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Anxiety and pain


#1

Hi guys, I’m beside myself right now. I’ve just gone through a week of hell. So I had my vasectomy 6 months ago. I for sure had some congestive pain that was on and off for around 2 or 3 months. The past 3+ months I had felt really good. So two weeks ago I got hit in the nuts by my 3 year old. But the pain went away after 15 min. However, it returned 2 days later and I’ve had it almost constantly for 2.5 weeks now. I don’t know if it’s related to the hit or since it’s 2 days later could just be congestion pain?? I took time off work over the long weekend and literally laid on my back and slept for 4 days straight. When laying doing nothing it was down between a 0-1 in terms of pain. Well ofcourse this week I have to work and now it’s fluctuated between a 2-4 atleast. Feels like a burning and aching. Almost always it’s really good first thing in the morning when I wake up. But by the time I’m in the car and to work it’s back again.

I’ve had SEVERE anxiety/panic attacks from all of this which seems to be making it worse. I finally got some Ativan from my family doctor that I can’t wait to try tonight to let the anxiety down.

I guess my question is to those more experienced: considering my pain is better in the mornings and usually worse in the middle of the day and then a bit better if lying on the couch at night, any ideas what it could be? The urologist thinks I could just be a ‘slow healer’ and I have read some that get better with time but to me there is congestion pain there and maybe the blow created more inflammation that my body just can’t get rid of. I’ve taken a course of ibprofein which did nothing. I’ve waited a few days and now trying alieve. I donno, I just wanted to get this off my chest and get any advice. I don’t want my family and work life to be ruined. I feel such a sense of dread. Like I’m imprisoned.


#2

Mate, can relate to all of these. Anxeities, painic attacks, depression. It will pass and you’ll improve. Buy yourself papaya seeds powder, take it daily, you’re still early, with this.


#3

Thank you for replying. It means a lot. I’m going through some real shit right now with this (as I’m sure we all are). Has pappya seed helped you I take it. Worst part of all this is I’ve already paid for a Disney trip were going to next month. I donno how I’m going to do it but I can’t let my family down so I will make it work.

Did you find lying down help you at all? Is it weird I’ve woken up most mornings pain free only to have it shortly after walking around?


#4

Should also say it always seems worse sitting to drive. Is that because the inflammation is squishing the nerves? I’m now worried that will lead to more nerve issues.


#5

My first panic attack of my entire life happened 6 weeks post vasectomy at the age of 33. I’ve had a total of 3 in 3.5 years, 2 of which put me in the ER. You’re not alone. Vasectomy changes you and it’s not just in your head. Things are different now and your body is trying to adapt. Interesting that your physician calls you a “slow healer.” He has surgically separated the main communication between your testicles and the rest of your body. This isn’t natural. Just because the surgical wounds may have healed, doesn’t mean your body has healed from its current state. Your body is under no obligation to approve of the vasectomy and move on. It could be the pain, your sleep, overall worry, probably some psychosomatic, definitely some hormones, with a healthy dose of depression. I’m sorry for your loss. We hear this same story over and over again. Vasectomy may not kill you but it certainly isn’t a “healthy” decision for your body. Good luck in your journey towards recovery.


#6

Hi Help

I was a slow healer myself and now after almost 3 years I’m as good as new. Looking back I was improving all of the time, if not necessarily in a linear fashion.

Time and acceptance of the transitory nature of the pain is the best healer. My GP and urologist told me that time would clear up my symptoms and they were correct.

Try your best to accept it as it is now as the more we focus on issues, the larger and more intransigent they appear and this has a corresponding knock on effect on your nervous system which leads to panic attacks etc.

I didn’t bother taking any Papaya powder or anything else after taking too many meds for the first period of recovery.

You will be fine - try and listen to the positive, non-surgical solutions.


#7

Soon after mine I fell into deep depression. I always had anxiety issues and never trusted condoms (yeah, I was paranoid). I was sold the idea of an easy, quick, and safe procedure. Not only me, but also my long-term partner (who I’m still with). Since all the urologists I saw told me there was no problem with my surgery, then I sought help of a shrink who put me on depression and anxiety medication. This has been a long battle for me. A painful, regretful one.

Vasectomy changes you. It’s not that you’re permanently sterilized. It affects your mind, especially when you realize you have been fooled into doing it.


#8

@Help ,

Honestly, I would agree with @irishguy about really trying to relax and accept some of this pain at this point as part of the healing process. I wish having a vasectomy was a 3 day, very little pain, procedure for everyone that has it done. I had a revision surgery where they cut out a granuloma. It didn’t fix all my issues, as I seem to still have some nerve or muscular issues and it’s been almost 3 years since my original vasectomy and a little over 2 years since the revision surgery.

What I can tell you is that anxiety will definitely make the pain worse, because it tightens the muscles in your body and potentially puts some additional pressure on nerves. It sounds to me like you were healing well, until the kick. It may have caused a bit of epididymitis and/or inflamed the surgical site as you suggested. I would try some supportive underwear, some NSAIDS for a few weeks (if your gut can handle it) and some warm baths daily. You may also try some papaya seed powder, in addition to helping reduce sperm I believe I have read that some people actually use it as an anti-inflammatory as well.

Just try to relax as much as possible and don’t push your body during this recovery period. I have found for myself, when I am relaxed and not stressed about my job and/or just thinking about what is wrong, the pain either goes away or is greatly reduced. I have found over the past few months, that exercise, stretching, massaging, relaxing, and accepting that I may have to modify some things in my life have really helped me feel normal 90-95%% of the time (with very few aches/pains). This is much better than it has been in the past and I seem to be trending more positive, with a few set-backs here and there. But I do have some muscle imbalance that I am dealing with currently and getting them back in balance.

I will say that I am currently on 10mg amitriptyline each night, but I have reduced that down from 25mg (took at that dose for 6 months) a month ago with no difference in pain, so I may get off of that soon. I also take 2 mg of Diazepam each night, to help with the relaxation and to get some good sleep. I plan on getting off of that in the next few months as well and see how I am.

I’m not saying that this will in fact cure your pain. I’m not a doctor. But relaxation and understanding your body vs. fearing the what ifs, can’t hurt. So just try relaxing and give your body some more time to heal from the kick and take a deep breath. Odds are you will be fine again and you will be able to put this behind you.


#9

Hey @help like you and @SomeGreyBIoke i had and still have the same issues of anxiety/depression. The mental part is just as bad or important as the physical. I know for a fact because when am busy with life and kids and not thinking about my pains or PVPS i feel better not %100 but better. But when am alone with my thoughts ie driving to work/sitting @ my desk/ in the shower, these is when i feel my pains the most and i know it’s also because my mind is constantly thinking about PVPS and the BS situation where all in here. If it is congestion related papaya seed powder is a good choice and anything to help with the inflammation like a naproxen or naturally a tumeric powder concentrate. I believe time is on your side… as it is with others dealing with epididymitis/congestion including my self.


#10

Guys, you don’t know how grateful I am to see these replies. I took some Ativan last night and my mind is back under control for now at least. I lurked this forum for a bit and some discussions hit me with so much anxiety I had to stop. But I’m so glad I joined, were in this together.

As a follow up I decided last night to go to the emergency department today. Doctor sees some ‘minor’ swelling in the epititimus (sp?). No other major lumps or swelling anywhere else. Even tho I told her about my vasectomy 6 months ago she thinks theres a chance of infection. I think it’s congestion but I will take the antibiotics and another round of aleve in case.

Now I think it’s a question of how long does it last. Why did I have this after surgery for a couple of months to have it go away and then come back?

I find laying down gets the pain down to almost gone but anytime I’m walking for a bit or driving or even sitting at a computer chair the pain can get real bad. I told the doctor if I’m walking I know it increases pain but will it cause long term damage? She said no but lifting heavy things can make it worse. Anyone verify if walking etc has made it much worse?

Anyways, I’ve ordered some ground papaya seed (not cheap is it!) and will try warm baths. I haven’t exerted myself much today but I feel the stress level going down and the pain level too. Thanks again guys.


#11

It’s important to remember that the vast majority of people who experience pain make a full recovery.

My recovery followed a similar pattern of seemingly being fine followed by a flair up followed by being fine etc. - in order words a non-linear recovery process. I’m now completely pain free.


#12

It’s important to guage your reactions to particular posts and if they’re stressing you out stop reading them. In the non-virtual world if one is anxious, it’s not a good idea to seek out similarly anxious people if one wants to feel more grounded.


#13

Thanks for sticking around here even though your pain has subsided. Makes me feel hopeful. May I ask how long those flare ups lasted for you (knowing that everyone is different)?


#14

The first 6 to 9 months or so my testicles were incredibly sensitive and pain could be triggered by something as innocuous as washing them in the shower.

After about 9 months, the flare ups seemed to be related to ejaculations and would last for anything up to a week / fortnight at a time. 10 months after the vasectomy my holiday to Barcelona was ruined by a post ejaculation flare up where I literally couldn’t sit on any hard surface for more than a minute without the pain becoming unbearable.

But as time progressed, the flare ups became less frequent / intense and the intervals between them grew longer until there was a complete resolution of symptoms.


#15

Never had anxiety or depression before my vas if anything I was a polar opposite happy go lucky person that never stopped talking. Had seen a doctor probably 2-3x in the previous 20 years. 6 weeks post vas had a full blown anxiety attack that started when entire perineal region and back of legs went completely numb. It’s not in your head, my wife and daughter say I’m a completely different person now.


#16

I can believe that mate, its life changing for many men,


#17

@help @Acschiro i can contest to the anxiety and depression side. Pre vas was good mentally post vas am dealing with the constant thoughts of pvps, what should i do next, when should i take the next step, will i ever get better. These are constant thoughts that run through my end everyday but i keep the faith and tell myself am better today than i was 6 months ago. Trying to accept this as my new normal for now; and altered my expectations from expecting a full recovery right here and now, to micro improvements month by month. @Help what helped me was changing to briefs for added support, naparoxen, papaya, turmeric powder, and now taking nortrypline. Am seeing micro improvements month to month but like @irishguy said it can be non-linear recovery.


#18

Sounds a lot like my experience so far. I was 8 months post vasectomy when my pain began. I have three small kids who usually get a nut shot in there once in a while, but I’m not sure I can tie it to any-one specific incident.

I can physically feel, and had a doc confirm, some congestion/swelling of epid on my right side and a granuloma on my left.

I had several exams, ultrasounds, and a CT scan. (Turns out I have a horseshoe kidney but was told that wouldn’t have anything to do with pain in my testicles.) Nothing showed up on the scans that was out of the ordinary otherwise,

I’ve spoken to several urologists and read all of the limited studies that are out there. Basically, the pain originates from congestion or inflammation, but probably some amount of both.

You’ll likely get similar feedback from helpful folks here, but this has been my current game-plan.

In General - avoid too much drinking or anything (food or otherwise) that might trigger inflammation. Take various supplements to see what helps. Try not to agitate the area in general. Wear supportive, but not restricting, clothing. Keep a healthy lifestyle, sleep, food, exercise.

Step 1 - 3000mg of ibuprophen/day for 4-6 weeks: If it helps, it may confirm inflammation as a primary trigger. This did nothing for my pain though. Onto step 2.

Step 2 - A friend of mine recommended Kratom to me for the pain (others had had success with other herbals). It’s helped a lot and even helps my mood, but only lasts a few hours. I take 1-3g of this leaf powder stuff once a day or every other day. Keeping this one for sure, but still moving on with therapies and options.

Step 3 - 10-15mg of Amitriptyline (once before bed) prescribed by my urologist (I cut the 25mg pills in half) last month. Took a couple weeks so far, but seems to be helping. Gave me a lot of drowsiness and some restlessness the first week when I was taking a whole 25mg. Been much better now that I cut them in half. Probably taken my pain from an average 6/7 down to a 4/5. However, this is not a drug I want to be on long-term, for good reason.

Step 4 - Doc recommended I try Gabapentin next if the Amitriptyline isn’t cutting it. Hesitant to try this one, but might give it a go. I have read and been told by my doc that it is possible to take Ami or Gaba for several months to a year, then wean yourself off and the inflammation and pain may resolve itself, but I’m skeptical.

Step 5 - Schedule a vas reversal - I think once you exhaust your pharma and lifestyle options, a reversal is the next logical step. It will put things back as best as they can be. It won’t fix the nerves that were cut, but it gives the area back its function and relieves back pressure in the epi. They also should remove any granulomas while they are in there. I have a high deductible, so am waiting until Jan 2019 to make this decision. I don’t want to hit my deductible for 2018 only to have it jump back up in 2019, know what I mean?

If the reversal fails to get me to a level I am comfortable with, there are always more drastic measures (which I pray I never ever ever feel the need to explore. These being:

  1. Microdenervation of the spermatic chord - this is where a highly trained specialist would go in, locate the spermatic nerve cord, and carefully cut the tiny nerves that are sending the pain signals to your spine/brain.

  2. Removal of the epididymis

  3. Removal of the testicle

not discussed - open vasectomies. these may relieve some congestion issues but come with more granulomas issues.


#19

Well summarized write-up of the standard/accepted protocols. Most of us here favor reversal over other options as the first surgery, but by no means is that a rule, just anecdotal. Medicinally, ami and gaba seem to be the go-to meds off the bat as you suggest. Each has its own side effects.

Best of luck with your journey.


#20

get it reversed mate, don’t loose your testes over a bloody vas