Part II: Answers

Medicine defined is The science of diagnosing, treating, or preventing disease and other damage to the body or mind.


I love medicine. Before, during, and hopefully after our current life situation, I have loved medicine. I love the uncertainty. The problem solving part where you try and figure it out. I love when I have the knowledge to hear signs and symptoms and then know the diagnosis because it fits so perfectly. I love knowing what treatment works best depending on the situation and then applying that knowledge to the way I counsel people.  I love that medicine gives us answers that we need in order to process our feelings and emotions. I love that medicine can give us expectations for the progression of an illness, so that even when we are flying blindly we can at least cling to the statistics and facts. I also love that even when the odds are against us, there is always hope in medicine because it is not exact, those statistics have outliers, and medicine is always evolving.


"Medicine can only cure curable disease, and then not always" Chinese Proverb

Facts to take home from our appointment...

1. The new MD was incredible. He answered all questions, performed all tests that I think the first urologist was missing, and did it all with intelligence, confidence, and compassion. 

2. Hormone concerns from previous lab work seem like a fluke to him and are not an issue to treat. Nor is the varicocele which he could not feel with his "sensitive fingers" and therefore it is not the problem and not worth the surgery. 

3. All ducts and passageways are clear and free flowing. No scar tissue, no swelling, no obstructions, no concerns (I admit that this surprised me to hear, this is what I was betting on). 

#4 is the biggie...the answer I feel like we waited 3 years to hear...

4. Kevan has a calcification in his prostate. Most likely cause was an infection that produced no signs or symptoms. Calcium is a waste product of infection and since the prostate is a giant sponge, the calcium could not be dispelled through the body and therefore hardened at the infection site. The calcification which measures 6x3mm is putting pressure on the seminal vesicle. This pressure is not yet closing off the vesicle entirely, but if more calcification were to occur (ie. another infection) then it might. The pressure on the vesicle effects the volume of semen and the motility of the sperm.

For the visual learners...Imagine all your little swimmers have to pass thru a tunnel, however your tunnel is jagged with sharp edges that bump and injure the swimmers on their way out. It is only expected that after that journey they would have trouble swimming and therefore would be unable to be successful in the remainder of their venture.

The calcification is deep in the prostate, in a difficult to reach location. A TURP procedure (transurethral resection of the prostate) would be difficult due to location and etiology. Since the mass is a calcification, not a tumor or a cyst, it does not have defined edges and would be difficult to cut out.  The MD has done this procedure before and in our case, he thinks the risks might out weigh the benefits. He also is not sure that removing the mass would improve the vesicle and therefore lead to better swimmers.

Deep breath, long pause....He thinks that IVF with ICIS would be our best bet for biological children and he is doubtful that we will ever conceive without these steps.

5. There is nothing we did to cause this problem, nothing we could have done to prevent it, and (my personal favorite) nothing that could have been done differently to correct the calcification had we come to him 3 years ago.

6. There are also no medical indications, concerns, or risks that arise based on having this calcification. The only issue it should ever cause is our continued infertility.


If those aren't answers then I don't know what is...


jenn