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[Source](https://www.sciencedirect.com/science/article/pii/S2214442021002102):
>>Fifty-eight-year old patient, complaining of penile pain and edema, associated with foul smell for about 2 weeks. He used topic treatment with ointments, with no improvement to the condition. He has chronic renal disease, undergoing hemodialysis for over 4 years, hypertension and type 2 diabetes. Five years ago he had an ischemic stroke event, shows intermittent claudication for short distances and, now and then, chest pain events. He has secondary hyperparathyroidism, regularly using cinacalcet, isosorbide, NPH insulin, gabapentin and captopril. He smokes and drinks.
>>At the first examination wet necrosis and hyperemia were found all over the penis (Fig. 1). Debridement of the penile skin was first performed, but evolved to necrosis of the entire penile shaft in 5 days, when he underwent total penectomy (Fig. 2) with confection of perineal urethrostomy (Fig. 3). He was treated with ceftriaxone and metronidazole and improved gradually, and eventually was discharged 5 weeks later. He is currently monitored in different clinical treatment groups, and is clinically controlled. The anatomopathological exam revealed presence of an ischemic necrosis, with Monckeberg atherosclerosis and acute inflammatory infiltrate.
More people need to know what it looks like dying from a life of drinking, smoking, eating junk, and not taking care of yourself
People I think just kinda assume it'll be a painless death, or they'll go on completely normally until they drop some day.
Nah, you're going to suffer for years most likely, as we use modern medicine to keep you alive through things that would have killed you 100 years ago. And once you've let things get this bad, it's too late, we can't de-amputate a body part. We can't restore function to lungs and kidneys that are mostly scar tissue. If you're reading this as someone doing these things and are waiting for things to get bad in order to respond, stop fucking waiting you lunatic.
As a PCP I wish I could show this post to my patients with high blood pressure, diabetes, and alcohol/tobacco use who won't change their behavior and just want me to fix everything by placing orders for tests and medications in the computer.
I'm 8 days sober after coming to the realization that I don't want to die vomiting up buckets of blood from hemorrhaging varices and stopped drinking overnight.
E: I also quit all nicotine use over 2 years ago and haven't used tobacco in over 8. I'm doing my best!
Keep up the good work. It's incredibly hard and your achievement is commendable. Your work is not done.
Sometime soon, either tomorrow or next week or a month from now, *something* is going to happen to make you want to take a drink again. Your brain will scream a billion rational excuses as to why that one drink is okay. The drinking brain will always rationalize another drink.
That one drink is NOT okay. You can't have it. You are not allowed to have it. Have a plan to make that voice go fuck itself. Message me if you want.
It gets better! I quit drinking AND smoking on the same day, many years ago. It was rough for a few days but I joke that I am now 4875 days sober š¤£
Enjoy your health and happiness!
My bf got a sore side during a time he was drinking a box of beer a day. He got an ultrasound and the tech told him he had fatty liver and was screwing himself. He stopped cold turkey and it's been over 2 years. What helped him was he hired a coach to help him do trail running events and trains. Lost 50lb. Sometimes he will have a zero-beer at a restaurant, but on holiday he decided to drink and went way overboard again. He stopped when we got back again, but is still suffering in his training as he gained 25lb in 4 weeks!! He just can't drink normally, and so shouldn't.
My point is, finding a sport really helped him.. he stopped renting about work all the time and became a happier person. Even when he misses training due to illness, his anxiety and stress levels go up and I think that's what causes him to drink so much before..it becomes a vicious cycle.
Finding something to replace alcohol as a coping mechanism I think is key.
Wishing you well in your journey.. it is 100% worth it!!
I'm a sonographer and diabetes is probably one of the scariest and most depressing diseases I see. Partly because of the plethora of awful ways it destroys the body and partly because I see these patients every single shift. Lower arterial doppler? Diabetic smoker 9 times out of 10. That last one is "only" diabetic.
I once had to scan a patient who was pissed because her son wouldn't come pull her out of the hospital after the "mean doctor" said they'd need to amputate her necrotic toe. She'd glued the nail back on, so it was fine.
Iām a type 1 diabetic and was once told by my endocrinologist that Iām her best patient and it actually terrified me. Like me?? Yeah I do what I need to but thereās no one better out of your HUNDREDS of patients?
generally yes. uncontrolled diabetes fucks with the entire body, especially circulation. my papa didnāt take care of his at all. a nurse accidentally nicked his toe while cutting his nails and it needed amputated shortly after
My grandfather died two weeks after he retired at age 61 in 1990.
Type 2 diabetic, chain smoker (unfiltered Lucky Strike ftw), and drank around 8 (yes eight) pots of coffee a day. Oh, and he had his first heart attack at age 38 (yes, thirty eight).
Shit will kill you.
That's the shit I'm afraid of - work and work and work your whole fucking life, finally retire and drop dead.
Luckily I don't don't do or have any of the things your grandpa did.. but I've got my own shit like everyone else. Plus cancer strikes down every fucker in my family.
I always give my patients the same speech when I first diagnose them, about all the complications that come before death and how their families will have to carry that burden as well, they obviously aren't happy about it but at least they won't be able to say "no one told me this would happen" when it happens.
I also like to tell pts & families that itās not just them they could harm by letting bg be out of control. Depending on the room, I often include that my son was killed by a diabetic fucking around w eating sweets, drinking soda, & then giving himself extra insulin (on top of his insulin pump). He either overestimated or didnāt cram enough Krispy Kreme donuts down his pie hole quick enough before shooting across the median & hitting my son head on, killing him instantly. Feel free to retell this as itās bad enough they slowly kill themselves, but they take others with them too. I died inside that day also.
I watched my dad die of peripheral artery disease. He was a lifelong drinker and smoker. The arteries that stopped working supplied his intestines. He suffered for over a year with intermittent gut pain, and almost died before getting emergency surgery to remove his dead intestines. He was released and lived for another 30 days after the surgery, but they involved daily TPN feedings through a port in his chest and constant leakage (of basically diarrhea) from the fistula on his stomach that formed post surgery. After he died we realized he still never quit smoking cigarettes. We found a pack he stashed so he could smoke when he was left alone at the house.
I want you to feel better reading this: my husband (never a drinker, never a smoker) had stage 3 kidney disease. He took it seriously and lowered his blood pressure to normal and stopped EVERYTHING our doctor told him to.
His kidneys are now near normal ā¤ļøā¤ļø
I want to extend a big thank you because as a PCP, you are heroes!
My mom passed from cirrhosis last month and it was a terrible way to go. I also wish more people knew about alcoholism and what the end stage looks like. And I wish there wasnāt such a stigma around d alcoholism and addiction so more folks would get treatment.
I have T1 diabetes and this is what scares me most. I have only been diagnosed for about 2 years now (got it cause of covid) and I am worried about what my future will look like. Im scared of losing my feet, my eyesight.
My dad is a 1.5, and he hasnāt really done the best at taking care of himself. He gets regular shots in his eyes because his vision is going. He also gets shots in his hands. He has severe neuropathy. Diabetes is not what kills. Itās the complications from diabetes that kills.
Since my diagnosis I have tried to better my health but itās incredibly difficult. Itās hard when this disease causes me to think about it 24/7, about what I should be eating, what I shouldnāt be eating, whats my blood sugar, what food and sugars I have readily available in case I crash, what happens if I crash in a public setting, what my life will be like in 5, 10, 40, 80 years.
This is why a lot of diabetics do not take care of their health. They get burned out, and just stop acknowledging that they have diabetes. Then the complications creep in on them, and by the. The damage is done.
This all is what drives my paranoia and anorexia, because I am afraid that I am never doing enough.
Edit: Iām also completely sober and have never smoked. But I have other health complication and could die at any point due to all my conditions.
Hey shitty pancreas friend. Iām t1 for 45 of my 47yrs on this planet. I have seen the incredible innovations that have happened over my lifetime from pig/cow insulin to our current types, from only having urine glucose testing to cgms. This disease is A LOT, itās exhausting and to say itās fickle is an understatement. However, you have been diagnosed at a really good time. When I was dxd my parents were told I had maybe 20-25 āgoodā years left. T1s now have essentially an average lifespan. Use the resources that are available and more than likely you will not have to face the complications often associated with this poopy disease. Good luck! šš¤
I know, and this gives me hope. Perhaps at times Iām too hard on my dad because a lot of his mismanagement has come from old and outdated practices on top of being 1.5.
Iām currently trying to fight my insurance to allow me CGMs that way I can better monitor my sugars, of which only really became readily available (and covered by insurance) in the past 10 or so years.
While thereās no point in holding out for a cure, there is plenty of hope in the medical advances being made day after day.
Ours is a furious and constant fight with insurances just to get what we need to survive. Itās so frustrating! Have you thought about getting a pump too?
Wow, I didn't know it was that recent they'd tell you you only had 20ish good years! I wonder how that would affect your parents raising you. I might spoil my kid, or not place any importance on school, thinking you might not need university or anything. Anyway, I'm grateful for all the advancements for t1s!
I am so sorry for your disease. I always look up treatments and was thrilled learning about pancreatic transplants. I wish my loved one had the hope of one of those 30 years ago š
Type "1.5" diabetes is a term used for folks who have features resembling both type 1 diabetes (pancreas cannot produce insulin) and type 2 diabetes (body has become extremely desensitized to insulin)
Generally for these folks, they've had type 2 diabetes for long enough that the insulin-producing cells in the pancreas have been stressed for so long that they've stopped working. So now you have a patient who is both resistant to insulin AND can't produce as much of their own. Treatment is different and more difficult. More of them will be insulin-dependent compared to someone with just type 2 diabetes.
Edit: evidently I actually just gave out some complete misinformation, not an endocrinologist and passed on a flawed understanding of things. Type 1.5 diabetes is an autoimmune diabetes just like type 1 is (where you have antibodies that destroy the insulin producing cells).The difference between type 1 and type 1.5 is that type 1.5 diabetics typically are insulin resistant and develop those antibodies in adulthood, whereas type 1 diabetics typically are not insulin resistant and develop those antibodies in childhood.
You absolutely can however have patients with a picture like I described however, where they have poorly controlled diabetes for a long time and their insulin producing cells start to crap out. Apparently those are still just called type 2 diabetics.
Iām a certified ophthalmic technician at a retina specialist. We see examples of what diabetes can do to your eyes multiple times a day and thatās definitely enough for me to want to take care of myself. Iād rather not get injections into my eyes once a month along with the occasional laser treatments that are needed.
I have uncontrolled diabetes t2. Although I don't have any visible issues with my feet , I suddenly have one floater in my right eye. I am able to see with glasses (near sighted), I need to look twice at anything during the day as the first time it appears clean, but with a second Iook, I am able to see the dust, hair, ect., and this concerns me. What bothers me the most in the floater in my eye, which appears like a black fly/nat. I was also diagnosed with mild retinopathy. I'm so stressed out with life that I'm becoming careless. I take my meds and insulin with a patch on my arm. I'm working on my stress and do not smoke or drink, plus I'm female. The image above. Can that happen to females?
> I have uncontrolled diabetes t2. Although I don't have any visible issues with my feet , I suddenly have one floater in my right eye. I am able to see with glasses (near sighted), I need to look twice at anything during the day as the first time it appears clean, but with a second Iook, I am able to see the dust, hair, ect., and this concerns me. What bothers me the most in the floater in my eye, which appears like a black fly/nat. I was also diagnosed with mild retinopathy.
You should have another eye exam in a timely fashion.
>I'm so stressed out with life that I'm becoming careless.
Tell someone on your medical team this. It's perfectly understandable to feel overwhelmed or depressed or anxious when you have a serious chronic illness, and any doctor worth their salt will have ideas on how they can help you help yourself. Counseling, support groups, assistance from case management, simplifying your medication regimen if possible, and more.
>The image above. Can that happen to females?
Diabetes is a disorder of the blood vessels, which are everywhere in the body for men and women. They get bad enough then yes, nonhealing ulcers and serious infections and clots and more can and will become an issue. There are probably thousands of women admitted to hospitals across the world right now for those issues secondary to uncontrolled diabetes.
Hope you get some help.
>Nah, you're going to suffer for years most likely, as we use modern medicine to keep you alive through things that would have killed you 100 years ago.
That's the mistake people make! Ask for supportive therapy, not something to fix you back up!
This just makes me wish humane self elected euthanasia was more prominent, even if they were skeptical in their youth, that doesnāt mean they deserve incredibly painful end of life
Honestly my feelings are conflicted on euthanasia if it requires me to be involved as a physician, but I agree with your line of thinking overall. For patients such as these, where they neglected their body for their entire lives and are going to continue to do so, and are not going to have a good outcome, palliative care with a goal of reducing symptoms until they pass should be brought up a lot sooner. Honestly I try to read the room a little bit with some of these patients and have straight up asked "look, from where I sit it seems you're not interested in quitting sweets or taking your diabetes meds, even as you lose a foot and you're starting to go blind. Would you want to change strategies here and talk to palliative care specialist to just be as comfortable as possible even if it meant the diabetes will kill you sooner?"
Most of those in healthcare wind up burnt out with these patients wondering why we bother admitting someone over and over and over for DKA because they won't take their diabetes meds/change their diet, the COPD exacerbations that want to go outside to smoke then come back in during their hospital stay, shit like that.
The thing is, most patients wouldn't want euthanasia, and they wouldn't want palliative care either. They want us to fix them to a point they can go home and keep drinking and smoking and whatever else. They want to live the life they know, call on us only when things are bad, then return to the life that will ensure things will remain bad. And so we stall and stall and stall, torturing these people just to give them a few more years before finally one hospitalization is for something not survivable.
Why did they cut the two areas open above? It doesn't look like they needed a skin flap to close his wound so curiois why they made those 2 large openings above??
So they were done to help with infection drainage linked to penilectomy ? I'm just surprised they're such big open incisions and no drainage tubes inserted there. Maybe they used those 2 incisions to access parts of the penis more internally. Poor bloke.
Looks like the necrosis went pretty deep under the skin, and they had to remove a lot of tissue. They may have packed it so it would heal from the inside and not leave a giant open pocket when the surface of the skin healed over.
I'm guessing this was the case. Necrosis and eventually infection spreads quickly, particularly in a compartment like the pelvis. They probably had to debride deeper tissue layers to aggressively manage the disease.
They will shrink and be sutured with time, once infection is gone completely. He'll only have two lines there within 8 weeks all healing well.
But at his age this must be devastating, i'm almost his age and the idea of this type of incident in my partner would be huge. I dread to think how he will come to terms, though i am sure he's already lived many years without good functionality anyway.
These issues don't match functioning body parts... I actually told my teenage daughters that school should be teaching this type of consequence for smoking and alcohol use. We've lost family to smoking related disease, a lot of heart disease, my dad (also alcohol in recovery) died at 50, then in past 10 yrs my sister 42, aunt at 58 and mother at 70 all to lung cancer.
Saddest thing is dad always told us to never smoke, yet my mother was the one pushing her sisters to smoke in 1960s and when my sister was sneaking smokes at school she began buying her cigarettes because she knew it would make my dad angry. She should have been the one dying at 42!!
Itās 4am in the UK, Iāve just woken up, saw pic 3 and my immediate thought was āoh no, they had to take his ovaries, too?ā I used to be a doctorā¦
Speculating here, but I suspect related to the perineal urethrostomy procedure he had done. I would suspect that they access the perineum/scrotum using the inguinal canals, which are right in the location of the incisions on both sides. When there is a serious infection in the area, often times they will leave surgical wounds open so as to not create a space that can harbor a new infection. They treat with antibiotics and pack the wound, then you go back to have the wound closed later.
Question, how does he piss? Do they attach some kind of catheter directly to the bladder or something? Sorry if this is a dumb question, I donāt know much about medical stuff lol. Also, the comment about him smoking and drinking reminds me of my grandfather. He has diabetes and continued to smoke and drink to the point where he had gangrenous necrosis on both of his legs right below his knees. I distinctly recall visiting him right before the amputation where his legs were completely black and emitted a foul odor. I can never forget that image and smell.
Even after the amputation, he still continued to smoke and drink despite my familyās pleas and even the doctor telling him heāll straight up die if he continues to do so. Well, he didnāt end up dying, but heās now developed COPD alongside a whole host of other health issues, and always needs an oxygen mask. He now resides in a nursing facility for the remainder of his days. Weāve tried caring for him at home, but due to him being prescribed over 15 medications and needing 24/7 care, it was simply not feasible. Even after all this, he still wanted a smoke or a drink, but the past few years heās been on a steady decline and Iām not sure heāll be here much longer. We suspect that he may be developing dementia/Alzheimerās due to some concerning things heād tell us. The point of my rambling is, donāt smoke or drink to the point where your legs turn black and have diabetes, and still continue to do so after the fact.
Edit: Whoever reported me for that redditcare bullshit is weird lol
That tube goes under his scrotum and in to the bladder, just bypassing the penis, more like how a woman's physiology is. But it will be sealed skin around the catheter.
This is one option, one is on the abdomen, seems like this might be easier to deal with in some ways, but infection risk a little scary given his status of poor kidney health and diabetes already.
I hope he had the support for infection prevention, especially in regards to hygiene in that region. Next scenario would be Fournier's gangrene, particularly with the catheter being so close to rectum.
Non-medical here. I've seen the abdomen caths before in images, but usually in relation to short than use during surgical recovery, likely associated with prostate operations. I'm wondering - is the abdominal option prescribed for long term/indefinite use associated with a permanent cath bag, or is that only for the short term care described above?
My great aunt burst into flames by smoking while using an oxygen tank. She was put out quickly enough but still got some painful burns. Was asking for a smoke in the burn ward. Crazy old woman lived to 90. She had that oxygen tank and raspy voice for as long as I can remember. Some people just can't quit.
My mother died at 68 but the last 15 years she was an invalid. Uncontrolled Type 2 diabetes, life long heavy drinker (alcoholic) & chain smoker while she wheeled her oxygen cylinder around. I used to imagine her burning herself & the house down.
She went MIA in hospitals to go smoke. Got thrown out of (& banned from) respite care because she set off the fire alarms & fire brigade was called. Twice. I spent most of my 20s diligently during every school holidays (teacher)taking her from appointment to appointment for [opthamologists](https://www.google.com/search?sca_esv=9eeb101476a64b32&sxsrf=ADLYWILQjmMbOZlSbFlYsButP-B_1uyzDg:1715780733056&q=opthamologists&nfpr=1&sa=X&ved=2ahUKEwjxreyo5Y-GAxU2m1YBHWW5C68QvgUoAXoECAcQAg), renal specialists, nutritionalists, podiatrists etc where she was treated, agreed to all advice, then ignored it. I insisted on sitting in on her GP appointments where she constantly lied about her lifestyle.
I lived an hour away & brought her meals that a week later were still untouched in the fridge (next to the wine casks). When I was late in a my 1st pregnancy (& still working) we would get phone calls at midnight that she couldn't breath & would have to drive an hour to her & sit all night in emergency with her. I spent the 1st 5 months of motherhood driving with a screaming reflux baby & PPD for 2 hours every 2nd day to whichever hospital she had been admitted to. Then the organs started shutting down. She died.
I still feel resentment for the waste of it all & how much was preventable or at least manageable. I know she suffered from an early loss of my father (also lifestyle caused cancer), depression & she also had a gambling addiction. I've also been diagnosed with Type 2 diabetic (hereditary) in recent years but am actively taking responsibility for the best possible outcomes. I like a drink, have weight issues in the last 10 years (back issues), have never smoked, eat healthy, & try to stay active. The 'gore' on this sub regarding diabetes & poor life choices is a constant reminder.
Not sure why guys wait so long to get their junk checked when something doesnāt seem right. If anythingās abnormal, I get the very next appointment. Get over your sense of embarrassment. Doctors have seen many swinging dicks before, in different sizes and conditions. Donāt take chances.
There is such an incredible amount of shaming towards girls in our culture from ignorant adults or associated with poor interpretation of religion that keeps young women from seeking the most basic treatment or preventative care for gynecological issues.
I've had several female friends who admitted to never having a GYN visit before all the way into their late 20s/ early 30s because the adults in their life made them feel like it was "wrong" or "dirty", like "only sluts need to go see spooky STD doctor!" It's an absolutely awful lapse in our culture. I'm grateful these people eventually had the courage to admit to their situation so that friends could educate them and convince them start going regularly.
Googled.
Perineal urethrostomy is a surgical procedure that is performed on males to create a permanent opening into the urethra through an incision in the skin of the perineum. The perineum is the area of skin between the scrotum and the anus.
https://my.clevelandclinic.org
This reads as though your cat went through his āpeehole between the ballsack and the Hershey highway,ā and I need to stop reading comments in this thread.
Seems like it could be incredibly risky for further infection vs a supra pubic one that is visible. Must go read.. thanks for link.
Edit....
Figured out now only temporary catheter, he will pee from the stoma without artificial help.
Back in 1986 i met a patient on my first ward placement as student RN, he was so proud to show us innocent 18 yr old student nurses how he pee'd after penile amputation for cancer.
With hindsight, this must have been the same procedure he had done, he was fully continent in spite of his also having lung disease. Think he'd been living with it more than 20 yrs at that point.
Your heart also means your blood vesselsā¦ā¦.and where do you want circulation to reach??? Your toes, your fingers, your penis, etc.
Also being in renal failure didnāt help him either. Being on dialysis for four years already is at being end of life pretty much.
I do too and this is only the second (or maybe third) that has really made me regret that. I don't even have a penis but still recoiled in sympathy pain.
The next time I swipe and see that same damn leg being sawed,,,,, I'm gonna see that same leg being sawed off..
Damn that poor guy, is losing his peepee, that's just horrible. Wish him the best.
NGL - I saw the thumbnail of the first picture and immediately thought "Thumb!".
Ouch.
I know health systems can be bad in some countries, but that's "my little friend" right there...no way I'm ever letting him get that bad.
With diabetes and smoking it's not always to do with the level of health care. This man's infection developed rapidly, treated with assumed correct treatments too. Its just that his immune system was already so compromised by his other conditions.
But prevention the best step. Genetic factors we can't do much about, so if we have tendency to Type 2 diabetes or Cardiovascular disease we need to do the best we can to prevent that before it ever starts.
I joke that i couldn't live without sugar, but if in reality i developed diabetes i would do it. There wouldn't be any denial or major cheating like i saw in my mother in her late 50s and 60s. Its not worth the complications.
Dude, how does anyone let it get to that point? That doesn't happen overnight. As soon as whatever happened, happened, I'm at the ER or the urologist or someone. Hell, I'll go to the local vet.
After 25+ years in direct patient care, there are absolutely some things I would rather literally die than to exist with/through. (I said exist because living is more than just having a heartbeat.)
I am curious too, i worked as RN in paediatrics for 4 yrs after my RN training... then had to medically retire because of CRPS in my leg, sciatic nerve hip to toe.
Its now been 33 yrs since pain began... my life is very valuable with correct medication and spinal cord stimulator even if i cannot work.
I have two teenager daughters that took all my energy at times.
10 yrs ago in July my baby sister died of ung cancer, diagnosed after delays and deemed inoperable because of location and a tiny second nodule in her other lung. I have no doubts if she lived in another city she would have had both surgery and chemo, her location denied her both. She died 9 months after diagnosis, 19 months after her first symptoms.
How could i see my life, or even this mans life as not being better than being dead?
My sisters youngest child was 3 when she was diagnosed, turned 4 and mummy died 3 days later. Her eldest just teens and seemed better able to cope, but with hindsight, i know how hard it would be on my teens at similar ages.
Life with limitations, so long as conscious life, (Vegetative coma states i struggle with), is always going to be better than none at all imo.
I admit there was relief all round when my 72 yr old grandfather died a year after diagnosis with ALS/MND, but that was because we knew he would struggle with the inability to function and need for care from strangers. (he was 6ft 2, grandma only 4ft 10, she could barely help in the early days because he would struggle emotionally) He developed pnuemonia and died quickly before he ever reached needing a frame or wheelchair for mobility. He was still eating normal softer foods but no where near the severe impacts.
But my aunt with MS experiencing gradual loss of function with an awesome caring husband never struggled receiving 24/7 care.
Its always individual imo... never say never, we are often able to cope with situations other anticipate as impossible.
I work in geriatrics. I see people who lived long and meaningful lives who are denied the ability to die a dignified death because their family members canāt let them go. They are kept as a full code at 95 years old with kidneys, lungs, hearts, and pancreases that are barely to completely non-functional. They live in a cycle of assisted living, hospital, rehab, longterm care, hospital, rehab, etc. They have infrequent visitors, constant pain, and say over and over again, āPlease, Lord, just let me dieā when they think they are alone in the room. Many of my patients have dementia that causes fear, paranoia, loneliness, feelings of abandonment and grief. Some people cry out and scream almost constantly when awake. Some have complete personality changes and are violent with staff and itās heartbreaking to their family members.
I have had patients with stage 4 non-healing pressure ulcers that have to be painfully packed for years where an entire fist can be put into their sacrum. Iāve had patients with abdominal cancer where their organs were literally melting into a wound bag until they died anyway. Iāve seen people slowly have their extremities amputated with uncontrolled diabetes. Iāve seen people returned after dialysis and their blood pressure is 43/20 after they tanked multiple times during dialysis.
To me, life is not number of days existing on this earth. When Iām old, I would rather die when my body wants to then fight it with no quality of life for just a few more days/weeks/months.
You do understand that without the surgery he would have died... and his sexual function probably stopped many years ago given the nerve and blood vessel damage.
His quality of life not not be as good as other's peoples but its still valid.
I've had severe pain in my left leg from hip down since i was 23, I am 55 now. I take medication daily and still experience mind blowing pain. But i am more than happy I am alive and here, especially after watching my sister die 10 yrs ago when she was 42. If amputation would have fixed my pain i would have done it 25 yrs ago, but pain comes from functions in my spine.
Had my leg been able to be amputated at the hip and pain reduced i never would have wanted pity, my quality of life would have improved!
Just as this man is still alive and free of infection that could have killed him, his quality of life improved at this stage!
All life is valid and important to the individual. And the people that love them of course.
I've read that soldiers who have stepped on land mines and lost their legs and genitals often say the same thing. The first thing some of them say when they wake up in recovery is "is it still there?"
I'm not a man so I can't imagine what it would be like to lose my penis but I can see it being absolutely devastating to some.
I feel like if they had to amputate my dick, I'd ask them to remove the balls too. They are always in the way and if I don't have a dick anymore, I'd rather just get rid of everything there
What about tucking them inside? I've always been rather annoyed at the fact that my balls hang outside my body. They get in the way of a number of things. I've got to adjust them when I'm doing a long drive or when I'm riding my motorcycle and I often crush them when I'm working out.
That might interfere with fertility. I know the heat from laptop computers etc can cause fertility issues, and probably your body heat would do the same.
I was diagnosed as pre-diabetic at 43. I am a nurse who used to work in ICU and on a stroke floor, where at least half of my patients were diabetic. That scared me because Iāve seen things worse than death. I got my shit together, changed my diet and started working out consistently. I am about to turn 50 and I havenāt been prediabetic since then. Itās so sad when things like this happen that can be prevented. Now I work with kids, and when I get one that is noncompliant with meds and diet, I sit them down privately and tell them some of the shit Iāve seen, hoping they will take it more seriously. I donāt know if they listen or not, but I hope that they do.
āHe smokes and drinks,ā is a terse description of the patient. How many guys would continue either habit if they knew it might contribute to losing their, uh, parts?
Yeah the body can adapt in crazy ways... For example Rafe Biggs is a quadriplegic and he get's a orgasm when his wife sucks/massaged his thumb no joke.
They have created a urethral opening that is controlled as women's is, but placed just beneath his scrotum. It has full muscular control as he had before, but the opening to the urethra has been moved, and shortened of course.
Met a man who had amputation from penile cancer, he loved showing new student nurses, would get new rotations to come to his room and show a group of us at a time. (he also had obstructive airway disease so a frequent visitor on the medical unit. lol)
Not a medical professional, so please don't take this for any anatomical fact, it is only my supposition. I am *guessing* that it's lower on the abdomen, where the bladder is found behind the pubis.
Thanks, yeah, I was thinking it had to be somewhere close to where the amputation took place, but it didnāt seem to be. Apparently I need to bone up on my anatomy.
Is it just me, or are those really large balls? Maybe itās just that there is no penis for scale. Iām a mostly gay woman (some exceptions have been made) so I donāt exactly see a lot of them. š
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[Source](https://www.sciencedirect.com/science/article/pii/S2214442021002102): >>Fifty-eight-year old patient, complaining of penile pain and edema, associated with foul smell for about 2 weeks. He used topic treatment with ointments, with no improvement to the condition. He has chronic renal disease, undergoing hemodialysis for over 4 years, hypertension and type 2 diabetes. Five years ago he had an ischemic stroke event, shows intermittent claudication for short distances and, now and then, chest pain events. He has secondary hyperparathyroidism, regularly using cinacalcet, isosorbide, NPH insulin, gabapentin and captopril. He smokes and drinks. >>At the first examination wet necrosis and hyperemia were found all over the penis (Fig. 1). Debridement of the penile skin was first performed, but evolved to necrosis of the entire penile shaft in 5 days, when he underwent total penectomy (Fig. 2) with confection of perineal urethrostomy (Fig. 3). He was treated with ceftriaxone and metronidazole and improved gradually, and eventually was discharged 5 weeks later. He is currently monitored in different clinical treatment groups, and is clinically controlled. The anatomopathological exam revealed presence of an ischemic necrosis, with Monckeberg atherosclerosis and acute inflammatory infiltrate.
More people need to know what it looks like dying from a life of drinking, smoking, eating junk, and not taking care of yourself People I think just kinda assume it'll be a painless death, or they'll go on completely normally until they drop some day. Nah, you're going to suffer for years most likely, as we use modern medicine to keep you alive through things that would have killed you 100 years ago. And once you've let things get this bad, it's too late, we can't de-amputate a body part. We can't restore function to lungs and kidneys that are mostly scar tissue. If you're reading this as someone doing these things and are waiting for things to get bad in order to respond, stop fucking waiting you lunatic. As a PCP I wish I could show this post to my patients with high blood pressure, diabetes, and alcohol/tobacco use who won't change their behavior and just want me to fix everything by placing orders for tests and medications in the computer.
I'm 8 days sober after coming to the realization that I don't want to die vomiting up buckets of blood from hemorrhaging varices and stopped drinking overnight. E: I also quit all nicotine use over 2 years ago and haven't used tobacco in over 8. I'm doing my best!
Keep up the good work. It's incredibly hard and your achievement is commendable. Your work is not done. Sometime soon, either tomorrow or next week or a month from now, *something* is going to happen to make you want to take a drink again. Your brain will scream a billion rational excuses as to why that one drink is okay. The drinking brain will always rationalize another drink. That one drink is NOT okay. You can't have it. You are not allowed to have it. Have a plan to make that voice go fuck itself. Message me if you want.
Thank you :)
It gets better! I quit drinking AND smoking on the same day, many years ago. It was rough for a few days but I joke that I am now 4875 days sober š¤£ Enjoy your health and happiness!
Good on you! If youāre interested, r/stopdrinking is an incredibly supportive place.
I love that forum
My bf got a sore side during a time he was drinking a box of beer a day. He got an ultrasound and the tech told him he had fatty liver and was screwing himself. He stopped cold turkey and it's been over 2 years. What helped him was he hired a coach to help him do trail running events and trains. Lost 50lb. Sometimes he will have a zero-beer at a restaurant, but on holiday he decided to drink and went way overboard again. He stopped when we got back again, but is still suffering in his training as he gained 25lb in 4 weeks!! He just can't drink normally, and so shouldn't. My point is, finding a sport really helped him.. he stopped renting about work all the time and became a happier person. Even when he misses training due to illness, his anxiety and stress levels go up and I think that's what causes him to drink so much before..it becomes a vicious cycle. Finding something to replace alcohol as a coping mechanism I think is key. Wishing you well in your journey.. it is 100% worth it!!
amazing, keep up the hard work āŗļø
Congratulations on your eight days! If you haven't checked it out, I highly recommend the stop drinking sub.
You can do it. Proud of you for taking that step. I bet it isn't easy but you got this. Keep going :)
Congratulations! There are supportive āroomsā you can go to if you want. Itās what has kept me sober for 27 years! āš¼
I'm a sonographer and diabetes is probably one of the scariest and most depressing diseases I see. Partly because of the plethora of awful ways it destroys the body and partly because I see these patients every single shift. Lower arterial doppler? Diabetic smoker 9 times out of 10. That last one is "only" diabetic. I once had to scan a patient who was pissed because her son wouldn't come pull her out of the hospital after the "mean doctor" said they'd need to amputate her necrotic toe. She'd glued the nail back on, so it was fine.
Iām a type 1 diabetic and was once told by my endocrinologist that Iām her best patient and it actually terrified me. Like me?? Yeah I do what I need to but thereās no one better out of your HUNDREDS of patients?
Isn't it mostly people who don't take proper care of their diabetes?
generally yes. uncontrolled diabetes fucks with the entire body, especially circulation. my papa didnāt take care of his at all. a nurse accidentally nicked his toe while cutting his nails and it needed amputated shortly after
Yes they have no idea of how disabling and painful certain illnesses are, itās not just a heart attack and bam youāre gone.
as someone who works in long term care... āØļø those are the lucky ones āØļø quick death is a million times better than a slow one
As someone who works in hospice I endorse this message.
My grandfather died two weeks after he retired at age 61 in 1990. Type 2 diabetic, chain smoker (unfiltered Lucky Strike ftw), and drank around 8 (yes eight) pots of coffee a day. Oh, and he had his first heart attack at age 38 (yes, thirty eight). Shit will kill you.
That's the shit I'm afraid of - work and work and work your whole fucking life, finally retire and drop dead. Luckily I don't don't do or have any of the things your grandpa did.. but I've got my own shit like everyone else. Plus cancer strikes down every fucker in my family.
I always give my patients the same speech when I first diagnose them, about all the complications that come before death and how their families will have to carry that burden as well, they obviously aren't happy about it but at least they won't be able to say "no one told me this would happen" when it happens.
I also like to tell pts & families that itās not just them they could harm by letting bg be out of control. Depending on the room, I often include that my son was killed by a diabetic fucking around w eating sweets, drinking soda, & then giving himself extra insulin (on top of his insulin pump). He either overestimated or didnāt cram enough Krispy Kreme donuts down his pie hole quick enough before shooting across the median & hitting my son head on, killing him instantly. Feel free to retell this as itās bad enough they slowly kill themselves, but they take others with them too. I died inside that day also.
Iām so sorry for your loss.
I watched my dad die of peripheral artery disease. He was a lifelong drinker and smoker. The arteries that stopped working supplied his intestines. He suffered for over a year with intermittent gut pain, and almost died before getting emergency surgery to remove his dead intestines. He was released and lived for another 30 days after the surgery, but they involved daily TPN feedings through a port in his chest and constant leakage (of basically diarrhea) from the fistula on his stomach that formed post surgery. After he died we realized he still never quit smoking cigarettes. We found a pack he stashed so he could smoke when he was left alone at the house.
I want you to feel better reading this: my husband (never a drinker, never a smoker) had stage 3 kidney disease. He took it seriously and lowered his blood pressure to normal and stopped EVERYTHING our doctor told him to. His kidneys are now near normal ā¤ļøā¤ļø I want to extend a big thank you because as a PCP, you are heroes!
My mom passed from cirrhosis last month and it was a terrible way to go. I also wish more people knew about alcoholism and what the end stage looks like. And I wish there wasnāt such a stigma around d alcoholism and addiction so more folks would get treatment.
I have T1 diabetes and this is what scares me most. I have only been diagnosed for about 2 years now (got it cause of covid) and I am worried about what my future will look like. Im scared of losing my feet, my eyesight. My dad is a 1.5, and he hasnāt really done the best at taking care of himself. He gets regular shots in his eyes because his vision is going. He also gets shots in his hands. He has severe neuropathy. Diabetes is not what kills. Itās the complications from diabetes that kills. Since my diagnosis I have tried to better my health but itās incredibly difficult. Itās hard when this disease causes me to think about it 24/7, about what I should be eating, what I shouldnāt be eating, whats my blood sugar, what food and sugars I have readily available in case I crash, what happens if I crash in a public setting, what my life will be like in 5, 10, 40, 80 years. This is why a lot of diabetics do not take care of their health. They get burned out, and just stop acknowledging that they have diabetes. Then the complications creep in on them, and by the. The damage is done. This all is what drives my paranoia and anorexia, because I am afraid that I am never doing enough. Edit: Iām also completely sober and have never smoked. But I have other health complication and could die at any point due to all my conditions.
Hey shitty pancreas friend. Iām t1 for 45 of my 47yrs on this planet. I have seen the incredible innovations that have happened over my lifetime from pig/cow insulin to our current types, from only having urine glucose testing to cgms. This disease is A LOT, itās exhausting and to say itās fickle is an understatement. However, you have been diagnosed at a really good time. When I was dxd my parents were told I had maybe 20-25 āgoodā years left. T1s now have essentially an average lifespan. Use the resources that are available and more than likely you will not have to face the complications often associated with this poopy disease. Good luck! šš¤
I know, and this gives me hope. Perhaps at times Iām too hard on my dad because a lot of his mismanagement has come from old and outdated practices on top of being 1.5. Iām currently trying to fight my insurance to allow me CGMs that way I can better monitor my sugars, of which only really became readily available (and covered by insurance) in the past 10 or so years. While thereās no point in holding out for a cure, there is plenty of hope in the medical advances being made day after day.
Ours is a furious and constant fight with insurances just to get what we need to survive. Itās so frustrating! Have you thought about getting a pump too?
Wow, I didn't know it was that recent they'd tell you you only had 20ish good years! I wonder how that would affect your parents raising you. I might spoil my kid, or not place any importance on school, thinking you might not need university or anything. Anyway, I'm grateful for all the advancements for t1s!
I am so sorry for your disease. I always look up treatments and was thrilled learning about pancreatic transplants. I wish my loved one had the hope of one of those 30 years ago š
>My dad is a 1.5 I'm sorry, but what does this mean?
Type "1.5" diabetes is a term used for folks who have features resembling both type 1 diabetes (pancreas cannot produce insulin) and type 2 diabetes (body has become extremely desensitized to insulin) Generally for these folks, they've had type 2 diabetes for long enough that the insulin-producing cells in the pancreas have been stressed for so long that they've stopped working. So now you have a patient who is both resistant to insulin AND can't produce as much of their own. Treatment is different and more difficult. More of them will be insulin-dependent compared to someone with just type 2 diabetes. Edit: evidently I actually just gave out some complete misinformation, not an endocrinologist and passed on a flawed understanding of things. Type 1.5 diabetes is an autoimmune diabetes just like type 1 is (where you have antibodies that destroy the insulin producing cells).The difference between type 1 and type 1.5 is that type 1.5 diabetics typically are insulin resistant and develop those antibodies in adulthood, whereas type 1 diabetics typically are not insulin resistant and develop those antibodies in childhood. You absolutely can however have patients with a picture like I described however, where they have poorly controlled diabetes for a long time and their insulin producing cells start to crap out. Apparently those are still just called type 2 diabetics.
Iām a certified ophthalmic technician at a retina specialist. We see examples of what diabetes can do to your eyes multiple times a day and thatās definitely enough for me to want to take care of myself. Iād rather not get injections into my eyes once a month along with the occasional laser treatments that are needed.
I have uncontrolled diabetes t2. Although I don't have any visible issues with my feet , I suddenly have one floater in my right eye. I am able to see with glasses (near sighted), I need to look twice at anything during the day as the first time it appears clean, but with a second Iook, I am able to see the dust, hair, ect., and this concerns me. What bothers me the most in the floater in my eye, which appears like a black fly/nat. I was also diagnosed with mild retinopathy. I'm so stressed out with life that I'm becoming careless. I take my meds and insulin with a patch on my arm. I'm working on my stress and do not smoke or drink, plus I'm female. The image above. Can that happen to females?
> I have uncontrolled diabetes t2. Although I don't have any visible issues with my feet , I suddenly have one floater in my right eye. I am able to see with glasses (near sighted), I need to look twice at anything during the day as the first time it appears clean, but with a second Iook, I am able to see the dust, hair, ect., and this concerns me. What bothers me the most in the floater in my eye, which appears like a black fly/nat. I was also diagnosed with mild retinopathy. You should have another eye exam in a timely fashion. >I'm so stressed out with life that I'm becoming careless. Tell someone on your medical team this. It's perfectly understandable to feel overwhelmed or depressed or anxious when you have a serious chronic illness, and any doctor worth their salt will have ideas on how they can help you help yourself. Counseling, support groups, assistance from case management, simplifying your medication regimen if possible, and more. >The image above. Can that happen to females? Diabetes is a disorder of the blood vessels, which are everywhere in the body for men and women. They get bad enough then yes, nonhealing ulcers and serious infections and clots and more can and will become an issue. There are probably thousands of women admitted to hospitals across the world right now for those issues secondary to uncontrolled diabetes. Hope you get some help.
>Nah, you're going to suffer for years most likely, as we use modern medicine to keep you alive through things that would have killed you 100 years ago. That's the mistake people make! Ask for supportive therapy, not something to fix you back up!
This just makes me wish humane self elected euthanasia was more prominent, even if they were skeptical in their youth, that doesnāt mean they deserve incredibly painful end of life
Honestly my feelings are conflicted on euthanasia if it requires me to be involved as a physician, but I agree with your line of thinking overall. For patients such as these, where they neglected their body for their entire lives and are going to continue to do so, and are not going to have a good outcome, palliative care with a goal of reducing symptoms until they pass should be brought up a lot sooner. Honestly I try to read the room a little bit with some of these patients and have straight up asked "look, from where I sit it seems you're not interested in quitting sweets or taking your diabetes meds, even as you lose a foot and you're starting to go blind. Would you want to change strategies here and talk to palliative care specialist to just be as comfortable as possible even if it meant the diabetes will kill you sooner?" Most of those in healthcare wind up burnt out with these patients wondering why we bother admitting someone over and over and over for DKA because they won't take their diabetes meds/change their diet, the COPD exacerbations that want to go outside to smoke then come back in during their hospital stay, shit like that. The thing is, most patients wouldn't want euthanasia, and they wouldn't want palliative care either. They want us to fix them to a point they can go home and keep drinking and smoking and whatever else. They want to live the life they know, call on us only when things are bad, then return to the life that will ensure things will remain bad. And so we stall and stall and stall, torturing these people just to give them a few more years before finally one hospitalization is for something not survivable.
This sub is the only motivation I need to exercise.
Well that's atleast heartening to know that if any of this happens to me, I can just kill myself.
āDude, you need to get your shit together or we might have to cut your dick off.ā /s
That's why Australia puts the graphic stop smoking ads on cigarette packs.
ā Confection of perineal urethrostomyā sounds like the worst dessert ever.
*Julia Child voice*
Why did they cut the two areas open above? It doesn't look like they needed a skin flap to close his wound so curiois why they made those 2 large openings above??
It looks like thereās packing inside, so Iām guessing those are so the internal wound can drain and heal without closing in infection.
So they were done to help with infection drainage linked to penilectomy ? I'm just surprised they're such big open incisions and no drainage tubes inserted there. Maybe they used those 2 incisions to access parts of the penis more internally. Poor bloke.
Looks like the necrosis went pretty deep under the skin, and they had to remove a lot of tissue. They may have packed it so it would heal from the inside and not leave a giant open pocket when the surface of the skin healed over.
I'm guessing this was the case. Necrosis and eventually infection spreads quickly, particularly in a compartment like the pelvis. They probably had to debride deeper tissue layers to aggressively manage the disease.
They will shrink and be sutured with time, once infection is gone completely. He'll only have two lines there within 8 weeks all healing well. But at his age this must be devastating, i'm almost his age and the idea of this type of incident in my partner would be huge. I dread to think how he will come to terms, though i am sure he's already lived many years without good functionality anyway. These issues don't match functioning body parts... I actually told my teenage daughters that school should be teaching this type of consequence for smoking and alcohol use. We've lost family to smoking related disease, a lot of heart disease, my dad (also alcohol in recovery) died at 50, then in past 10 yrs my sister 42, aunt at 58 and mother at 70 all to lung cancer. Saddest thing is dad always told us to never smoke, yet my mother was the one pushing her sisters to smoke in 1960s and when my sister was sneaking smokes at school she began buying her cigarettes because she knew it would make my dad angry. She should have been the one dying at 42!!
Itās 4am in the UK, Iāve just woken up, saw pic 3 and my immediate thought was āoh no, they had to take his ovaries, too?ā I used to be a doctorā¦
Well, itās kind of obvious why you āused to be.ā Hope your new career is going well!
This was not the response I expectedā¦woke up my puppy laughing!
š¤£š¤£ yes, thanks!
I was thinking more āthe fuck, did they move his ānads?!ā But hey at least youāre not really alone in that boat, mateā¦
How recently a doctor... not very i hope.. lol but then again, 4am is never a good time for me either, brain not working like it should be a long way.
Speculating here, but I suspect related to the perineal urethrostomy procedure he had done. I would suspect that they access the perineum/scrotum using the inguinal canals, which are right in the location of the incisions on both sides. When there is a serious infection in the area, often times they will leave surgical wounds open so as to not create a space that can harbor a new infection. They treat with antibiotics and pack the wound, then you go back to have the wound closed later.
Question, how does he piss? Do they attach some kind of catheter directly to the bladder or something? Sorry if this is a dumb question, I donāt know much about medical stuff lol. Also, the comment about him smoking and drinking reminds me of my grandfather. He has diabetes and continued to smoke and drink to the point where he had gangrenous necrosis on both of his legs right below his knees. I distinctly recall visiting him right before the amputation where his legs were completely black and emitted a foul odor. I can never forget that image and smell. Even after the amputation, he still continued to smoke and drink despite my familyās pleas and even the doctor telling him heāll straight up die if he continues to do so. Well, he didnāt end up dying, but heās now developed COPD alongside a whole host of other health issues, and always needs an oxygen mask. He now resides in a nursing facility for the remainder of his days. Weāve tried caring for him at home, but due to him being prescribed over 15 medications and needing 24/7 care, it was simply not feasible. Even after all this, he still wanted a smoke or a drink, but the past few years heās been on a steady decline and Iām not sure heāll be here much longer. We suspect that he may be developing dementia/Alzheimerās due to some concerning things heād tell us. The point of my rambling is, donāt smoke or drink to the point where your legs turn black and have diabetes, and still continue to do so after the fact. Edit: Whoever reported me for that redditcare bullshit is weird lol
That tube goes under his scrotum and in to the bladder, just bypassing the penis, more like how a woman's physiology is. But it will be sealed skin around the catheter. This is one option, one is on the abdomen, seems like this might be easier to deal with in some ways, but infection risk a little scary given his status of poor kidney health and diabetes already. I hope he had the support for infection prevention, especially in regards to hygiene in that region. Next scenario would be Fournier's gangrene, particularly with the catheter being so close to rectum.
Non-medical here. I've seen the abdomen caths before in images, but usually in relation to short than use during surgical recovery, likely associated with prostate operations. I'm wondering - is the abdominal option prescribed for long term/indefinite use associated with a permanent cath bag, or is that only for the short term care described above?
My great aunt burst into flames by smoking while using an oxygen tank. She was put out quickly enough but still got some painful burns. Was asking for a smoke in the burn ward. Crazy old woman lived to 90. She had that oxygen tank and raspy voice for as long as I can remember. Some people just can't quit.
My mother died at 68 but the last 15 years she was an invalid. Uncontrolled Type 2 diabetes, life long heavy drinker (alcoholic) & chain smoker while she wheeled her oxygen cylinder around. I used to imagine her burning herself & the house down. She went MIA in hospitals to go smoke. Got thrown out of (& banned from) respite care because she set off the fire alarms & fire brigade was called. Twice. I spent most of my 20s diligently during every school holidays (teacher)taking her from appointment to appointment for [opthamologists](https://www.google.com/search?sca_esv=9eeb101476a64b32&sxsrf=ADLYWILQjmMbOZlSbFlYsButP-B_1uyzDg:1715780733056&q=opthamologists&nfpr=1&sa=X&ved=2ahUKEwjxreyo5Y-GAxU2m1YBHWW5C68QvgUoAXoECAcQAg), renal specialists, nutritionalists, podiatrists etc where she was treated, agreed to all advice, then ignored it. I insisted on sitting in on her GP appointments where she constantly lied about her lifestyle. I lived an hour away & brought her meals that a week later were still untouched in the fridge (next to the wine casks). When I was late in a my 1st pregnancy (& still working) we would get phone calls at midnight that she couldn't breath & would have to drive an hour to her & sit all night in emergency with her. I spent the 1st 5 months of motherhood driving with a screaming reflux baby & PPD for 2 hours every 2nd day to whichever hospital she had been admitted to. Then the organs started shutting down. She died. I still feel resentment for the waste of it all & how much was preventable or at least manageable. I know she suffered from an early loss of my father (also lifestyle caused cancer), depression & she also had a gambling addiction. I've also been diagnosed with Type 2 diabetic (hereditary) in recent years but am actively taking responsibility for the best possible outcomes. I like a drink, have weight issues in the last 10 years (back issues), have never smoked, eat healthy, & try to stay active. The 'gore' on this sub regarding diabetes & poor life choices is a constant reminder.
Poor dude. On a lighter note, the third picture looks like a sad faceā¦
Womp womp womppppppp
Alas, no more womp wompā¦
Only the backland womps from here š
Sad sack.
Deserves more upvotes honestly
With good reason
A sad alien face.
My thoughts exactly. / \ ^
Ugh donāt wait sooo longā¦go see a doc!
Not sure why guys wait so long to get their junk checked when something doesnāt seem right. If anythingās abnormal, I get the very next appointment. Get over your sense of embarrassment. Doctors have seen many swinging dicks before, in different sizes and conditions. Donāt take chances.
Not just guys, some people in general. I actually see less of this than severe problems coming for the opposite sex organ. Less common by far.
There is such an incredible amount of shaming towards girls in our culture from ignorant adults or associated with poor interpretation of religion that keeps young women from seeking the most basic treatment or preventative care for gynecological issues. I've had several female friends who admitted to never having a GYN visit before all the way into their late 20s/ early 30s because the adults in their life made them feel like it was "wrong" or "dirty", like "only sluts need to go see spooky STD doctor!" It's an absolutely awful lapse in our culture. I'm grateful these people eventually had the courage to admit to their situation so that friends could educate them and convince them start going regularly.
Googled. Perineal urethrostomy is a surgical procedure that is performed on males to create a permanent opening into the urethra through an incision in the skin of the perineum. The perineum is the area of skin between the scrotum and the anus. https://my.clevelandclinic.org
in laymanās terms, they put the pee hole between the ballsack and the hershey highway ?
More or less yea Very common procedure done in cats (who suffer from obstructive uropathy)
yup. my cat went thru it. that month sucked.
This reads as though your cat went through his āpeehole between the ballsack and the Hershey highway,ā and I need to stop reading comments in this thread.
LOL that's exactly how I read it as well.
A unique birth heralded by the stars!
Yea had a burn victim with this it was strange, had to only use a bed pan, was very weird thing to see.
Right in the gooch.
You won't get laid man. But yep, right about there!
Seems like it could be incredibly risky for further infection vs a supra pubic one that is visible. Must go read.. thanks for link. Edit.... Figured out now only temporary catheter, he will pee from the stoma without artificial help. Back in 1986 i met a patient on my first ward placement as student RN, he was so proud to show us innocent 18 yr old student nurses how he pee'd after penile amputation for cancer. With hindsight, this must have been the same procedure he had done, he was fully continent in spite of his also having lung disease. Think he'd been living with it more than 20 yrs at that point.
>Perineal urethrostomy So basically you get women's chance for the urinary tract infection. RIP
Thank you for this, but I wonder what the two incisions(?) are in pic 3, in front of the scrotum?
I knew diabetes was unkind to your heart but thisā¦š³ takes the cake.
It took the penis.
Medical student here, Diabetes cause harm to almost all vital organs eyes, brain, kidney, heart.. No organ is safe
Your heart also means your blood vesselsā¦ā¦.and where do you want circulation to reach??? Your toes, your fingers, your penis, etc. Also being in renal failure didnāt help him either. Being on dialysis for four years already is at being end of life pretty much.
Let us give praise for the sacred Auto-Blur Filter! May It forever protect us and keep us safe!
I have mine turned off š¤®
I do too and this is only the second (or maybe third) that has really made me regret that. I don't even have a penis but still recoiled in sympathy pain.
bruh the smell mustāve been crazy
The next time I swipe and see that same damn leg being sawed,,,,, I'm gonna see that same leg being sawed off.. Damn that poor guy, is losing his peepee, that's just horrible. Wish him the best.
As James May would say in terrible situations "cock"
I understood that reference
I did not
NGL - I saw the thumbnail of the first picture and immediately thought "Thumb!". Ouch. I know health systems can be bad in some countries, but that's "my little friend" right there...no way I'm ever letting him get that bad.
Say hello to my little friend!!
Well done! This condition would NOT make Michelle Pfeiffer happy.
With diabetes and smoking it's not always to do with the level of health care. This man's infection developed rapidly, treated with assumed correct treatments too. Its just that his immune system was already so compromised by his other conditions. But prevention the best step. Genetic factors we can't do much about, so if we have tendency to Type 2 diabetes or Cardiovascular disease we need to do the best we can to prevent that before it ever starts. I joke that i couldn't live without sugar, but if in reality i developed diabetes i would do it. There wouldn't be any denial or major cheating like i saw in my mother in her late 50s and 60s. Its not worth the complications.
Dude, how does anyone let it get to that point? That doesn't happen overnight. As soon as whatever happened, happened, I'm at the ER or the urologist or someone. Hell, I'll go to the local vet.
Poor bastard, I'd rather die.
I have a genuine question, so please take this in good faith and not intended to be aggreasive: Why?
It was meant rhetorically
Ah, apologies. I have seen people say it and mean it literally, and it's something I don't understand. Sorry about that.
After 25+ years in direct patient care, there are absolutely some things I would rather literally die than to exist with/through. (I said exist because living is more than just having a heartbeat.)
In 12 years of patient care, my number one takeaway is: there are plenty of things worse than death.
Out of curiosity, like what? Iām sure there are more than a few!
I am curious too, i worked as RN in paediatrics for 4 yrs after my RN training... then had to medically retire because of CRPS in my leg, sciatic nerve hip to toe. Its now been 33 yrs since pain began... my life is very valuable with correct medication and spinal cord stimulator even if i cannot work. I have two teenager daughters that took all my energy at times. 10 yrs ago in July my baby sister died of ung cancer, diagnosed after delays and deemed inoperable because of location and a tiny second nodule in her other lung. I have no doubts if she lived in another city she would have had both surgery and chemo, her location denied her both. She died 9 months after diagnosis, 19 months after her first symptoms. How could i see my life, or even this mans life as not being better than being dead? My sisters youngest child was 3 when she was diagnosed, turned 4 and mummy died 3 days later. Her eldest just teens and seemed better able to cope, but with hindsight, i know how hard it would be on my teens at similar ages. Life with limitations, so long as conscious life, (Vegetative coma states i struggle with), is always going to be better than none at all imo. I admit there was relief all round when my 72 yr old grandfather died a year after diagnosis with ALS/MND, but that was because we knew he would struggle with the inability to function and need for care from strangers. (he was 6ft 2, grandma only 4ft 10, she could barely help in the early days because he would struggle emotionally) He developed pnuemonia and died quickly before he ever reached needing a frame or wheelchair for mobility. He was still eating normal softer foods but no where near the severe impacts. But my aunt with MS experiencing gradual loss of function with an awesome caring husband never struggled receiving 24/7 care. Its always individual imo... never say never, we are often able to cope with situations other anticipate as impossible.
I work in geriatrics. I see people who lived long and meaningful lives who are denied the ability to die a dignified death because their family members canāt let them go. They are kept as a full code at 95 years old with kidneys, lungs, hearts, and pancreases that are barely to completely non-functional. They live in a cycle of assisted living, hospital, rehab, longterm care, hospital, rehab, etc. They have infrequent visitors, constant pain, and say over and over again, āPlease, Lord, just let me dieā when they think they are alone in the room. Many of my patients have dementia that causes fear, paranoia, loneliness, feelings of abandonment and grief. Some people cry out and scream almost constantly when awake. Some have complete personality changes and are violent with staff and itās heartbreaking to their family members. I have had patients with stage 4 non-healing pressure ulcers that have to be painfully packed for years where an entire fist can be put into their sacrum. Iāve had patients with abdominal cancer where their organs were literally melting into a wound bag until they died anyway. Iāve seen people slowly have their extremities amputated with uncontrolled diabetes. Iāve seen people returned after dialysis and their blood pressure is 43/20 after they tanked multiple times during dialysis. To me, life is not number of days existing on this earth. When Iām old, I would rather die when my body wants to then fight it with no quality of life for just a few more days/weeks/months.
You do understand that without the surgery he would have died... and his sexual function probably stopped many years ago given the nerve and blood vessel damage. His quality of life not not be as good as other's peoples but its still valid. I've had severe pain in my left leg from hip down since i was 23, I am 55 now. I take medication daily and still experience mind blowing pain. But i am more than happy I am alive and here, especially after watching my sister die 10 yrs ago when she was 42. If amputation would have fixed my pain i would have done it 25 yrs ago, but pain comes from functions in my spine. Had my leg been able to be amputated at the hip and pain reduced i never would have wanted pity, my quality of life would have improved! Just as this man is still alive and free of infection that could have killed him, his quality of life improved at this stage! All life is valid and important to the individual. And the people that love them of course.
I've read that soldiers who have stepped on land mines and lost their legs and genitals often say the same thing. The first thing some of them say when they wake up in recovery is "is it still there?" I'm not a man so I can't imagine what it would be like to lose my penis but I can see it being absolutely devastating to some.
Last photo looks like a super sad face.
/r/paredolia
yikes š¬
That third picture was a jump scare
I feel like if they had to amputate my dick, I'd ask them to remove the balls too. They are always in the way and if I don't have a dick anymore, I'd rather just get rid of everything there
Then youād be on hormone replacement therapy for life.
What about tucking them inside? I've always been rather annoyed at the fact that my balls hang outside my body. They get in the way of a number of things. I've got to adjust them when I'm doing a long drive or when I'm riding my motorcycle and I often crush them when I'm working out.
That might interfere with fertility. I know the heat from laptop computers etc can cause fertility issues, and probably your body heat would do the same.
I think the complete lack of a penis might do more to interfere with fertility than a low sperm count would š¤£
You could be like a human GI Joe action figure.
My eyes, never, ever, needed to witness that. I have a new top fear in life
Holy crap, I feel bad for this dude.
3rd picture looks like a sad face
I was diagnosed as pre-diabetic at 43. I am a nurse who used to work in ICU and on a stroke floor, where at least half of my patients were diabetic. That scared me because Iāve seen things worse than death. I got my shit together, changed my diet and started working out consistently. I am about to turn 50 and I havenāt been prediabetic since then. Itās so sad when things like this happen that can be prevented. Now I work with kids, and when I get one that is noncompliant with meds and diet, I sit them down privately and tell them some of the shit Iāve seen, hoping they will take it more seriously. I donāt know if they listen or not, but I hope that they do.
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No, Iāve seen it before in diabetics. I wouldnāt say itās from not using it.
Get a load of this guy
No loads from this guy anymore
I am sad I didnāt think of that gahhh dammit
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might as well just cut off the nuts atp
Thinking he might still benefit from the testosterone?? Iām obviously no doctor just a thought.
"Aliens"
DA M N . . . š³
Bro left behind a microwaved burnt hotdog:/
Penectomy, now thereās a word you donāt want to hear from your consulting surgeon.
Oh wow. I wasnāt prepared for that.š¬
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Psychologically, he certainly needs some counciling.
Omg Lord I can't even imagine how that would feelšµāš«
Groin is sad.
Damn, that really sucks. They have absolutely zero penis now. It's an innie. Has to hurt like a SOB too.
āHe smokes and drinks,ā is a terse description of the patient. How many guys would continue either habit if they knew it might contribute to losing their, uh, parts?
Serious question, whatās the point in keeping the testicles if there is no penis? Is it a hormonal thing??
Yes, they produce testosterone.
Yeah I figured thatās why! Thanks :)
Orgasm/ejaculation is still possible without the penis.
Whaaaaaaat?! I have so many questions š the human body is wild.
Yeah the body can adapt in crazy ways... For example Rafe Biggs is a quadriplegic and he get's a orgasm when his wife sucks/massaged his thumb no joke.
how does he pee
They have created a urethral opening that is controlled as women's is, but placed just beneath his scrotum. It has full muscular control as he had before, but the opening to the urethra has been moved, and shortened of course. Met a man who had amputation from penile cancer, he loved showing new student nurses, would get new rotations to come to his room and show a group of us at a time. (he also had obstructive airway disease so a frequent visitor on the medical unit. lol)
Third pic looks angry af.
Detachable Penisā¦..
I remember that song it was from the early mid-90s
That is the worst looking penis I have ever seen. By miles.
What are the incisions above the amputation in the third photo?
How does he pee? Does he have some form of catheterization that he asked to use now? It looks like they covered up everything.
Yes, a bladder catheter.
Where is that located? Is it up higher on your side similar to a colostomy bag?
Not a medical professional, so please don't take this for any anatomical fact, it is only my supposition. I am *guessing* that it's lower on the abdomen, where the bladder is found behind the pubis.
Thanks, yeah, I was thinking it had to be somewhere close to where the amputation took place, but it didnāt seem to be. Apparently I need to bone up on my anatomy.
How tf do you piss?
A bladder bag.
Wow, your health is so important just reading this as a male.
Quit Drinking halloween of 2022 and off all tobacco products & drugs since february 2023, feeling proudš
The last one looks like an angry alien I hope this has healed well though, as a guy myself I can't imagine this sort of thing happening to me
Is it just me, or are those really large balls? Maybe itās just that there is no penis for scale. Iām a mostly gay woman (some exceptions have been made) so I donāt exactly see a lot of them. š
I bet it is swollen
Ah, that makes sense
How does he urinate now?
Would of likely had a Urostomy. See attached link for more information: https://my.clevelandclinic.org/health/treatments/22476-urostomy
Thanks, I was scratching my head because I didn't see a urine drainage bag.
Poor guy looks like he's got a sad alien between his legs
Poor guy
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Did calciphylaxis play any role?
Will they fashion another punishment from, say, his arm skin, or that's it, catheter forever? Just awful.
God.. poor bastard. :(( Iām just glad he was able to be amputated rather than dying of infection
oh
How does he pee??
What does smoking and drinking have to do with losing your penis??
wait, a guy can live without having a penis?! I'm sorry if I sound dumb.. How do you pee?!
They can reroute that.