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Vasectomy Discussion

Do I need a specialist for my vasectomy?

This is a great question.  Full disclosure—I had our family doctor do my vasectomy and he did a great job.  There are a variety of providers that can perform vasectomy.  Urologists and family practice doctors perform the highest number, but technically a physician assistant, or a nurse practitioner could perform the procedure.

A vasectomy is a simple straightforward procedure and when things go well, who could argue for the need of the services of a specialist?

I am reminded of an experience I had when in undergrad at Idaho State University studying biochemistry.  It was a Wednesday with a paper due on Friday.  I sat down to my Micron 486 DX with 4 MB RAM (yes MB not GB) to start working on my paper.  The computer was getting little old, but back in the day there was not much left in the budget for new tech in our house.  (I think I paid two times more for that computer new than I have any recent tech purchases.)

Well, I sat down, flipped on the power, green light turns on, but nothing on the monitor.  After about 30 minutes of plugging and unplugging cables I made the diagnosis of premature monitor failure.  I talked to my wife we decided on a budget for the new monitor.  I headed out to a local computer store (more of a mom and pop shop that had 20 used monitors any one of which would do the trick).  I spent an hour discussing a slightly used 24-inch behemoth of a monitor I had fallen in love with.  It would officially be the largest screen in our small apartment, and it was going to be mine.  I talked to the owner of the shop—a man in his late 60’s who was a retired engineer who ran the shop for something to do more than anything else.  He obviously knew his stuff as he spouted off terms like OHMS refresh rate, etc.  But alas, the monitor was 50 dollars over budget and I knew just how tight the budget was.  I thanked him for his time and decided I better keep shopping.

Across town there was a new shop recently opened with a big sign out front reading “blow out on monitors today only.”  I drove by everyday for a few weeks it was amazing how that “monitor blow out today only” lasted three weeks.  Anyway, always a sucker for a good sale, I stopped.  I walked into the shop immediately greeted by a 20-something-year-old welcoming me to the store in his bright green golf shirt company logo front and center.  After listening to a sales pitch for the latest gaming pentium the guys in the back could build for me, I simply replied that I was in need of a used monitor and told him my budget.  I added that I had just looked at viewsonic 24-inch monitor that I had fallen in love with.  He was obviously a little depressed to not see me in the market for a new, custom-built gaming machine, but none the less showed me to the back corner for used trade ins.

He did have the same 24-inch monitor sitting in the corner.  Told me they had just taken it in on trade and made it clear all used equipment was sold as is and that there was a strict no-return policy.  I was not about to walk out the door with a lemon so I asked if he could hook it up to a computer so I could see the picture quality.  I even quoted some of the refresh rate numbers the first guy had told me about so as to sound like I knew what I was doing and he should not try to pull a fast one on me. After reaching around unhooking a VGA cable and plugging this one in, it looked good.  He then told me that the previous owner had wanted to keep his cables when he traded this one in.  I asked the cost of new cables he walked me over to a bin of cables and told be to go ahead and pick out and cable you need for 5 dollars.  Well now we were talking.  The monitor was 50 dollars less then the first shop and minus the 5 dollar cable.  I could make this work.

I could not have been prouder walking out of that shop both arms holding this 50 pounds of cathode ray tube beauty.

I got home, announced the new addition to the family like it was a new child.  I was so excited about the new monitor I had almost forgotten the paper due in a couple of days.  I sat down plugged in and powered up as excited as a 5-year-old on Christmas morning.  Power turns on and it flickers to life.  My wife watching over my shoulder (she does not get Christmas-morning excited for tech) and nothing.  What?! I must have plugged this in wrong.

I unplug and plug in screwing in the set screws to secure they cable turn it back on and it does come to life this time, but there is an absolutely crazy line that keeps crossing the screen from top to bottom with distorted colors.  I then get the “did you at least try it before you bought it” from my not-so-excited wife.  “Yes, dear I had them plug it in for me and it looked perfect in the store.”

“Well that doesn’t look perfect to me,” she says.

My would-be Christmas morning just turned into a lump of coal.  I was ready to wow my wife with this new monitor, and I just knew when she saw this she would understand my child-like joy in buying tech.  I still have not heard the end of this when it comes to buying tech in my house.

My chance to convert my wife to a technology junky over, I fidgeted with the cord for another 30 minutes or so before finally giving in.  I unplugged put it back in the back seat of the Pontiac Sunbird and was back on my way to the shop where I just hours ago walked out triumphant in my purchase.

I walk in the door monitor in hand the salesman I saw earlier caught eyes with me monitor in hand and must have realized he was on lunch break because he took off for the back room to not be seen again.  I sat down with the 30-something-year-old manager.  He reminded me strict no returns on used equipment.  I said just plug it in and see that this piece of crap you sold me two hours ago is defective.  He resisted my urges reminding me that even if it did not work I would not get a refund.  At this point, I was convinced that I could win the argument if he could only see how bad this thing performed.  After several minutes of coaxing he relented plugged it back into the computer turned it on and the screen sprang to life……….Just as I got ready to let him have it for poor quality the screen looked perfect.

I stood there jaw little open feeling pretty stupid and can only utter well it does not look like that on my computer the image is not even readable on mine at home.  So after sitting through the same sales pitch for a new computer I grabbed my monitor and left.  Tail between my legs I walked out as dejected as the kid picked last to play kickball.  I put it in the car a started to drive home.

About that time, I remembered the sign on front of the first shop’s window reading we fix computers.  With my pride on the line I thought one more effort to resurrect this 24-inch wonder of the world would be worth it.  I walked in, monitor in hand, or more accurate wrapped with both arms, trying no to drop it.  I started to recount the story to him.  He had me set the monitor on the table and asked to see the cable that I bought with the computer.  I went back to the car and produced the cable.  He says to me “that’s the problem.”  I ask him “What’s the problem?”

I just spent an hour trying to figure out what the issues was with the monitor at the other shop working with a technician that builds computers.  He then explained to me the difference between and engineer and a technician.  He further went on the explain that the cable was the issue because it was not shielded.  It would work well with a much smaller monitor but this 24 inch viewsonic needed a shielded cable to work properly.  He must have seen my disbelief in a fix so simple so he offered to show me the difference.  He plugged my cable in.  Line starts flashing distorted color and like a victory cry I said, “Yes, see that’s what it does on my computer.”

Finally vindicated that someone could see my pain, it was a small victory.  Then he wanders around the corner comes back with a 50 dollar cable.  Plugs it in and the picture, well, a thing of beauty.  Turns out, I paid the same amount for the monitor and cable as if I would have bought it from him to start.

Lesson learned.

When things go well, you can get service from just about anyone and be happy.  Sometimes you can even save a little money and be very happy.

When things do not go well, an expert, in this case an engineer, can diagnose and fix the problem when a technician cannot.

What does this have to to with a specialist doing your vasectomy?

The vast majority of vasectomies with go well, no problems, no complications, no issues.  In those cases, a non-specialist is a great choice.  Problem is, there is no way to know if you are going to be the guy who has things go wrong.

A urologist is the specialist in the field of male reproductive health.  Urologists spend 5-6 years studying the male reproductive system and have experience in operating on the structures in the scrotum for a variety of conditions.  Based on this, the knowledge of the anatomy, the diagnosis, and treatment of complications is that of the engineer not the technician.

I see patients on a monthly basis who have had a vasectomy done elsewhere and have been referred to me to fix problems with the vasectomy.  The question I think you have to ask yourself before having a vasectomy is if you want to start off with the specialist.  Anyone can have issues after their vasectomy, regardless of the level of training of the provider performing the vasectomy.  The difference is the specialist has the tools and knowledge to diagnose and treat complications as quickly as possible.

In the end, the 24-inch monitor did not turn my wife into a technology junky.  I buy new computers now, but when given a choice I choose the engineer over the technician.

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