Day 775: He's Dad Enough

I figure if putting the things I’ve written on this blog out there on the Interwebs hasn’t already blown up my computer, I should just keep going. So, I’m going to share an interview that I just did with my husband Gabe, who turned 37 a few days ago and greatly enjoyed his 7th Father’s Day yesterday. Why the interview, you ask? Well, because today he had a vasectomy. At Planned Parenthood. And oddly enough, no one was threatening to firebomb the joint while we were there or anything like that.

I've put some stuff on this blog for the sole reason that it didn't seem like anyone else was talking about the things I really wanted to know and understand about cancer, and this fits right in with that theme. This time, maybe some guys will benefit from the information. If not, there are at least two people who find it entertaining. Gabe's pleased that I'm letting him talk for a change, even if I am posting pictures of him all doped up on painkillers.

Right after Augie was born, when we were both half dead from sleep deprivation, Gabe said he wanted a vasectomy. I thought it might be a little soon, and that we should make that decision when Augie was a little older. Then, he was a little older, and I found out I had cancer.

And we didn’t know what the hell to do, in general, much less about family planning.

I figured there was no use in Gabe getting snipped if I were to, say, die, and we also had no idea if and when I would come out of my chemo-induced menopause, so the operation would have been a waste then too. I was in a strange situation for a woman with breast cancer. Most women are post-menopausal. For those who aren’t, the vast majority are estrogen positive, and are on tamoxifen or other drugs that often keep them in menopause for five years. But since I’m triple negative, I took no drugs after chemo, and I knew it was possible that I could get pregnant, even though that could have disastrous consequences. Even after menopause left me and my hormones came raging back, leaving me in this perpetual adolescent state of uber-fertility and libido, I didn’t want him to have the operation. I mean, he’s still a fairly young man. If I don’t make it, I want him to be able to have kids with someone else. I told him this about a year and a half ago and he became absolutely enraged with me for giving voice to that idea. I still carry this strange guilt about the whole thing, though.

Well, the whole point of having control over our bodies, sexuality and fertility is that we should be able to have control over those things ourselves. And Gabe wanted a vasectomy, so my guilt is really beside the point. This is the kind of thing women have been fighting for, to keep men out of the decisions they need to make for themselves. And in our situation, it makes perfect sense. We are happily married and we have kids—one of each, cute and smart. It would be extremely dangerous and potentially deadly for me to get pregnant again, as my cancer recurrence risk would go up, and then there’s the pesky issue of leaving Gabe with three kids to raise alone as opposed to just the two. And we could always adopt; Gabe has been supportive of that idea, as his mom and aunt were both adopted. But I don't think we would qualify as adoptive parents with my health history, and that would still leave the specter of him raising more kids alone. So, I think we are really done having children, which is a reality that is both unfortunate and a relief.

Those are my thoughts, however. It’s his body and his sperm, so I’m letting him have final say. Here goes nothing. Good thing neither of us is interested in running for office.

K: So Gabe, why did you decide to get a vasectomy?

G: There were many reasons. I love you and I love making love to you and I don’t want to get you pregnant accidentally, especially not anymore, not after cancer and definitely not after Augie.

K: Why you though, why wouldn’t I take care of the birth control situation?

G: It’s only right that I volunteer once to do a surgery that would be much more difficult for you to do, especially after all the surgeries you’ve had. You can’t take the pill or do other hormones so it’s the least I could do to improve an unpleasant situation.

K: Are you sad about not being able to have more kids, with me or with some other potential woman after me if I don’t survive cancer?

G: You’ve already survived cancer and you are going to survive for a long time. I can’t imagine having children with anyone but you. I can’t imagine us having any other child more perfect than the ones we have. (Gabe is tearing up). I do feel sad in that I feel like cancer has forced our hands and we will never know what we would have done otherwise, though otherwise I might have done it long ago. But we do have this big house now and I can imagine us filling it with kids, if we won the lottery or something. There are circumstances under which if you hadn’t had cancer, yeah, maybe we’d have a house full of kids running around and going crazy and pissing us off. But this was the right time for the right reasons. I’m a little wistful but I’m good with it.

K: Do you think you’ll regret it?

G: No, never.

K: OK I won’t ask you many more emotional questions. So why Planned Parenthood? I knew they offered vasectomies since my dad had one there when I was a baby, but not many middle class families think of them for men’s needs. In fact, when I told my ob/gyn the plan, he was surprised and said he didn’t think “they dealt with men.” But the truth is they’ve been offering vasectomies for 100 years.

G: Because my insurance wouldn’t cover a regular urologist, as they don’t cover voluntary sterilization. It would have cost about twice as much to go through private practice. Planned Parenthood asked me why I came to them and I told them I knew other people who had done it, and I tried to go through my insurance but they wouldn’t cover it, which is ironic because if I got my wife pregnant again, and she had the baby and got cancer again, it would cost hundreds of thousands of dollars to have the kid and to do the cancer treatments. I’d like to send the receipt to the insurance company and bill them for the money I saved them.

K: OK so let’s get down to business. What did you have to do to prepare for the operation?

G: I had to do a consultation visit to learn about the procedure, check my medical history, and make sure that I was doing it for the right reasons and wasn’t being forced into it. As one of 15% of men who have had a medical problem known as varicocele (varicose vein in the scrotum), I had an operation on the left testicle almost exactly four years ago. I had known about it since I was about 19, but it was affecting our ability to get pregnant after Lenny was born and I was in pain and discomfort all the time. There was a slight chance that because of that surgery they might not be able to do the vasectomy at the clinic but that turned out not to be the case. That varicocele surgery was under general anesthesia and I don’t remember much of it. I was apprehensive about it and that turned out ok so the vasectomy seemed like much less of a big deal. The most annoying thing I had to do to prepare was I had to shave the underside of my penis and the front of my scrotum. I just shaved the whole damn thing though and it took forever.

K: Let’s take a sidetrack here and you can tell everyone about the conversations you held at the clinic about shaving your balls.

G: Well, after I complained about how long it took they told me I did a very good job. In the course of the whole thing I kept telling them I was most annoyed about shaving my balls. I said they should have a support group for how to do it right. Then when I was leaving I saw the guy after me coming in. I told him he looked good for a guy who was about to have an abortion. Everyone cracked up; the doctor told me that was the funniest thing anyone had ever said in that room. And then I asked the next guy about the whole ball shaving thing. Apparently this guy shaves once a week so I told him he should lead the support group. We were bonding.

K: I think there are about 100 people who just unfriended me on Facebook after reading that. But anyway, what was the procedure like?

G: When I went in they asked me if I was there for a vasectomy and since it looked like a salon with all the chairs, I said I was there to get my nails done. Then they needed to make sure I was there by my own choice. They asked me why I chose a vasectomy and I said because of this wonderful thing called cancer. My wife had breast cancer and she isn’t supposed to get pregnant again. They asked if I had kids, and I said I had two beautiful smart redheads and I DIDN’T WANT ANY MORE OF THEM. Then they asked if I wanted to go under or have anesthesia. I asked what most people do and they said that some people just walk away or even drive themselves home and some people have more fun on anesthesia. I said oh I guess my wife didn’t need to take the day off work to drive me home, and I think I’m pretty fun anyway so I’m going to not do it. I told them that when I had the varicocele surgery I was under general anesthesia, and I had missed the part where the doctor told me that one of the veins he removed was so big he could stick his finger through it. I didn’t want to miss anything good like that.

K: But they must have done some local anesthesia.

G: Yeah there was some topical stuff applied. They gave me an IV but I didn’t use it. I told them I thought IVs were to make their jobs easier, and I told them about how you refused to have a port. But they got my vein on the first try because my veins are so huge. Anyway, then I went to the operating room and I sat on the table and asked if I should pull my pants down, and I started screaming about being afraid of stirrups, though of course there weren’t any.

K: They must have loved you.

G: Well the doctor had already high fived me, because at the beginning they explained that I would have to come back for a semen analysis after ejaculating 20 times to make sure the operation worked. At the consultation, they had told me 15 times, but not to do it all at once. So I told the doctor that, and asked who these people are who are going to try for 15 at the same time, and she said, can you imagine the kinds of men that come in here? I said, well I know enough to think that about 90% of all men should just be euthanized, at which point she high fived me.

K: Another interjection. Do you think you’re one of the 10% that deserves saving?

G: (long pause). I’ll defer that answer to my lovely counsel, also known as my wife.

K: Good answer! and I suppose you are. Anyway what about the procedure? What did they do? Did it hurt?

G: She started moving stuff around down there and told me it might pinch. She used something that was like the scrotal equivalent of a staple gun. It didn’t hurt. Then she warned me again and I told her to just do it and stop warning me. After the staple gun it felt like she jammed something right into my testicle, which did hurt. Then I got more local stuff, and eventually they cauterized the vans deferens or something. The whole surgery took like half an hour.

K: Yeah I was surprised to see you walking out of there on your own so quickly. How do you feel now?

G: I feel ok though I need an ice pack for my balls. Can you get me one?

K: Yes dear.

K (back with ice pack): So any worries? About pain or sex or anything?

G: The biggest pain so far was when they tore the IV tape off my arm since it’s so damn hairy. They said that 4 out of 1000 men who get vasectomies lose the ability to maintain an erection without any physiological reason so it’s more of a psychological thing related to the fact that there are these morons out there who think that if they can’t get a woman pregnant they aren’t manly or something. They are in the 90%.

K: So, you feel just as manly?

G: Yes, I do. I feel more manly, actually, because I did it without anesthesia.

K: Yeah, way to man up. Are you excited about the prospect of not having to use condoms soon?

G: Absolutely. And I’m excited thinking about how fast we can get to that 20 mark.

K: Right. Anyway I’ve talked about condoms my fair share in this blog. I’m a fan, for a lot of reasons. But from a guy’s perspective, what did you think about using them? I mean except for the 9 months I spent pregnant, we’ve used them continuously since Lenny was born. Did you think they were annoying or that it didn’t feel as good?

G: Putting them on and taking them off is annoying. But with the newer super thin condoms you can’t tell that much. And it’s sex, and it’s sex with you, so you know, it’s awesome.

K: I’m kind of looking forward to not having to worry that people will find the condoms that you stashed all over the house, just in case. Like the ones in houseplants.

G: Thanks Kate. Now no one will ever want to visit our house again. Maybe you shouldn’t say that in the blog.

K: Too late. So should I be concerned about you cheating on me now that you don't have to worry about getting anyone pregnant?

G: That is a completely ludicrous question. Though I was going to ask if you care if I go to my 20th high school reunion by myself. No seriously, you are more than enough woman for me.

K: Good to know. Any last thoughts?

G: Yeah now there’s one less thing for you to nag me about! And I love you. And it was better than CATS. I would do it again.

K: Love you too, babe. Happy Father’s Day. I guess you are already dad enough.

Day 637: Komen, Planned Parenthood, Women, and Sex

It would be impossible for me to ignore this entire Komen fiasco over the halted funds to Planned Parenthood, even though I would really like to ignore it. So rather than talk about Komen directly, or Planned Parenthood, or abortion or politics or pink, I want to talk about one specific topic:
Sex.
It has to be said—every aspect of women’s health, and often of women’s lives, is often reduced to this. We are sex objects at the same time that we aren’t supposed to actually like sex, or want sex, or make decisions about sex. Someone decides that an organization that provides a wide range of health services for women should no longer be given money, and the underlying reason (regardless of Komen’s overall goal to not give funds to groups under Congressional investigation) is that sometimes—after they have sex—women get pregnant when they don’t want to. If an organization that might save women’s lives is willing to accept this, it apparently does not deserve to exist.

And how does this happen? How do we get marginalized into talking about sex or sexuality when we should be talking about living or dying? Well, here’s an example of how that happens. We find out that we have breast cancer, and it is terrifying, and sad, and unbelievable. And then the world wants to save our breasts. Not US—our breasts. Our tatas. Friends joke about how they would definitely get them both cut off so they could get bigger and better ones for free. Doctors try to lead us to believe that deciding between a lumpectomy or a mastectomy is a “personal choice” that should be based on what will make us feel “more comfortable.” Nurses counsel us on dealing with our body image—or our husbands’ or boyfriends’ reaction to our new bodies—as if following the operation, we will be somewhat less than whole. Because something has happened to those beautiful breasts.

Or, the world wants to save our hair, to protect the world from the vision of a bald woman, through a relentless marketing blitz for wigs and hair coverings. Men cry when they find out our long beautiful red hair will fall out. Women tell us we are beautiful “anyway.” Everyone and their mother tells us “it’s just hair, it will grow back,” as if to say dear God it’s really not just hair, you strange bald freak, and boy I cannot wait until it grows back so I can look you in the eye again. The world even wants to save our faces. We are offered “beauty” classes to show us how to hide the discoloration in our skin left by chemo, how to draw on eyebrows where there are none, how to stop looking tired, how to stop—STOP IT GODDAMN IT! Stop looking sick!

And so often no one thinks, wow, she just lost a body part—she just had an amputation. That must feel different, that must be strange when you move your arm and notice something’s missing. No one says, I wonder if her head is just cold, perhaps I could knit her a hat? No one asks if it hurts, if you’re scared, if you’re still attracted to your husband.

Perhaps it’s too easy for me to say these things. I am sitting here now with a normal head of hair, a remarkably well-functioning body, the same face I’ve always had, and by God a decent looking pair of perky breasts of my own. A little scarred and tattooed maybe, a little dented in one place, but still perky, still mine. But I lost so many things myself, so many things—and none of it felt the way other people thought it would feel. I didn’t feel unattractive. I didn’t worry that Gabe wouldn’t want me. I didn’t think that being bald and scarred eroded my femininity. I thought I might feel those things, I anticipated those losses before they happened, but once I was in it, I didn’t feel that way at all. Because I really didn’t give a shit.

Because I had cancer. And I thought I might die. And I didn’t like being reduced to a perky set of tits, a beautiful head of hair, and a pretty face. I wanted to live and be healthy and know that my body could do the things it could do before I had cancer.

I wanted doctors to listen to me. When I said that chemo-induced menopause was the second most depressing thing that ever happened to me from cancer (after fear of death), when I said that my “impotence” (we don’t have a word for it for women, do we?) made me feel like someone else, when I said that having somewhat painful sex three times a week was unacceptable to someone who had been used to having wonderful fun sex every day, I wanted the doctors to look me in the eye and HELP ME. Not look away embarrassed, make sly comments about my husband, tell me he was a lucky guy, say just wait, tell me well now you know how it is for many women, or shrug and say at least you’re still alive. But Doctor this is crazy! I’m sure your husband understands. Excuse me, is he even here? Has anyone ever told a man dealing with impotence for any reason that it is irrelevant, unimportant, or the least of his problems? (For that matter, has anyone ever told a man with testicular cancer, well, you only have it in the one, but we’re going to take the other one too—you don’t need them to live? Has anyone ever proposed halting funding to clinics like Planned Parenthood because they provide vasectomies? Or pulled ads from NFL or NBA games because one of the players commits a rape?)

I wanted to think that if it is common for women with lumpectomies to have recurrent mastitis due to “mouth to nipple contact” (these MDs apparently can’t say “kissing or sucking your breasts”), someone could have told me that rather than treat me like I was 11 years old. I’m sure that husband everyone always seemed so worried about would have liked that too; he would’ve appreciated the opportunity to NOT pass on to his wife an infection that gave her a 103 degree fever, almost sent her to the hospital, required a 10 day course of strong antibiotics, and made her believe she had inflammatory breast cancer.

What’s more important in the medical field—infantalizing women by doing things like asking their husbands of 20 years to leave the room during breast exams because the staff is too embarrassed, or actually giving us good information and access to care? What person in the world, man or woman, thinks a mammogram is sexual? Why are men—often our closest confidants, the ones who shaved our heads, held our hands while we vomited, changed our bloody post-surgery dressings, and swabbed our hips with alcohol before they gave us painful shots to stop our white blood cell count from plummeting—not allowed in mammogram waiting rooms? Who really thinks that women will feel embarrassed to be around men in their hospital gowns when waiting for an exam that is excruciatingly painful and might tell you that you have a life-threatening illness?

Why is it always about sex?

Or never about sex, when you need it to be?

Women have breasts, and uteruses, and we are the only ones who get pregnant and we are generally the ones who get breast cancer. But as a society we have this need to see women as simultaneously over sexed (pole dancing for fitness, anyone?) and sexually naïve or incompetent (good girls don’t talk about those things!) We hammer information about pregnancy into teenage girls heads, push the pill on every 18 year old in the country, and don’t seem to care what the effects of such decisions are. We don’t care about the side effects, the link to triple negative breast cancer, the insane 80% rate of HPV infection among American women. (Can I get an Amen for being in the 20%? Yeah I was that kid in high school whose keys hung on a chain that said “No condom no way.” And yes, there was a condom inside that keychain). That’s why there are outcries against the only cancer vaccine that has ever been developed, because rather than focus on the amazing lifesaving potential, we are wrapped up inside someone else’s panties, worried she’ll do the wrong thing. I’ll say it again: Lenny, you can decide never to have sex in your life, or start having sex when you’re 13, and I will still love you and want you to live. I will not deny you access to Gardasil in order to protect you from your own hormones, your own desire, or your own life. I won’t do it.

Women are sexual beings, with sexual bodies. So are men. But men get to be just that most of the time—men. They are allowed to be fathers, husbands, friends, co-workers. And on the other side, so often, we get to be wombs, tits, hair, battlegrounds for other people’s repression or cluelessness or bullshit.

That’s what I see when I read an article about Komen and Planned Parenthood. I see myself, bald, tired, scarred up and tattooed, with no eyebrows, suffering from sexual dysfunction, walking around the streets of Chicago in my fashionable clothes, ignoring all the assholes staring at me. Walking around. Still alive. Still worth saving.