Tuesday, September 08, 2009

Health Care, How Care: Part 3

Of course men and women are sensitive and even paranoid about problems with their primary and secondary sex characteristics. For example, cancers of the breast, prostate, ovary or testicle have strong emotional and identity components.

Text Notice: This post is not sexual but does contain mentions of nether region body parts.

Series Links: Part 1 on hip replacement is here and Part 2 on shoulder surgery is here. Also, this is cross-posted at Harrumph!.

Thus, you can likely imagine my distress at severe pain in my right testicle during my first year of marriage. The agony was frequent and daily. It often immobilized me and doubled me over as well. I imported my new wife to my tiny bachelor apartment and moved to a larger one also in the West Village. This was not a good omen for our new lives.

In my 20s, I knew I was at prime age for testicular cancer. That has a much higher morality rate than breast cancer and most others. Such a diagnosis would have been particularly grim three decades ago.

Yet, being a typical member of my family, I did not hide, but staggered to the doctor to face the diagnosis of whatever it was. Instead of physical and emotional relief, I experienced months of continuing pain and uncertainty. Also, the process further diminished my dwindling respect for doctors in general.

I went from what we used to call a GP to an internist to a urologist to a proctologist. There were numerous x-rays, scans and other diagnostic tools, hard and soft-tissue. In particular, I remember two sessions of tears-to-the-eyes prostate milking for testable fluids.

The weeks passed in slow and too vivid spasms, literally and figuratively. Multiple doctors had no cures and no causes. My wife and I remained nervous. Plus the time and money costs mounted.

This ended up not being one of the chronicles of dogged diagnosis the Sunday New York Times Magazine or the TV series House feature though. In contrast, there was a specific problem and remedy, one that illustrates another reason to be skeptical about medical treatment.

Coincidental to the agony of the right testicle was a follow-up on my shoulder dislocations that had been under control since the introduction of the chest expander. The neurologist who was checking for internal damage up top found the problem below.

pudendal nerve diagram

My tests for him were fine and he was a trifle bored after the quick session. Then he asked whether there was anything thing else. Suspecting he could do nothing the gang of other generalists and specialists had failed at, I said something about my painful right nut.

He seemed to light up and asked for some of the information the other doctors had gotten. He was particularly interested to hear that we had recently moved. He asked if I carried heavy furniture and I noted that there was a huge oak and Masonite desktop that I protected my much smaller wife from handling because of its weight. I had discussed the marriage and move with the other docs, who dismissed such personal detail as meaningless.

He then asked me to turn around and lower my trousers. My testicle was in moderate to high pain at that moment, but he changed that. He placed his thumb firmly on a spot in the lower back and gave me instant relief.

He had properly and precisely figured that I had severely strained major nerves from the spine leading directly into the scrotum. What would now be called acupressure proved his hypothesis.

Moreover, he pulled down a chart and out an anatomy book. Those nerves run like two huge hands with very long fingers from sacral vertebrae 2, 3 and 4 directly into the external genitalia. The major pudendal nerve structure was the cause of the pain.

My immediate question to him was why didn't the large set of other doctors think of that. He allowed as that was a very good question, as the nerve plexus and geography are very basic anatomy they all had taken.

My solution was treating the damaged nerves with rest, massage, heat and cold. All the years later, I can still cause a flareup with macho behavior, but I know what to do for relief.

This instance at least did not lead to recommendations for unnecessary surgery and I did get relief. However, the months of fretting and pain were avoidable through what seems to be reasonable competence by the previous medical guys.

I am not a litigious sort and have never sued a doctor. However, given my experiences with bumbling diagnoses, I am not too sympathetic with plaints of the medical types over what they say are unfair suits and resulting high malpractice premiums.

No doubt, some people try to make big bucks off others for the smallest reason, or no reason. On the other hand, shunting patients into unneeded surgeries and other treatments because of incompetent or lazy diagnoses may be all too common.

Medical doctors in the main enjoy, expect and demand high status and income in this society. As G Love has sung, "You got to earn it to own it."

Tags: , , , , ,

No comments: