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Boys Coverage

Ryan has struggled with his body image for nearly a decade at 17 years old. He is one of the hundreds of boys that struggle with eating disorders. 

WERE SOLD AT WALMART AND ON AMAZON. YOU CAN CONTACT THE COMPANY IF YOU HAVE THESE PRODUCTS. >> BOYS AND EATING DISORDERS, IT'S AN ISSUE THAT OFTEN DOESN'T GET THE ATTENTION IT DESERVES ABOUT ONE IN 3 PEOPLE STRUGGLING WITH AN EATING DISORDER IS MALE. BUT EXPERTS SAY THEY'RE SEVERELY UNDER DIAGNOSED SAVANNAH SELLERS SPOKE WITH ONE FAMILY TRYING TO GET THEIR SON THE HELP HE NEEDS >> AT JUST 17 YEARS OLD, RYAN HAS BEEN STRUGGLING WITH HIS BODY IMAGE FOR CLOSE TO A DECADE. >> AND FIRST KIND OF WAS JUST LIKE, OH, I'M TOO BIG. >> IN 6TH GRADE, RYAN BEGAN SKIPPING SNACKS AND DESSERT. HE JOINED THE WRESTLING TEAM AND OVER THE NEXT 2 YEARS STARTED TO RESTRICT EVEN MORE. >> THERE WAS A LOT OF CUTTING YOUR WAY TO GET A LOWER WEIGHT CLASSES BY 8TH GRADE FOOD CONSUMED HIS THOUGHTS. >> A STUNNING ABOUT USING. >> EVERY DAY, EVERY MEAL BE DOING. GILL. YOU KNOW, DREADING A MEAL. >> THE CHANGE IN RYAN'S PHYSICAL APPEARANCE WAS DRAMATIC. THIS HERE IS ONE FRESHMAN YEAR. YOU'RE A LOT THINNER. YEAH. STILL, IT TOOK YEARS FOR RYAN TO SEEK MEDICAL TREATMENT FOR HIS EATING DISORDER. I THOUGHT IT WAS JUST A GIRL THING. >> WHEN DID YOU THINK OKAY, MAYBE IT CAN APPLY 2 BOYS TO WOULDN'T BE UNTIL I STARTED TREATMENT. EVEN DOCTORS STRUGGLE TO IDENTIFY MALE PATIENTS IN PART BECAUSE THEY HAVE NO ROAD MAP TO DO SO. >> 99% OF THE RESEARCH UP UNTIL NOW HAS FOCUSED ON FEMALES. DOCTOR JASON, THE IS AN EATING DISORDER SPECIALIST AT UCSF PUSHING FOR GUIDELINES SPECIFICALLY FOCUSED ON BOYS AND MEN. HE SAYS NO EATING DISORDER ACCOUNTS FOR BOYS TRYING TO BULK UP AND UNTIL 2020 TO BE DIAGNOSED WITH ANOREXIA, A PERSON HAD TO MISS AT LEAST 3 PERIODS, ESPECIALLY WITH ATHLETES, ARE DOING THE EXACT SAME THINGS THAT GIRLS, YOU KNOW, WITH EATING DISORDERS ARE DOING TO TRY TO GET THESE WEIGHT CUT OFFS. >> BUT IT'S THIS VIEW IS NORMAL BECAUSE EVERYONE IN THE TEAM IS DOING AT RYAN'S MOM. CARRIE NEVER SAW THIS COMING. >> I REALLY THOUGHT I'M GOING TO HAVE TO DEAL WITH THIS WITH MY DAUGHTER AND IT ENDED UP BEING DRY. AND IT JUST THAT WAS VERY SURPRISING. >> A SAVANNAH SELLERS REPORTING. SO WHAT DO YOU DO IF YOU SUSPECT YOUR CHILD MAY HAVE AN EATING DISORDER, ASK THEM IF THEY CAN TO OPEN UP ABOUT IT, LEARN ABOUT THEIR DISORDER. AVOID DISCUSSING TOPICS ON FOOD AND THE BODY. GET PROFESSIONAL COUNSELING. ONE PLACE TO START IS THE NATIONAL EATING DISORDERS, HELPLINE. WE PROVIDED THAT NUMBER HERE FOR YOU ON YOUR SCREEN. 809, 3, 1,

'Not just a girl thing': Family explains how teen boys struggle with eating disorder 

"In general, testicular pain, especially if it's severe, is an emergency regardless of age,"  Dr. Sherry Ross said.

Boy moms: The one complaint to always follow up on

Stethoscope

UNC School of Medicine Dr. Sherry Ross explains what testicular torsion is and how it differs from appendage torsion. 

So I'm here with Sherry ross. Um you are a pediatric urologist and I didn't realize they had pediatric urologist. Um they, which is wonderful because you need them. Um and we're gonna talk a little bit about testicular issues because these are things that pop up. I feel like when you have a son, um sometimes things just pop up and you don't really necessarily know what's going on. They might be complaining of pain like in their leg or their groin. And it's it's kind of one of those things where things can occur. So take it away Sherry, you got a presentation for me, which I love. Okay, so we're gonna talk a little bit about testicular pain and thank you Cathy for allowing me to talk about this because as you said, it is a very important important topic and one um that as a urologist just in general we want the public to be aware of. So, so I'm gonna start out talking a little bit about the anatomy of the testicle. You can see here this dark pink area is actually the testicle and the gray area is an organ called the epidemic thomas. And the light pink color muhanned is a continuation of the epidemics which eventually becomes the vast deference and basically sperm develop in the testicle. They then migrate to the epidemic thomas where they mature. And then upon ejaculation they go through the tail of the epidemics and through the vast deference out into the ejaculate, interestingly. There are appendages that are associated with the testicle as well as the epidemic. Emus. Um you can see the appendix testis which is the little pink um piece of tissue hanging off the tests and that is actually a remnant of what we call the malaria in duck. The malaria in Duck would have been female structures had the boy been a female instead of a male. And then the other is the appendix epidemic thomas which is a remnant of the wolfy end up which is the duck that actually forms the internal mail structures. And you can see that there are multiple other potential appendages, all of which unfortunately can twist um and wreak havoc. So we're gonna talk a little bit about that. Oh yeah, we're talking about some twisting going on because this is type of stuff that happens. Um It can be very terrifying, very painful. Um It has affected my family and it's something that you know, it really can be traumatic and frightening when you don't know what's going on or you don't know what's happening. So let's look at this appendage, I didn't even know this thing existed. This appendage thing uh those, those little things are all over down there and can really wreak havoc. Um We don't really understand why the the testicular appendage twist but it definitely the testicular appendage, the appendix epidemic. Any of those appendages can twist. Usually we see this in pre puberty, all males. Um it can be either sudden or gradual onset of testicular pain which can be quite severe um When it occurs generally speaking, the pain is typically located in the upper part of the testicle, which makes sense because that's where the testicular appendage exists. Generally speaking, there's pain but no nausea and vomiting. Um They can often have swelling redness. We refer to a physical exam finding called a blue dot sign. These little appendages when they twist they macros and become purple. And in boys with very thin scrotal skin oftentimes it looks like a little blue dot down in the scrotum. Generally speaking, we treat this very conservatively with ibuprofen rest scrotal elevation, elevation, there's no potential loss of the testicle, but it can be quite scary. Um And that is in contrast to torch version of the testicle, which is a very, very important thing to note early. And we're gonna talk a little bit about that. So Torgyan of the testicle is when the entire um chord of the testicle twist. So you can see here we have the testicle, the epidemic thomas. And then you can see the red and blue that represents the artery and the vein that exists within this what we refer to as this chromatic chord. Um And when this occurs, we generally speaking, see this in peri or post puberty. All males. We can see this in infants. Oftentimes we see Children that are born with swelling and discoloration of the scrotum but generally speaking, uh this type of torgyan is then on peri and post puberty in males is the sudden onset of severe testicular pain. Pain is located throughout the entire testicle. Unlike the appendage where it's just located at the top of the testicle, often associated with nausea and vomiting. And in fact, if we have a child with nausea, vomiting and testicular pain, we consider that a testicular tourism until proven otherwise and will often times take that child straight to the operating room. The schematic cord is very much like a rubber band and as you twist a rubber band, the rubber band will get shorter. And we see that with testicular torsion as the schematic cord twist, it pulls the testicle up out of the lower aspect of the scrotum. And then you can see the testicle instead of sitting in its normal vertical position, will often be in a horizontal position. So we refer to that as a high riding testicle with a horizontal lot. There's um there can be swelling again, severe pain, There can be redness. Generally speaking, the redness occurs if it's been prolonged a prolonged period of time. You may not see that immediately. This is a urological emergency. Uh These Children. Um and young men need to be seen immediately. Treatment is often emergent surgical intervention and there is potential loss of the testicle. Now one is tori version of the appendage or torsion of the testicle occur. Well, as I said earlier, we're not really sure why the testicular appendage twist, I will tell you as a pediatric urologist who operates on testicles quite frequently. Often the appendage can be very long. Um and so there may be some association with the length of the the appendage, but we really don't know for sure in Tarzan of the infant. Um that is because there is a structure at the lower part of the testicle called the gubernatorial. Um and an infant, sometimes the gubernatorial um is not attached appropriately. And we believe that plays a role in peri and post puberty males. However, the testicular torsion is associated with what we call a bell clapper deformity. So if you look at the this schematic over to the right, you'll see this purple um lining that represents what we refer to as the tunic. Imagine Alice. And that structure is supposed to attach the testicle basically to the inner aspect of the skin. And if you look over to the right, you'll see that in the testicle that tours the tunica vaginal is actually inserts very high on the schematic cord and therefore doesn't hold the testicle in place. And so the testicle hangs much like a clapper on the inside of a bill. And so without that security that allows the testicle to twist and we think that as males develop and the testicles grow and the weight of the testicle increases, this may increase the risk of testicular portion and while we see it in this age group. So in in general testicular pain especially if it's severe is an emergency irregardless of age, All of these um references to age and um are really just in general, we always take testicular pain very seriously. Um If there is a appendage, torgyan, there's no impact to fertility. No risk of loss of the testicle, Testicular torsion. As I just said, it's a very different animal. Um testicular pain plus knowledge and vomiting equals testicular torsion and that those signs together or 98% specific for testicular torsion. So we take that very seriously. Um interestingly if the if a man our boy has testicular torsion, They have a bell clapper deformity. There's an 85% chance of a bell clapper deformity in the other testicle. So we surgically treat both testicles um to prevent tourism in the contra lateral testicles. Um there is risk of testicular injury or loss. And so time is of the essence. Generally speaking, if we can get to the testicle in four hours or less, we can save it. Um but after four hours the testicle doesn't begin to die in the crows. And so at 24 hours very rarely can we do anything to save the testicle in terms of fertility. There's no loss of the ability to father Children if one testicle is preserved. However, in neurology we do like to save both testicles if possible. So kind of in conclusion, if your son experiences testicular pain, please seek emergency medical evaluation either in the emergency room or with your doctor. Please don't give them anything to eat or drink. They may need surgery. Drive safely but go immediately. Exactly exactly go immediately. Um You know you said it can occur you know at any age we can they can experience any type of discomfort or pain at any age. Um And to always get that checked out. You know our experiences um were relatively young. Um And we knew nothing about testicular torsion in any way shape or form. Um We my son presented with pain in his leg. He kept saying he had pain in his upper like like thigh. Um And nothing was nothing was wrong. Nothing looked wrong. And within a couple hours we were at the pediatrician's office and she took a look and said I need you to go to the hospital right now I need you to tell them it could be towards him, I need you to tell them that immediately, they will take him in. It could be an emergency surgery. Um And you know whenever they have something like that they do take you in right away they do take a look in our case the ultrasound, everything was okay. We were dealing with an appendage issue. Um Now my question with appendage is you said there were there were appendages is it when you have it on one side and you've had it on the other side is it can you still have another appendage twist, you could, it depends on how many appendages are present. Generally speaking, we unlike um testicular torsion and the presence of the bell clapper deformity where there's an increased risk to the other testicle. Um We we don't really have that information for the testicular appendage. Um I have seen many Children have twisting of the appendage just on one side and never have any problems on the other side. And there have been a few rare cases. However, where we had what we call bilateral, bilateral portion of the testicular appendage very rarely doesn't happen at the same time. It generally in general is like your situation where it happens and then it happens again later, which can be scary. I'm sure as a mom, as a mom it can be, I mean it can happen as young as you know, five or six, you know, with with something like this. Um Yeah, we did have it twice and um it's a thing where it's very, very terrifying. But time is always of the essence and I tell anyone who has a parent is a parent of a boy, if they tell you any type of discomfort is going on in their groin or anything going on even with the leg, get it checked out. Make sure that doctors checking to make sure, you know, there's nothing going on testicular because you don't want to be caught off guard with having to rush to the hospital. Um You know, when you're just going for a routine appointment or if it's, you know, in our case, we, my son did not complain of just pain in one area. It was really just like all over it was, he really couldn't, it was it was generalized, kind of went everywhere. So it was like one of the things we're trying to figure out what it was. Um So many different things to just no go in and get seen, just go in and get seen, make sure everything's okay. Um I had a doctor literally standing in, the surgeon had come down and was standing in the ultrasound room while the ultrasound was done waiting like, okay, do we need to do this? Um And it was no, we don't. It was okay, wonderful. But let's take a look at that, make sure you see a pediatric urologist and they were able to really explain to us a little bit more about these things and I had no idea these appendages existed. You know, I was like, what? And I said, well, let's do a story on this, Let's talk about this because it's something that I feel like I wouldn't know my husband didn't know all of us, kind of, we sat there and like, okay, now we know, yes, and it's very important for all for all moms who have ways to know about the potential for testicular Georgian and luckily most of the time and younger Children, it does end up being the appendage, but there's other causes of testicular pain. There can be hernias, there can be infection or inflammation. And in all of those cases, those are all um diseases or abnormalities that need to be investigated by by their either their primary care physician or their pediatric urologist. Um so, but if you see swelling, if you see swelling and there's pain, you got to go see somebody because it could be something could be tortured, or it could be something else serious if you speak out with what is exactly. Right. Thank thank you so much. Uh dr ross for like explaining all of this stuff to us. We'll have more information, of course, on wrl dot com. For people to follow up and just, you know, make sure always take care of your health and your Children's health. Thank you. Thank you.

What is torsion?

Rex Hospital

It appears parents are eager for virtual programs to talk about puberty with their kids as Poe Center for Health Education's Girl Talk and Guy Talk sessions are filling up.


Boys Coverage

'Not just a girl thing': Family explains how teen boys struggle with eating disorder

Boy moms: The one complaint to always follow up on

What is torsion?

Poe Center lines up another virtual session to talk puberty with boys and their parents