patient so they administer an IV of Benedryl and give you Tylenol to mitigate this up front. They advise you to take another dose when you get home after treatment. Since I was exhausted when I got home, I decided to take a nap instead of taking additional pills. Do you think that was a mistake?

I awoke after about 2 hours of sleep in a cold sweat with the chills. It felt about the same as having the flu, slight fever, cold sweat, chills and shaking, extra layers are too hot, regular is too cold.... This was the one time so far (I'm writing this at the end of my 2nd round) I lost my appetite. I couldn't eat, it was too uncomfortable. I couldn't bundle up to deal with the chills because I got too hot. I couldn't not bundle up because I was too cold. I finally took a Tylenol and Benadryl as I had been advised originally. By then, however, it was a little late. I just had to ride it out. It continued for about 48 hours after treatment. 

That night was the oddest night's sleep I've ever had. I wasn't entirely asleep, nor entirely awake. I had some dreams I think, but they could have just been psychotic fever visions. I could never get very comfortable since the temperature was never right and every shift in position lead to a new round of chills as cool air hit the formerly warm side of my body. At one point, my brain tried to trick me with magical thinking such as burning the chills out of my body with a shot of Fireball Whiskey (Fireball may or may not contain antifreeze and is banned in several countries). Not only was that suggestion unhelpful and stupid but it would require me to get out of bed. There really were no good solutions besides taking the Tylenol and Benadryl like clockwork and riding it out. 

This seems like a good time to note that there are two very distinct themes that have come out of my treatment course: 

1. Tylenol and Benadryl are the answer for almost everything so buy bulk;

2. Tylenol and Benadryl only really work well if you take them prior to the onset of symptoms or side effects

After sweating through several rounds of clothing, my fever finally broke about 32 hours after onset and the chills began to go away. I was probably back to par around 48 hours after treatment. I made sure I took the Tylenol/Benadryl duet religiously after those two days. They were a nightmare. 

So round 1 was officially over Sept 30th and round 2 began the following day with another Monday-Friday treatment. It really was very similar to Week 1 so I'll be covering something more interesting next time. 

Trivia question of the week: How many new testicular cancer diagnoses occur in the United States annually?

In the previous post, I explained what the actual prescription for my chemo looked like. If you have not read that (and you should, because context) here is a quick review: 

• 3 x 3 week-long courses of BEP Chemotherapy was prescribed (9 total weeks)
• A full course consists of one week (Monday - Friday, 6 hrs each) and two, one day weeks (Tuesdays, 2 hrs each)

I used the previous post to more generally try to explain what my treatment looks like. In this post, I wanted to explain more about the impact the treatment had during the first course. 

Week 1 (Monday - Friday, 6/7 hrs a day)

Originally, I thought this week would be absolutely brutal. Not just because of the daily grind of treatment but more so because getting any drug via IV for 5 straight days is bound to take its toll. In my case, I would be receiving 2 every day. 

It was an interesting feeling, not unlike the first day of school, to be loading up my backpack to head out at 8 AM on a Monday but there I was, doing just that. The morning of September 11th, I packed up my bag with -- what would become my daily care kit -- my Nalgene water bottle, laptop, Nintendo Switch and headphones. Since there was concern about just how well I would respond to treatment, my mom drove me to the facility for the first few days of treatment (okay.. So it was a lot like the first day of school). For subsequent treatments, I drove myself. 

Once I checked in, I was weighed, my blood pressure taken and then temperature and pulse recorded as well (This would be an everyday part of the check-in process). Once the vitals were completed, they hooked up the port via a specialized needle and "flush" the port with saline to do a "quick" blood draw of paltry 7 vials of blood for the first of 9 weekly blood tests.

The blood tests are to check that your body is responding to the treatment without totally falling apart (e.g. liver/kidney function, white cell count, red cell count) and establish a baseline for treatment that week. This completed, I walked back to the chemo area to select an open lazy-boy recliner chair for treatment (there are 18 total chairs, of varying levels of occupation depending on the day). 

Treatment basically consists of sitting in that chair for however long is needed, in my case 6 - 7 hours a day this week. 

In all honesty, I spend most of my time during treatments playing the Nintendo Switch I was graciously gifted by my friends especially for chemo (again, best gift ever). You don't -- or at least I didn't -- "feel" the treatment really. I would equate it to the same feeling you get when you take Robitussin or a similar medication in that it kind of gives you "medicine head" but you don't "feel" much. 

The nurses are especially attentive during the first week (again, can't say enough about the staff I've worked with so far) since allergic reactions can be common, especially to the Bleomycin drug. Generally speaking, however, I seemed to react to the treatment well and spent almost the whole week either a) Playing the Nintendo Switch; b) blogging for you savages. 

For this first week, I tended to crash fairly hard coming out of treatment. It was explained early on that and subsequently hammered into your skull that, "the fatigue will be cumulative". That is certainly accurate as I usually took a nap when I got home, woke up and had lunch, then went back to bed by 8:30 or 9:00 PM. Rinse and repeat for 5 days. 

The most common side effect for me was/is definitely Fatigue. Since the start of treatment, there has been this lingering feeling of tiredness both physical and psychological. If you've pulled a succession of all-nighters in the past, I would say that's what it feels like. It's workable but certainly sub-optimal. Concentration can also become an issue from the fatigue as well. 

I didn't really have any expectations for side effects coming into treatment other than bracing myself for the worst possible (nausea, loss of appetite, aches and pains, brain tooth and other potential side effects). I think that was helpful for me. Not having expectations made me more aware of my body and made sure I didn't "psyche" myself out prior to treatment. Other than fatigue, there weren't many side effects week 1.

Next post, I'll talk about some of the fun side-effects that week 2 brought.

I wrote in my previous post that many of these are exhausting to write. To be honest, I knew this was coming up chronologically, I was dreading writing it and I've allowed it to delay a lot of further writing as a result. It's not so much the vulnerability I know I'll have to show to post this, it's more so the fact I'll have to live through the emotions again in order to do this justice. That's why these end up being exhausting. So, sitting in my chemo chair, hooked up to an IV for the next 5 hours, I finally decided to half-sack up and write it. I hope you can understand that it represents a brief moment of collapse in what has otherwise been a strengthening experience.

I was told by both my doctors as well as other cancer survivors that everyone seems to have a "Cancer Moment" after diagnosis. The general definition of that moment seems to be the realization that a) You have cancer; b) It's very serious; c) Treatment will not be fun; d) Hardest of all that there is a possibility, however remote, that you won't survive the experience. 

It seems to vary from patient to patient as to when that moment occurs. Some get hit their first day of chemotherapy, confronted with the reality of the IV and seeing other patients at various stages of the fight. Others seem to let the moment wash over them after the port or PICC install or when their doctor shows them the CT Scan of the actual tumor(s). For me it was a little different.

For me it was my 5 year old nephew yelling, "I love you, Uncle Mike!". I had just fixed his Transformer toy before my brother, his wife and my niece pulled away in their Honda Pilot. It was heart-warming for a moment until reality kicked in and my anxiety addled brain played a mean trick on me. 

You have cancer. What if he grows up without you? He's still so young he could forget you.

As I walked back inside, I could feel an emotional tidal wave coming. Like a good Irishman, I tried to push back the impending disaster; to stuff it down and deal with it when there was time to do so (which means never). I flopped down on the couch and tried to distract myself with Netflix and a Jameson. My brain decided to taunt me again.

You have cancer. What if it spread to your liver and you can't drink Jameson ever again? 

That certainly wouldn't be the worst thing in the world, I suppose. But I was starting to get the sense there was something I was dancing around to avoid. Above the TV in my parent's family room is a portrait of me and my three siblings as kids. I was maybe 6 or 7? Close to my nephews age. 

You have cancer. What if you can't have kids after treatment?

Well, I guess the message was getting more positive. At least whatever anxiety driven bullshit was being concocted in my head had come down from not surviving to surviving but being infertile. That's an improvement, right? 

You have cancer. What have you done with your life? 

A lot, you fucking asshole brain. Jesus, get it together.

I've had these internal fights before, it's part of living with anxiety. These jabs seemed especially caustic given my current predicament. These were above and beyond the usual internal dialogue about being good enough or smart enough. It crossed into an unknown territory and it was getting frustrating to deal with. I wasn't able to distract myself as I usually would and I started to fixate. 

My mom sat next to me after pouring herself a Jameson and asked how I was doing. My lips twitched sideways and I just shrugged, trying desperately to squint my eyes hard enough to stop whatever waterfall was trying to break past my tear ducts. 

"I don't know...", I finally managed to stammer out.

After a small demonstration of mom-prying, she managed to get past my thin attempts to hide what I was feeling and I opened up. I had to. It was getting physically painful to contain it. 

"I don't know..", I managed to get out again before my lips twitched to the side again and tear managed to sneak down my cheek, "It's just a lot."

By now I had devolved into a full-blown breakdown, tears streaming down my cheeks. It was more frustration than anything else, I knew what was happening with me was serious. But the percentages were great, my prognosis excellent, why is this so difficult? I had already told many people face-to-face and on the phone without much difficulty. Was it seeing my niece and nephew knowing they wouldn't understand? Fear of the isolation? After talking through it with my mom for who knows how long, it finally hit me. 

"I guess, I just haven't said it," I said through a few sobbing breaths, "I've told people but I haven't really said it myself. I have cancer. It's serious and I know it's treatable but I have cancer."

It took me some serious parental comforting and a few more admissions about my current condition to come back from that cliff. Admitting it was hard. Previously, I had told people using couched words and clinical distance to describe what was going on. Like a doctor explaining to a patient, I was a few cold steps removed from the diagnosis itself. 

Simply uttering the words I have cancer brought an odd amount of relief and allowed me to think about it clearly again with the acceptance and determination to come through it. That was also the moment I resolved to blog about the experience. I had a friend who recently passed away from pancreatitis. It had seemed to me he had isolated himself after his diagnosis and his death took many people, both close and distant, by surprise.

Isolation, I decided then, wasn't an option for me. While I was supremely confident in my prognosis, my mental wherewithal and my body's ability to heal, isolation would kill me. Beyond the depressing aspect of isolation, it occurred to me then as it does writing this now, that isolation kills in these situations. Beyond people being inherently social creatures, isolating yourself during difficult situations hides the light at the end of the tunnel. It makes us forget that people love us and there is something to fight for. Whether it's people in close proximity letting you know they care or those more distant expressing their love, you have to let the village in. It can be hard and, at times, overwhelming. It's difficult to know how to respond to everyone without sounding canned and sometimes, people slip through the "Thank you" cracks.  For me, however, I decided it wasn't an option to isolate myself, as tempting as it was as a very private person. The risk was too high.

Mostly, it's people expressing a simple, "You've got this." or "Just wanted you to know I care". Semblances of normalcy are nice too, a game night with friends, going out for dinner, coffee or a smoothie. Helping people to understand what's happening helps me comes to grips with it as well (e.g. understanding through education). All of it helps. All of it is appreciated.

It took a little to write this one. It was harder than the others. Especially since I had to try and choke back tears as I sit here, in public, in my chemo chair, surrounded by people in various diagnoses and stages of treatment (many are much worse than mine).  As I've said before, part of what makes these exhausting is reliving those moments emotionally and mentally so I can explain them better.

My cancer moment is what made me blog about this. It forced me toward the decision to let people in and to allow them to lend me a seemingly endless source of strength when mine inevitably lapses in private moments of weakness. Most importantly though, it helps me remember that when this is over and my life is my own again, things will be better than they were before. It's something I look forward to and focus on every day. 

Now to the start of Chemo…

Well, you're going to.

I wanted to share some insight on Chemotherapy, specifically the kind of Chemotherapy I'll be receiving: BEP Chemo (or, "Cheems" if you're one of the cool kids). On September 11th -- Yes, that September 11th -- we launched the second vicious salvo against zee tumahs in my fight with cancer. The first salvo was, of course, the Pyrrhic Victory that was the Battle of the Bulge and resulting Radical Orchiectomy.  

The prescription in this fight is for 3 Courses of BEP Cheems over a period of 9 weeks. A course consists of 3 weeks broken up as follows: 

• Week 1: Monday thru Friday - Approx. 6 - 7 hrs/day

• Week 2: Tuesdays Approx. 1.5 hrs

• Week 3: Tuesdays Approx 1.5 hrs

Helpful video on platinum and its uses in modern life.

Now chemo comes in many varieties, if you're some kind of dweeb you can read all about it here but, in my case those 6 - 7 hours are spent sitting in a lazy boy chair hooked up to an IV which drips poison into my system.

Many times, however, chemo is abbreviated into an acronym for the specific drugs that will be used. For my 3 courses of treatment, I will be/have received Bleomycin, Etoposide and, Cisplatin. Speaking of cancers though, before you grammar freaks throw start your pedantic screeching, yes, I am aware that should be BEC Chemo. 

BUT ARE YOU A DOCTOR?!  Why are you like this?!? 

It's BEP because Cisplatin is one of several chemotherapy drugs that is platinum-based. Cisplatin is a generic drug version of Platinol®. There's platinum coursing through my veins. Don't you think that's cooler now? 

As of this writing (I'm a little behind schedule due to, you know, Cancer) I am starting my second course of BEP treatment so I now have a fairly good idea of how this all works. I'll be lumping the courses together in terms of description and trying to call out any specific side effects I experience as individual stories. I'd chronicle the days themselves but that would get repetitive and boring. How many different ways can I tell you that the massage function on my Cheems-Lazy Boy Chair also has a heater? 

As was suggested earlier, my first course started on September 11th. The course of drugs goes like this: 

Week 1 ("Prime" Week): 

Monday, Wednesday, Thursday, Friday:

• Preventative Steroids, Anti-Nausaual (30 - 60 Min)

• IV Fluids/Electrolytes (1.5 Hrs)

• Etoposide (1 Hr)

• Cisplatin (1 Hr)

• IV Fluids/Electrolytes (1.5 Hrs)

Tuesday: 

• Blood Draw (30 min, including waiting on lab results)

• Preventative Steroids, Benedryl, Tylenol (30 - 60 Min)

• Bleomycin (40 Min)

• IV Fluids/Electrolytes (1.5 Hrs)

• Etoposide (1 Hr)

• Cisplatin (1 Hr)

• IV Fluids/Electrolytes (1.5 Hrs)

Week 2, 3 ("Off" Week): 

Tuesday: 

• Blood Draw (30 min, including waiting on lab results)

• Preventative Steroids, Benedryl, Tylenol (30 - 60 Min)

• Bleomycin (40 Min)

All this takes place via the port, which I've talked about previously (were you paying attention!?)  in a lazy boy chair with an IV Tree sitting next to me. The nurses I have worked with here have been fantastic, knowledgeable and very caring. It's difficult to compliment them enough given the job they have to do here.

Primarily, my day is spent doing one of three things: A) Playing the best chemo gift ever, my new Nintendo Switch; B) Blogging for you assholes so you can feel my pain; C) Eating lunch or random snacks I scavenge from the break area, my current favorite is Cheddar Sun Chips which, under normal circumstances I would scoff at.

As brutal as the "Prime" Week schedule sounds, it hasn't been all that bad. Usually, when I get done, I drive myself home take a brief nap, wake up and eat dinner then go back to sleep shortly after to wake up and do it again. 

The "Off" Weeks are very hit or miss in terms of how I feel. It's a little rougher doing the one day a week since the Bleo treatment is so caustic and by then the other drugs are out of my system. Usually, that Tuesday and Wednesday are recovery days for me and then I resume a somewhat normal schedule. 

Next post, I'll tackle the individual drugs and side effects I've experienced to date and feelings. What else would be interesting to hear about on the chemo side? 

You can ask on Twitter or e-mail me.

In trying to provide as comprehensive of a history on this whole saga as possible I somehow forgot to include the story of my "Port" install. I guess you could the say the reason I forgot is that I now take the port for granted, using it every time I have a chemo session or need a blood draw for lab workups. It's easy to forget about but it is a major convenience and everyday part of treatment. 

So what is the Port? Well, according to the company that created it, the PowerPort® Implantable Port Device is: 

• Lightweight for Patient Comfort (Can confirm)

• Easily Identifiable (More on that in a moment)

• Power Injectable! (It's called a power port for a reason. Strap yourself in!)

• Titanium Port Body (okay, so their web designer isn't an English Major)

So what does all this mean? When you're facing the prospect of being injected with an IV drip daily for a week or more, efficiency and limiting needle punctures becomes medically advisable. Also, you don't want to look like a heroin addict, so the options are do the port install, have a semi-permanent PICC catheter installed in your arm or, just start a new IV every day which will give you the arms of early year 2000s Courtney Love. As I understand it, medically speaking, it's really only option one or two here because heroin chic went away with the 90s [citation needed]. 

So let's compare the two options before we get into the nitty gritty of the Port.

This gets "installed" in your arm. Read more about it here.

Looks like fun having that hang out of your arm right?

This is surgically implanted in your chest and leads up to a major vein. Learn by clicking through here.

You can see how it's surgically implanted under the skin here.

The PICC Catheter:

• Semi-permanent install into the arm vein

• Dangles out from your arm

• Must cover with plastic during showers like a savage

The PowerPort:

• Surgically installed under skin

• Turns you into a cyborg

• Can shower like a normal human

It might not be obvious given these vague images and descriptions but there is a huge downside to the PICC Catheter option: the ends of it are exposed and require constant attention. For example, with the PICC, you have to wrap it in plastic (i.e. Glad Press and Seal) if you plan on taking a shower ever. You also potentially need to tape it down so its not flopping all over the place. Let's take a break for a second to ask ourselves a question: Does cancer sound fun yet?

Honestly, for my part, the answer isn't as obvious as you might think. Does it suck I have to go through this? Yeah, but it's happening. Soo... on the plus side the medical technology at play here is really quite incredible and totally fascinating for the dweeb in me (Editor's note: my Dweeb-cell tumor is also being treated by the chemotherapy). 

The "PowerPort" or "Port" for short seems to be a vastly superior option here as far as temporary implantable devices go. It has made everything easier for this process from blood draws to actual administration of the chemo drugs. But how does it work?!? You might be thinking like the selfish, voyeuristic blog reader you are. Don't worry, baby birds, I'll feed you. 

The Port is a pretty neat combination of plastics, titanium, silicone and -- I think -- fairy wings. Pictured above and here, it's a relatively small little device with a couple grooves over a silicone membrane. 

When getting an injection or drawing blood, the technician can feel for the three grooves beneath the skin to target the needle entry easily in between them. The device is flushed with a saline solution and then anti-clotting agent before treatment is administered. Because of the devices makeup, it is safe for most imaging scans (i.e. MRI and CT) which will be needed for follow up coming out of treatment. All told, it saves time, energy and cuts down on infection potential. 

The install of the port itself was a fairly straight forward, outpatient procedure. It was a little strange though since the numbing agent they use is local (i.e. on the skin) and the anesthesia is a minor "waking" anesthesia. Over the course of the 40 minute long procedure, I think I fell asleep once or twice but was awake for most of it. Generally speaking, it felt like being poked and pulled and pushed by a nonspecific manipulating digit. Let your mind run with that one. The port is generally installed for the duration of treatment and short time after depending on need.

Once treatment is over and you don't need to get stabbed with a needle every 24 hours, the device will be removed via a quick outpatient procedure. We should talk about two recommendations I have, though: 1) Keep the port until after you go on a celebratory bender when treatment is over, it will make administering IV Fluids easy to prevent hangovers; 2) Keep the port in a trophy case, you have earned it.

Next we start with the Chemo. It’ll be fun, I promise?

-- Post Script -- 

I'd like to take a second to thank you for reading. Most of these posts are emotionally draining to write so I don't take the time to edit them because I'm not in english class anymore, Dallas!  They are ultimately enjoyable and cathartic to write, however. It's like taking you on this journey with me and the resulting outpouring of love and support has been very uplifting. 

To that end, I've setup easier ways to follow the blog than just checking to see if I have the energy to write. You can now subscribe for e-mail updates every time there's a post or follow my twitter account which will post all new blog posts. You can use the buttons below. I might add them to the footer going forward to make it easier. 

Thanks again, people!

Previously on "Out of Puns".. 

So I've mentioned previously that the initial, pre-op CT Scan showed two "suspicious nodules" in my left lung. To determine what those two nodules are, as well as check for additional metastatic spread of the original testicular tumor, my new Oncologist ordered a follow-up MRI (a wut?) for my noggin and a PET Scan (and that is?) for my torso, pelvis, and lungs.

For whatever reason, those simply had to be scheduled on a Friday afternoon. I emphasize that because depending on the results of those tests, the currently prescribed round of chemotherapy could shorten or get longer. If, for example, the MRI showed it had spread to my brain -- which is not uncommon -- the chemotherapy could go 4 rounds (12-weeks) or more. So while my current prognosis remained excellent, there was a large asterisk next to it pending the follow-up scans. You know what's fun going into a weekend? Not knowing if you have brain lesions. 

The night before the scans, I was instructed to abstain from any carbohydrates and eat a high protein meal, followed by nothing except water the day of after 11 AM. So I arrived at the imaging place at 2 PM slightly hangry and anxious to get it over with. First up was the MRI, here's what that looks like:

1. Have an IV put in your arm for the "contrast fluid";

2. Remove all metallic objects from your person;

3. Lie motionless in a large metal tube for roughly 30 minutes;

4. Read Harlequin novels in the waiting room and wait for the PET Scan

So basically, you lie on a table that they push into a huge tube. Because they were doing the MRI of my brain, my head was put in a sort of harness to keep it as immobile as possible. They also told me the MRI is very loud and offered a pair of large, over-ear headphones to listen to music while the imaging took place. Not quite Beats by Dre® more like a pair you get at the Public Library to watch educational content. They offered my choice of music and, since Insane Clown Posse wasn't one of those options, I chose "Classic Rock". 

They really aren't lying when they say the machine is very loud. After they push you inside the tube, they talk to you via the headphones. What followed was an endless process of,

"Alright Michael, are you okay? Okay, this scan will be 3 minutes. I need you to remain very still.",

"Okay Michael, are you doing okay? This scan will be 6 minutes." [Insert Rolling Stones 'Fade to Black' over the sound of a machine].

What does an MRI sound like? So glad you asked. Here's an MRI simulator for you.  Why does it sound like that? Because magnets are loud and medicine should occasionally terrify you. After about 15 minutes, the MRI tech came back out, injected the "contrast fluid" into my IV and the process repeated.

All told, the process is pretty painless, but you always end up with an itch you can't scratch while getting scanned. When you're not getting scanned, you're also not supposed to move in case it shifts your head, potentially creating a "shadow" on the MRI or blip that they mistake for something more sinister. So, you know, don't move so we can see if you have cancerous brain lesions and if you do move, we might think you have cancerous brain lesions when you don't. Fun, right?

So after the MRI, I went back into the waiting room to get better acquainted with exactly what a rancher does while undercover (I'll give you a hint: it's sexy) and wait for my PET Scan.

The PET Scan is an interesting one because it involved radioactivity and a whole lot of waiting. So the process is very similar to the MRI with a couple important differences. First and foremost, the needle they inject the "contrast fluid" with is encased in lead. Why is it encased in lead? Well because it's radioactive, of course. After that injection, you get a cup of cloudy liquid to drink and then you wait for an hour and 15 minutes because -- I'm just guessing here -- the radioactivity really needs to sink in.  Before you go into the PET Scan room, the tech asked me if I would be "handling" children or the elderly after this appointment. Who... Knows how to respond to that question so I said, "Well.. I mean... Maybe?" Apparently you aren't supposed to come into contact with either party for at least 4 hours after because you might make them also radioactive. So that's fun. 

The PET Scan machine is very similar looking to the MRI machine, but it's mostly silent. Also unlike the MRI, you don't stay motionless in waves but instead you stay motionless the whole scan. 25 minutes with no music, no dialogue, just thinking. What do you think I was thinking about that whole time? 

Luckily, by the time I was coming out of the PET Scan, I received a voicemail from the Oncology Office: the results from the PET Scan wouldn't be in until after the weekend, but the MRI images were in. There was no evidence of tumor activity in the brain. Have you breathed an actual sigh of relief? I don't think I had really until that day. What it really meant was that the prognosis likely couldn't get worse, it could only get better with the results of the PET Scan. That was good to know going into the weekend since I would have to mentally prep myself for starting Chemotherapy on Monday, September 11th.

That's the subject I'll cover next time to get you all up to speed.

Last time I lost my something important.. 

The Oncology center is in the same building as my dentist. I passed it every time I went to get my annual cleaning and always remember thinking, "Well, hey, at least I'm not going there for my appointment."

Well, on September 1 I did go there for my appointment. There wasn't a lot of new information, to be honest, so I expect this to be short. The thing I will say about it is that from the moment I walked in to the moment I walked out, the staff was impressive. They were surprisingly upbeat, caring and engaged. In sharp contrast to some of my previous experience with, for example, getting the ultrasound done, they were on point each phase of the process. Even their paperwork seemed less onerous than others.

The big takeaway from the appointment with my new Oncology doc was that I would be going in for follow up scanning - A PET Scan and an MRI - to nail down what the previous CAT Scan had shown in the lungs and whether there was any evidence of additional spread. Regardless, my new Doctor wanted to emphasize that the prognosis was still excellent. 

Next time we get into scans. Lots of scans.

Last time, we told people about nuts... 

A week ago, if you had asked me how I would have spent my Wednesday, I wouldn't have said "Getting up at 4:30 AM to check-in at a surgery center promptly at 5:30 AM to have a radical orchiectomy" but that's what was going to happen. It was written in the scrolls. Righty had become too ambitious and begun taking territory beyond its given purview, Lefty was terrified of being lumped in, and the insurrection had to be stopped to save the Sacred Kingdom of Scrotanium.  

After check-in, I was shown into a personal waiting room with my father (who had the... balls to accompany me WHAM! PUNS!) and asked to put on a hospital gown. After gowning up, they took my vitals and a steady rotation of staff began to come through the small room. 

First was the on-call nurse who went through a checklist of items to confirm why I was there, any prior surgeries, any medication I was taking, the pain I was feeling, etc. 

Next was a relatively goofy surgical nurse who would set up my IV and explained that next in would be the anesthesiologist to explained the process of being put under.

The anesthesiologist was a lanky, goofy looking guy who had a quirky sense of humor, which I appreciated. 

Paraphrasing him: "Ever been put under before? Great. So, here's what's going to happen. We're gonna wheel you into the operating room and get you up on the special table for special guys. Then I'm gonna ask you if you're ready to be put under. I'm not going to wait for a response and then you're gonna wake up back in this room with one less testicle. Sound good?"

Hard to argue with calculating logic of that process. It was nice hearing a joke or two in such a sterile environment. Shortly after the sleep-doctor left, my Urologist showed up for his final consult. 

After a little banter, he got down to the surgery (which again, I appreciated his forthrightness on). 

"So, Michael, here's the deal. The surgery should be a breeze, but your blood work and your CT Scan came back. The blood work is... Okay, not great, but okay. The concern is that the radiologist saw a nodule in your lung which we are assuming is evidence of metastatic spread from the tumor." 

It's hard to describe how you can feel "lower" than knowing you're about to lose a testicle, but I found it. My heart dropped out and I felt a little faint at that notion. Not knowing much, all I heard was "Lung Cancer". 

"So, here's what that means. In my experience, you're looking at 3 rounds of what's called BEP Chemotherapy. Each round is 3 weeks long. Basically, we're going to knock you down for a week, you'll feel better and then we're going to knock you down again. The good news is that at the end, the objective is that you'll be cured. I called a friend of mine to see if he could fit you in for your Oncology Consult, he's one of the best I know. So I don't want you to worry. We're going to make this go away. Any questions?"

I wasn't quite sure what questions I could have, so I tried to reassure myself the way I always do.. Making a joke, "You know it's the right one that's defective right?" 

You can Google your own results to see what a Radical Orchiectomy is or what it looks like.  In the meantime, here's something else that needs radical removal and is radical.

Fast forward an hour and a dull pain in my groin for August 30th to count as the second time I've woken up wearing a jock strap I didn't fall asleep with. As a note, they use that as a "support" for surgery recovery. So that's a fun fact for you.

There wasn't much pain, but I was also still coming out of anesthesia and an IV painkiller. As soon as I had my wits about me, I checked. I bet everyone checks, to be honest. Who wouldn't? Upon checking myself, three things occurred to me: 1) Huh, that's a jock strap; 2) My whole groin seemed like it had lost a bet and was half shaven; 3) Lefty was still there, the Kingdom would survive!

After an hour and 30 minutes of recovery or so (some still sedated, some conscious), I was released. After a 5:30 Check-in I was out of the surgery center and on my way home by 10 AM. Let that sink in. That is how easy it is to radically remove something. 

I spent the balance of the day doped up on pain killers, sleeping and making liberal use of an ice pack. There wasn't a lot of pain to be honest and movement, while stiff, came relatively easy.

During one of my more lucid moments of recovery I phoned my sister who, as I have suggested earlier, is a Doctor in Ireland. She was understanding and likely knew more about the condition than I did. She was helpful in suggesting that she could operate as "Doctor Advice" or "Sister Advice" and I just needed to tell her which one. We made a few jokes about it to help with recovery and she reiterated she would be back in town for Thanksgiving. 

I would later find out out after my consultation with the Oncologist that, by Thanksgiving, I should be almost back to par and, if all goes well, Cancer free.

Next time we take a trip to see the Cancer Doc!

So as a bridge between the the diagnosis and surgery date, I decided I would start telling a limited number of people outside of my parents. This was a difficult and conscious decision on my part. The rest of my family and friends knew I had an infection of some sort and it had kept me from several events, including a trip to Denver for a Bachelor party. I knew telling anyone would be hard, but I figured who to tell and when would come naturally. 

My parents gave me one piece of advice on the subject, "This is yours to tell. Tell everyone or tell no one. It's really up to you."

Mentally, I began to compartmentalize a list. Though the surgery wasn't major, the implications were more broad. I decided I would need to tell my brothers and my sister before the surgery. With a limited amount of time, my sister became an impossibility given her living in Ireland so I started with my older brother. 

I thought I was prepared for the conversation, to be honest. I had gone through it in my head enough times to have it down pat, cold and medical. When he picked up my call I asked him if now was a good time to chat. I cracked a joke I don't recall and then I told him. His initial response was, "Are you serious?" and that is when my voice cracked. I continued to border on tears as I explained to him the ultrasound, the consult and the surgery I would be getting early the next morning. It was hard and still, as many times as I went through it in my head, I don't know why. He had a few questions about the implications and I made sure he understood we would know more after the surgery. Before we disconnected, he made sure to tell me he, his wife and the kids would say a special prayer that night and into the week for me.

After hanging up, I broke down. It took me a few moments to get myself back together, clear my nose and breathe. It wasn't sadness or fear, I don't think. It was more like exasperations and exhaustion. There was no good way to break the news to someone that cares about you and who knows even less than you do about what's going on. Most times, I would pour myself a Jameson to calm the nerves but that was a pre-op "no-no". 

The next call was to my younger brother who was on vacation. That call was easier after the first. He was calm and supporting and wanted to know as much about the prognosis as I could tell him. I reiterated we would know more coming out of the surgery, but that initial signs were all good, all things considered. I made a joke about being much more like Lance Armstrong now and we agreed to touch base after the surgery. We agreed telling my sister, a Doctor in Ireland, as soon as was possible the next day was best as well. 

That was about all I could take that night. As I suggested in my previous post, as early as surgery was, sleep was difficult to come by. I had done everything I thought I could to prepare but the mind still races with ridiculous ideas and far off possibilities.

Luckily, there was a great staff to help me through.

Over the weekend, I became an anxiety riddled hermit with an internet research and vodka addiction. I absorbed as much information I could on the potential for testicular cancer, the possible prognosis, how they might narrow it down and whether or not I would die from a faulty ball. It's amazing what the mind does when it doesn't have answers. When I wasn't researching different types of cancer, I was marveling at some of the stories that people told about their similar struggle. It made me feel good and it made me feel prepared for my consult.

I was told that the Urologist at Urology Associates fit me into his schedule late on Monday. As I arrived at 4:00 PM, two things occurred to me:

1) I was the youngest one in the waiting room by at least 30 years and it felt like everyone was wondering who I was there to console; 2) Oh god, oh god, oh god, oh god.

Apparently, there was an emergency surgery just prior to my arrival so there was a long-expected delay. That gave me plenty time to research my doctor and browse Reddit. While I was already told all the doctors at this clinic were top notch, it appeared to me like mine was great. Internship at Mayo, Director of Urology at Abbott, lots of experience, seemed top notch. That made me feel better. So did the daily ridiculousness of the internet.

At around 5, I was finally asked back for my consult. Right out of the gate, I liked my Doctor. He was to the point but not overly blunt. We brought up the ultrasound images and he explained what was going on in my coin purse. Medically speaking, the ultrasound showed a 2.5 cm growth on my right testicle. As far as tumors go, "It looks good, unbroken, etc. That's all good." 

(Here's my ultrasound. Fair warning, it's a sonar image of my cancery gonad.)

He then turned to me to explain the score, "Michael, if you could have a meeting with god, he'd tell you he has some bad news and some good news for you. The bad news: You're going to have cancer at some point in your life. The good news: you can choose which cancer. Might I recommend testicular?" 

That made me smile. At least it was unorthodox. 

He continued on, "No, seriously. Testicular Cancer is extremely treatable and ultimately curable in most cases. We won't know for sure until we're able to get the pathology done but you're going to have to go through a procedure called Radical Orchiectomy"

Spoiler alert: you don't leave the hospital with sunglasses and a skateboard. In layman's terms, they're going to take the tumor out with the testicle and then biopsy it. So I have that going for me. Would have preferred skateboard feet, to be honest. 

The surgery was scheduled for August 30th at 5:30 AM for Check-in. On Tuesday, I would have to get a pre-op physical, blood tests and CT Scan to see if the cancer had spread. That was a whirlwind of a day, at the end of which I packed a bag for a few nights at my parent's place for recovery. 

I didn't sleep much that night. It was too difficult thinking about the implications of the surgery. 3 hrs of sleep or not, 5:30 AM rolled around very slowly.

But first, a brief note on telling people from earlier that night.

My Ultrasound was finally scheduled at Fairview for Thursday the 24th of August. To put things into perspective, it is very similar to an Ultrasound a pregnant woman might have but... you know... location and context are everything. 

It's difficult to describe how awkward and exposed it feels to have a very talkative ultrasound technician apply gel and a wand to your man-scrote. There's really no way to "prepare" for it per se, it's just plain awkward.

Know how it can get more awkward? When the formerly talkative ultrasound tech falls silent halfway through the procedure. You know when you get the sense something in the room changed? That happened. In spades. The rest of the 10 minutes was dead silent for the most part, though she did tell me the "Wah wah wah wah" sound I was hearing was blood flow (not a baby).

She completed the procedure and I asked her when I could expect the results, 

"Usually 1 - 2 business days. The radiologist will review today and then send over to your Doctor for review. That's usually what takes the 1 - 2 days."

She told me to get dressed and she would be back in a moment. The moment came pretty quickly. She stepped back into the room with a phone in her hand, "It's your doctor, they'd like to speak to you."

Oh how the air changed again. I took the phone and she left the room, "Michael, it sounds like the radiologist saw one or two masses on your right testicle. We're going to refer you to the Urologist for a consult as soon as possible."

Well that certainly didn't tell me much, "Should I be alarmed?" 

"Well, obviously, the concern is that the mass is a testicular cancer. So we'll want to take care of that as soon as possible. Our office will be in touch later today with an appointment at Urology Associates. They're all great doctors. They will take care of you."

My first thought as I handed the phone back to the ultrasound tech was, Obvious? Is it REALLY obvious? 

The tech took the phone and asked if I needed a moment. Still not knowing exactly what was going besides the obvious concern about testicular cancer, I told her no and left Fairview.

I decided the best place to go would be my parents place which was nearby. During the car ride, the gravity of the situation started to sink in. There were plenty of thoughts, none of them good, running through my head. I smiled when I walked in the door to meet my mom and tell her about the results. 

Can you imagine? Smiling. I tried to play keep it together but when she asked about the results I broke down. I couldn't get the words out. I wanted to say, "They think they found a mass on one of my testicles. They're worried its cancer." But the words didn't come. Only a sigh, a deep breath and a few tears. 

My parents were extremely supportive and having gone through health scares of their own, could relate. The consult with the Urologist was scheduled for the following Monday, August 28th. I made the decision to withhold talking about it outside of my parents until I had a clear idea of what it was and what the treatment might be. I decided to forgo a trip to Denver that weekend for a Bachelor party. No reason to ruin white water rafting by having my testicle explode. 

As far as most people were concerned, I had an unspecified infection and possibly a cyst that would require surgical removal. Not far from the truth as I found at the Urologist the following week.

A week ago, I took a trip to see my Primary Care Doctor, the reason? Well in the shower the previous morning, as I was soaping up, one of my two boys hit my hand like a golf ball. 

Not everyone might be aware but that is not normal. I called my primary care doctor that morning after some panic induced WebMD-ing. Spoiler alert: WebMD was right this time. It was Cancer. 

My primary care doc prescribed some antibiotics (as the other possibility was it could be an infection) and referred me for a precautionary ultrasound. When I agreed with the course of action, he thanked me for being willing to go in for the ultrasound. That seemed odd, but it certainly could be the case that some men are just unwilling to get it checked for fear of confirming what it is.

During the following week, I was ping-ponged back and forth between the Imaging Hospital -- who had yet to receive the faxed order -- and my primary care office who continually reiterated they had, in fact, faxed the order over. 

Let's take a moment here to address what I'm sure will be a running theme through this ordeal: Even with the excellent people and technology in medicine now, many aspects of it are still woefully outdated and frustrating to deal with. 4 days were lost between the time of the referral for an ultrasound and the actual scheduling of it. No accountability was taken on either side of the equation to ensure it was scheduled and required me -- who at this point was terrified -- to proactively call back and forth between the parties. Turns out the problem was an outdated fax number.  

Being forced to call back to the year 2002 to get my ultrasound scheduled was frustrating, even as my testicle continued to grow. No one helped. Everyone pointed fingers: "Check back in 4 hours, that's usually how long it takes to process the fax." "We just faxed it over again, give them an hour or so to receive it." and around and around. 

So finally, Ultrasound order sent, I scheduled a date for my testicle prom photos on Thursday, August 24th. And that's what we'll go through next.