diagnosis (with a little drama)

On Wednesday, May 15, 2024, I arrived for my first ever urology appointment. As I mentioned in my last post, at this point I was highly motivated to get my swollen testicle dealt with given I had just ~2.5 months until I was slated to be out of Germany travelling for >3 months for my wedding + honeymoon/sabbatical.

I remember being so calm heading to that appointment, completely unaware of how drastically my life was about to change and continuing to believe I was just dealing with a sports injury. Within a few minutes of explaining my concerns to Dr. "D" (not sure if I am supposed to share names), I was lying down with my pants around my knees for an ultrasound. The look of concern on Doctor D's face as he completed the examination was - to put it mildly - distressing. And while I praise Dr. D's commendable bedside manner and empathetic delivery, the words that came next were even worse. I don't remember exactly what he said, but "tumor" was the word that rang through and stabbed like a knife to the gut. The doctor explained that, despite the crazy coincidence with my gym injury, he was convinced I had a tumor, which was in all likelihood cancerous. Testicular cancer - wow. He was quick to point out that testicular cancer is highly treatable, but that it was a very serious disease and we needed to act quickly, which included running some further tests. Before I knew it, I was whisked upstairs to another floor for a blood test. Then, the drama...

I am an intermittent faster (yes one of those guys, probably the type you hate who tells you unsolicited about how many hours they fast, how good it makes you feel, etc.). On this occasion though, fasting was not my friend. I am not great with needles, and in the past have fainted or had to take a time-out after having blood taken or getting a vaccination, especially if my blood sugar level is low. Having not eaten that morning due to being in the midst of my weekly Monday 24 hour fast, it was pretty predictable what came next. I somehow made it back downstairs to speak to the receptionist - who was scheduling an MRI scan for me as the next course of action prescribed by Doctor D. While standing at reception, everything then went bright white, then black, and then I don't remember anything except waking up to a lot of commotion and a slightly sore head. I had fainted; passed out completely, and in the meantime all the doctors and nurses in the urology department were surrounding me to help, already giving me an IV drip (another first! there would be a few firsts that day) and feeding me candies to get my blood sugar up. So much drama from just a little blood! I was highly embarrassed, and couldn't believe this was all happening. I'm so grateful to the folks at Doctor D's office for looking after me.

the view of my first ever IV drip as I lay in the back of Doctor D's office after passing out

After a short rest and completing my IV drip, I was off on my way to get my first ever MRI scan at a clinic on the other side of town. Somewhat miraculously, I was able to get an appointment the same day. Doctor D had sent me for this scan out of an abundance of caution - he did not want to diagnose me with a testicular tumor and start the chain of dominoes falling after that based on the ultrasound alone, given the coincidence with the gym injury. For those of you who haven't had an MRI before - I won't lie, it's not fun. Mine took about 30 min, and it's as claustrophobic as it looks in the movies, but also quite loud. Apart from the claustrophobia in that little tube (and I am normally not at all claustrophobic), the other extremely challenging thing is being left with nothing other than your thoughts for 30 minutes. Especially just hours after being told you likely have testicular cancer. I remember trying to meditate, name various categories of things to pass the time (NHL hockey teams, countries in Africa etc.) but it was a tortuous half hour.

After completing the MRI, naively I thought I wouldn't get results back for a while - maybe even days. Isn't that how it works in the movies? But within probably 15 minutes I was called into another Doctor's room where he explained what he saw on the scans. And there it was, confirmed once again. The Doctor explained that I had a tumor growing in my right testicle. A pretty big one already - almost 5 cm long, but that he hadn't seen anything else suspicious to suggest it had spread. Once again, this Doctor was very quick and deliberate in emphasizing that this was a treatable disease. That with overwhelmingly good odds, I would be OK. But he explained that I needed surgery, and I needed it fast - within the next 1-2 weeks.

I remember pretty vividly walking out from the clinic to the metro station - at first, an overwhelming sense of being dazed, emotional, and perhaps the first thoughts of "how the hell is this happening?". Fairly quickly though, I also remember that feeling fading and - while I know this sounds overly dramatic and cliché - I remember a strong feeling of gratitude. Gratitude that I had lived such a full life so far - a life of adventure, travel, fun, and with the world's best family and friends. So strange how the mind and your emotions work. I also very quickly called my fiancé Joanna ("Jo") and told her the news. I'll write a post about "telling people" so won't dwell on that here.

The next day, I returned to the urologist, where Doctor D explained a bit more about what came next - that I needed to go to the hospital ASAP to get scheduled in for surgery, that he hoped we had caught the tumor early and we could avoid chemotherapy, but that it was too early to tell. It feels like an understatement, but everything was moving extremely quickly.