Saturday, November 23, 2013

Partial Nephrectomy

In late June, I got very ill from a viral disease (that may have been mononucleosis, but the doctors still aren't sure).  In the course of my diagnosis, one of the tests revealed that I had a suspicious growth on the top of my right kidney.  Long story short: the growth was cancerous, but small and contained.  Surgery was scheduled for November 19. 
The surgery went as planned.  The surgeon was able to do the procedure robotically, which allowed him to make four very small incisions instead of one relatively large incision.  And, he was able to just remove the portion of the kidney that was diseased and to save the remainder.  There will be no need for chemo or radiation follow-up.  After the procedure, I asked the surgeon about the potential for (1) regrowth of the tumor in situ and (2) appearance of a tumor on the other kidney.  He said he wanted to review the pathology reports before giving me a definitive answer, but said that typically the odds for both are about 5%.

I was discharged from the hospital at noon on Thursday, so I was in just Tuesday (surgery day), Wednesday (one day of recovery), and Thursday (another half-day of recovery).  I had no ill effects from the surgery or the anesthesia--no nausea, very little pain.  Though I'm taking an analgesic, I think it's mostly prophylactic because I'm not really in pain; I just have a little discomfort at the incisions.

I have a drain (and a collecting bulb) exiting my abdomen.  It's draining blood and urine from the cut portion of the kidney.  The volume of fluid has declined remarkably over the last three days (like it is supposed to do).  If everything continues to go smoothly, I will have the drain removed on December 2.  The drain is probably the biggest hassle, but even that is not really much of a bother.

Actually, the worst part of the whole experience may have been my roommate, Jim.  He was 71 and had had a partial liver removal.  Tuesday night he was disoriented and confused, slept very little, and kept urinating all over the floor when he got up to use the urinal.  Every two hours or so, half the night staff invaded the room to clean up his messes.  Wednesday night, his confusion had vanished, but he still slept very little and repeatedly told the nurses that he was going to call his wife to pick him up - at 2 a.m., 3 a.m., 4 a.m, etc.  Plus, he and his wife (who was in the room from 9 a.m. until 8 p.m.) liked to watch TV with the volume up loud.  Actually, they were pleasant people and they said that it was nice for Jim to have a "quiet, understanding" roommate, but needless to say, I didn't do much reading - or sleeping.  I was nice to get back to my own bed.

Mononucleosis very well may have saved my life!

Saturday, November 16, 2013

Autumn's Last Hurrah

Last Saturday (November 9), Kali and I circumabulated Lake Galena, a flood control and water supply reservoir in Peace Valley County Park about 15 miles north of our house.  The walk around the lake covers 6 miles, so it's a commitment of a walk, and the scenery is not inordinately interesting, so we don't do the walk very often.  But, we had to pick up a prescription for one of our cats at a specialty pharmacy near the lake, so we took advantage of the nice day to get some exercise.

Throwing sticks for a happy retreiver

Lake Galena was formed by damming the North Branch of Neshaminy Creek in the 1970's.  The lake is is very narrow, about 2 miles long, and covers about 365 acres.  The county park encompasses over 1,500 acres. 

Lake Galena was so named because of rocks in the area. Galena is another name for lead sulfide, an important ore of lead.  Lead was discovered in the area around 1860 when two people digging a post hole came across a large rock. When split open, it glistened and the diggers brought it to a blacksmith who smelted it and determined that it was indeed lead. A mine was established, which raised land prices, but enthusiasm for mining quickly waned. Towards the end of the 19th century, the metal ores were examined for both gold and silver content and were found to contain about 10-15 ounces of silver per ton of ore.  A small gold speck was also found, which was deemed rare enough a find to put it on display in the Philadelphia Mint. 

Lake Galena has been eutrophic from the time it was originally impounded.  As the lake's watershed  became urbanized, farm field pollution was replaced by runoff from suburbia, with the same net effect on the lake. In addition, fecal coliform concentrations have always exceeded Pennsylvania water quality standards due to both human and animal wastes, preventing any use for contact recreation and rendering useless the bathing beaches originally included in the lake design. 
The legions of Canada geese don't help, either

Canada geese circling for a water landing

There is a lot of interest  in improving water quality since the lake serves as a significant source of drinking water in the area. Water is purified in a treatment plant about 2 miles downstream.  In order to ensure that enough water remains in the reservoir,  water is actually pumped from the cleaner Delaware River (about 15 miles away) into the headwaters of the North Branch of the Neshaminy Creek, which then flows to Lake Galena. When the pumping station was built in the 1980's (to supply drinking water and to provide a consistent source of cooling water for a nuclear power plant) it was very controversial and many people fought it, using the slogan "Dump The Pump." In the end it seems that any negative consequences of the pump were inconsequential.
The trail around the lake crosses the earthen-fill dam
Wooly bear caterpillar
The asphalt trail across the dam sported scores of wooly bear caterpillars, the larvae of a tiger moth (probably Isia isabella).  Folk wisdom suggests that it is possible to forecast the severity of the upcoming winter by comparing the dark and orange strips on the caterpillars, but anecdotal observation by Kali and me revealed that such prognostication is ridiculous because the variation in striping is very high.  The caterpillars were probably enjoying some of the last warmth of the autumn and looking for a place to safely overwinter.  Unfortunately, many had fallen victim to careless recreationists.

Long view (eastward) down the lake

Norway maple (Acer platanoides)
Many of the trees around the lake had lost their leaves, but the woodlands were ablaze in places with the yellow candles of Norway maples, an invasive species that holds its leaves longer than most of the other trees in the area.  They're easy to pick out in late autumn.
For the last week, I've had a lone hen turkey coming to my bird feeder accompanied by a single poult.  Based on its size, the poult probably hatched in August (rather than the more typical late May-early June).  I hope it makes it through the winter; I've been putting out extra seed for mother and offspring - and rooting for them both!
On Tuesday, November 19, I'm going in for some surgery, so I won't be posting (or commenting) for a while for those of my followers who check me out regularly.  I'll provide more details when I'm up to snuff again.

Tuesday, November 12, 2013

Frosty November Morn

I awoke on Saturday morning (November 9) to beautifully frosted native grasslands adjacent to my house.  I did my best to capture the crispness before the rapidly rising sun dispelled the magic.

Weedy, non-native foxtail (Setaria spp.) in front of tawny Indian-grass (Sorghastrum nutans)
Rimed thistle rosette and oak leaf

Monday, November 4, 2013

Autumn...At Last!

I was in a bad mood most of the weekend, which was a shame because "autumn" had finally arrived and I wasn't in much of a mood to appreciate it.  I'm having big personnel problems at work, I've got to complete a major grant application in the next two weeks for a project that my heart's not in, I've got to deal with a proposed capital project that once was my "darling" but has transmogrified into a monster, and I'm scheduled for surgery in two weeks.  Plus, Kali wants to re-upholster two living room couches and we don't agree on new fabric.  We spent most of Saturday looking at upholstery fabric in stores on "Fabric Row" in central Philadelphia, which consumed most of that day.  On Sunday morning, I proposed to Kali that we hike at a state park about 1-1/4 hours away that we haven't visited in several years; she said that she didn't want to drive that far (that was a legitimate and understandable response), but when I pressed her for what she would rather do instead, she gave me her standard answer: "I don't know."  That reply drives me crazy, so I just went out into the back yard to rake leaves until she decided what she wanted to do.  About an hour later, she proposed that we walk a long route in "my" preserve, to which I agreed.  After lunch, we walked about four miles on trails that we don't frequent regularly; most of the walk was in silence, though, because I was still seething.  I don't know how Kali puts up with me.
A glowing candle in an otherwise dark wood
This sycamore along the creek had lost most of its upper leaves, but I liked the contrast in tones
Wineberry (Rubus phoenocolasius) backlit

Sweetgums ablaze on the floodplain