Getting Over the Flu

It's now been six days since I was stricken with the stomach flu that is going around. The first couple of days were terrible. Nausea, cramping and all that comes with that. I have only yogurts and a couple of bowls of cereal since then. I'm still not hungry though.

This sitting around has been the worst. I can't go to the gym (no energy) and they cancelled the two days I was scheduled to work this week. So this has been a good test as to where I am with regards to my vasectomy side effects. I have to say that I am cautiously optimistic as my nerve pain has not really materialized. In fact, outside of the reminders I had (as a result of my retching) on Sunday, my PVPS has been non-existent.

This reminds me of an article I read that said, most men reported being PVPS pain free after vasectomy reversal in about 18 months. Now since the reversal caused my nerve-like pain, I guess it is reasoned enough to guess that it would take me a little longer to get over it.

I'm just past the two-year mark and things are remarkably better. I've also noticed that I can enjoy more sleeping positions at night. Before I could only sleep on my back or in the fetal position, with a pillow between my knees. Last night, I slept on my left side, with my left leg straight, and my right leg crossed over on a pillow. It was very comfortable. I'm not so brazen as to remove the pillow just yet, but maybe some day.

There is only the Lord to thank for the recovery I've experienced. I know he has his hand in my life and has been using this PVPS thing for his glory and will. Again, that may sound kind of weird to some of you readers, because you don't believe like I do. But trust me, if I could ever put into words what Jesus has done for me, how he's used this PVPS, how he's changed me (for the better, I think:), how I couldn't be the man I am today without this; then you'd probably believe like I do, because the journey would seem so fantastic, so full of miracles - you'd simply have no choice but to believe.

But since I'm not that eloquent, I guess you'll never know exactly what I mean when I say the Lord has helped me. For that, I apologize. Maybe one day, I'll be able to write it out in a way the world can understand.

In the meantime, my vasectomy side effects continue to be in the shadows as the flu bug still has center stage. 

Status of Pain After Two Workdays

Like I said in my previous post, I have a new job. It started last Monday, two days ago. As with any new job, they have to do a period of orientation first. For me, this orientation meant sitting in a chair for 8 hours listening to speaker after speaker talk about things like environment of care, infectious disease, and other hospital type of stuff. Pretty boring.

I was curious to see how my PVPS would respond to the continuous sitting. To my surprise, I was feeling any aches or sharp pains Monday or Tuesday. This is quite a big deal for me, because there was no way on Earth I could have sat for 8 hours at a time, in uncomfortable chairs without feeling the pain after about 20 minutes or so.

However, while I was sleeping last night, I was awakened suddenly. I was having a dream where I was experiencing tremendous pain in my left inguinal area. It took me a little while before it woke me up. Then I realized the pain wasn't just in my dream, it was real. I was experiencing real pain and it wasn't good. It began to fade away after 5 minutes, or perhaps I started to fade back to sleep, I'm not really sure which happened. But the pain kinda stunk. I always wondered that if I dreamed about pain, did that mean I was having it for real, outside the dream. Well, in this case the answer was yes.

I can't say that I'm bummed by the pain, although maybe just a bit. In contrast, I'm excited that I was able to sit for so long without having pain during the actual sitting. Today, I go back to work for a few hours, but I'll be on my feet for most of it (I hope anyway). Then tomorrow and Friday I actually do my departmental orientation, where I'll be up and at it. 

Sitting at the Thanksgiving Dinner Table

Thanksgiving has come and gone, and now we find ourselves in the middle of a consumer binge known as Black Friday - what would our forefathers think of this? Last night was wonderful. We sat around a friend's dinner table and had our fill of turkey, dressing, etc. The food was as good as the company. Lots to be thankful for sure.

We sat at the table for probably 2 hours, just eating and talking. What a grand time. Then we all realized we had food babies growing within us, so we retired to the comfort of the sofas. There we watched football and talked about nothing in particular.

When we got home, I noticed another familiar friend which decided to drop in on us for the holiday - PVPS. Yep, all that sitting at the dinner table had done it's worst to me. I had knifing pains on the left side mixed in with a distant racking sensation to boot. My wife wanted to us to be intimate, but after seeing me in pain, figured I wouldn't be able or interested.

So off to the medicine cabinet I went looking for some ibuprofen. Within about 1 hour the pains were gone, but unfortunately, my wife was asleep for the night. Today, we walked around the stores for what seemed like hours as my children added ideas to their Christmas wish list.

Funny, but all that slow walking, aka: meandering, and standing around while my kids took everything in, was almost as difficult as the constant sitting from last night. Only this time, my lower back and of all things, the area around my waistline, below my belly button, started to ache. This is quickly relieved by sitting.

There you go, another entry of how my life is different because of my vasectomy. I still wish I hadn't gone through with it. I sit here sometimes and wonder how much better my life would be if I had opted for our old tried and true method of birth control.

Battling Through the Pain

It's been a couple of days since I noticed this hernia-like pain on my left side. Wearing the athletic supporter and taking the ibuprofen seemed to help. Yesterday, I went to bed feeling ship-shape. However this morning, I noticed the return of that sensation on my left side again. I just pray and hope this sensation will go away on in the next few days.

In the meantime, I guess it's a return to the athletic supporter. There have been times when I've worn the athletic supporter for weeks at a time. So this won't be anything new for me. I just wish I were past this stage of needing to resort to this coping mechanism. Perhaps, I'll never get past this stage.

While sitting here this morning, I've also noticed the familiar twinge in my left inguinal area. It feels like something is folding on itself inside my inguinal area. I've often wondered if this pain and sensations I have, aren't some how related to the mesh inside me from my inguinal hernia surgery way back when I was in my early twenties. I'm not sure about the lifespan of a hernia repair.

My title is battling through the pain. It really does feel like a battle sometimes - a real war. Some days I lose and other days I win. The back and forth is very frustrating. People who suffer from chronic pain, probably struggle with this most of all.

It should just make me glad for the good days. I really am thankful for the good days. It just gets a little frustrating having to get off that high plateau and tumble back into the war zone.

On an unrelated matter, I've been having sharp chest pains too. I'm not sure, but it feels like ribcage pain. Sometimes, it worsens when I breathe in deep or push around on my ribs and sternum. Weird. Anyway, just thought I would throw that one in. I hope it's not real chest (cardiac) pain. Challenging nevertheless, especially when I'm hurting down under.

Walking on Trails Helps Vasectomy Pain

So yesterday I was recovering from a flare up of pain. The pain was some of the worst that I've had in quite some time. Thank the Lord, the pain didn't really return, but I also made sure I stayed off the computer and any prolonged sitting. Since my kids had the day off from school, I decided to take a little walk with them.

We walked about 2 miles or so. There is a concrete path/trail next to our house that leads to a fun little park by a river. It's one of my favorite little places up here in Washington. Anyway, we had a great walk. It was sunny and about 48 degrees.

The walk was not aerobic in nature, just a fun little walk at a relaxed slow pace. When I returned home, I felt much better. It continues to amaze me how exercise, especially relaxed trail walking/hiking, seems to help my pain.

I haven't spent the money on a gym membership yet, and I don't think I will. Not as long as the weather holds and I can access this trail. Granted, it is November, so the sunny days may not last much longer, but if I can save some money and walk in nature, that's what I'll do.

Fishing season is open now, so I've also been kicking around the idea of getting a fishing license. I figured, I could get some exercise by walking around the rivers, lakes and bays around here. Maybe I could bring home some dinner as well.

No real pain today. But like I said, I didn't sit around much yesterday. The game plan will be the same for today and tomorrow.

Also, thanks to all those who downloaded my ebook yesterday during the free promotion on Amazon.com. You can still download it today, but at the retail price of $2.99 - still a bargain. I am thinking about turning it into a hardbound book also. But will have to get more details before heading down that trail.

Completely Shocked by Pain

I've blogged recently how things have been somewhat status-quo. No real pain to speak of, outside of a little pain or ache here and there. And yet, in the back of my mind, I know the PVPS pain can strike without rhyme or reason, and that's exactly what happened last night. But what caught me off guard, was the frankness of the pain.

I started having that knifing nerve pain in my right groin last night, while sitting at a school dinner for my kids. I stood up, walked around and even went to the bathroom. I thought getting up and moving might help the pain. However, the pain just intensified. It almost brought me to my knees, as I was doubled over and writhing in pain. When I gently touched the right inguinal area, where the pain was most extreme, the pain tripled. It felt as if my old inguinal hernia repair was exploding through my skin.

After about 10 minutes, the pain began to subside and we decided to leave the function. I gingerly stepped into the car and sat down. The pain was not worsening. We drove home (about 25 minutes) and I took a Tylenol. But by this time, the pain seemed to have faded. But I didn't want to take any chances.

When I awoke this morning, there was a twinge of pain on the right inguinal side. The pain is made worse when I bend my right knee upwards; like in the fetal position when you sleep. So I took another Tylenol and will try to avoid sitting or doing anything too aggressive today. In fact, this should be the last I'm on the computer today (although, I'm not sitting, but rather kneeling at the computer while I write this entry).

On a positive note, the new ebook about my vasectomy is moving off the shelves at Amazon.com. Today is a free promotion day so it can be downloaded for free to your Kindle device, but only until midnight tonite. Then it goes back to $2.99, which is still a good price.

I had my book reviewed by someone yesterday and received very positive feedback. Hope it will shine some light on this syndrome and serve to help people make better decisions regarding their vasectomy.

Need to Walk

I can always tell when I've sat for too long. Even though I have this great cushion, which lets me sit for longer periods of time, I still suffer from prolonged inactivity or more specifically, sitting. It's a great day here in the pacific NW, so I think I will go for a walk.

What's great about living here, is I can go for a walk down to the river and see salmon swimming upstream; or I can go down to the beach; or I can go up to the mountains to climb a trail. So many choices. It just becomes a matter of discipline. Doing the things you are supposed to do and then reaping the benefits.

That is an area I struggle in. I've had so many "additional" final touches to my ebook that it's required a lot of time in front of the computer. I think I spent 6-7 hours in front of the computer yesterday. Without my cushion, I would probably only lasted about 2 hours, max. So I am thankful for the cushion.

As a result, I've had a return of the knifing nerve pain to my left inguinal area. Nothing too dramatic, but still, pain is pain. The knifing pain is one of the worst. I talk about it in the book some. It strikes you out of nowhere and can literally, bring you to your knees. I'm not kidding.

So now that I have my book finally finished (for the second time), I hope to spend less time on the computer and more time on the trail.

Physical Changes After Vasectomy Reversal

It's almost been two years since my vasectomy reversal surgery. It just kind of dawned on me a few moments ago that I have some noticeable physical changes to my boys down there. When I first had my reversal, I noticed my epididymous was still a little swollen. Although nothing like it had been for the previous three months prior to my reversal. However, as of today, it is still a little swollen. I guess that swelling will never go down. It used to scare me because I'd look down there and wonder if my epididymitis was returning.

On my left side, there was this "horizontal line" indentation going straight across my testicle. I never really knew what it was. Strange, but it really is a perfectly straight horizontal line. I'm not sure what my reversal doc did inside there to make the skin kind of fold like that, but it certainly isn't natural. Again, it is still there to this day.

So there are two weird physical changes that are still present almost two years after the surgery. So if you have a reversal surgery, don't be surprised if your boys physically look different from that day forward.

My wife and I had some intimate times and all seems well. No pain to speak of, except for a mild inguinal ache on the right side, that is hardly noticeable. But that could be due to me spending so much time sitting, on-line at my computer trying to put the finishing touches on my book publishing (see link on tab above). I sent my book to a guy at the forum and so far he likes it. I hope lots of people will take a look at it before they decide to have a vasectomy.

Sleeping a Bit Better

Well, I guess you could say I'm sleeping better. I still wake up, but not because of pain or having to go potty - to quote my son when he was 3 years old. Now I'm just waking up and going back to sleep. I've made a point not to eat or drink anything after 8:30 pm. Maybe that is helping.

Regarding the inguinal pain, I didn't have any yesterday or last night. I am really hoping that activity will take care of all those little aches and pains - over the long term, that is. In the meantime, I'm just trying to be careful about how I cross my legs, sit, bend over, etc.

Sadly, it's those everyday "little things" that can cause the most pain. Cross your legs without carefully surveying the room in your drawers first and "ouch!" you can really hurt yourself. Same way with bending over, at least for me.

Other guys with PVPS probably don't have the pains manifest in the same way. For me it always seems to come down to a space issue. If I have room, then no worries. If it gets kind of cramped, then watch out.

Sitting continues to be a source of frustration for me as well. Even though I have this great cushion, which helps TREMENDOUSLY, I still get pains here and there from just sitting. They aren't nearly as bad as they used to be before the cushion. They're more annoying, than anything else.

So I guess you can add the adjective "annoying" to the endless list of ways to describe how PVPS affects your life.

Cushion for Prolonged Sitting

I was told about a guy at my church who had some kind of a portable seat cushion I should try out. It's hard for me to sit for a long time on a hard surface (> 20 minutes) without feeling the dreaded inguinal nerve pain. If I didn't feel it right away while I was sitting, it would be there within a couple of hours and stay with me for a day or two.

So I didn't think much about this cushion of his, but I thought I'd be polite and ask about it. The next Sunday, I was introduced to Casey. I asked him about the cushion. He went to his car and came back with a cushion. He then proceeded to give me the full sales pitch on it. He was obviously excited by the product. It is made of a special material that does not push back on your body with as much pressure as any other type of poly-fiber or foam material used for seating. This cushion is truly space-age.

I thanked him for the use of the cushion and proceeded to use it for the next hour and a half. We had a new-comer lunch at the church. We sat in the same seats that we use for the Saturday men's bible study. I usually can only sit in those chairs for about 20 minutes before I start squirming into different positions to relieve the pain. By the end of the bible study (60 minutes) I'm very uncomfortable and in a good deal of pain.

But the cushion changed all that. I sat there for 90 minutes without squirming. No pain. No twinges. No nothing. It was amazing. Since then, I've used the cushion at my computer and in fact, am sitting on it now. It allows me to sit for much longer periods of time with less pain and discomfort. If I sit for too long for too many days, I still have some pain. So it doesn't take it all away. All I'm saying is that I feel better and it allows me to sit longer than I would normally with less adverse consequences.

I don't really know the owners of this company or do I have stock in it. But I'm here to tell you. Anyone with PVPS who gets worse symptoms with sitting, needs to get one of these cushions. The difference is night and day. Here's the weblink for the company  http://www.oregonaero.com/softseat.

They do a lot of work in the aerospace and health industry, designing interfaces which allow pilots to sit longer at their stations and patients to lay in bed longer with less risk of developing pressure sores. One hospital in Washington has had zero pressure sores since they implemented their products.

Like I said, I have no financial stake in this company. But I'm going to be one of their best word of mouth advertisers. I've even placed their link on my blog. I can't say enough about them. For PVPS sufferers, sitting is the death nail. It makes everything worse. So if this describes you and you have to do a lot of sitting, either with commuting or it's your job, these cushions could save your butt - literally.

Here is an exerpt from their website...

What is so great about the SoftSeat^® Portable Seat Cushion?

• The pain is gone.
  Enjoy pain-free sitting, no matter how long you sit. The seat cushion system design shifts your hips and pelvis into the proper, pain-free posture.
• The "hot spots" are gone.
  Visco-elastic foam “reads” body temperature and pressure and prevents the burning sensation of ischemia, or “hot spots.” The cushion system can help prevent bedsores and deep vein thrombosis.
• You’ll have a perfect fit, every time.
  Lots of people can use the same cushion and get the same comfort.
• Extreme cold or heat? Not a problem.The seat cushion system works equally well in extreme temperature environments.
• Use the seat cushion system just about anywhere you sit.
  Cars, boats, wheelchairs, office chairs, airplanes, helicopters, etc.

Worst Day to Best Day, Sort of...

Yesterday was terrible, no denying it. Today has been pretty good, except for when I sit for too long. So I've been standing and walking around the house. That has helped. The problem is, I'm sick. Got a cold or flu or something. So I want to sit down or lay down, actually. But I know that will make my pain worse. So I've been the definition of the "walking wounded".

I haven't taken any medicine today because I've felt pretty decent. So to sum up, today hasn't been bad. I've been coping the best I can and trusting God to help me get through. I think it's the last thing that helps the most.

Cold Weather Effect on Scrotal Pain

I always wondered if the colder weather of the pacific NW would have an impact on my scrotal pain. Well, last night I started to have a crushing/racking pain on my left side. Now, I'm not sure if the cold weather was the cause of this phenomena or perhaps the sitting I did prior to bed time. But my sitting tolerance has been somewhat improved lately. Although, I still hate to put myself at risk by sitting for long periods of time on my computer chair. But I digress...anyway, like I said, I was having this pain last night prior to going to bed. It was very painful, maybe a 3-4 on a 1-10 pain scale.

I checked out the boys in the bathroom before crawling into bed and they were pulled up extremely high. That is what got me wondering if there is a correlation between them being so high and the racking pain. Then I got under the warm covers and started to feel better after about 5 minutes. Now maybe it was because I was laying down or maybe it was because the warmth of the collected body heat under the covers. I'm not sure.

As usual, that's the thing with post vasectomy pain or reversal pain, you're just not sure what's causing the pain. Could be the cold, could be the sitting. Could also be the fact I haven't walked in several days. Maybe it was just a cycle thing and the pain was going to be there regardless of anything else. But I can't really complain. The pain has been so much better lately.

Now when I get sensations and pain, I'm disappointed because in the back of my mind I keep allowing myself to think the pain will be gone forever. I know those are dangerous thoughts because when I do have pain, I become disappointed. That means I'm putting myself on that emotional roller-coaster again - which isn't very fun. So, I'm trying to keep perspective and not let myself dream too much. Remaining subdued is the best approach. Don't get too high or too low...stay on an even keel.

Anyway, this morning, all seems okay. Just the normal awareness that my scrotum is down there. King of like an upset stomach. It may not necessarily hurt, but you can feel your stomach. Well, that's how my scrotum is most days, no real pain per se', but I know it's there.

No New is Good News

Today is over half way done and I've got nothing to blog about. Although, I was on the computer for a long time last night and I don't seem to be suffering any ill-effects. I guess that's good news. I know that during the summer, a couple hours of sitting would have killed me for a day or two, minimum.

So, no news is good news. Feeling okay. I did have a slight bit of nerve pain in my johnson yesterday, but it abated when I "repositioned" myself. It wasn't super painful, just uncomfortable, like a prostate exam, if you know what I mean.

I hope my future posts are as boring as this one. Then I'll know I would be making some progress.

Need to Walk

I'm feeling bad because I haven't walked in a couple of days. We've had a lot of "stuff" to do regarding our kids' education which has effectively distracted me from my duties to my health. It's also been a little rainy which makes it hard muster up the energy to go outside and walk. But I can feel it in my loins, it's like they're trying to urge me on to go walking. If I've learned anything, it's that you have to listen to your body. If something is telling you to get up, then you probably should.

Now we've got the education stuff worked out so we'll see if I can get back on track. I rather miss walking to be honest with you. It's nice to stretch the legs a bit and get your HR up.

Regarding my pain today, it's been good. Although, it is time to get off my terrible computer chair and start moving around. So until next time...

Yep, Sitting Sucks

I know I harp on this all the time, but sitting is like the "deathnail" for PVPS. Just something about it makes your nerves down there get all angry. I wish I knew how my nerves were injured, then maybe this sitting thing would make sense. But as it stands (pardon the pun), sitting is just a killer.

After a great weekend with no pain, I now have pain after sitting down for 60 minutes. Yep, that's all it took, just 1 hour and the nerve pain has made its presence felt. What is the deal? So if you are having PVPS or groin nerve pain or whatever, then try getting off your backside and see if that helps.

Time to go for a walk I guess. Maybe it can undo whatever the sitting did in the first case.

Good Cycle On Its Way, I Hope

I hope I'm on the upswing now. I had my bad week or so and am ready for a good couple of weeks. But there is no predicting exactly what will take place. Who is to say the good cycle will only last a day or so. I hope I can have several days in a row of good days because we're about to go overnite camping. Our first time and I'd hate to be laid up with nerve pain the entire time. I'd like this experience to be a good one for the kids, you know. I don't want them worrying about their dad's "boo-boo" pain.

Yesterday was one of those days when I was feeling so good, that I kind of over did it. And by over doing it, I mean I sat at the computer a little too long. I'm sure I'll be paying for it today. I've already had a couple of twinges, thankfully, nothing too painful yet. But the apprehension I feel isn't very settling, if you know what I mean.

I've been very prayerful these last couple of weeks. That always gives me peace and hope. I've also been taking vitamins. I don't think they're helping a ton, but I do feel better since taking them. More like an overall feeling of more energy I guess. My mind seems sharper and I have more zip in my step.

I guess this is all I wanted to say today. I'll be back after our camping weekend to let you know how it went. I will be taking my tylenol with me just in case. Take care and until next time, may God bless you.

Later in the Day...

Okay, well the other foot finally dropped today. I said in my post this morning that I wasn't going to wait for the bad cycle (I'm paraphrasing). It turns out I didn't have to wait, it came and found me a couple hours ago. Lots of right sided inguinal nerve pain. Having difficulty driving, sitting, etc. Walking is okay, but twisting and leaning is out of the question.

I took some tylenol and that seems to be helping a bit. Will see how the rest of the night goes. Just thought you'd want an update from earlier this morning.

Need to Make a Change With My Computer Chair

This computer stuff has got to change. I can't keep sitting in this chair unless I want to be in pain all the time. I think it's time to join the 21st century. Time to get a laptop computer. That way I can sit comfortably on the sofa and blog, create lessons for the kids, etc.

I spoke to my wife about this yesterday. I think we're going to get a laptop and call it a Christmas gift to each other. Maybe we'll get it earlier than Christmas but still call it a present. Not sure yet. But I know I can't keep doing what I'm doing. If I want to have good days that last all day, then I need to make a change. Sitting seems to be a big nemesis. One that I can control. The walking has been great. Although I won't be walking today.

Instead of walking, we're going on a day camp. Which means we'll be hiking and standing a lot. Hopefully, that combination will work for me. I also hope the walking I've been doing this last week will give me a little more endurance for the day camp.

I did have some scrotal pain last evening. Mainly because of the computer time spent in this poorly designed chair. I woke up with this same tight feeling below my belly button, that I had yesterday when I woke up. Since I won't be on the computer very much today, I'm guessing (hoping) my pain will be consistently low level today. But I will be driving a ways to get there to the camp site. Who knows. We'll just have to wait until the end of the day.

Walking is Good

I went walking again this morning and it makes me feel better, overall. Not just physically, but emotionally and mentally. Kind of refreshing. Gives me a routine I guess. Could be a coincidence, but my groin pain seems to be better. I still get the random pain or sensation, but nothing that lasts very long.

I can't say walking is a cure all, because I know PVPS just doesn't act that way. There are guys on the forum who exercise faithfully day in and day out and PVPS still hits them. One is a tri-athlete for crying out loud. I would love it though if I could maintain this trend for a long time. The last time I had an extended period of feeling pretty good, it lasted about 2-3 weeks. Then it all fell apart and I had a very difficult 3 weeks, followed by what can best be described as a roller coaster since then. Some good days and some bad.

Sitting continues to be a nemesis. This is a challenge for someone who blogs a lot and runs a couple of websites (my side hobby). I spend about 2 hours a day doing just these activities, but then get suckered into the big time waste that a computer is. Before I realize it, 4 hours have gone by. Quite a time waste for sure.

Anyway, today I feel okay. I woke up feeling great. Once I got out of bed, I began to feel a pull below my belly button. But once I started my walking program, it was gone. Now that I've been on the computer a while, I'm starting to get more reminders that sitting is bad for me. Time to get up and do something else I guess.

I probably won't do any walking over the weekend, so I'll be curious to see how it goes. Hopefully, we'll go hiking or something, so I can still be upright for an extended period of time.

Long Day of Sitting

You know how sometimes you find yourself doing something that you shouldn't be doing? That was me yesterday. I sat around a long time at the computer and my nuts paid the price. I had a continuing education class to take on line which started me off on the wrong track. Then I checked my blogs, piddled around on the net for a while. Talked on the phone and basically just had a stationary type day. I haven't had one of those in a long long time, since we've moved out here to the pacific NW.

I suppose it was inevitable. The kids were at school all day and the wife was away to work. I should be better about going on walks during these type of days. There is still a lot to explore on foot that I haven't been able to do yet.

So I'm keeping this blog post short so I can get out, move around, enjoy some of this healthy lifestyle - which was a primary reason we moved out here in the first place.

With that said, here's my status today. No real pain to speak of, other than a feeling like I might be in pain down there. It's like how your arm feels right before the pins and needles hit, after the blood has been cut off for too long. It doesn't hurt, but you know what is coming. I guess it's the post vasectomy pain "dread". You know it's there, lurking around the corner. You just don't know when or if it will strike. I slept ok last night.

Remember the mantra - vasectomy bad, healthy scrotum good.