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!


robin andrea said...

So glad to read that the surgery went well and that you are home and recovering. Hospitals are very strange places. Too much light and noise.

I had mononucleosis when I was 15. I was home from school for six weeks. The school system sent teachers to my house (Monday was english class, Tuesday was math, etc). Is mono sometimes called Epstein-Barr? I'm never sure.

1st Man said...

Wow! So sorry you went through all that but glad you did (if that makes sense, ha). I don't always comment but I always read your posts and I needed to say best wishes. Sending good energy your direction!!! :-)

packrat said...

I'm glad the surgery went well, Scott, that you're on the road to recovery, and that the prognosis looks good. Life is pretty scary at times, but your attitude is excellent; and you've maintained your sense of humor. Best wishes for a continued speedy recovery.

Mark P and Leah P said...

I'm sorry to hear that, but at least it was found early. It's scary to hear "cancer." Leah had just been operated on for colon cancer and was still getting chemo and radiation therapy when we were dating. Sometimes she didn't feel like eating, but she soldiered on. The good news in her case, as I hope it will be in yours, is that the longer she goes without a recurrence, the lower the probability that it will come back. It's been about 14 years for Leah. Since you had no symptoms I would expect yours to have been an early stage. The fact that no further therapy was recommended is also encouraging.

All in all, I think things sound reasonably good. Of course that's easy for me to say, sitting here in all my ignorance, but I hope your worry level is not too high.

Gail said...

OH SCOTT, what a courageous story of challenge, and hope, positive attitude and promise of better days. I am overwhelmed. I will send prayers and all good thoughts.
Love Gail

Scott said...

Robin Andrea: Thanks for your good wishes. My gastroenterologist tested me specifically for Epstein-Barr and said that the test came back negative (as did all the other "disease specific" tests that he ordered). His fallback was, "Scott, you probably had something like mononucleosis.", but I don't think he tested for that disease specifically.

Scott said...

1st Man: I must be feeling the good energy you're sending my way 'cause I feel pretty good right now. Keep it coming! And, yes, I agree that I went through "all that," and that it was a good thing!

Scott said...

Packrat: My brother, a general surgeon, called to ask me how I was doing yesterday (Sunday). He said that my attitude and account of the evenings with Jim, my hospital roommate, indicted that I had maintained my level of good humor and was obviously on the road to recovery. Thanks for your good wishes--now, go out and play in the snow with Becca!

Scott said...

Right now, Mark and Leah, my worry-o-meter is set very low. The needle may move when I talk with my surgeon after he's had a chance to look over the pathology of the tumor; let's keep our fingers crossed.

I'm glad Leah's had no recurrence for a long time now; who'd take care of the cats? My hospital roommate Jim had had a melanoma on his shoulder in 2007, then had metastases show up on his lung, large intestine, and now his lover at about 2-year intervals. When I told my surgeon brother this, my brother (in his typical, inimitable style) blurted out, "He's toast!" Nice goin', bro. I hope you have better bedside manner with your patients.

Scott said...

Gail: Given all your trials and tribulations, I know that your wishes and concerns are genuine and heartfelt; thank you. I'll keep everyone posted, but my health is not going to become the theme of this blog--unless I can't get outside any more :) !

Grizz………… said...

Scott…Please forgive me for being so very late in voicing my heartfelt concern and wishing you well and the speediest recovery. These last couple of months have been very hectic and trying around here, for a number of reasons—hence my own dearth of blog posts. I didn't read of your surgery and health issues until this morning.

From what I know of these things, you are very fortunate. Finding that cancerous growth of your kidney so early on was a real blessing…one which not only made the whole issue easier and more manageable, but may have saved your life.

My best friend Frank had a similar deal—while being x-rayed for a back injury during a Florida vacation, a growth on his kidney showed up. The surgeon there sent the suspect pix off to a specialist he knew in Columbus, and when Frank got back home, they did additional tests, quickly got him in for surgery, ended up removing the entire kidney (which was cancerous) and followed him closely for several years. Though Frank was in his late-60s at the time, he recovered quickly and never had another problem throughout the final twenty years of his life. But his doctors all said they same thing…you fared so well because you caught it early, before becoming symptomatic or metastatic issues developed.

So as scary as I know this has been—and will likely continue to be, to a diminishing lesser degree for some time to come—this is a really good thing; a situational best option. I'm confident your outcome will be favorable…that the worst is already over.

Such experiences can help but be—to a degree, anyway—life changing. If nothing else, they cause you to reflect on priorities, to realize what really matters, what's important to you, the person, the individual. None of us can live in the past or the future; only the here-and-now. Life takes place in the moment. Love matters. Family matters. Friends matter. Your "calling" matters—whether it's what you do for a living or what you do in your precious spare time. Feeding your heart and soul and spirit matters. A day is not something to be "gotten through," wasted, but to be savored, enjoyed, used to its fullest.

I expect you know this already. So just use this experience, this trial, to re-energize your joy in art and nature and life. Know, too, that I appreciate your friendship, and that you will be in my thoughts and prayers. And again, I'm so sorry to be late in writing you. Best, as always.

Scott said...

Grizz: Thank you--a lot--for your heartfelt good wishes. I couldn't have agreed with you more--you're very wise.

I had my post-surgery follow-up visit yesterday morning (Thursday, 12/5). My surgeon (and his surgical colleagues) were all at a conference in Baltimore, so I only saw a Physician's Assistant (PA). The PA said that everything looked good, that my surgeon would telephone me next week to discuss the pathology of the tumor, and that I didn't need to come back for 6 months (and that the 6-month visit would be routine). Great news!

The PA did remove the drain from my belly--which was my main reason for wanting to go to see the doctor. During surgery, the surgeon inserted a device to drain out fluids (i.e., urine and blood) from the cut end of my kidney until the kidney had a chance to heal itself. So, I had this "aquarium air hose" coming out of my belly attached to a suction bulb that was sucking maroon-colored fluids from my insides. It wasn't painful, but it certainly was bothersome, and the skin at the point at which the tube exited my belly was becoming more tender and irritated every day, so I wanted that sucker out! Well, little did I realize (which was probably a good thing), that there was a very long and very wide soft, porous plastic filter residing within my insides attached to the other end of the aquarium hose. Removing the aquarium hose portion of the drain was no big deal because my abdominal body wall had gotten used to the thin tube that had been piercing my belly for the last two weeks, but when the PA had withdrawn that thin part of the drain and then got to the long, thick part, he said "We're almost done!" and I said, "Good, 'cause it's really starting to hurt!" (What an understatement!)

After the procedure was over, the PA asked, "Do want to see the drain?" and I said, "Sure." When I looked at what had come out of me through the tiny hole in my belly, I blurted, "Holy shit!"

The procedure, while unpleasant, must have been even more taxing than I realized because I was "in a bad way" by the time I went to bed last night. I probably should have taken the day off work and just gone to bed after I returned from the doctors' office, but I'm stubborn(and then I pay for my mule-headedness).

The hole in my belly should close up on its own over a period of two days. Now, I just have to take it easy for another two weeks or so.

Grizz………… said...

I'm so very glad to hear that everyone is going well, plumbing issues notwithstanding. Drains are no fun, useful, but bothersome and often painful to remove. Now, you can begin putting all this behind you and get back to having fun and enjoying the last of autumn and the winter which follows.

Again, I'm so pleased you're doing well.

RB said...

Glad to hear that everything went so well.

Scott said...

Thanks for your good wishes, RB! I get stronger and the sutures get less tender each day.