I have decided that someone somewhere doesn't want my life to be straightforward. I went to my local hospital today to have a uteric stent removed and replaced - normally a simple and routine procedure. Afraid not here. I don't do simple or routine.
The stent was put in because the residue of my original bowel tumour was thought to be restricting kidney function and the free flow of urine to my bladder. These things have to be changed at around six monthly intervals as they can "fur up" and cause more problems than they are meant to prevent. It's not an open surgical procedure but it is not the most appealing one either as there's only one way in. However it's done under general anaesthetic so at least the eye watering is saved until later!
It seems that the original stent came out without a problem, but try as he might the surgeon couldn't get a new one in place. The link between my kidney and bladder is not diseased, but it proved to be too narrow to re-stent. So an alternative procedure has to be considered, and it appears that the only one suitable is something called a nephrostomy.
If urine cannot drain from the kidney pressure would rise within the urinary system and the kidney would be damaged, so some other outlet needs to be found, or rather needs to be created. This is where a nephrostomy comes into play. It is created by inserting through the skin on the back a catheter which then rests in the kidney itself. It is performed under ultrasound guidance, CT fluoroscopy or image intensifier, using a local anaesthetic to numb the area where the drain would pass through to the kidney. Urine is then collected in an external bag which can be emptied as often as necessary, in a similar way to the more common urinary catheterisation.
There was talk of delaying my next week's chemo and carrying out this procedure sooner rather than later as a precaution. However the surgeon took into account my concerns about the prospect of yet another delay to my already badly interrupted treatment regime and decided to play wait and see. It may be that my left kidney will function normally without the stent, but there's no telling for how long. It could last out for only days, weeks or even months.
More antibiotics to make sure today's procedure doesn't cause any infection, and I have to go back tomorrow for some blood tests to check kidney function after when the aftermath of today has settled down a bit. I'd better pack a bag just in case! In the meatime I have a list os symptoms to watch for, with instrctions to take myself off to hospital if they manifest themselves.
So, it's the possibility of yet another procedure and the highly likely conclusion that eventually the well establish ileostomy pouch on my right side will be balanced out with a smaller cousin by way of a catheter bag on my left. Suppose they'll have plenty of time to get to know each other, and at least a bag on each side will balance me out, stop me being lopsided and prevent me walking round in circles!
UPDATE - Wed 28th. Today's blood test indicate kidney coping without stent but have to recheck on Friday. Doc still talking about doing the nephrostomy anyway as he's certain it's got to be done sometime.
Update - Fri 30th. Good kidney function is essential to dealing with chemo drugs.Today's tests indicate kidney fuction still OK so next week's chemo given the go ahead. Oncologist and urologist have consulted and it looks as if they might leave nephrostomy until essential so long as kidneys coping with things. It seems that my right kidney will most likely take on extra work to compensate if the other slows down a bit.
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