Thursday, December 19, 2013

Vasectomies and Ultrarunning

As the title suggests, this is going to be a touchy topic. So feel free to leave now. If you continue to read, you'll be graced with graphic descriptions of my own penis and testicles and a few mentions of my sex life. Hopefully I can keep the dick jokes to a minimum though. I would like to keep this as clinical and objective as possible. On a positive note, I won't be showing any pictures. So, with that said, let's move one.

Okay so this is going to be very TMI and graphic and, by the very nature of things, sexual. In the past I have always hesitated to disclose any specifics about my sex life because as far as I'm concerned that is private between my wife and myself. However I have decided to disclose a wee little bit, no pun intended, specifically about how my recent surgery affects me.

Now for those of you that do not know what a vasectomy is, it's where the vasa deferentia is transected, removed, truncated, capped, whatever you wanna call it. It's separated therefore live, active sperm is not introduced into the ejaculate and therefore the man is no longer capable of impregnating the woman. I know that's a whole lot of science and medicine and biology and big fancy words but it's the only way I can do this with a straight face. So anyway, it's not like a dog or cat or something like that where they are neutered. I still have my testicles, they still work, it's just some of the plumbing is no longer connected.

So having said all of that I don't necessarily want to make a big deal out of why I did it or how it will impact my sex life. What I really want to do is get into more of the running-related impact of having a vasectomy and how it will impact my life in that manner. I am NOT comfortable disclosing all the details of my sex life so we'll just leave it at my wife and I do not want to have any more children. After researching all the different alternatives to birth control, this was the most viable option. But before I get to far ahead, let's break things down into three main categories of discussion. First, there's the psychological baggage, then the social stigma, and finally the physical impact.

Psychological Baggage
For some men, many men, I don't think it's a big deal. You go, you get it done, and that's it. But for me it's a whole lot more. I'm not a big fan of doctors, not in the sense that I don't like doctors as much as I don't like going to the doctors. Or hospitals for that matter. And I think part of it stems from my mother and when she was diagnosed with multiple sclerosis. That really scared me away from hospitals. And I've always been afraid of death but for me to go to the doctor even when I'm sick is a big deal. It's just one of those mind sets that I have. So I tend to tell myself "let's give it another day another week and let's see if my body will heal itself." Not always the case obviously but that's kind of where my head is. So going for a vasectomy is a huge deal even though it's like 20 to 30 minutes of outpatient surgery. Along with that there's all the horror stories that I've read and seen pictures of and heard about where things went insanely wrong. That's not something I would suggest that you go out and look up beforehand but I know that there are risks just like driving down the road where anything can happen. Bad things do happen, can happen, will happen but statistically they're not that common so even though I know the numbers were on my side I still was not comfortable going. Along with that there's this philosophy that I have that I want my body to be whole. Almost like the Sikhs who don't believe in cutting their hair.  That's kind of how I feel. I mean, I'll obviously shave and cut my hair but that philosophy of being whole is more what I'm talking about.

Now I'm not saying that I'm not whole as a person but it's that mental aspect of wondering if I will be whole. Yes, there's a part of it that revolves around will I be a man and will I be able to function as a man but while I'm worried about the physical repercussions, I'm less worried about being a man than I am about being whole. Add to this mentality the question of what would happen if we ever did want another child. God forbid something bad happens to our two children, and there's no way having a third could ever replace one, but there's that thought in the back of your mind about how can we make another one if we go through with this? That's a lot of emotional weight to handle when your family lineage is something that's important. We're not exactly royal blood here and there's no lordship at stake, but there is still the family name and traditions to carry on. A big part of that, for me at least, is in the blood line of the family. Not that my adopted family members are any less a part of the family, they just aren't blood relatives. I don't know why that's important, but it is. And I do realize it makes me sound like some crazed Nazi when I say it.

Social Stigma
Very much like mental illness, there's a huge social stigma with vasectomies. HUGE. Part of it is the social stigma of sex and I think every country and culture has their own set of morals when it comes to things related to sex. I get that. But vasectomies seem to bear a bit more burden than other surgeries related to reproductive organs. For example, women who have a hysterectomy don't seem to have as many issues talking about it or dealing with it. At least not from my point of view. But when it comes to a mastectomy, that seems to draw some of the same stigma of a vasectomy. Maybe the social issues are related to more how people define themselves as male or female than anything else. I know it was some of my own problem with this surgery but I think it goes deeper for the culture we live in now.

Yes, biologically, I am defined as a male because of my genitals but I'm also socially defined as a male because of them. And while I'm okay with that, I think there needs to be some responsibility that comes with the power of defining who people are. So just because a woman has her breasts or uterus removed, doesn't mean she's any less of a woman. Same goes for a man. I mean, nobody would think of Lance Armstrong as anything but a man and yet he only has one testicle. Of course he carries his own stigma with drug use, but that's not what we're talking about here.

So while the rich and famous and the news outlets find it okay to talk about a woman braving a double mastectomy to reduce her odds of getting cancer, there isn't a damn thing out there about a dude getting a vasectomy to prevent future pregnancies. And there's barely anything about getting a colonoscopy to prevent prostate cancer. Is it because we, as men, see this kind of stuff as a weakness? Are we so wrapped up in our own machismo that we can't ask for help? I don't know what the answer is but I do know nobody wants to talk about getting their testicular tubes tied.

Physical Impact
This is where we get into the graphic part of the procedure. Even more so than before. So the pre-op part was fairly uneventful. There's a consult that takes place beforehand where you and your spouse can sit down with the doctor and discuss all the ins and outs of what's going to happen. Pretty standard office visit with no real surprises. The doctor should do a basic inspection and give you a good once-over to make sure you're suitable for surgery. They'll also probably give you a sheet that says you agree to this and so does your spouse.

After that comes the surgery visit itself. My doctor gave me some pain meds and an anti-anxiety pill to take before the operation. It helped but I think two beers and two shots would have made me even more numb to the pending procedure. Numb both to the physical trauma and the emotional trauma. Since I was on meds, this meant that I needed a chauffeur to take me to and from the doctor. Thankfully my wife was nice enough to see to this. While she won't admit it, I think in the back of her head she had a bit of perverse delight in seeing me go through this. I guess it was only fair since she's mother to two children.

Okay, the procedure itself took 20 minutes, maybe 30. That's from leaving the waiting room to being done. Once in the room, you strip from the waist down and wait with a piece of paper over you. I say paper because that's what it was. They may have called it a blanket or something else but it was a piece of freaking paper that would have dissolved like cheap toilet paper if it got wet. My feet were cold and I closed my eyes because I had no desire to see what was on the little table of torture.

Finally the nurse comes in and preps the area with Betadine. It's a little cold but not bad. It does smell a little funny and, as I found out later, is a dark liquid that's easily mistaken for blood or iodine. From there, the doctor came in and the pain came. It felt a bit like having your testicles wrapped up in a rubber band while the doctor pricks you with a needle to give you a local anesthetic. I'm not sure if it was a rubber band or a medical clamp or a freaking vise, but it was uncomfortable. From there he begins his poking and prodding. I was grimacing more than he expected so he asked if I could feel pain. I said yes so he gave me more local. At least I'm pretty sure he did since I felt another pinch and then didn't feel much more than pressure and tugging. From that moment through later in the afternoon, I could still feel pain but it was very mild. Not a sharp pain like getting kicked between the legs as much as a steady, dull ache of having a small child stand on your testicles all day. Or like you got karate chopped between the legs yesterday and it still hurts today.

At some point he said something about moving to the other side and I just continued to lay there with my eyes closed. I'd wiggle my toes or clench my hands but I did my best not to jump or jerk. While I wanted to make jokes I was too focused on surviving to come up with anything good. The nurse and doctor did comment on my "I Love Coitus" shirt. I figured it was fitting to wear it on such an occasion because, well, just because. Anyway, I was bearing down as I gave birth to this vasectomy and the doctor eventually says he's just stitching up and then he'll be done.

After that, he said his good-byes and the nurse gave me a little washcloth to clean up some of the Betadine. That's when I realized it looked like iodine. Once I got cleaned up a little with the washcloth from hell that left more lint than it cleaned up, I inspected the damage and asked the nurse about the incision. It was much higher than I expected which I was happy for since it meant I could see it and clean it. I was thinking it would be much lower on the scrotum or even underneath but instead it was more at the intersection of the shaft of the penis and the scrotum. Side note, it was also more off to one side than I expected. At about, let's say, 1 o'clock on the dial (assuming 12 was my toes and 6 was my nose).

After I cleaned up a little, I stood up and began to get dressed. That's when I noticed that the Betadine looked like blood. It took a second but I finally realized that if I had bled that much I would have been covered in it. Once I was dressed, I gingerly made my way back to the waiting room and my wife and we left. Since I skipped breakfast, we grabbed an early lunch and headed home.

The rest of the first day was spent wearing tight shorts, icing the impacted area, and watching Band of Brothers. Things hurt but not too bad. Well, just a tad too bad to just live with it. So I took pain meds on a regular basis and even managed a nap. The next day I made my first mistake. I continued to wear the tight shorts but felt restless and went to town to run errands and do Christmas shopping. Bad idea. I should have stayed on the couch. So by the third day I paid the price and stayed in bed a few extra hours. That seemed to help some but the dull ache is still there. I managed to live without meds until the weekend (about V+4 days) when I took some ibuprofen. That seemed to help with some of the swelling and pain but again, it's still there.

Now that I'm at V+6 days, I'm moving around much better, not icing, and only taking meds when I absolutely need it. My pain varies from 1 to 7 on the scale but it's mostly in direct relation to what I'm doing. Sitting, standing, and some walking is fine. I say some walking because I need to adjust myself for it to feel comfortable. Most of my pain comes from sitting or standing. That's when things move too much for comfort and I need move things around to get them settled. The tight shorts help some but not as much as I'd like. Loose pants help more than tight jeans.

There's also more bruising than I expected. I think if the doctor would have rummaged around anymore, I'd be as black as ebony. The stitches haven't fallen out yet and I've been periodically cleaning the incision with hydrogen peroxide. Those things are annoying because they catch on any sort of fabric in the area. Which means any sudden movements suddenly get your attention. And the swelling has continued to rise and fall for no apparent reason. Some days are better than others. They are incredibly tender and often get treated as if they were eggs being carried around for a high school home economics class. I've even shoved my kids away from my just to avoid any careless bumping.

Speaking of kids, I haven't really told either of them what happened. I had no idea how to broach the topic since neither are really at an age to understand all the reproductive parts of the body and what all the implications are. My daughter, age 9, knows some stuff and understands some stuff but is still very much a kid. My son, age 6, has no clue and, well, I'll just keep it that way for now.

While my recovery isn't complete, I would feel remiss for not at least touching on the topic. I am down to almost no pain after about ten days. I've been able to run with no issues beyond my stitches occasionally catch on the fabric of my shorts. They've been doing that since the beginning but I trimmed one of the longer ones and that greatly reduced the number of instances where I was suddenly struck with pain.

Speaking of stitches, the incision is healing quite nicely. It doesn't look super pretty but looks a lot better than it did after a few days. I've been cleaning it with hydrogen peroxide periodically and carefully cleaning it in the shower. I feel no major scaring underneath the skin and the first, gross scab has come off. The much less gross scab is still present but is much smaller.

My bruising has also healed almost completely. It went form a small, almost invisible bruise to a larger bruise to black and blue to black, blue, and red to deep black. I also saw other bruises come and go in other areas that I didn't expect to bruise. Aside from the appearance of an old bruise, there's not nearly as much tenderness as before. I'm not shoving defending the area like Fort Knox any more.

Which brings me to my final point, tenderness in general. From the moment the doctor started, things were pretty sore and tender down there. I didn't want to touch anything. Moving my underwear hurt. Pants hurt. Everything hurt. I would have walked around naked if I thought it would have helped but I knew I'd eventually bump into my thigh and just set off another chain reaction of pain. While I still have moments where there's some residual pain, I'm happy to say that it's mostly gone know. Most of the pain comes from sudden movements, usually involved with standing or sitting. Running doesn't seem to count as I've been able to go short and long distances without any big issues. Maybe a minor readjustment here or there but that's it. It's the smash that usually gets me. Any pressure beyond moderate will make me recoil. That's fairly normal I think but things are more sensitive to touch than before. I guess what I'm saying is, before the vasectomy, I could handle moderate to strong pressure but now have a lower threshold for pain.

Other Reading
- The Effects of Various Types of Birth Control on Runners via Runners Connect - This article is focused mostly on the options of birth control available for women although condoms are mentioned. There are way more options out there than those listed in the article but it's a good place to start with the basics.
- Vasectomy via Jason Lytle's message board - This is more of a very short discussion on vasectomies and their potential impact on prostate cancer. Not really much information here.
- Bizarre Facts About Ultramarathoning via Men's Fitness - One brief mention of famed ultrarunner Marshall Ulrich getting a vasectomy. The comment felt a bit tongue and cheek so I'm not sure if it's true but if it is, he's the only elite ultrarunner that can be confirmed with having one. And then of course there's the questionable source itself.
- A Vasectomy and Riding a Bike...FUN!!! via Running Man Dave's blog - One of the better first-hand accounts of a vasectomy from an ultra runner I've read. Not a lot of details but enough to whet your appetite for more. If you're into that kind of thing.
- Facebook post via UltraRunner Podcast - Not sure if it's visible to everyone but it has a nice long list of fellow ultrarunners with a vasectomy. Best of all, the URP folks are a solid source of information about ultras.


Paula Kiger said...

I appreciate your sharing all of this (and even though it was heavy on TMI for the obvious reasons, it was still informative and kinda entertaining!). I will share (TMI) that we never had to make this decision in our marriage because I went into early menopause (around 43) when we were still (kind of) trying to have a 3rd child. No surgery involved at least.

Neil Richard said...

Thanks for reading Paula!

Lauren said...

I'm counting on menopause. But it's not arriving (and 49 is just a few months away!!!) I know a lot of males who would not consider the surgery you went through. I also know a male (a good friend) who did so at an early age because his fiancee didn't want any more children. She died way, way too young, and they never married. His story haunts me and it is partly why I am scared of such surgeries. I think you have a lot of courage to go through with this, and also to share the info.

Neil Richard said...

I had a lot of fears going in. And still have some fears now that it's done.