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Micro-Cryo Ablation of the Spermatic Cord


#21

That’s great. Incision pain isn’t the kind that scares you. You can be pretty sure that it will go away, unlike pvp. Glad to hear it is considered permanent!


#22

Don, how is the post cyro going?


#23

Hi J,

As I told Dr. P earlier tonight, I’ve been laying low since last week because on Wednesday, the pain returned in all its “glory”. I’ve been kind of down about it, although Dr. P told me up front that it would be 1-2 months before I would know if there would be any relief from the pain. It’s just all the emotional ups and downs seem to be taking a toll.

As far as healing from the surgery itself, that has been a piece of cake. There is no pain from the very small incision, and it seems to be healing quite nicely, especially since it was just one week ago today.

I trust Dr. P completely, and will follow his advice to wait to make any kind of decision on the next move. I have put this all in his hands, and I know he is doing everything he can to come up with a solution that will help, which is so much more than any other doctor I have ever seen.

I’ll continue to keep you posted. Thanks guys!


#24

I now have additional insight as to why I felt so great immediately after the cryo. I spoke with Dr. P by phone yesterday, and he told me that he did another cord block prior to the cryo procedure. That explains the complete resolution of pain immediately following the cryo procedure. But as in the first cord block, the results are temporary, hence the return of the pain. In talking with him yesterday, he assured me there were additional steps that can be taken, and I will be discussing them with him next week, when I have my surgical follow-up.

I certainly didn’t mean to sound like a “Debbie Downer” with the previous post, but I feel like I’m grasping the end of the rope. At least at this point, I think there might be some light at the end of the tunnel. He said the response to the cord block is an excellent predictor to additional treatment outcomes. So we’ll wait and see.


#25

Don, you don’t need to worry about sounding down or negative. What you are going through is awful and I actually commend you for staying positive in the wake of it. You are in constant contact with Dr P, so you are in great hands, but I can only imagine that you need to give it more time since your surgery was just last week I believe. Please keep us updated on the additional steps which Dr P suggested can be taken.


#26

Hey Don, hang in there. It does seem like if the nerve block has such a dramatic effect there has to be a way to relieve your pain. Hopefully its just a matter of time for the cyro to kick in. Sorry for the setback.


#27

We are praying hard for you
There are some other options down the road if the pain does not let up. The transient response to the block and or the micro-cryo gives us hope that it may still be a nerve issue that is causing the pain.
Hang in there and let us know how we can help
Sijo Parekattil, M.D.
The PUR Clinic, Clermont, FL.


#28

kja,

Sorry for the delay in replying to your request to update you on the additional steps that Dr. P and I discussed at our last appointment, but I’ve been busy at work and trying to wait out the time frame to see if there would be any resolution to the pain. On Monday, it will have been 4 weeks since the cryo. So far, the pain persists as always.

So, what we discussed are what additional steps might be undertaken. First, we discussed Botox block injections. To me, this seems like a ‘stop-gap’ measure since the botox is temporary, although he said that it could give months of relief, and that a series of 3-4 injection procedures could feasibly stop the pain permanently. Here’s the rub: the Botox is not covered by insurance (although the block itself is). My insurance considers the block “out-of-network” which results in higher deductibles and well as a higher co-pay. It could very well be completely out of my budget.

Secondly, we discussed orchiectomy. Since my pain issues are concentrated in the testicualar area and nowhere else, it might be a viable option. I asked if the Botox injections would simply be postponing the inevitiable (orchiectomy), and he said that in my case, that may very well be the case.

Finally, we discussed what would happen IF after orchiectomy the pain did not stop (i.e.“phantom pain”), and he said they could do an abdominal denervation, but only as a last resort.

I am still hopeful of some sort of pain resolution from the cryo. Like I said, it has only been 1 month, and as he told me, it could take a month or two before we would know anything for certain. But, those are my options. I’m really on the fence about which way I will eventually be able to go, but I’m still willing to wait. I don’t see Dr. P for another couple of months, so I have plenty of time to weigh out all options and considerations.


#29

Thank you Dr. P.

Wow, you’ve been busy…I came back here to see that you have been VERY busy replying to a lot of the posts. I did read about the “Drive for Men’s Health” and wish you both the very best, and truly appreciate all of your efforts into research and trying to end the pain that so many men have to endure.


#30

What a difference a month makes. This past Monday marked 8 weeks since the cryo was done and for the past two weeks I have been feeling a lot of improvement in the level of pain I have been in. I have been hesitant to post…like waiting for the axe to fall and the pain to ramp back up again, but I have to admit, I think that my overall pain is much improved. I go to work each day, and now I suddenly realize that the pain is not “always” there. I can actually forget about it, it is not a constant nagging, debilitating feeling that I have to work around.

Now, I am still on the meds, particularly the Gabapentin, which I feel has really made a big difference. Sometimes (more often lately) I forget to take the Meloxicam, but I don’t notice any big difference in pain levels when I don’t take it. Many days I only take two doses of the Gabapentin, and knowing that the 3-a-day 300 mg. dosage was already a very low dosage compared to many of the posters here, feel very good about reducing that medication level and still maintaining a manageable pain level.

The pain is not gone, however, it is now at a level I think I might be able to live with. I had almost wrapped my mind around having the orchiectomy as the next procedure, but now am giving that second thoughts. Maybe it won’t be necessary. God knows, I would prefer not to go into surgery again.

It is still about six weeks away before I go in to see Dr. P. again, but I am very hopeful that the initial relief of pain I am now feeling will continue and perhaps even improve. Until then, I will just go on with my day to day activities (mostly pain free) and wait and see what happens.

Thanks again Dr, P. As I heard so many times…“You Rock!!!”


#31

That’s is fantastic news Don! Keep your head up and hopefully given some more time it will improve even more.


#32

Don, that’s great! Really happy for you. Have you been able to engage in rigorous exercise without having additional problems? Just curious.


#33

Actually, that’s how I realized the pain is decreasing. I had a customer who forgot something in our office, and ended up chasing them down in our parking lot to give the item back to them and realized I was running without the agonizing pain that that kind of activity would have previously caused. Now, mind you, I’m not that much of an “exercise” type, but do have to be quite active at work, a lot of time on my feet, lifting and running all over a 60,000+ sq. ft. building to get my job done.

This weekend will be a good test for me though…I’ve had some trees cleared in back of my house and have a stump grinder reserved for rental tomorrow (weather permitting) to grind up about 12-15 stumps left in my back yard. I would have never even attempted to do that kind of work myself until the past two weeks.

Another clue was the Gabapentin schedule I have been on since the block, denervation and then the cryo. Three times a day: one in the morning, one at about 3:00 p.m. and then one about 11:00 p.m. My right testicle was like an alarm clock, especially if I forgot to take it at 3:00…it would let me know that it was time. But lately, I have been forgetting it (mostly because I get busy at work), so I wait until about 7-8 p.m. and take it, then not take it at 11. The pain does get a little worse, but nothing like it used to be, and almost non-existent in the morning.

One thing that did worry me though was the length of time I had been in pain before finding Dr. P. I recently went to a local urologist (different reason altogether) and he told me he had a patient who had been in pain for about 8 years before seeking treatment. He eventually had an orchiectomy, but the doctor said that because he had been in pain for so long, it didn’t work and he developed “phantom pain”. I never told him that I had been in pain for about 11 years before seeing Dr. P. But seeing this ‘new’ doctor has made me appreciate Dr. P that much more. Without going into details, lets just say I was not impressed in any way with him or anyone in his practice.

Anyway, I’ll let you know how the stump grinding “exercise” goes this weekend!


#34

Orchiectomy has always had a terrible success rate for pain resolution.

There’s a number of reasons to get phantom pain, but I’ve never seen any convincing evidence that elapsed time to a corrective surgery has any impact.

I don’t think the urologist you saw knew what he was talking about.


#35

Don that is such good news for you. Even just a little relief adds quality to your life. Good luck with the stumps, grind away. We are all happy for you.


#36

Stump grinding was a washout today…we had some real downpours here in Central Florida. I’ll have to postpone it. Still feeling good though and willing to tackle the project.


#37

I agree, the urologist I saw was clueless to the pain that I had been in, and I was not comfortable with the followup ‘care’. He admitted he referred patients to Dr. P for pain problems, so at least he was aware of a professional who could actually treat a patient


#38

This weekend a friend and I did the stump grinding. It went well, and two days after the fact, I still feel okay, although there is still some pain, it still seems to be manageable. I am in a quandary as to where to go from here. I think I have less pain, but its still there. So should I go for further surgical treatment, I.e. Botox injections, or what? I’m quickly running out of options, having had the denervation and the micro-cryo ablation. At times I think I could live with the level of pain I am in, but knowing how pain free I was after the initial cord block, I wonder what releif there might be from further intervention.


#39

Hey Don, I would imagine speaking with Dr P would be the best bet at answering this question. He could probably suggest further surgery options or perhaps alternative treatments. Time may also be needed as I recall it hasn’t been too long since your ablation. I know recently talking to Vic he suggested that his denervation recovery took around a year but he’s in a much better place now.


#40

@Don_H, Hey Don, what about using medication for pain management? I wonder if a good pain specialist could advise you based on your experiences with the procedures that you’ve had. When I last talked to Dr. P. he mentioned another drug that was showing some effectiveness (in addition to gabapentin and Lyrica.)