Doctor, Doctor Give Me The News
Before we get into this blog, I wanted to take a quick second and give you a little preface of what you’re about to read. I won’t be going into too much detail of the overall experience, but I’ll talk about more of my emotions and reactions during my experience of banking sperm. So, if you’re not fully comfortable with reading about that you can skip a few paragraphs. Although in my opinion, looking back at this situation it was quite humorous. Also writing about this made me realize how many double entendres can be made without meaning to do so.
Monday, October 18th, 2021: Shannon and I are on our way to the sperm bank. Looking back, we probably should’ve done a little more research on the process because we were not prepared. We thought we were going to be able to sit down and talk to a doctor and learn more about this process, and that is not what happened. First off, we had trouble finding the building. There was no sign on the actual building, so when we parked, we weren’t too sure if we were in the correct place. A little hesitant, we enter the building, looking for a directory board to see if we were where we were supposed to be. To our relief we saw the sperm bank sign and proceeded to climb up the stairs. When we reached the doors, we were further comforted because the office was rather welcoming compared to the sketchy building exterior. The woman working at the front desk was very nice and had me sign in and told me they’d be right with me. Before I even have the chance to sit down, a door swings open, and my name is called. As I look at the woman in the doorway, I noticed that she was carrying a plastic cup, and that’s when I realized that there would be no sit down with any doctors here. It was all business. She confirms my personal information on the cup and leads me just a couple of steps to this small room, where the first things I noticed were the tv and the leather chair, and proceeded to instruct me to wash my hands and penis with soap and water before and after. She also pointed out that there was a noise canceling machine. Before leaving the room, she lets me know to ring the bell if nobody is there to help me right away.
As the door closes, the situation really sinks in, and how unprepared I was for this experience. When dealing with uncomfortable or difficult things, I tend to use humor to diffuse the situation. I tried to make myself more relaxed and comfortable with the situation by sending out some funny snapchats to my friends, but to no avail. I was still stuck in that room until I made a deposit. I try to get this whole ordeal over with, but I kept creating this self-imposed pressure over the situation that made it quite difficult. I kept thinking about how I was masturbating in essentially a closet, with my future wife out in the waiting room, and an office full of what appeared to be only female staff. The worst part was that every single person knew what I was doing in there. It felt almost shameful. I knew I was there for a good reason. We were taking preparations for chemo so that we had a fail safe for starting a family. I knew this was something I had to do, but it just felt so shameful while doing it. The more I thought about it, obviously the more difficult it became to want to finish. Which then made me think that everyone must be wondering why it’s taking so long in here, which made me feel like a pervert. I was beginning to think that I was going to have to leave without doing what I was here to do. I took some time to compose myself, reminded myself why I was here, cleared my head, and I did what I had to do. After cleaning up, I open the door and the first thing I see is the bell. When I looked at the bell, I imagined that ringing it would kind of feel like Cersei Lannister being shamed in Game of Thrones.
Source: Game of Thrones
Luckily, one of the lab technicians came over and took my sample and I was free to go. I signed out and they told me I’d have a report by the end of the week. Shannon and I walk in silence back to the truck. As soon as the doors close, I look at her and tell her she’s never coming with me to the sperm bank again, and she agreed. Reflecting on my first experience with the sperm bank, I’d say my biggest take aways for someone who might need to go in the future are:
When scheduling an appointment, ask to speak with someone who might be able to answer your questions, because when you get there, it’ll be straight to business.
Since its straight to business consider going alone for so you feel more comfortable behind that closed door, even though you’re there for a good reason it can still feel quite awkward.
Something I wasn’t told before hand was to abstain 2-5 days before visiting the sperm bank.
The ideal number of samples for freezing is 12 vials, so that means you might have to make multiple trips.
After dropping Shannon off at her office, I head to work for the first time in 2 weeks. When I get there, I meet up with my boss, and I recount my morning I had with them and we laugh over the situation, because the comedy pretty much just writes itself. Settling back into work wasn’t that hard, but I felt bad because in the next couple of weeks I would be in and out for doctor’s appointments. I didn’t want work to think I was taking advantage of them, but I knew I had to take care of myself. They reminded me though, that my health was important and to take whatever time I needed to, they fully understood and supported me. Which I am eternally grateful for, not a lot of companies do that anymore, especially with this pandemic still going on.
Friday, October 22nd, 2021: At the end of my first week back to work, I had my appointment with the uro-oncologist in Boston. Shannon and I meet both of our mothers at her office where we carpool to the appointment. We got there with some time to spare so we ate some lunch and the moseyed on over to the hospital. When being checked in they told us that I could only bring 2 guests with me, but they let all of us go up to see if we could all go in. When we check in on the floor I’m supposed to be at, they tell me I’m only allowed 1 guest. When the nurse called my name to take me back, she saw that there was 4 of us, she hesitated told us to wait a minute. When she came back, she said she that everyone would be able to sit in on the appointment, which was a relief so that not everyone made a trip up to Boston just to sit in a waiting room. After waiting in his office for a while, the doctor finally comes in. He introduces his self to all of us and comments on it being a party in there. He begins to go over my case with me, telling me that from what he sees my testicular cancer would be classified as Stage IB. He agreed that he saw no spreading to my lymph nodes but reiterated that they were slightly enlarged and that would be something to monitor through blood work and scans. He brought up the possibility of needing retroperitoneal lymph node surgery (RPLND) if my lymph nodes do increase in size or show cancer. This surgery entails the removal of the lymph nodes that the cancer spreads to first in order to stop the spreading. He said where I stood now, if we took no other action, I’d be living with a 25-50% chance or reoccurrence, but a 1-3% if we opt for chemotherapy right now. Before we left, he scheduled me an appointment with the head of oncology for the urology field for October 28th as well as a blood draw when we got down to the main floor. Little did I know this would be the start of becoming a human pin cushion. Leaving the Boston that afternoon, all of us were convinced that chemotherapy would be the best option for me.
Wednesday, October 27th, 2021: The next week, Shannon and I met with the oncologist in Plymouth. After our introduction he starts going over the pathology reports with us. This is where we learned that we were misinformed about what cancers I really had. He tells us that my tumor was comprised of yolk sac, teratoma, and embryonal carcinoma. When he tells us this, he could clearly see the looks of confusion on our faces. We tell him this was the first-time hearing about the embryonal carcinoma, so he excuses himself to go print the pathology report for us and to double check for himself. He comes back and hands us the report, where clear as day we see embryonal carcinoma listed, and not choriocarcinoma as we were previously told. From here he begins going over what he feels would be the best treatment for me. He said right now he was on 50-50 on whether to put me through chemo or to go with active observation. If we did chemo he was thinking maybe 1 or 2 rounds would be sufficient and potentially getting a port implanted in me for chemo to save my veins from being burned from the drugs. Active observation would entail me coming in every so often, more so in the near future, and then every 3-4 months later on for some blood work and ct scans. He also started going over my tumor blood markers with us. The marker that was the highest at this point was the AFP (Alpha-fetoprotein) which can be increased by all three types of cancers that were in my tumor. The other tumor marker that was present was Beta-subunit of human chorionic gonadotropin (b-hCG). Pre-orchiectomy levels of my AFP were 418 ng/mL where normal levels are less than 6 ng/mL, and b-hCG was at 37 mIU/MI and that should be less than 5 mIU/MI. We also learned that the tumor itself was 7.8 x 6.8 cm and the testicle grew to 9.4 x 8.3 x 8.7 cm, or roughly the size of a grapefruit. At the end of the appointment, we agree to see what the doctor in Boston, who just so happened to be his mentor, has to say about my case and re-evaluate after I meet with him.
Thursday, October 28th, 2021: After getting our results back from our initial visit to the sperm bank, we decided it would be best to make another deposit so we could reach or exceed the ideal number of vials. We chose to triple book ourselves for today, making a stop at the sperm bank on the way to Boston for our appointment with my oncologist’s mentor. Since this meeting wasn’t too long after my appointment with the sperm bank, Shannon once again had to accompany me, but this time she stayed in the car. I knew what to expect this time around, so this visit was much less stressful. When we eventually get to Boston, and into our appointment, we are told a lot of the same information we’ve already heard. My tumor was a non-pure seminoma, meaning it was comprised of multiple types of cancers, there was no evidence of spreading to my lymph nodes or any other organs. We were told that there are 3 options for treatment for my case, which would be the RPLND surgery, 1-2 rounds of chemo, or active observation: where I’d be facing 10-20% chance of reoccurrence. We were informed chemo would not be an easy chemo and that I would face fatigue and hair loss. According to textbooks and guidelines, its up to the patient in these situations, “But why would you come to a doctor for them to not to give you an opinion?” he asked us. He looked at us for a second, and he told us that looking at everything he would be comfortable with us proceeding with the active observation route of treatment. “No need to put you through chemo if you don’t really need it” he said. He warned us though, that if through this observation we see that the cancer has returned it’ll be more rounds of chemo than it would be right now. But he was comfortable and confident that active observation was the best route right now and he assured us that my oncologist in Plymouth was more than capable of handling my treatment from here on out, he will also work with him if anything changes. He wanted me to give a blood sample for testing before we left, which I was not expecting, but it was quick and painless, nonetheless. Shannon and I left Boston in high spirits, feeling very confident that this battle with cancer was essentially over. We then headed back to Plymouth so that they too could get their blood sample from me.
Wednesday, November 3rd, 2021: We meet with my oncologist in Plymouth to review how our appointment in Boston went. He agreed with his mentor active observation was the best option, and if we did chemo now it would be 80-85% of going through chemo for no reason. We got some more information back from pathology, saying that my tumor was mostly composed of teratoma cells, which don’t respond to chemo very well. We scheduled my next ct scan for Valentine’s Day in 2022, and we decided I would give blood samples every 2 weeks for the time being. So before leaving the hospital, I go and give another blood sample.
Thursday, November 4th, 2021: Going through this journey so far, I discovered that my support system was larger than I could ever imagine. Through my best friend from college, whose mother battled stomach cancer, was able to get me in touch with doctors at another hospital for a 3rd opinion. We had a virtual appointment to go over my case. To no surprise everything we’ve heard up to this point was reiterated to us. My tumor was a non-pure seminoma comprised of embryonal, yolk sac, and teratoma. There were no signs of spreading to my lymph nodes or other organs, no lymphatic vascular intrusion (LVI) (which is just spreading at the microscopic level). They confirmed that there was a cluster of lymph nodes that were slightly enlarged but it didn’t warrant concern. My tumor markers were trending in the right direction. They said they felt I was 80-85% cured with the orchiectomy alone, but if there were signs of the cancer returning, I would have to go through 3-4 rounds of chemo instead of 1-2 cycles now. Ultimately, they felt comfortable with us proceeding with active observation. We were 3 for 3 on our path moving forward. We were ecstatic. Besides some blood work every so often and then ct scans every 3-4 months this wasn’t so bad. No chemo or surgery was needed. I could start returning to my normal life.