The "C" Word

The people at the Cross Cancer called me on Valentine's Day in follow up to my MRI, a day earlier than I was expecting. They didn't tell me much of anything, they were just calling to tell me about my consult appointment that had been set up for February 24th. I even asked, "is that all the information you have?", apparently Suzie from appointment bookings is John Snow and knows nothing. A few days later the confirmation letter came in the mail. The letter read that my appointment was for a "new patient consult", this was worrisome enough, but then I looked up the doctor I was to see. She was listed on the College of Physicians and Surgeons website as a Radiation Oncologist; fantastic.

I come by a positive outlook on life quite honestly. I was raised to focus on the good things rather than the negative ones with a real belief that everything happens for a reason (thanks mom). This doesn't, however, make me delusional. So I sat there, staring at my computer, quietly losing it, hoping for the best, but planning for the worst and trying to keep my wife calm. Resigning her and myself to the news that they found something and I would likely need some type of treatment, however, hoping that the relative non-urgency of my appointment in two weeks meant that they must not have found something that serious.

Then it hit me, a common side effect of radiation is infertility; but I already have fertility issues! If radiation could wipe out over 20 million sperm, I think it's pretty fair to assume my six little swimmers would be sleeping with the fishes. I told myself right then there's no way I'd be getting radiation until K is pregnant, knowing full well now that I'm married this decision wasn't just mine anymore, and knowing full well K wouldn't want me to wait. We were somewhat prepared for this though, the fertility doctor had ensured us they prioritize people dealing with cancer and would help expedite the process for us. So if there is a silver lining, I guess it's that we might get to have a baby sooner than expected, but with much more at stake.

So the morning of the consult, K came home from her night shift and stayed awake to accompany me to the appointment. The appointment was for 09:45 so we bummed around the house for a bit and played with the dog before anxiously departing for our destination. We got to the Cross Cancer a little early (an occupational hazard of K being an EMT is that she knows where all the medical facilities are). We found parking and made the ominous march from the parking lot, following the Cross Cancer Institute signs. I'm sure if they weren't so large there's no way we would have found our way; not because it was difficult to navigate, but because walking in, in that mindset, was like standing in thick, blinding fog.

We did our little check-in at the front reception and they directed us to Area C. Again, K knew where to go, and we filled out some forms and sat in the waiting room for what really seemed like forever before a nurse came over, called my name, took my measurements, and guided us into a little room. The nurse gave us basically no information, but did proceed to repetitively ask me the same questions I answered on the forms I had completed 10 minutes previous. She handed us a thick envelope of cancer patient resources, assured us that our questions would be answered by the time we left, and then hurried out of the room. Then we waited, again, for probably only 20 minutes, but again felt like forever, for the resident to come in. She went over everything once again, along with my medical history, once again (one thing you can't accuse this place of is not being thorough), before telling us that my MRI results had come back normal. We weren't out of the woods yet, but I gave a huge sigh of relief. She told us the Oncologist would be in shortly to discuss the plan moving forward.

Thieved a souvenir from the oncologist's exam room

We waited another 20 minutes (this time it actually felt like 20 minutes) for the Oncologist. The resident came in with her and we went over everything again before she asked us if we had any questions. Then she proceeded to explain that the tumor I had removed was called a "solitary fibrous tumor". It did not test positive for being a sarcoma (cancerous soft tissue tumor). That said, this type of tumor, in 10-20% of patients, can act cancerous and spread, so although they didn't find anything, they would like to do another surgery to make sure they got it all. I asked her if the tumor or the surgery could have any effect on my fertility, she said not likely. Mixed emotions on that one, but I never thought I'd be so happy to hear that I needed surgery. No chemo, no radiation; this went from being the worst day of my life to the best news I'd ever heard.

Prior to leaving, the doctor assured us they would make the referral to the Surgical Oncologist and they sent me for a quick chest x-ray, with the rockstar of all x-ray techs who told me that the the Cross is "kicking the shit out of this type of tumor" and I had nothing to worry about. The chest x-ray would be used to set a baseline and make sure they had something to compare future x-rays to down the road if something spread. Then we got in the car and drove our asses to our favorite restaurant, Ampersand 27, to celebrate. One problem down, one to go!

Under the Needle

With the second sperm analysis looming, K and I wanted to make sure we did all the necessary research and made all the necessary preparations to boost my number of soldiers. We scoured the internet for information on nutrition, exercise, and treatments to help increase sperm count and quality. It wasn't easy either, because the majority of information out there is for female infertility, not male infertility. We were somewhat desperate and willing to try almost anything so don't judge us.

I emailed a registered dietitian to ask her about her experience with male fertility. She said she had none, and referred me to my primary care network dietitian for "overall health". This is not what I wanted. I already know how to eat healthy, I needed to know what to eat to make an army! So back to Google. 

I found some emerging patterns as I searched countless websites. Some things were obvious: no smoking, no drinking, no drugs. Some were new to me: such as eating foods rich with zinc like walnuts and spinach. And high in omega fatty acids, like salmon. I love salmon! This is going to be a breeze! I also learned that foods high in mercury could have a negative effect on sperm count. In 2016 I lost a lot of weight by eating canned tuna and veggies every day. Convenient? Very. Healthy? Apparently not for your junk. So that's off the menu now.

As many of you may already know, sperm thrives in conditions slightly lower than body temperature. Which is why your balls sit in a sack outside your body; to keep the sperm cool. So things like a warm laptop on your lap, or sitting in a chair all day (pretty much my job), wearing tight underwear that keep your nuts close, all increase the temp of your balls. K found a company that makes a product called "Snowballs". It's underwear with a pocket sewn into the front, and an ice pack in a wedge shape that you can tuck under your nuts to cool them off. For best results, ice your balls for 2 hours daily. Will this work? I have no idea, but I figure for $50 its worth a try.

When the package came in, K made me try them on as soon as I got home. I reluctantly obliged, feeling silly, but found the cool sensation quite nice after a day working in a hot office. I had some trouble figuring out which way the ice pack went in, and after some overly-dramatic adjustments (for comic effect) the comfortable alignment I settled on did not make sense to K (women just don't understand balls) but it did the trick for me.

Another endeavour we read about was acupuncture for infertility. Personally, it doesn't make sense to me; it sounds like a giant ball of garbage. You have energy lines in your body and you jam needles into certain spots and BAM! sperm? Sounds crazy to me. What made me decide to try it though, was my grandmother. When she was battling cancer she told my mom that none of the narcotics, the Morphine or the Demerol, none of them even touched the pain; but acupuncture helped. So despite my skepticism, I agreed to give it a shot. I found a clinic in Sherwood Park that offered the treatment and made an appointment.

K came with me (she insists on co-attending as many appointments as possible) and she sat and watched while the acupuncturist inserted her needles into my ear, forehead, arms, legs, and wherever else that I have no idea about because its nearly impossible to move for fear of catching one of these things and ripping it out. I took a little nap, snored for 20 minutes, and they came and pulled all the needles out. While I was paying, they insisted I book my new patient consult. I didn't know what this meant, but agreed.

A couple days later I went in for my "new patient consult" with the "doctor". Although the person who attended to me was a registered acupuncturist, I was pretty certain she was not an MD. I was there for fertility issues but she was insistent on hearing all of my issues. So I told her about my heartburn and my night sweats, she took a gander at my tongue, noticed the dark circles under my eyes (which have always been there) and then used a "diagnostic tool" that I like to refer to as "playing a three fingered piano on my wrist". When we were complete our 45 minute session she told me I had Qi (pronounced "chee") blockages in my liver and kidneys which were causing my infertility. She told me I would have to continue with acupuncture but that it would not be nearly as effective without the Chinese herbs. Then she handed me a $100 invoice and told me to book another session to start treatment.

I'm far from convinced on this course of treatment but I'll keep going and taking these Chinese herbs at least until my next sperm analysis. If it works, fantastic, I won't care how, I'll just keep going. If it doesn't work, well, I did say I'd try anything.

Waiting Ain't No Game

You would think the most difficult parts of these situations would be finding out, but personally, I can tell you it's the waiting that kills you. You see the doctor, you wait for a test, you have the test, you wait for the results, the results are inconclusive, you wait for another test, you have the test, you get referred to a specialist, you wait to see the specialist. Meanwhile, you are trying to stay calm, think happy thoughts and find Tinkerbell's fucking fairy dust so you can fly to Neverland where time stops. It's maddening; but that's the process.

I had the pelvic MRI at the Cross Cancer on February 6, 2017 at 7:30 in the morning. Lucky for me, my boss, who has been extremely understanding and supportive, works with me to make it easy to attend all these appointments. It was so cold that morning that the electronic parking station was frozen up and I had to wait for what seemed like forever in the cold for the ticket to come through. I walked into the Cross Cancer for the first time and waited in line at the front reception. Reception sent me to a side room to set up my patient file and they presented me with a cool little red bank card which indicated I was a patient of the Cross Cancer. I hated that stupid card. It was a symbol that made this whole thing just a little too real for me. I preferred to keep my head in the clouds until I actually knew something but this card was like a rope pulling me back down.

The new patient coordinator walked me across the facility to radiology and the lady at the front desk there instructed me to disrobe and change into the hospital garb. I did so and when I came out she handed me the standard clipboard of information to complete. The usual stuff - Do you have any metal in your body the giant electromagnet might rip out? I answered the questions to the best of my ability before bringing the clipboard back to the desk. Before I could walk away the woman asked me, "Excuse me, are you wearing the pajama pants?" I looked down at my hospital gown and dress shoes and responded "There's pants?" - She nodded and as I felt my face turn beet red she directed me back to the change rooms where I tried my best to shake off my embarrassment while I pulled on the missing clothes.

I was brought in quickly and they explained the MRI to me, asked me another series of questions and sat me in the chair to inject the contrast. The contrast is basically a dye that is injected into you and provides contrast on the pictures against things like tumors. The pictures are apparently so good that sometimes, if tumors are present, the doctor can even tell if they are malignant (cancerous). The MRI tech was asked to mark on my body the site of the surgical incisions from my hernia surgery. Because my surgery was laparoscopic (done with tiny incisions and a camera) I had three scars.  She marked the scars by taping a vitamin E capsule on top of each of them. One over the left scar, one on the right, and one settled nicely into my belly button.

The MRI team then placed me nicely onto the bed and slid me into the MRI tunnel with some headphones and light music where I promptly fell asleep snoring. Seriously, who falls asleep during an MRI? It's so loud! When it was all over I got changed, removed the vitamin E, and returned again, to waiting.

Things I learned from my MRI experience:

1. Dress shoes and striped socks are a hilarious idea
2. Read the directions on the change room wall
3. I can sleep literally anywhere

The Hopeful Dad

Now that you have context, you have a pretty good idea what comes next, because a story isn't a story without a problem, or in my case two big problems. I decided to change doctors after the fiasco with the previous clinic and after providing my scrotal history to my new family doctor on December 12, 2016, she agreed there was cause for concern and referred me for a semen analysis and some blood tests through Alberta Health Services. I was nervous on so many levels:

1. What if I couldn't have kids? K had been so disappointed every time the test was negative. What if it was my fault?

2. The requisition form for the test said on it: "Ensure you provide the sample to the lab within one hour of collection, be sure to keep it at room temperature the entire time".

a) Where in the hell was I supposed to put said sample?
b) I live an hour away, am I supposed to do this in the parking lot of the hospital?
c) Albertan's exist in -30C weather, how in the hell do I keep this thing at room temperature?

My concerns listed above were addressed when I made the appointment. Of course when I first called and received the clinic's voicemail, I - like an idiot, had my office door wide open and my phone on speaker. Out of my door blasted "thank you for calling the semen analysis clinic" BAH! I don't know if anybody heard, but nobody said anything. I'm sure it would have been even more embarrassing for them to ask me about it.

So I eventually spoke with a coordinator at the clinic who advised me of my appointment details. I asked her: "Do I need to bring anything?"
She responded "Just your health care card and your requisition form."
"So everything that happens...it happens there?"
Her voice sounded like a combination of having heard this question before, and being slightly confused as if she was thinking "where else would it happen?" but she chuckled a little and said "Yes".

Now I had all new questions that I didn't want to ask:

1. What does the room look like?
2. Does it have a big comfy chair like a thousand other men have used?
3. Do they provide...material?
4. Is said material used? Is it current or from the 1970s?
5. Is there mood lighting?

This stayed on my mind for the next month until I showed up for the appointment on January 30, 2017. It turns out, the clinic had its own elevator which opened into a waiting room. At the front of the waiting room is an enclosed room for the reception (enclosed with a glass door and wall for privacy). I spoke with them and they said, "Oh, semen analysis is just around the corner at the window." It was literally a window, in a hall. The women and couples get a private reception, the men get a freakin window!

I know, I complain too much, but my concerns were validated when I saw the room.

The directions on the door said to put on gloves, use the sterile wipes to clean the chair, remove the gloves, wash your hands, do your business into the plastic cup, and repeat steps one and two. So I did my duty as a hopeful dad and proudly placed the cup at the window before leaving.

Two days later I got an email from my doctor telling me the analysis was non-diagnostic and that I'd have to do another one, but that I could wait for our appointment she set up for us at the fertility clinic.

On February 7, 2017, K and I attended the appointment our family doc made for us at the new private fertility clinic on Jasper Ave. They took her vitals and ushered us into a glass room where the doctor met us to take our medical history. K asked something about my semen analysis being non-diagnostic and the doctor said, "yes, lets talk about the semen analysis".

The next 20 minutes was a major blur as the doctor explained that my infertility could have been caused by any one of my historical issues, or possibly none of them. As a giant pit formed in my stomach she explained the results of analysis. Explained that 20 million sperm is the minimum they like to see in a fertile male, and how my sperm count was just 6. K asked the doctor, just like every person I've told this story to, "6 million?" which in itself is extremely low. The doctor responded "No, the number 6", and of those 6 only one was motile.

The doctor explained that I would be set up for additional testing; another sperm analysis, hormonal and chromosomal testing, complete with an ultrasound to "check the plumbing" following which I would be scheduled for an appointment with a urologist. The doctor explained that in the absence of "other causes" likely my condition meant that they would have to complete a sperm retrieval procedure which means that we would be committing ourselves to In Vitro Fertilization.

My dream of becoming a father seemed to be disappearing, slipping through my fingers like sand.

The Legend of Lefty

My newest and biggest ambition in life was to build my family and have children; my wife swapped out the word ambition for reality, and it became our number one goal to have children and raise them together. We started trying almost immediately after we got married and month after month with no success, we were disappointed. It had only been four months and everyone around us was telling us not to worry, but my wife’s impatience had reached her threshold. Not because she had unrealistic expectations, but because of a combination of her truly being an inherently impatient woman (love you babe), and her concern after having been informed of the story of Lefty.

Lefty’s struggle started as a very young child with an undescended left testicle which required and underwent correction. Unfortunately, this correction led to problems later in life.

At 18 I had been dry-humping my then girlfriend in the living room when my left testicle really started to hurt and swell. Being a concerned 18 year old thinking my nut was about to fall off, I immediately went to the hospital to get it checked out. When there, they diagnosed me with testicular torsion (basically a twisting of the testicle inside the scrotum). This apparently was a medical emergency so they decided to send me by ambulance to a hospital in Edmonton and to my horror, since my girlfriend was a member of the Students Against Drinking and Driving program, she knew the EMTs that would be completing the transfer. Lovely.

That portion of the story ended quite anticlimactically with me being discharged from the hospital once the swelling receded without any further care required - subsequent to lifting my hospital gown for countless doctors and nurses, and being asked loudly "has your left testicle always been much bigger than your right testicle?" while my girlfriend and my brother burst out laughing just outside the curtain.

At 21 I accepted a job in Canmore, Alberta, but it was short lived because after 3 days in my new position, Lefty swelled to the size of a grapefruit during a short visit from some close friends. For some reason, at that time in my life, that was a sign the job in Canmore wasn't for me and I left the next day...riding my motorcycle...through a snowstorm...with my grapefruit sized gonad. I made it as far as Olds before I abandoned my bike and hitched a ride in the back seat of a friend's car.

I got home on fumes, walking as though I was straddling a horse and wasted no time in attending the emergency room at the local hospital. They said it was an infection, booked me for an ultrasound to confirm and sent me on my way with my antibiotics. After two days of icing my junk I'd had enough. I went to a hospital in Edmonton where the doctor prescribed me some additional antibiotics as well as a bottle of Percocet. Those helped with the pain immensely and after a brief dinner and the shedding of some seemingly not-so-important inhibitions, I arrived at the tattoo shop with two of my friends.

My dear friend O is the one who coined the nickname Lefty. She thought my plight was hilarious and insisted that I commemorate such an incredible story by getting a tattoo.

So yes, as you can see, I had the name Lefty tattooed on my bottom lip by a long haired Australian artist who convinced me the font (which looks like a 5 year old wrote it) looked "badass".

And so ends the Legend of Lefty and begins the story of Lefty the Hopeful Dad.

Knocked Down

I always dreamed of having adventures. In fact, I did have adventures; great ones: I backpacked Europe with my brother, I hunted wild animals, surfed in Mexico, cliff-dove in Greece, ran with the bulls in Spain, partied in Ibiza, and climbed mountains. I lived much like a rock star without the fame in my younger years. I would say my life has been a truly amazing adventure.

The adventures I lived compared with those I dreamed of living, however, lacked the life threatening luster that makes a Hollywood action/adventure so thrilling. I imagined myself fighting for my country, or running from terrorists, or travelling the world looking for historical treasure, you know, world changing things, dangerous things.

That desire never really went away, but as I aged, my aspirations adjusted to reflect my maturity. My burning desire now is to have a family and provide for it. This new aspiration put a whole new twist on my thrill seeking persona by changing my definition of thrilling. I can’t imagine what could be more thrilling than watching a tiny human that came from my own genetic code stand up on its own two feet.  Or like my friend told me about his own son, to associate a picture of the sun, with the sun itself.

My new ambition suddenly became a reality when I married K, the most beautiful and big-hearted woman I’ve ever met. We got married on August 27, 2016. Everyone had been touting the year 2016 as the worst year ever, they couldn’t wait for it to end. The refugee crisis was never ending, Trump had been elected president, countless celebrities and artists had passed away; people were done with 2016. But for me, 2016 had been the best year of my life: I traveled to Jamaica and Scotland, watched friends marry, got married myself, been surprised in the most epic way with a 30^th birthday party, landscaped my house, built my fence, completed schooling I had been working on for 10 years, and welcomed our new pup Ruger to our family. The year 2016 was busy, and amazing.

2017 brought all of that to a screaming halt, like the young Asian girl in Greece we watched crash her ATV into a concrete wall. My landscaping adventure in the Spring of 2016 brought with it a pain in my right groin. I went to see the doctor that spring who then sent me for an ultrasound. In follow up with my doctor I was told I had a hernia on my left side (not my right where the pain was), and that the ultrasound also showed an enlarged and abnormal lymphnode. The doctor told me not to worry about it, and booked me to see a surgeon to repair my hernia. The consult with the surgeon was about the same, the lymphnode was nothing to worry about, it’s likely just swollen because of the hernia.

I had surgery on November 21, 2016. Surgery went well, recovery was painful, but I was back to work inside two weeks. The first week in January I got a call from the doctor’s office. The nice girl on the other end of the phone says “Hi, we got the results from your biopsy back, would you like to book an appointment with the doctor to talk about it?” to which I responded “What biopsy?”. I begrudgingly scheduled the appointment for January 6th.

K insisted on attending with me and it turned out the doctor didn’t have much information anyway. When I had surgery, they found what they called a granuloma, a tumor on my testicular cord. They cut it out and sent it for a biopsy, they just apparently failed to mention that to me after surgery, or at my follow up appointment with the surgeon in December. The pathology was negative but referral to a specialist was recommended. I’ll save you my complaints of the provincial health care system here and just say that getting this referred to a specialist was like pulling teeth, but in the end, it was referred to the Cross Cancer Institute in Edmonton.

Two weeks later, I received a call from the Cross to tell me I had a pelvic MRI booked for February 6, 2017. I was a little astounded that nobody had bothered to tell me why, but I did end up dragging it out of them (in a somewhat panicked voice) that the pathology report had been reviewed by a team of doctors specializing in sarcomas (Google defined this as a soft tissue tumor) and the doctors asked for an MRI to be prudent. They assured me that I would hear back from them by Wednesday, the week after the MRI.

At this point it’s important to backtrack to provide some context on a side story that really will become the forefront of this entire blog.