Freitag, 28. Februar 2020

POSITIV! WAS KANN HELFEN?

Dafür jetzt endlich mal wieder einen positiven Beitrag: Wenn man diese Schmerzen nach/von der Vasektomie halt leider bekommen hat, was kann man dagegen tun, was hilft vielen Männern? Aus englischsprachigen Foren (es gibt dort halt mehr Fälle, weil vor allem in den USA viele Männer eine Vasektomie vornehmen lassen) habe ich Folgendes zusammen getragen, was OHNE OPERATIVE EINGRIFFE ODER AGGRESSIVE MEDIKAMENTE MACHBAR IST:


What Has Helped
  • Massage therapy: this has given the most relief from pain overall. For myself scrotal pain never exceeds a 4/10, but the pain spreads elsewhere and left untreated eventually becomes worse than the scrotal pain. I found a massage therapist with experience treating chronic pain. She typically does trigger point and myofascial release all around my hips, upper thighs and lower back. This mostly eliminated the itching/burning nerve pain in my inner thighs that was driving me insane. There’s a feedback mechanism at work here as it decreases scrotal pain too. It does tend to make things a bit worse for a day following an appointment.
  • Pelvic floor physical therapy: In a similar vein to massage therapy this has been very helpful. But more so in teaching me things I can do at home. In particular using a foam balls to massage my psoas and pelvic floor around my anus. They suggested a tennis ball but I needed somethign larger for the psoas and something smaller for pelvic floor. I tried dry needling, which relieved some very tight leg muscles, but it set off a lot of nerve pain after each session. Massage therapy was far more bang per buck.
  • Exercise: exercise has been 50/50 for me. Sometimes its good and I feel better, other times it sets off a flare up. Walking was usually best. Anything more intense risked a flare up. I mostly credit the increased circulation, as I don’t have any other dysfunction which the physical therapists and medical imaging have confirmed.
  • Yoga: It is gentler than exercise and has been very helpful without risking a flare up. There are lots good of videos specific to pelvic floor issues on YouTube. I highly recommend the FemFusion Fitness channel on YouTube. I would add inversion is helpful in loosening up my low back and relieving nerve pain there. Just get a chin-up bar and ankle straps, the inversion tables very expensive.
  • Papaya Seed: early on I shrugged this off because I had so many issues and was trying everything under the sun. However it definitely decreases the pressure and swelling in my epididymis but it is slow acting. I’d say at least 3 weeks for full effect, 1-2 tsps per day. For myself it never brings complete relief but gets me to a point I could almost live with it. I prefer the organic brand on Amazon. The others taste foul. It tends to give me soft stools but no other side effects. I do worry about the safety of using it long term.
  • Supportive Underwear: Early on I could only wear boxers. Any pressure on my scrotum or thighs was unbearable. Once that calmed I should have switched to supportive briefs earlier. The best for me has been the Sepratec brand which have a separate shaft compartment. That keeps my shaft from bouncing around on the top corner of my epididymis. The relief was immediate and substantial. I don’t know if the scrotal support is as important for me, but it keeps my nuts from knocking around. I often still wear boxers at night because giving my nuts time unrestrained seems to help.
  • Hot baths / heat pad: Like many reported here, heat helps. I think its a combo of relaxing muscles and slowing sperm production. I would add epsom salts seem to enhance the effectiveness of a hot bath. Its frickin salt so just get the cheapest thing you can find. I found an epsom salt rub from ProCure to be pretty effective for muscle tightness soreness when you don’t have time for a bath.
  • B vitamins: I believe these definitely help with the neuropathic symptoms. But it can be too much of a good thing. Some of the neuropathic specific formulations have obscene amounts of B vitamins in them. Those make me irritable, unable to sleep, and make my skin itch in the areas I was already having pain. I also can’t imagine its good for you liver or kidneys when you’re piss is highlighter yellow. My happy medium is Garden of Life Vitamin B Complex. I haven’t tried alpha-lipoic acid by itself yet.
  • Tumeric & Ginger: I believe this helps with inflammation to a limited extent. Maybe like a low dose of ibuprofen without any stomach upset. Tea seemed more effective than pills form.
  • Magnesium: This helped me with muscle cramps and neuropathic pain. Its the same ingredients as the epsom salt soak, just taken internally. It can cause diarrhea. SloMag never gave me diarrhea but seemed much less effective.
  • Marijuana: What can I say I love weed, I just wished I lived in a legal state. It helps with pain and mellows out the anxiety. However when I was at the initial peak pain it sent my anxiety soaring because I was a mental wreck. Its no good when your head is a mess.
  • Kyolic Garlic / immune booster supplements: I really think there’s an immune response element to all this. The lymph nodes in my inguinal area have felt huge and hard at times, usually corresponding to when it is worse. Taking immune supplements seemed to help a little but we’re approaching placebo level here.
  • Mindfulness/distractions: I listed this last because ultimately you are tricking yourself that you are not in pain. But relief is relief. I found simply focusing on sensations in my fingertips or feet very helpful. Don’t forget to breathe and breathe deeply into your abdomen. You gotta get your mind off your nuts. Find something immersive to do like video games or reading.


    DAFÜR AUCH FOLGENDES NOCH:
What Has not Helped
  • My Wife: Her silence is deafening. Any mention of PVPS gets met with a blank stare. She actually told me I was “emotionally dumping” on her when this all started. She hasn’t touched me in months. Our marriage has decayed to where she’s basically a live-in baby sitter, so that I can have some child free time which I spend stretching, soaking, etc to deal with this issue. If/when I get over this I’m going to gleefully serve her divorce papers.
  • Most Urologists: While my vas uro has been proactive in prescribing meds he’s been fairly dismissive and wanted to hand me off to the pain management dept. A “specialist” nearby rattled off denervation and orchiectomy options like they were no big deal. None offered reversal as an option. Only recently have I been talking with reversal specialist, more on that in follow up post.
What makes it worse
  • Sitting: This is the one thing that without fail makes it worse. I’m an engineer and spend most days at a desk. It ranges from mildly irritating to excruciating. I pleaded for a standing desk which helps. But I’ve got to remember to stand before I feel it come on or its already too late. My low back cramps up within 15 minutes from standing now too. Which it never used to.
  • Getting sick: Every time my germ bag daughter brings home some illness and gives it to me, it flares up. I got sick twice in quick succession this winter and it knocked me back big time. My pain now is worse than its been in the last 6 months. I’m slowly climbing back. I definitely believe PVPS has an immune response component to it.
  • Anxiety / Anger / Regret: These emotions definitely don’t help even though they’re perfectly normal responses. I would add spending too much time on this site can be triggering. Early on, anxiety made my pain noticeably worse. When I’m angry I tend to clench abdominal muscles which isn’t helpful. Regret is basically worthless, you have to keep moving forward.
  • Bad diet / sugar / carbs / alcohol: You have to eat well to help your body deal with this. Sugar and alcohol are known to cause inflammation. I went sugar free and low carb for a while and it helped bring down my pain. But its very hard diet to pull off, especially with a child in the house. I used to be able to eat whatever I wanted because I was able exercise regularly.
  • Poor sleep: needless to say you need sleep. Use sleep aids if you need to. I’m a side sleeper so I started using a pillow between my legs to keep my nuts form getting squished at night.
  • Self examination: I definitely irritated things by feeling it too much. Resist the urge and maybe set a time once a day if you are looking for improvement in swelling, etc.

IMMER UND IMMER UND IMMER WIEDER DIE ZAHLEN

Ja, die Zahlen - also wie oft diese schlimmen Post-Vasektomie-Schmerzen vorkommen - hatten wir hier schon mehrfach. Aber in einem anderen Blog wurden die OFFIZIELLEN (!) Zahlen einiger Länder und medizinischer Gesellschaften zusammengetragen; hier: https://www.reddit.com/r/postvasectomypain/comments/9v173j/how_common_is_chronic_pain_after_vasectomy/
Kurz zusammengefasst die Ergebnisse: Die Gesellschaft, welche die tiefste Zahl nennt, ist die European Association of Urology: Sie gibt "1 Prozent oder häufiger" an.
Das Royal College of Surgeons of England hingegen gibt "bis zu 15 Prozent" an.
Es heisst nichts Weniger als: Die Anzahl der Fälle ist zwar umstritten, aber es gibt Länder oder offizielle medizinische Stellen, die zugeben, dass bis zu 15 PROZENT der vasektomierten Männer danach starke Schmerzen haben, die ein Leben lang bleiben können (oder zumindest Jahre lang).

Verglichen wird das dort mit der Definition der World Health Organisation (WHO), die vorgibt, wie man die Häufigkeit von Komplikationen bei Operationen nennen soll; nämlich so:

Very Common = Greater than 10%
Common = 1% to 10%
Uncommon = 0.1% to 1%
Rare = 0.01% to 0.1%
Very Rare = Less than 0.01%

Was immerhin heisst, dass das Vorkommen des Post-Vasektomie(-Schmerz)-Syndroms mit COMMON oder sogar VERY COMMON angegeben werden müsste. Und das bei einer freiwilligen Operation! Sprich: Eigentlich müsste man Vasektomien im Sinne von Staatsmassnahmen für die Gesundheit der Bevölkerung sogar verbieten!

Donnerstag, 27. Februar 2020

ALLER SCHLECHTEN DINGE SIND DREI: VASEKTOMIE UND BEZIEHUNG

In Schottland gab es eine grösser angelegt Studie, wo Männer, die eine Vasektomie hatten machen lassen, bis zu 22 Jahre später gefragt wurden, wie es die Beziehung beeinflusst hat: von denen, die sich getrennt hatten, gaben ein Drittel an, es sei ALS FOLGE UND ALSO WEGEN DER VASEKTOMIE geschehen; immerhin 29 Prozent gaben an, es habe an Störungen in der Sexualität gelegen, was auch von der Vasektomie kommen kann; und weitere 25 Prozent bereuten es einfach, eine Vasektomie gemacht zu haben, jetzt, wo die Beziehung zu Ende war ... = was heisst, dass gut 87 Prozent der Männer, die später nicht mehr mit der Partnerin zusammen waren, deretwegen sie die Vasektomie vornehmen liessen, diese bereuten! Und das sind Männer, die nicht zwingend jahrelang Schmerzen hatten von der Vasektomie! (Siehe hier: https://www.postvasectomypain.org/t/sex-pain-relationship-breakdown-and-vasectomy-large-cohort-study/5060 oder hier: https://auau.auanet.org/content/mp74-13-sex-pain-relationship-breakdown-and-vasectomy-large-cohort-study-3

DIE TRAGWEITE DER TRAGÖDIE

Einige der Männer, die diese starken Schmerzen von der Vasektomie haben, greifen aus schierer Verzweiflung auch zu drastischen und tragischen Mitteln: Sie trinken jeden Tag viel Alkohol, weil das die Schmerzen etwas dämpft; nachzulesen etwa hier: https://www.postvasectomypain.org/t/alcohol-affect-on-pain/2299

VERNETZUNG

Ich muss mal wieder auf diese Seite hinweisen: http://www.homepage-dienste.com/foren/F_15817/post-vasektomie-schmerzsyndrom_44_.html. Sie weisen nämlich einerseits immer mal wieder auf mich hin - und andererseits zeigt es eben auf, dass allein im deutschsprachigen Raum etliche Männer an diesen Schmerzen leiden. Wie viel mehr in den USA, kann man hier erahnen: https://www.postvasectomypain.org.

Der Anstoss zu diesem BLOG

WIE ALLES BEGANN

Nein, ich will nicht alles auf die Frauen schieben. Auch die Männer können einmal ihren Teil zur Verhütung beitragen. Und erst recht möchte...

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