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Synopsis from the post “A Pain in the F*cking Crotch – A Pain in the F*cking Ass “: Having prostate cancer I had a radical prostatectomy performed at the urology department at the Northwestern University Feinberg at the hands of Dr. Anthony J Schaffer Chairman. Prostate was removed leaving me incontinent and impotent.  Several years later I had an artificial sphincter surgically implanted to alleviate my incontinence.  The surgeon was Dr. Mulcahy M.D. professor of Urology Indiana University, Indianapolis, Indiana where the surgery was performed.  The surgery was successful; got my incontinence under control.  Unfortunately the procedure led to chronic pain. For the complete fiasco click here.


The Rehabilitation Institute of Chicago / Chronic Pain Care Center is where I got my life back. And where I was put on Nortriptyline, a tricyclic.   For postpartum depression a woman might have gone thru after giving birth, she was given a tricyclic. As you would have it, the tricyclic unexpectedly also suppressed any pelvic pain a woman was experiencing along with depression. Nortriptyline is a class of tricyclics that somehow blocks certain pelvic pain message to the brain; it first worked for a woman; it works for me. Thank you ladies.


Ideally it would be great if I could eventually get off the meds, eliminate the side effects and still be pain free. I tried 3 times to get off Nortriptyline, several years between each attempt. Eventually the pain came back, beginning very much like it began first time out, as an ache in my wiener.  I didn’t wait to see if it would accelerate.  I went back on the meds. Why I didn’t wait to see if it would or would not build to a full blown-out pain level 10 was, because as I was told, that for each attempt to go back on the med there would be a risk that the Nortriptyline would not block the pain as it once did; that’s because there was no guarantee the receptor sites that the Nortriptyline had to connect/lock with would be available again; that or something like that is what I was told. Not willing to take the chance of having to go thru the med trials again while I was in serious pain; no thanks. I’ll play it safe. I’m on Nortriptyline for life; learned to live with its side effects, as did my body.


With nortriptyline came significant side effects; they were not insurmountable.  Initially I was extremely groggy in the morning. When I took some meds in the morning and some later in the evening the morning-groggies no problem.

Three more side effects: increased heartbeat, dry mouth and decreased libido; still with me to this day.  All manageable with aerobics, a water container always at the ready or a mouth spray and …

… Several weeks after my radical prostatectomy, in the examining room Dr Anthony J Schaffer revealed a trade secret to me. Why? I’m not sure, possibly to leave our relation on positive note. “You know Howard” he said, “You know, you still can have an orgasm. “ (the nerves and blood cells responsible for an erection were removed or damaged during surgery) Out of the blue, no previous conversation or anything I said or questioned motivated this information. Possibly he dropped this pithy little tidbit out of empathy.  My response: “Oh. Okay.” Later, once out of hospital on the way home I chastised myself for not asking how. I cannot imagine what his answer would have been. Well, it remained for me to discover how.  As it was it proved to be a challenge I eventually solved, my initial thinking, clever enough, was to treat it as I would a clitoris.

As it was the nortriptyline did have a debilitating effect on my “clitoris”, presenting one more challenge with a much greater degree of difficulty.


Deep breathing, they stress deep breathing; you do a lot of that at the center.  It lowers blood pressure, relaxes mind/body, provides a way to cope with stress and obtain homeostasis.  Today I’m an ardent compulsive deep breather.

Physical conditioning; strength, endurance, balance, coordination, making use of  treadmill, machines, bands, medicine balls, balance boards, aquatic resistance, stability ball, yoga, all that good stuff. All part of the rehabilitation program. Most of my group left the clinic physically stronger with greater flexibility, more aware and confident of self/body. Today I workout 3 times a week, run 3 times a week, expanding upon those pathways discovered at the Chicago Center for Pain Management. At the new “75” I began Kettlebell training. Still swinging them, now at the newer 77. The Pain center fortuitously paved the way for my eventual and oblivious entry into the elderly.


Two key practitioners that saw me thru the month and were responsible for my ultimate pain free life. Outstanding doctors. They provided focus, empathy, humor and professionalism. Needless to say but said anyway, I like them.


Dr Michele Muellner, the attending Physician; she oversaw and prescribe treatment, responsible for one’s acceptance to the pain center, responsible for selection and course of drugs; she maintain daily contact with therapists and patient. Saw her as both a rock and pillow, had a crush; never let on though.


Dr. Patricia Cole, pain psychologist; besides deciphering the world of pain, besides, being intuitive, sensitive and smart she left me with a kernel of my personal reality that I wasn’t aware of. “Howard,  Pat said, I’ve seen one trait often come to the surface. Resiliency. You are resilient.”  Confirmation, just what I needed coming off 7 months of chronic pain and depression. She’s right. It still holds true because Pat said so. It’s all in the saying … If Pat said So … If Pat said So … If Pat said So. … Resiliency … If Pat said So. My mantra.

*Could not locate a photo of Dr. Cole. Thus the placeholder.

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A PAIN IN THE F*CKING CROTCH — A PAIN IN THE F*CKING ASS  The Invisible Wellspring of Chronic Pain. A search for an answer, a diagnosis, a treatment in a sea of medical indifference/ignorance when it comes to chronic pain.

“I’m taking my meds, taking my side effects, taking my Men’s Guards, taking my kettlebells, all 90 Lbs worth, taking them all to the grave with me. I’m pumped.”

Male Pelvic Pain: It’s Time to Treat Men Right.

When the touch of a feather feels like the flame from an acetylene torch. 
If you never had chronic pain you really don’t know what your missing.