Write On: "I Have A What?"

By PETER S. FERRARA<br>Record Columnist

Sat, May 17 2008

— As soon as I heard what my physical problem was called, I knew it was going to require surgery. Modesty prevents me from being too precise about what, exactly, was wrong. Let's just say that I had a non-malignant cyst growing in a part of my body that seldom sees the light of day.
On a regular visit to my doctor, I showed him what was bothering me. "That's a spermatacele (spur-mat-ah-seal)," he said. "It'll keep growing. When it becomes a problem, I'll refer you to a specialist who will remove it."
"Is it a cancer of some kind?" I asked with more than a trace of worry.
"No. It's not malignant and it's not a cancer. It's just a kind of cyst."
"How did I get it?"
"Nobody really knows why they happen, but they are pretty common. What happens is that a vital duct or passageway becomes blocked and this cyst begins trapping fluid that would otherwise pass through you. The cyst grows and grows and finally has to be removed."
"Cyst" is another word I don't much care for. "How will I know it has become a problem?"
"Oh, it will eventually get so big as to make it hard to bend over. Do you plant a garden?"
"Yes."
"Well, when the spermatacele gets larger, you won't be able to tend your garden."
"Should I just go have the surgery now?"
"You can, but I'd wait a while if I were you. The surgery will lead to a slow and painful recovery. You probably want to put it off for as long as you can. By the way, the rest of you is perfectly healthy."
Somehow, the fact that the rest of me was healthy did not put my mind at ease. Instead, my brain put its laser-like focus on what was wrong with me, as opposed to all my body's systems that seemed to be working perfectly.
Something was growing inside of me that shouldn't be there. I suddenly knew a little bit of how cancer patients must feel when told that something is growing in their bodies that may kill them if left untreated. The first thing you feel is betrayal. How could my body, which had been such a good friend to me for so very long, suddenly have turned on me in this sinister and unwanted way?
Following my doctor's advice, I waited for another couple of months. My cyst continued growing, until it was about the size of a somewhat flattened tennis ball. I did begin to notice that it was getting more difficult to bend over and do yard work or on other things that required stooping over. When just sitting comfortably became difficult, I went back to my doctor, who referred me to a specialist named Dr. Eric Ruby.
Dr. Ruby is part of an operation called Commonwealth Urology. They have offices in Somerset near Lake Cumberland Regional Hospital. My wife's life was saved at that hospital by another gifted physician named Amr El-Neggar, who performed two elaborate brain surgeries on her when she developed a leaking, balloon-shaped clogged vessel called an aneurism. Dr. Ruby said that before doing the surgery to remove this cyst, he could draw out the fluid that filled the cyst using a hypodermic needle-- a process called aspiration. Would I like him to try that? Right now?
I sat on the cold examining table and considered my options.
First, I could wait until surgery and have the thing completely taken care of. Of course, I would then be in store for the painful recovery which I was assured would follow. So I asked him how much time having the fluid drawn out by using needles would buy me.
"You might get six months to a year," Dr. Ruby said. "Or the spermatacele might just fill up again pretty fast. There's no way to tell."
"What would you do?" I asked. Dr. Ruby is a smart and pleasant young man who I knew would give me a straight answer.
"I'd try aspirating it, to see if it came back slowly or not."
"Okay," I told him, "let's do it." Now the sight of a man coming toward you with a large hypodermic syringe and preparing to stick you in the most sensitive place on your body is not something many of us would want to see. But Dr. Ruby is such a nice guy, I thought to myself, there's no way he would really hurt me. Well, I was a little off on that. Dr. Ruby is a very nice man and a very talented doctor, but having a spike jammed into your "personal being" is going to hurt no matter who does it.
I winced with pain when he jabbed me. "Do you want to see what's being drawn out?" he asked.
"I think I'll pass on that," I said, trying not to show the pain I was in.
"Oh my," Dr. Ruby said. "Looks like your cyst has segmented. There is more fluid in another compartment. I'll have to jab you again. Sorry."
It was then that I decided that maybe I would go ahead and get the surgery. But after he was done, I seemed to look as normal as I ever do. The thought of not having to do anything for six months to a year filled me with optimism. My sense of well-being was short-lived, however. Within a couple of weeks the cyst was back and bigger than ever. I scheduled the surgery for February 22, 2008.
Last Friday I reported to the Lake Cumberland Surgery Center, a building located below and south of the hospital in Somerset. I had been instructed to report at 9 in the morning, not having had anything to eat or drink since midnight the night before. Forms were filled out and I was taken to a "prep" room, where I changed into a hospital gown. They let me keep my cotton socks on so my feet stayed warm. Hospitals tend to be cold places. Only the set of the David Letterman show is kept colder.
They hooked me up to an "IV" site, so that the anesthetic which would put me under could be administered intravenously. Then I found myself being wheeled out of the big holding area toward a corridor. Lying on my back, I stared up at the ceiling as most patients do when being wheeled around. First I took careful note of the way the neon fixtures were attached. I tried to count the holes in the insulating tiles that covered the ceiling. That's the last thing I remember. I was unconscious before I ever left that large room.
When I woke up, I was back in my little prep room. My wife Phyllis was sitting across from me. An hour had passed.
"The doctor said everything went perfectly," Phyllis offered brightly. We left before noon that day and she drove us back home.
Now I am in recovery. While the incision the doctor made was necessary to get at and remove the cyst, any such invasion is painful. But I had been so led to believe that I would be in agony for weeks and maybe months after the surgery that what I actually felt didn't seem all that bad. I have to lie low for about two weeks to give things a chance to heal. The stitches will dissolve on their own. While there is some pain, it really is no big deal.
I am writing this in the hopes that some readers may read it and be inclined to show their doctors a condition they may be hiding. Believe me, it's a whole lot better to face a problem and deal with it than to pretend it'll go away if you just ignore it. If you have anything going on with your body that shouldn't be going on, please discuss it with your doctor. An ounce of prevention really is worth a pound of cure. I feel fine. I want to say thanks to those of you who knew of my condition and made inquiries. To all the readers of this newspaper I urge this: If you have a problem-- don't wait. Don't be embarrassed by any medical condition. We have fine doctors around here. Get help. It's what you don't know that can really hurt you.

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