The hot flashes started around January. I didn’t think much about them. I was still having lingering issues related to chemotherapy. My hair was still coming back and so were my nails. It was less noticeable, but my blood was recovering too. For a long time after chemotherapy I couldn’t walk long distances without being short of breath. The low blood counts started during chemo. One morning my white cell count was so low that a nurse came out to yell at me from across the waiting room that they weren’t sure I would be getting chemo that day. I thought about yelling back, “Thank you for letting everyone in the hospital know that right now a bad cold could kill me.”
Before chemo, before anything else, in fact, there was the orchiectomy, or having the offending testicle, which was on its way to becoming a goose egg, removed. I didn’t have much time to prepare for it emotionally because it happened two days after I got the news that I had cancer, but I took it in stride. I thought about when a friend of mine had his three male cats neutered. One of them was named Curly. Curly was a character, always doing something bizarre like climbing the kitchen cabinets or flipping over the litter box.
Curly was last in line to get neutered, and before the vet made the final cut my friend said, “Maybe you’d better leave him one testicle just in case we want another like him.”
After my own half-neutering there was chemotherapy. When I finished chemotherapy I thought, well, this is it! Back to life as it was before.
Then I had the follow-up work and found I had to have surgery.
When I finished surgery I thought, well, this is it! Back to life as it was before.
And then I had some other follow-up scans. These, I assumed, would be the first of my biannual, eventually to become annual, checkups. The tech who did my ultrasound had trouble finding my testicle, which had apparently retreated out of fear after it saw what happened to the other one. So she called in another tech. And they called in a third tech, and finally the radiologist had to come in and say, “No, no, no, don’t you know anything? It’s between his legs.”
The first time I had a CT scan I just felt an incredibly warm sensation in my groin, like it was being microwaved. The second time I threw up in the middle of it. The third time I just felt like I was being microwaved again. Back to life as it was before.
I met with my oncologist who told me everything was fine. Back to life as it was…okay, I need to stop saying that, because I also had to have a follow-up with my urologist. This required a blood draw first thing in the morning. Then my wife called me to say they’d made a mistake on the first blood draw, and I was thinking, did they accidentally draw phlegm or something? I went back that afternoon and had another blood draw.
So I got my blood drawn again the next morning.
My urologist told me my testosterone was between ten and thirteen.
“That doesn’t sound too bad. What’s normal?”
Actually that’s the low end of normal. Decreased testosterone is a fact of life. It’s part of growing older. If I may speak to my fellow Y chromosomes for a moment: you may have seen advertisements for drugs intended to treat low testosterone. These advertisements may have asked if you’re feeling tired, if you have mood changes, or if you no longer get the sort of erections that embarrassed you when you were in middle school and had to go up in front of the class to answer a math problem. If you’ve experienced these symptoms chances are you’ve just got a condition known as Getting Older. The only treatment is a healthy dose of Deal With It. This is available without a prescription.
Low testosterone, the sort that needs to be treated with hormone therapy, only comes from chronic conditions like cancer or being kicked really hard in the nuts. Low testosterone needs to be treated because it can cause things like muscle loss, aches, and migraines. Migraines are typically described as headaches even though they should be called everythingaches. When you have a migraine your hair hurts.
Low testosterone can also cause hot flashes. It wasn’t my blood after all.
There are three important lessons here. The first is, there is no such thing as life as it was before. The second is, every little thing can be significant. If you’re having hot flashes and you can’t find any reason why you might be having hot flashes tell your doctor. And third, spay and neuter your pets, but if you have a favorite cat leave one testicle just in case. Once it’s gone it’s gone.