The Digital Awakening » lump in scrotum

Garmin Nuvi 205W

Peter Tan — Mon, 25 Aug 2008 07:10:37 +0000

Thanks to Palmdoc who blogged about the Garmin Nuvi 200, I realised that I do not have to lose my way in unfamiliar territory again, especially in Petaling Jaya and other parts of Selangor. Wuan and I have been checking around for an affordable GPS device for us to get off our usual beaten track for some fun and adventure. Most of the time, our weekend jaunts are to Mid Valley Megamall, 1 Utama and Ikano with occasional trips to Suria KLCC and Pavillion – occasional because parking at those two shopping complexes are prohibitively expensive.

I went for a check up at SJMC last weekend because the lump in my scrotum has actually gotten a little bigger. The urologist was not too worried about it and assured me that it is not cancerous and is most probably a cyst caused by an infection previously. An appointment has been made for an ultrasound of my scrotum next month for the urologist to get a better picture of what is happening down there.

After the check up, Wuan and I went to Subang Square to collect the Garmin Nuvi 205W that we booked. From there, we planned to go to Ikano. The nifty little device took us on a path we would not have taken but we got where we wanted to all right. Now, our weekend do not have to be visits to shopping complexes only. We plan to venture a little farther out using the Nuvi 205W to exercise our photography skills. It has been a while since I last shot images of unfamiliar subjects.

Whacked Out By Fever

Peter Tan — Tue, 03 Jun 2008 09:14:36 +0000

The one good thing about being sick is that no matter how unhealthy I felt before that I would feel all hale and hearty after I got better. This is how I am feeling right now. It is a matter of perception but I am not complaining. I had fever last Friday. It went away on Saturday and I felt well enough to participate in an accessibility audit at Kuala Lumpur Sentral with a group of students from University Malaya. Early Monday morning, I had fever again. It consistently hovered above 39C. I was nauseous, light-headed and had abdominal pains. My body was burning hot.

Wuan decided that I had delayed enough seeing a doctor for the persistent fever that has been plaguing me for the past few weeks. She duly took a one-day emergency leave and dragged me to SJMC. I was already feeling better when I reached the hospital. The urologist prescribed a one-week course of antibiotics for urinary tract infection and paracetamol for the fever. I also had to provide urine specimens for culture and sensitivity test to identify the bacteria that is causing the infection. I took the opportunity to ask him about the lump in my scrotum. He said that it will take a while for it to disappear.

Today is the second day I am on the antibiotics. The fever has not returned. I feel a little weak but generally I am almost my normal self again – a matter of perception that is. I have not eaten much since yesterday due to the nausea. I am going to take it easy for now. Wuan and I will be making a trip up north again soon and I want to be at my best of health to endure the long journey there and back. Besides, there is a lot of packing up that we need to do while we are in Penang and a lot of food that I am looking forward to eating while there.

Lump In Scrotum And Detrusitol SR 4mg

Peter Tan — Thu, 29 May 2008 14:55:25 +0000

The lump in the scrotum has been bothering me again of late. Prior to the discovery of the lump, I stopped driving for a while because my legs were spasmodic. When the spasms struck, my legs would get in the way of the hand controls and steering wheel. The spasms went away about one week after I finished the antibiotics.

Its size has not reduced much after the two-week course of antibiotics. The spasms have returned. I believe there is a relation between the spasms and the lump. I was at the UMMC Rehabilitation Medicine Clinic for my scheduled three-month check-up yesterday. The doctor examined the lump and advised me to get a biopsy done. I am going back to SJMC soon to have the lump checked again by the urologist.

When I went to collect my supply of medication, the pharmacist changed my dosage of Detrusitol from the 2mg twice a day to one 4mg once daily prolonged-release capsule. I told him that I have had problems with the 4mg capsule as it caused problems with urination. He told me that was the only dosage the pharmacy has now and if I prefer the 2mg tablet I have to get it elsewhere. I decided to give the 4mg capsules a try again.

I cannot understand why the pharmacy prefers to dispense the 4mg capsules instead of the 2mg tablets. A one-month supply of Detrusitol SR 4mg capsules costs RM249 while the Detrusitol 2mg tablets costs only RM170 when I last bought them myself. Anyway, the instruction was that I should take one capsule at night. Based on my previous experience with Detrusitol SR, I decided to take the capsule in the morning instead. I had my first dose this morning and will be monitoring my bladder’s reaction in the coming days.

First Urodynamics Study

Peter Tan — Mon, 12 May 2008 14:41:29 +0000

For all the years that I have been living with spinal cord and chronic renal failure, I have not had a urodynamics study done to determine the pressure in my bladder. This test is needed to determine whether the pressure in the bladder will cause a reflux and further damage to the kidneys.

I had one done at SJMC last Saturday for once and for all as to see if the pressure in my bladder is the cause of my renal failure and whether I need further treatment. I have been waiting to get it done at UMMC but two appointments were cancelled. The first time was because the urologist was away and the second because the urodynamics clinic was under renovation.

All garbed up at SJMC waiting for the urodynamics study to commence.
Photo by Wuan.

There is usually a six-month waiting period at UMMC but it would have been done free of charge there as I hold the Kad Orang Kurang Upaya from the Department of Social Welfare Malaysia. It costs RM1,500 at SJMC. Another urodynamics study was schduled for mid-June at UMMC but I thought I better get it done first at SJMC just in case the one at UMMC gets cancelled again.

The procedure was not as embarrassing as I had anticipated. The technician was very patient in explaining the entire procedure and made me feel at ease even though I was bare-bottomed throughout. A thin tube was inserted through the urethra into the bladder and another into the rectum. The tubes were connected to a device that fills up the bladder with saline at a pre-determined rates – 30ml/min and 15ml/min, measured the pressure in the bladder as it filled up until urine started to leak.

The equipment used for the urodynamics study.
Photo by Wuan.

Another device was placed right below my seat to measure the amount of urine that leaked. After that, the residual urine in the bladder was sucked out with a syringe and measured. The results showed that the presurre in my bladder is normal until the volume is around 300ml where the pressure rises to slightly more than 50cmH2O and the fluid started to leak. The leaked volume was around 100ml while residual volume was around 200ml.

According to the urologist, as long as I keep up with my three hourly intermittent catheterisation programme, it should not be a cause for concern as reflected by the results. No further treatment or medication is necessary. He recommended that I get the urodynamics study done every two years. He also checked the lump in my scrotum which has gotten smaller after a two-week course of antibiotics. I am to go back to see him in two months to get the lump checked again.

What I Did Yesterday

Peter Tan — Sun, 20 Apr 2008 06:09:54 +0000

Woke up extra early and went to SJMC to consult a hematologist regarding my anemia. I have been breathless and feeling lethargic for a while now. It is no fun waking up after 12 hours of sleep feeling like I need another 12 hours more. At the same time, had the lump in the scrotum checked by a urologist. Apparently it is an infection of the epididymis caused by constant catheterisation. I am on a 2-week dose of Zinnat, an antibiotic, that hopefully will clear up the lump by then. He also scheduled me for a urodynamic testing to check on the pressure in my bladder.

In the 24 years since my spinal cord injury, I have never undergone any. UMMC had scheduled to urodynamic tests but both we called off – once because the doctor was away and the other because the lab was being renovated. These appointments are usually scheduled 6 months prior. Although the procedure is done free of charge at UMMC and costs RM1,500 at UMMC, I decided that I wanted to know if the pressure in my bladder is the cause of my renal failure and what can be done to prevent further damage.

After that, Wuan and I went all the way to the Palace of Golden Horse at Seri Kembangan for a buffet lunch with some good friends. One will be leaving Malaysia with his family in July. And then we drove all the way back to Damansara Mutiara for a meeting with the good people from the Malaysia Association of Standards Users at The Curve. We talked about the standards of accessibility which, although in existence since the last decade, are seldom adhered to by the local governments.

To sum it all up, I had to pull down my pants twice to have my testicles examined, drove all over Kuala Lumpur and Selangor to meet friends and make new friends, were extremely late for both appointments, and came back all fired up for no apparent reason and only fell asleep at 3am. It had been a tiring day but worth the effort.

I also have this one thing to say about SJMC. Although it is a hospital, there were no accessible parkings and I was made to circle the buildings twice before I found an empty standard-sized lot near to the entrance. The hospital management should really take note of this. They should not expect wheelchair users to park their cars at the open space which is a long distance from the entrance and down a steep slope. Of all places, I expect hospitals to be the most accessible place but this seldom the case. That is one of the reasons why I dislike going to hospitals.