This is pretty much a continuation of a post I started back in May 2008 that was deleted for some reason.

In short, I have been getting pretty much no help from the Navy or from the local medical community regarding an injury that happened on 30April08.

I was hit by a woman that ran a stop sign on base while I was riding my bicycle home, during the impact, I hit the frame of the bike. The woman took off before myself or any bystanders could get her plate #.

Over the next few days, hydroceles formed around my right testicle, then another around the left, and finally the ******* filled with fluid to the point where it resembled an orange.

The hydrocles are mostly empty, but the pockets formed by them have caused a lot of pain, and has allowed the right testicle to torsion on itself freely, and with enough effort, to free itself.

Both right and left testicles are significantly smaller than they were before the accident, the right used to be larger than the left, and according to the latest ultrasound, it is about 2/3 the size of the left, while the first ultrasound showed the left to be noticeably smaller than the right (as it originally was).

To top things off, there is a bulge in my groin that makes itself known when I am active (walking for extended periods), and tends to retract when lying down. The area is constantly tender, and when the bulge becomes larger, it HURTS!

Both testicles feel as though they are on fire most of the time, sometimes, they feel like they are in a vise.

Most of the time the right hurts more than the left, and often is cold to the touch.

I have been bounced around from one place to another for care, only to find that the place I get sent to does not deal with testicular injury.

I was sent to a urologist in New London, CT (Dr. Fraser), who originally said that I would need surgery to fix the problems, then at my last appointment with him, that he did not know what to do.

One thing I should mention to him is that I have had 4 appointments with him. The 3rd and 4th appointments were terrible.

I was in so much pain from the car ride over that I was doubled over on the waiting area crying. The head nurse at the office came out and told me to quiet down, that I was upsetting the other patients. My wife started crying shortly thereafter, and said nurse came out and offered a box of tissues to my wife and asked "If there is anything we can do for you ma'am?"

Dr. Fraser spoke to my wife exclusively during the entire 5 minute visit, except for instructions to take my shorts off. I was till crying when he came in, and when he applied pressure to my right testicle, I could not help but cry harder.

The 4th visit was less than 5 minutes long. I was Dr. Fraser's first patient for the day. Due to the bad weather outside, my wife had to make a hard swerve and stop to avoid being hit by the local yokels, cinching down on my testicles and again, I was in the waiting area, crying. This time the office was just opening, so the nurses and receptionists were filing in. NOT ONE of them asked if I was ok or if they could help. My wife had to demand to know why Dr. Fraser was a half hour late in seeing me. When we were finally called in, again the nurse only seemed to care about my wife's well being, not mine.

I have had two ultrasounds done at the NACC in Groton, CT. The first was on May 6th. The technician made it clear that she did not want to perform the scan, to the point that she handed me the probe and started to give me directions.
I told her that she did not need to be prudish and that she needed to do her job - she was the technician, not me.

Her first words to me, other than directions was "Do you have any children?" - That is not an appropriate question to a man when you are checking his testicles for damage.

She then told me that she preferred to perform scans on pregnant women. When I handed her the probe back, and told her to do the scan, since she was the expert, she told me that the scan was complete, and to get dressed and go.

The second ultrasound was done on June 30th. This was with a different technician, and this time, my wife was in the waiting are with me.

When I was called in, my wife followed me, only to be told by the technician that she would not be allowed with as the ultrasound was "A procedure like an X-ray or a CAT scan, you don't have people with you for that."

The technician asked why I was having this ultrasound, and the reason was to check on the status of the damage to both testicles, primarily the right.

I told her about how the first scan went, and the technician quickly defended the first one's questions and actions.

Her response was "We need to know if you have had any children so we can determine how detailed of a scan we need to perform, and what areas to focus on."

In short - since I already have a child, it is not as important to check for problems with my testicles as a man that has not fathered a child yet.

I filed complaints about both technicians, and regarding an ER visit I made to Lawrence and Memorial Hospital in May 2008 regarding the swelling from the hydroceles and the pain that was primarily in my right testicle.

Those went to the patient advocate at the NACC in Groton, LT Nicole Duffey, who promptly forwarded them to the base mental health clinic. She never replied to my e-mails, and never returned any calls. I talked with her once about the issue, and she never responded about what actions would be taken.

I finally got somewhere with squadron medical, as the pain is so bad at times I have a hard time breathing.

I have been put on Ambien to help me sleep, but with the pain as it is, I am not getting anywhere.

I was given a referral to see a pain specialist, only to find that none in the local area will treat testicular pain.

TRICARE has been little help either, they want me to call around and find out what urologist will see me for testicular injury, and what pain clinics will help me control the pain.

I was also sent to the base Mental Health clinic because of the effects the pain has had on me (lack of sleep, hard to focus, frustration, and fatigue).

When the Mental Health Doc first saw me, he said that "You do not belong here, you are visibly in a great deal of pain."

The mental health Dr. showed me the e-mails I sent to LT Duffey months prior to my referral to Mental Health, which lead to some confusion as to why they were being forwarded e-mails about someone that was not even a patient.

He agreed that something is wrong with local men's health care, and that they need to do something to stop the pain.

With all of the hassle I have been getting about trying to get help, it has become painfully clear that trying to get help with testicular pain in CT is a very hard thing to do.

quote:

With all of the hassle I have been getting about trying to get help, it has become painfully clear that trying to get help with testicular pain in CT is a very hard thing to do.

As your IDC to submit a referral to urology and the pain clinic at NNMC Bethesda.

I have asked to be sent to Bethesda multiple times. I made the request to both my IDC and to a LCDR at Squadron Medical. The IDC did nothing, and all I got out of the request from the LCDR was a referral to a pain management clinic and a referral to mental health.

The pain management clinic I was referred to would not answer my phone calls for 3 weeks, only to finally get someone to answer and to tell me that they would not help me, due to the nature of pain.

Based on the problems I am having with medical here, I have no intentions of making this a career, essentially wasting the last 6 years of my life.

Try getting in to see the LCDR at Squadron medical and sit down with him and discuss the problem you have been having. If that doesn't work try calling BUMED IG.

I have discussed this with him and with the IDC at length many times now. They want to send me to a different urologist, but with how few of them there are in the area, it looks as though it would be best to go to Bethesda, as the wait to see the kidney stone specialist I was send to was a two week wait for a consultation that got me nowhere.

Out here it seems that if you mention needing anything done related to testicular care, pretty much everyone here will say "Not my problem".

The urologist I was sent to months ago said that this was not his field and that he did not specialize in pain management, but the local Pain Management Clinic told me that I should be ashamed of myself for asking them to help with my problems.

I am really fed up with the Navy and with CT, especially the health care here.

If you have followed up with the chain of command and gotten no where. Submit a request to the BUMED IG. If you get no satisfaction in treatment or pain, from that result, then its time to go elsewhere. Call your Senator or Congressman. You may not get their attention, but this is an injury that someone is passing the buck on, but is very real to you.
Kinda reminds me of the second class that was told there was nothing really wrong with him...until he passed out and fell on the deck from the pain.
Active duty you have to go through the Chain of Command, but if you get no satisfaction of real help, then you have to go elsewhere.

My wife has already contacted our local congressman, and his response was that if we have seen so many different doctors, then I am getting the care I need and the problem is not real, and that there is nothing that he could do to help me.

The chain of command here is well aware of my issues. I used to be stationed on the USS Annapolis (SSN-760).

Before my second ER trip (the first one yielded nothing but humiliation at the hands of Dr. , not even an ultrasound was called for) my wife called up the CO, as the IDC would not talk to her, to explain the situation, and his response was that he "Will not talk" to my wife about what is wrong with me, and that I needed to suck it up and get off of SIQ and go back that what I was doing before the accident.

My chief, ETC , the only person of rank that was concerned about me, pushed for me to be transferred to a different command, a transient division that I might be able to get the care I need.

So, I am now off of the Annapolis. The command that I am now at is concerned about how I am doing as the pain can get so bad at times that I can barely do anything.

I was sent to squadron medical for a check on my vitals during a rather nasty pain surge. My pulse was 118, with blood pressure 186/93.

The reaction given by the LCDR is that might be a side effect of the pain killers, of which he has been trying to keep me off of, which is only make things worse. I know it is a bad idea to be on vicodin for extended periods of time, but it makes a big difference with the pain.

Said that he would not give me anymore until I had seen a pain management specialist, but none of the local places will treat testicular pain.

Besides, just killing the pain is not the solution, there is still the matter of the bulge in my groin and the fact that the right testicle maintains a lower temperature than the left and keeps twisting upon itself.

They really need something like this on a recruiting poster.

This message has been edited. Last edited by: GerryRM3,

AngrySailor
You can relate your story but keep names off of it.
The question I have about this whole thing is why don't you travel to Boston and go to one of the learning hospitals attached to Mass General or Tufts or those hospitals themselves. If your pain is that bad I'de sure look into a consultation there.

I have tried to get a consultation to go to a pain clinic and a urologist out of the area, the problem has been trying to get the referral for that. My wife and I have suggested Bethesda, Clinics in RI, and MA, to only be told by the said LCDR that "it would be in my best interest" to stay local, and that TRICARE might not cover some of the places we suggested.

We already had a consultation with a urologist at Yale that told us that we needed something better than TRICARE for us to see him.

The LCDR at Squadron medical has agreed that men's health in the area is terrible, but somebody local should be able to help.

Pretty much everyone has been convinced by the advice the urologist that I was sent to originally said which was to keep taking painkillers, stay in bed as much as possible, give it time, and everything will work itself out.

That was over 3 months ago.

Angry, I'm not a urologist or in the Navy...
That being said I am an RN and work in surgery. My first years were spent in urology.
If you're right testicle keeps torsing...why aren't they doing an orchiopexy??? (We did this routinely to male ped patients with undescended testes and for emergent torsions). All they do is secure the teste so it doesn't roll upon itself again. Simple procedure.

As far as hydroceles go...we usually remove them (intact)...I've never heard of pouches as a result of them.
Do they think the bulge you have is a hernia of some sort? Inguinal hernias will pop out in periods of increased intra-abdominal pressure and can be reduced. If they get stuck...incarcarated...it can become ischemic.

The General Surgeon on base (who is only there a few days out of the week) does not perform any testicular surgery except for removal due to cancer.

I was taken to Backus Hospital's Emergency Room due to a Torsion Episode, and I waited for about 3 and a half hours to be seen. The attending ER Doc manually untwisted it, and said that they did not have the specialists to do the surgery, and if it happened again, to go to a different ER that might specialize in male care.

There was no ultrasound called for when this was going on, as this happened during a period where the ultrasound staff was not "available".

The hydroceles, especially the one surrounding the right one, have a tendency to refill, at least partially, when I am more active.

There are pockets/pouches surrounding both testicles, primarily the right, when the hydroceles are not "pressurized"/filled.

From my understanding a hydrocele that is painful, and/or shifts in size based on activity, is reason to removed the hydrocele.

Both are focused around the head end of the epididymus, and on the right one, it is rather swollen at times, and feels as though it has been put through a wringer, especially when the hydrocele applies pressure.

Well, I finally have an appointment with the patient care case worker at the NACC today, although I am having my doubts if she will do anything for me.

Guy, Gerry has a very good suggestion about going to Boston and checking with the people there. I've known several people over the years that had similiar problems and got help there.
As far as members of congress, find out who the party chairman is for your district and talk with them and explain even though there have been myriad doctors on this case there still is no resolution in site. Remind him of the importance of how helping service people goes in keeping votes. If that one doesn't want to help, there's no saying another won't.

I had the appointment with the case worker today, and she had me see another doctor, a CDR, who gave me a different painkiller and a referral to see another Urologist. I made mention of going to Boston or Bethesda, and the CDR said that if the new urologist does not work out, then I will go to whichever one will see me sooner.

As far as the local congressman is concerned, it has been primarily his military case worker that has been giving me grief.

One more thing, after talking with the CDR at base medical concurred with pursuing charges against the LT (patient care advocate) that has delayed my care by months. He was pretty mad when I told him about how the LT treated me and how she has only made problems worse.

I am hoping that the CDR is right in that this will be a "fresh start, and hopefully everything works out right this time."

He told me to see the OIC regarding pressing charges, only to find that the OIC was out.

If I cannot get ahold of the OIC tomorrow, I will contact the BUMED IG.

This is ridiculous, the amount of running around I have to do to get any help. But I am pretty sure that any man going through this would be fighting just as hard. Women on the other hand, don't have to fight at all. For example, my wife has all of her GYN appointments done at the base hospital, and her first trimester's appointments were done at the base hospital. But do they have any urologists? Nope.

Neither of the local hospitals have their own urology staff.

More reasons to hate living in CT.

quote:

Originally posted by AngrySailor302:
TRICARE might not cover some of the places we suggested.

No I am just an old retired TM, but maybe some of you medical types can answer this. What the heck does TRICARE have to do with anything here. This man is Active Duty, is he not? Is not Uncle Sam responsible for one hundred percent of his medical care with NO out of pocket cost to him? Please tell me that has not changed since I retired?

I am not sure anymore.
I remember that on the way back from the 2nd ER visit, the Annapolis IDC called me up on accident (he pushed "call" when he was reviewing is missed calls.), and I told him about how much better I was treated by the staff at Backus Hospital vs. how I was effectively mistreated by the staff at Lawrence and Memorial Hospital.

(Backus Hospital promptly took care of me, treated me and my wife with respect, performed a thorough Ultrasound, and did their best to control my pain. They prepped me for surgery, as the hydrocele on the right side was noted to be interfering with circulation and was pressing on the right epididymus, causing a lot of pain; only to find out that the surgical staff did not perform testicular surgery.

They tried to get me transferred to L&M for surgery, which was denied.

They decided that with a pending urologist visit the next week, that the urologist could get me the surgery to remove the hydroceles.
They sent copies of their surgery request to the urologist I was originally sent to, who made mention of the paperwork during our first visit, only to be told that he would not perform the surgery until the pain went away.
Three and a half months later, the pain is still there, and the hydroceles fluctuate in size and pain levels.)

I got nothing from Lawrence and Memorial for actual care.

Anyways, back to the phone call. The IDC yelled at me for going to the ER again (the pain and swelling were worse, and the directions given was to go back if either got worse.) and then said that he was going to recommend to TRICARE that I be made responsible for that visit.

He then talked to my wife and told HER that she was wrong for taking me to the ER.

Even with the LCDR at squadron medical this has come up. When I asked him for a consult to go to Bethesda, he asked why I wanted it, and I told him that I was not pleased with how the urologist that the Navy sent me to had treated me, and that I needed to see a urologist that would actually be willing to provide a surgical solution - taking painkillers and trying to minimize power levels (i.e. bedrest) has not worked.
When I resume activity, the swelling and pain get worse, and the bulge goes from uncomfortable to unbearable.

The LCDR told me that I "need to stay local", and that if I need to see a urologist, it would have to be the same one that I had been to before, otherwise TRICARE would not cover it, as I have had a semi-independent second opinion at Yale Urology. (He used the written reports from the Urologist I was sent to by the Navy. I brought a CD-ROM with the Ultrasound Slides from Backus Hospital, but he never broke the seal on the case it was put in by Backus.

All he did was to lecture me on staying in bed, and accusing me of trying to "mom and pop" him into helping me, and saying that we were thinking that he "had a magic wand" that would find a cure for the pain, and then accused me of making the entire thing up.)

The LCDR then advised me to get my own health insurance to cover a different urologist.

I even looked into that, but most would not accept me because of the current condition, or would cost far more than most enlisted folks could spare.

I just hope that the new urologist I am going to get sent to will be able to help me out, and in a timely fashion.

This message has been edited. Last edited by: AngrySailor302,

One of the things that would help some is if there was some sort of a balance in healthcare on base, and in the area.

The 2 ultrasound technicians at the NACC are geared towards fetal ultrasounds.

My wife gets her annual checkup done at the NACC by a Navy gynecologist. Her first trimester's appointments were done at the NACC. But are there any urology services?

Nope.

There is close to a 20 to 1 ratio of women's specialists to urologist ratio around here, and that does not take into account the nurses and support staff at the local hospital's women's wings.

That and the differences in treatment such as the pain management doctor that turned me away.

I called that office for 3 weeks, only to finally get in touch with the head nurse, who told me that I should be ashamed of myself for asking them to help with testicular pain.

I know pain management is not a solution, but it would help with day to day operations. I told the LCDR at Squadron about being turned away, and he told me to call TRICARE to get them to find me a different clinic.

TRICARE told me to call around to find a clinic that would see me, as they do not keep track of who treats what. So far, nothing.

They did not even give me any numbers to try.
According to TRICARE, the pain management clinic I was referred to has treated everyone that was referred there.

Basically, in regards to testicular trauma, with TRICARE, you are pretty much on your own.

Gee Angry...all you're describing is so counterintuitive to me in civilian land. Pain is a reason for doing surgery...especially a torsion...and I can't believe the urologist won't do surgery on your hydrocele issue because of pain.
I do understand a general surgeon not wanting to touch you. This is definitely a urology issue.
The orchiopexy I described before is a very simple procedure. So is a hydrocelectomy for that matter.
I'm just befuddled by the run around you're getting.
My other half spent two years going through the medical ringer...what started out as hip pain (to me the symptoms described were a classic sign of herniated disc)...went through hip xrays, bone scans, etc for the hip. Finally did an MRI of the spine and wow...herniated (dead) disc with a fracture. Again, it took two years for a diagnosis and led to a spinal fusion.
Can't complain too bad because this was all handled for free. However, I do know resources are sometimes lacking.
I am so sorry you're having to suffer with serious pain while dealing with the frustration of getting a surgical consult.

And as far as ultrasound is concerned...
The urologist can perform the ultrasound himself if the technicians there don't know what the heck they're doing. We do prostate biopsies all the time...and the surgeon runs the ultrasound machine...not a technician.