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How i spent my summer vacation, part one: severe testicular injuries.

I Think I Need to Go the Emergency Room?

Or, How I Spent My Summer Vacation, Part One: Severe Testicular Injuries.

General content warning: this post discusses medical stuff that some people might find squicky. Possibly men in particular. As if they needed more reasons to not read this blog!

Last Sunday was a pretty damn perfect day. It was my wedding anniversary—FOUR MORE YEARS! It was also the last weekend before my little brother (who lives with us) leaves for a life-changingly awesome two-month working vacation overseas.

So we drove into the Big City to celebrate. We marveled at nature’s weird-ass creations at the local aquarium. Afterwards we ate an obscene amount of oysters, shrimp, scallops, and hot buttered lobster rolls. Then we drove home and laid out in the king-size hammock in the backyard, reading The Subtle Knife aloud to each other. The air was warm; the world was still; and the late-afternoon light was hazy and golden. It was a perfect day.

And then all hell broke loose.

Sidenote: dafuq are scrotums even doing out here?

Ahem.

Have you ever watched someone fold like a fainting goat after a hit to the balls and wondered, “huh, it seems like a design flaw that such a delicate body part is just hanging outside the body like that”?

Well, ancient lifeforms agree with you! Gonads (testes and ovaries) used to be kept inside, with the rest of our organs. You know, where organs belong. But at some point in our evolution, we decided that temperature regulation was more important than protection, and our little bodies were too hot for ideal baby batter storage. So they migrated down.

When each of us was an embryo, our testes or ovaries developed inside our chests. So around the seventh month of our development inside the womb, our reproductive organs suddenly shoot down through our mostly-developed bodies to their final resting place in the lower abdomen. Why the seventh month, when the body is basically damn-near fully formed? IDK, man. Bodies are weird. Nothing makes sense.

That means that the walls separating the abdomen and sex organs are weak—especially with testes, which must move much farther than ovaries. These weak walls can eventually fail, allowing body tissues to exit the chocolate pudding section of the Kid Cuisine tray and pop over to visit the macaroni and cheese section.

And just like the commingling of pudding and pasta, the results are very bad. My brother had what’s called an inguinal hernia, meaning, a loop of his intestine had pushed out into his scrotal sac.

Scream.

“Suddenly it just felt like someone kicked me in the rocks, and they never took their foot away!”

My little brother is an amazingly cheerful person. He’s sporty and athletic (I cannot relate), and handles injuries pretty stoically. But as we drove to the emergency room, he transformed. His face was grey. He started shaking and sweating. Eventually his whole body was overcome with trembling, and he began vomiting from the pure pain.

At this point the hernia was what’s called “incarcerated.” Basically the loop of intestine was caught too tightly in the hole of the hernia, and was being deprived of blood flow, and slowly strangling and dying. Google Image that shit, if you dare!

Doctors made three attempts to nudge the intestinal loop back inside, with no success. During these, my baby bro was on three doses of fentanyl and still writhing in agony. After the third failed attempt, they called in an emergency surgical team. He was on the operating table forty minutes later.

His surgeon told me that, in all of her career, she’s never had a patient whose first words upon waking up were “I feel so much better.” After a few days in the hospital recovering, he was able to come home, with a brand new prosthetic mesh to keep his guts from ever fraternizing with his junk again.

What should you do if you think you need to go to the ER?

When in doubt, go

When the surgeons opened him up, they found the loop of intestine was blue from lack of circulation. As soon as they freed it, it pinked back up within a few minutes. If it hadn’t, he would’ve needed much more extensive surgery to cut out the dead section and resection his bowels back together.

He was lucky. His situation would’ve been MUCH worse had he waited even another hour to go to the hospital.

The fear of a large hospital bill makes a lot of people think twice about going to the emergency room. And in some ways, that’s good! Many small ailments and minor complaints aren’t worth the trip. But you know your body. If something feels really wrong, go immediately. The cost (in money, quality of life, and time) can balloon quickly if you resist going when you really need to.

I repeat: yes, the emergency room can be expensive. Scary expensive. Especially if you don’t have health insurance. But debts can be negotiated, paid down, mitigated, avoided, altered, discharged. Not so with health. Money is ephemeral; but bitch, your body is the one and only throne of your soul. Take care of that shit.

If you don’t need an ambulance, don’t take an ambulance

Ambulances are not medical taxis. They’re emergency transport for people whose lives are at immediate risk. They’re the ideal transportation to call for people who cannot move without risk of injury, or who need the immediate attention of EMTs, or whose situation is so precarious that waiting for traffic would cause further harm.

Given this, you should avoid calling an ambulance when you don’t really need one. Riding in an ambulance is enormously expensive. A short ride can easily cost four figures, and your insurance is going to be extremely picky about what constitutes a “medical necessity.”

Now, use your sense. If you are in serious pain, or feeling lightheaded, or panicked, it is a terrible idea to try to drive a car. Ask a friend, family member, neighbor, or coworker to drive you. Or call a cab or ride share.

And if someone else calls an ambulance for you out of concern, and you don’t want to take it, you don’t have to. You know yourself. I’ve had strangers call 911 on my behalf when I suddenly fainted. Now, good on them. They have no way of knowing that I have low blood pressure—a basically benign condition—and that fainting is just a normal thing I do sometimes. If I got in an ambulance every time it happened, I’d be a Victorian-Era ragamuffin with dirt smudged on my face, wringing my bonnet, calling “Alms, alms for the poor!”

Figure out which emergency rooms near you accept your insurance

You can’t look that shit up when you’re doubled-over, vomiting from pain. And the difference between in-network and out-of-network coverage can be a $1,000 copay versus a $5,000 copay. It’s HUGE. And unfortunately, it can be a tricky situation depending on the kind of care you need. Read this article and think of how nice it would be if we didn’t expect each and every American to be an expert in labyrinthine medical billing procedures.

If you don’t know the closest emergency room that accepts your insurance, stop what you’re doing and look it up right now. And then resume what you’re doing, because you’re reading our blog and we like that.

Know what to bring

If you need to go to the emergency room, you should try your best to bring the following:

Must Bring

  • Identification
  • Insurance card
  • A fucking sweater—no, seriously, every ER I’ve ever been in has felt like Mr. Freeze’s meat locker in the basement of Dante’s Hell

Must Know

  • Names of medications currently taking
  • Known allergies to food or medication
  • Emergency contact’s information

Nice to Have

  • Your phone and a phone charger
  • Tissues (helpful for sneezing, coughing, crying, and puke cleanup)
  • Coins (there are usually vending machines—but don’t eat until given permission)
  • Something to do (see below)
  • A second fucking sweater—I was sent from the future to warn you

Keep yourself sane

I’ve spent many days and nights in hospital waiting rooms, and what I’ve found is: it’s both extremely stressful and extremely boring. This combination can drive you insane. Especially when the only TV in the waiting room is blasting the Disney Channel at an unignorable volume. (Related: did you know that there’s a sequel to That’s So Raven where Raven Symone plays a divorced mother of two, and seems to be in a low-key lesbian relationship with her other divorced friend, and also one of her kids inherited her psychic ability? I watched six consecutive episodes while the surgery went on worryingly long, and it was definitely a void-gazing-back situation.)

Whether you’re a patient or a visitor, much of your time there will be spent waiting for the next thing to happen. So find something that will help you make time pass as quickly as possible. The things I like to bring occupy my hands and my mind, but in a passive/meditative way. Some people like books, but I personally have a hard time reading in times of stress; I’ll read several pages without absorbing any information at all.

  • Jigsaw puzzles
  • Coloring books
  • Crosswords
  • Sudoku
  • Handheld game systems
  • Cards
  • Nail polish (only if you’re alone b/c smell)
  • Headphones for music, podcasts, movies

Avoid bringing expensive things like laptops, and always keep your phone, wallet, or game system on your person. It’s sad to say, but the moment you turn your back, they will get stolen.

Take it from me. Someone once stole my bag of coloring books from an ICU waiting room. I guess they hoped there would be something better at the bottom. Or, I don’t know, they were in a dark place and needed to color in a hurry, and after sizing me up, decided I did not look inclined to share, even though I totally was.

Burn in hell, coloring book thief, wherever you are...

Advocate for yourself

This is general advice for medical situations: be prepared to advocate for yourself. If you don’t understand what’s going on, ask questions. If you’re not comfortable, say so. If you are super bad at this kind of thing, call your pushiest friend to come help you.

I had a horrible emergency room experience once where the (male) doctor insisted I was having an ectopic pregnancy—no matter how many times I insisted that I’d never had PIV sex in my life. He completely disregarded my words and insisted I take a pregnancy test. When it came back negative, he made me take it again because he still didn’t believe me. 

Paying that emergency room bill was one of my bitterest expenses, ever. I was young and alone, and I was used to doing what authorities told me to do. I wish I’d known I was well within my rights to refuse.

Just try like hell to not go

Please, please listen to your Internet Grandma on this point. Be a good boy or girl or nonbinary individual and perform preventative maintenance on your body.

My little brother knew he had a hernia, and at his last annual, his doctor said it was probably time to get it fixed. He had a loose plan to do so after arriving back home from his two-month trip. But when he gets back, he’ll also be moving, and applying for jobs, and hanging out with friends, and it’s easy to imagine that he’d put it off for one reason or another. I know I’ve certainly done similar things in the past. Who hasn’t?

Let this scary tale of scream-and-punch-the-wall scrote pain be a lesson to us all. Take advantage of all the annual medical maintenance opportunities already built into the cost of your insurance. Don’t put off the recommendations they make. Eat well, exercise, wear your seat belt every single time, and try not to do dumb shit with fireworks or power tools or dildos or snapping turtles. The emergency room isn’t fun, and it isn’t a cheap date.

I wish I could say my vacation got better after this. Unfortunately, it got worse… but don’t worry. Blogging is the act of spinning shit into gold! Or if not gold, some kind of protective covering to help keep the shit off of others.

More medical advice and tales of woe:

Inviting your emergency room horror stories in the comments!

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13 thoughts to “I Think I Need to Go the Emergency Room?”

  1. I made the mistake of once telling Tim about a friend who had a torsion and ended up losing the testicle. He’s now crazy paranoid about it, and I rue the anecdote to this day.

    Inre: ERs I’ve never had a problem with insurance accepting any given ER. While it’s always good to do your homework, I’ve never heard of anyone’s insurance giving them grief about which emergency room gets picked. It’s true of regular docs, but in general (again: as far as I know) the insurance just wants you to get your ass into any ER before the situation gets any worse (read: more expensive for them).

    Good point about the ambulances, by the way. Tim had to take an ambulance twice when he was uninsured. It was a 5-mile drive and cost $900 each time. Even with insurance it’d be a $300 co-pay for him and full price for me until my deductible is met. So yeah whenever possible I’ll be finding a friend to drive me in a pinch.

    And finally yes yes yes YES to the “bring something to do.” Tim and I went into the ER so many times that we had the procedure down pat. Decide to go; get iPad, get iPod, get book, get game system, get chargers for all, then skeedaddle to the car. At one point I could assemble everything in the time it took him to get dressed. Because we’re just that good. Or laden with maladies. But I prefer to go with “good.”

    1. My content warning about scrotal injuries was flippant but sincere. I know many people who get faint just thinking about it.

      AND YES! The more unscheduled time you have in the ER, the more anxious and tormented the whole thing feels. And visits can easily be six, eight, ten hours or more. As much as I love Raven Symone sitcoms…

  2. I grew up in the States, we only went to the doctor if it was Absolutely. Necessary. After my parents divorced, my mom, my sisters, and I moved to Canada where my mom is from. I thought it was odd, people would go to ER or their doctor’s office for way more (mundane IMO) reasons than we ever did. Now that its been *cough* 30-ish years and one child later, I would not give up the access to healthcare here for anything. The wait times can suck but I don’t have to know which hospital will cost me freaking $4,000 more than another one. Just … makes me super sad and angry all at the same time.

    1. This, this, this. It’s like going to an expensive restaurant and everything is “market price.” The stress of not knowing, and not being able to plan, is so freaking harmful and unnecessary. Medicare For All, Literally Anyone Else 2020.

    1. I know. I pulled an SJW muscle trying to not let that be the focus on the article. The whole system is fucking preposterous.

  3. I am so glad that your brother is okay! Sounds like a horrible experience, but at least it happened with you guys and not once he got abroad!

    One note about taking a ride-share in lieu of an ambulance- there are some tricky legal/ethical issues at play that Uber/Lyft drivers are already dealing with. The drivers could potentially open themselves up to lawsuits and be held responsible for anything that happened to a passenger enroute since they are independent contractors, not company employees (like cabs). However, a driver is not held liable if they refuse to take an ill passenger.

    If you are alone, with poor insurance coverage, a ride share may be your only option. However, you can be placing your driver in a dicey situation, especially if you turn out to be in worse shape than you thought. Some may even reject you for this reason.

    1. That is a really interesting point! I had no idea that was a concern!

      Confession: I called my first-ever Uber this week. And it was only due to the confluence of emergency + car in shop + local taxi quoting a half hour wait. I don’t personally use ride shares because I feel very conflicted about it, as I am about most things in the gig/sharing economy…

  4. I totally get that doctors can be assholes, but I also understand the ER doc insisting that you take a pregnancy test. I’ve delivered the babies of women who have sworn up and down that they’ve never had PIV sex.

    The second pregnancy test was a true dick move though.

  5. I’ve always looked up hospitals ahead of time for when I’m away from home, especially when I was traveling while pregnant (just in case!). Luckily, most hospitals are in-network, though at least one time I ended up in the ER, one of the doctors was out-of-network. How are you supposed to plan for that?

    I’ve been back and forth on the “should I go to the ER” question for plenty of issues. A few times it was necessary, but a few times I think I was being overly cautious (and paid for it with time and money). It’s so hard to know sometimes if something is really as bad as you think! Glad brother is feeling better!

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