I was playing with my infant daughter one day and she stood on my balls. I felt nothing - I thought it was a bit weird but I put it to the back of mind. I had a bit of a feel in the shower and felt "something" that shouldn't be there. We were in the middle of an interstate move so I made an appointment for my new city, Chicago.
When we got there, I had an ultrasound and didn't think much else of it. I had barely got out of the parking lot when my phone rang - it was the PA's Attending - could I come back in?
That afternoon was a blur of blood tests, X-rays and CT's. He asked if I was free the next day for surgery, I put it off until that Monday to have some time to arrange childcare etc
Surgery came and went, I was diagnosed with Seminoma stage I and was put on surveillance. I kept up to date with my scans and in November of 23, a recurrence was found. Chemo was seen as next step but I had read about RPLND as a first line treatment of Seminoma via the SEMS study. I moved my care to University of Chicago and Dr Eggener took my case and said I was a candidate for RPLND.
Arrival at hospital and pre op
You get checked in and taken down to the pre-op area where you get set up with various IV's and bloods taken. It seemed to take forever but there was always people coming and going. First a resident would come and go through the consent for the surgery and "mark" you. Next the anesthesia resident comes and goes through their consent. Finally the anesthetist comes and does their exam. She was awesome and very comforting and very funny. While she was talking to me, the surgeon came to check everything was good, told my wife to give me a kiss and I suddenly felt..woozy. They give you a quick something to start the "memory block" and take away any anxiety. I kind of remember being wheeled down to the OR and climbing onto the table and confirming my name but that's it. It was basically lights out.
The surgery
I obviously don't remember any of this - however the open surgery is long and it's amazing that the doctors and nurses and techs can do all this and just go on with their day to day life. They make an incision right the way down from your chest to your belly button. Once that is done, they basically take your bowels out and put them on a sterile sheet on your chest while they go to work. They dig deeper and deeper in to your belly and remove the nodes in the RP. They move super slowly and visually inspect EVERYTHING to make sure there is no spread. I note from my operation notes that the bad nodes were clearly seen.
After about 4 hours, they put your bowels back in ( it all goes back to normal with gravity) and sew you back up. You get bought round from anesthesia very quickly. Apparently I was awake within 10 minutes of leaving the OR and chatting to the nurse and came back to "consciousness" about an hour after asking where I was and asking for a coffee.
In Hospital recovery
You get taken up to your room and from then it's a waiting game. My surgeon came up AFTER he had done another one of these surgeries to check how I was and got me standing up there and then. The first night was rough but I was on Oxy as well as "magic button" that I could press every 10 minutes. They take pain very seriously and want to do everything possible for you not to be in in.
The first night was odd because you are in "high dependency" you have nurses coming in every 2 hours for vitals and run meds so you are high as a kite but also can't sleep for long because once you do...in comes the nurse.
From here on out you fall into a routine of trying to walk, poop and sleep. Time stops existing. By day 2 they had taken away the magic button and I was just on oxy as needed and Tylenol. They monitor your urine output to check that everything is OK. By the evening of day 2 my catheter was taken out.
Day 3 I pooped and was more mobile despite being bloated up like a motherfucker. The surgeon came for a final check then asked if I wanted to go home and "really start recovering". I went home! (surgery was Tuesday, went home Friday).
At Home recovery
You're given a prescription for Oxy to take as needed. 7 tablets initially and you get more if required. I ended up needing 3 in total. For the first week I went from the sofa to bed with periodic walks first up and down my street, then around the block, then around the block twice. Each day getting stronger. Fatigue was real, and there were lots of naps. Eating was fine. I was on 30 day of low fat which was a pain BUT tolerable - it's actually amazing what you can eat on it. By week 3 I was mostly back to normal. Was able to walk into my downtown for a coffee etc. By week 4 I was back at work (desk job)
Now
TBH the whole thing seems like a distant dream. After 6 weeks I went back to the gym and within 6 months I ran a 5K. I do have some discomfort with certain foods still and foods that never used to make me feel gassy. After a meal I do get SOME bloating as my food digests but that has lessened a lot over time.
10/10 would not want to go through again but grateful to the doctors and nurses for making it as easy as they could
Since then, I have kept up with all my scans and crossed the 2 year mark. I am holding out hope that this may all be behind me now. I know that if it comes back, chemo will crush it - but I'd prefer not to
Mentally, this has taken it's toll. I went onto antidepressants for a period of time which helped me get over some depression and anxiety that surfaced. It still hangs over me but am starting to hope this cloud is being lifted