There’s no place like home!

My last entry was Tuesday 10/21/2014. We had made the momentous decision to wait a while longer for the bleed to stop and not institute more invasive procedures. It was the right decision. By 10:00 PM Tuesday my urine was running clear.

Needless to say by 6:00 AM Wednesday I’m ready to get out of this torture chamber. I let that be known to the nurse and of course he cannot do anything without orders. Orders only come from doctors who don’t make rounds or do anything before 9:00 AM. Again Shawn does his thing and gets in direct contact with Dr. Braun and gets permission to remove the catheter and begin the discharge process.

Removal of the ‘garden hose’ was quick. The most painful part was the 3 inch square sticky patch on my inner thigh. I now have a bald spot in that location. Having this ‘garden hose’ in place for this length of time causes the bladder to forget what it is supposed to do. So the next milestone that has to be passed is that I must urinate on my own before I can go home.

That’s great I get a big breakfast with lots of liquids and figure I’ll be out of here before lunch. Wrong again! I do manage to urinate but after urination they want to do an ultrasound on my bladder to check how much I retain vs. what I expelled. Guess what, they can’t get  a good reading because the battery is dead on the ultrasound machine. So I agree to a second try a little later. (I contemplate sending out a prayer request for pee.) Bring me more fluids I’m going to get this job done. I drink myself full and the IV keeps running. I manage a second unremarkable pee. The ultrasound works this time but I’m told I can’t leave because I’m still retaining too much. So again they want me to wait in the hospital for my body to relearn how to function. It can do that at home as far as I’m concerned.

Nurse Shawn again directly contacts Dr. Braun who OKs my discharge. Nothing happens fast in a hospital. I end up having lunch there and we head home by 1:00 PM Wednesday.

Here we are more than 24 hours later on Thursday. I’ve had a great breakfast and lunch at home. I’ve enjoyed my recliner, bed, cat, TV, fellowship with friends and lack of interruptions. Except for a few potty calls I had a good nights sleep in a comfortable bed. As expected my plumbing systems are returning to normal albeit with a bit of reluctance. The “need for potty” warning system is on a very short fuse. Hopefully that will improve.

I have not had any pain meds since Monday. I still have a fair amount of abdominal soreness from the surgery and I’m basically just a bit worn down by the whole process. ( I did do one pill at 3:00PM I got tired of being the tough guy.) I have lost 5 pounds since the beginning of this ordeal. Which is OK with me. I’ve been trying to lose weight the past few months anyway. I have every confidence that in a few weeks I’ll be my old self and this life adventure will be all but forgotten except for the bills that already have begun to arrive. A new blog on this will probably follow.

There has been a lot of speculation as to why after being 5 days post surgery did I get this sudden bleed. The consensus seems to be that I resumed two of my normal meds two soon after surgery. When they sent me home on Thursday the discharge papers said resume normal meds. I had been taking 81mg aspirin and Saw Palmetto (both of which are blood thinners). So three doses of both of these drugs were apparently enough to break loose the healing scab/clot and start this whole mess. It only took another 3 days for the thinning to wear off and for the wound to heal again. Needless to say I’ll not be restarting either of these for several weeks if not months. The devil is in the details.

Why God sent me down this path I’ll probably never know. I do know that I have controlled my overall attitude and frustration through this encounter with the medical community better than I have in past encounters. Either they are getting better with interfacing with me or I’m becoming more tolerant and understanding of the system.

Every doctor, nurse, aide or assistant has a different level of expertise, personality, risk tolerance level, willingness to think outside the box, etc. This was greatly illustrated with a couple of the decisions that needed to be made in my treatment. What I know is that in order to get the treatment that you want and deserve you need to take an active part in the decision making process. Ask questions, say no, change doctors, do whatever is needed to be comfortable with what they are doing to you.

My cynical side believes that there is a considerable number procedures, tests and protocols that are done just to add to the bottom line of the hospital or doctor’s balance sheet. In addition many of these things are done just to keep the lawyers happy. For instance I asked my kidney doctor if I could get the video CD of my procedure. He was in agreement that that could be done but wasn’t sure that he would be allowed to do it because of liability. I am a strong believer in the rule of law but we are in extreme need of Tort reform in this country!

Another small but extremely annoying thing is why does every one that touches you look at your wrist band and ask you your name and DOB every time they come into the room to check your vitals or do something??? I was that person when they put the band on me. Why or how would I change the band. Why would I want to change the band? Makes absolutely no sense to me what the purpose of this inane procedure is. But its got to be done. It’s the rule. How stupid can intelligent people be?

This is likely to be my last post on this subject so I just want to give all the praise to God for the marvelous machine he has given us to live in. I also want to praise the skill and patience of each of the Doctors, Nurses, Assistants, etc. etc. that make our modern medical community work. They have a special gene that allows them to minister to old grouches like me and keep smiling. I could not be paid enough to pursue a caregiver profession. It’s not in my genes. When we need them I’m very glad they are there. Nevertheless I know where their skill comes from and my ultimate faith for my well being lies with my creator and God Jesus Christ.

Thank you all for being my friends and caring enough to read through all of this blather, pray for me and send your thoughts and good wishes. They do make a difference. Also getting this off my chest helps even if no one reads it.

I went home Thursday afternoon in good spirits and apparent good health. I relaxed and recovered all day Friday with normal urinary and bowl functions returning. I eat and enjoy solid food and think I’m moving a little slow but this is not so bad. I’ll be good as new in a week or two.

Saturday I go to my woodturning club meeting and bum around with the guys sitting, standing and walking from 9 till 3. I do fine with a pizza lunch and a great vegetable soup dinner at home. All systems seem to be functioning normally.

Sunday I go to a woodturning class where 7 of us work one-on-one with the instructor from the Saturday meeting. Another great day of low stress activity, a great Fire House Sub lunch and veg soup for dinner at home. I’m feeling really good and have begun tapering off on the pain meds.

Then it happens! I go to the bathroom after dinner and fill the bowl with blood. All prior urinations had been normal. Then the next time I try to go I can’t pee at all. Cold sweat, nausea, Something isn’t right. JoEllen and Hannah call 911 and I take a bumpy ride to the hospital in the EMT van. That was Sunday evening at ~9:00 PM. It is now Tuesday noon and I’m still here.

The assumption is that a scab in the kidney incision has come off and entered the bladder and blocked the flow of urine. The first thing they do is insert a Three Way catheter about the size of a fire hose. Not fun but not as bad as I thought it might be. Getting past the prostate was the most ‘interesting’. They hook this up to pairs of 3 liter bags of sterile fluid and stat flushing the bladder of blood and blood clots. I think they have run 5 or 6 bags full through me at this time.

Sometime on Monday they turned off the flush and just let the catheter drain on its own and evaluate the amount of blood in the urine. Now the frustrating part. Even though I have a primary kidney doctor (whom I like very much) he is only at this hospital 2 or 3 days a week. As a result other doctors from his Urology Group come through to see me as well as the hospital doctor. They all have a different opinion about what they see coming down the catheter pipe. Is it clearing up? Is it too red? Are there more clots? Should we turn on the flush again. Should the catheter come out? Should the catheter stay in?

The bedside manner of this retinue of doctors varies from excellent to less than none. I don’t think these doctors have a clue as to how frustrating this difference of opinion is to a guy like me. I want facts and figures, whys and wherefores, risk vs. benefit. What are my options? Why would I chose one option over another? What is the downside of waiting? etc. etc. etc. The only doctor that is willing to talk to me on those terms is my primary kidney doctor (Dr. Braun) and he’s not here.

My blood count dropped overnight so the thinking took a turn to, we need to do an angiogram catheterization to find and plug this leaky vessel. So in prep for that they took me off of solid food again till that decision is made. When I ask about this angiogram procedure they can’t tell me the process or the risks but they think I need it. Not on your life till I know more!

My very helpful nurse Shawn takes up my concern and manages to get a call through to Dr. Braun who in detail explains the procedure and the risks. We together decide to wait a while longer to let the body heal itself before starting a new invasive procedure.

The issue is that I’m leaking blood from somewhere in the kidney. If it doesn’t stop I will need a blood transfusion. There is some risk in a transfusion but not extreme as far as I know. If I have the angiogram procedure they may or may not correctly identify the leak and plug it. There is a possibility that the plug partially or completely shuts down the kidney. Hey folks loss of this kidney is what we have been trying to avoid from day one. So Dr. Braun and I decide that waiting a while longer with the downside risk of a blood transfusion is not a bad course to take. The upside is that if the bleeding stops on its own we avoid another risky procedure.

I’ve got a lot of faith in modern medicine and science. But when things start to get iffy and there is a lot of speculation and little or no concrete evidence then I’m more inclined to rely on my God and the abilities that He has built into this complicated, fragile box we live in. So at this juncture we are waiting another day to see if my old body can’t stop bleeding on its own. If it doesn’t then I guess we go in tomorrow with the zappers to plug the leak. Either way your prayers are appreciated.

More to come I’m sure.

My last post was Tuesday. Here it is Thursday already and I’m sure most of you have been wondering what’s going on with Kratzer. So here is the story with more detail than anybody needs to know.

Wednesday was a day of waiting for that gas to pass, punching the Morphine button and flirting with the nurses. 🙂 Well it didn’t pass on Wednesday so Thursday was more of the same with no substantial nourishment. I graduated from the IV only to a clear broth, jell-0, sherbert, and of course the IV still dumping several liters of fluid into me every day. This fluid wasn’t so bad with the catheter as I didn’t have to think about urinating. The nurse just emptied the jug when needed. After they removed the catheter on Wednesday evening I was getting up to the bathroom every hour to get rid of all the fluids. In one sense the hardest part of this whole process has been the lack of sleep for one reason or another. Vital sign checks, IV equipment acting up, blood draws, housekeeping, potty breaks, walking the halls and a very noisy neighbor that had something a lot worse than mine.

By mid morning Thursday I had convinced the powers that be that as much as I like the nurses and all the attention that they were giving me I could do this waiting at home and save myself and Medicare a lot of money. I promised to not eat solid food till the gas had passed and they they started getting the required signatures to make a Thursday departure happen. As it turned out, without warning, I had the long awaited and prayed for passing of gas before they got the papers signed. So we got home around 1:30 in the afternoon.

So the most important part that you all have been waiting for. The tumor was benign! It was a golf ball sized oncocytoma. It was completely removed with very little loss of kidney tissue. We are praising the Lord. Your prayers have been effectual and I am very grateful to everyone who has in any way expressed their concern or lifted my name to the great Healer.

So I am anticipating a quick and complete recovery from this point on. I have my supply of powerful pain pills that I’m allowed 2 every 4 hours and I haven’t needed more than two ever six hours so far. I’ve got the mandatory follow-up doctors appointments but don’t anticipate any surprises. So a couple weeks of healing and back to my normal activities. I’m actually planning on going to some low stress woodturning meetings on Saturday and Sunday. So I’m having no fluids after 8:00PM tonight and going to bed at my usual 11:00PM with my trusty CPAP machine & I hope I don’t have to move for six to 8 hours.

Night, night!

Here it is Tuesday evening 7:00 PM. I woke up about noon yesterday but haven’t been up to computing till now. Seven holes and 3 hours is all it took to remove gall bladder (1 hour) and the growth on my right kidney (2 hours). No biopsy results yet so don’t know for sure if it really is cancer. Will know in a day or two.

We learn all sorts of interesting things about our body when we do something like this. First oddity is that the post-op pain is more severe in the shoulders than in the belly. Why do you get sharp pains in the shoulders when nothing was done in that area? Well, they poke the holes then inflate you abdominal cavity like a balloon with air or CO2 or something to give themselves some space to work. It seems that that air migrates up to the shoulder area and causes severe pain until it dissipates. Don’t get me wrong. The belly hurts too but it is a duller constant pain than the sharp shoulder pain that comes in waves.

Another thing is that all that mucking around with your guts gets them confused and the rhythmic contractions that usually keep your food moving in the right direction stop working. Guess what. You can’t have anything to eat till they get their rhythm back. So that is why the doc says no food till you pass gas. Gas passing is the indicator that things are moving in the right direction. Apparently there is no way to educate your intestines to move in the right direction. Everyone is different. Walking the halls with your IV pole is supposed to help. So I’m just starting my “laps” and waiting for my digestive track to relearn it’s duties. Mine must be a slow learners because I have had no sign of gas passing yet. Prior to this I’ve always been pretty well known as a gas passer. I don’t know why I can’t seem live up to my reputation now.

So, here I sit about to ask my friends to pray that my “gas passer” gets back on the job soon.

So I went to bed last night thinking I was coming down with a cold and that the surgery would probably be postponed. My head was stuffed up and getting worse. I want to get this over with and not have to do another round of pre-op appointments. Besides the longer we wait the more chance the tumor has to spread. Not a good idea.

Then it occurs to Hannah that it may be allergies. I had done some leaf blowing and rummaging around in the dusty attic. Earlier in the week I had stopped taking all medications (including my daily allergy pill) in prep for the surgery. Nevertheless I decided to take one last night. After an hour or so my head began to drain. Took another pill this morning and head is clearing but I still have a sinus headache but no temperature. Hopefully I’ll be back to normal by Monday morning and surgery time. I’m trusting that a few allergy pills are less detrimental to surgery than an stuffed up head.

Tomorrow (Sunday) will be purge day. Milk of Magnesia first thing and clear liquids only all day. Nothing to eat or drink after midnight. This should help my quest to lose a few excess pounds. Don’t think I’ll get much to eat on Monday either. After a two day fast I’ll be hungry on Wednesday! Maybe they make you purge and fast so the hospital food will taste good to you. 🙂

Surgery is scheduled for 7:30AM Monday. I have no idea how long it will take two surgeons to remove a gall bladder and than a kidney tumor using robots working through multiple holes in my gut. Probably several hours. They tell me lots of little holes are better than one big one. The wonders of modern medicine.

We appreciate your continued prayers till we get through this and safely out the other side. We’ll try to keep you posted on progress. I’ll be on my computer as soon as I’m able and they let me.

I’ve had a follow-up X-ray and the blasted stone is no where in sight. Strained pee only revealed a few fine grains of sand. Don’t know where the rest of it went but the doc says all is well and we are a go for dual surgery on Oct 13.

I had a pre-op appointment with the hospital. WOW! They are serious about no germs in the OR. The night before surgery I have to shower, put clean sheets on the bed and then wipe myself down with giant disinfectant wipes per specific instructions of how many wipes to use on each part of my body. No deodorant, no hand cream, no nothing on my skin but clean sheets and clean clothes before surgery.

One more pre-op appointment this week and then all of next week is free to catch up on any physical projects before the big day. Depending on how far they have to open me up I’ll be laid low for from 3 to 12 weeks. Not looking forward to that.

The gall bladder guy says he is going first. He will poke a few holes and plug in his robot and remove gall bladder. If for some reason he needs to open me up he will do that to complete the job. No need to wake me and ask. 🙂 Then kidney guy takes over. He says even if gall bladder guy opened me up he will sew me up and poke his own holes and plug in his robot and proceed to remove the growth from my right kidney. Oh, the wonders of modern medicine.

I do hope the kidney Doc is right about my 3 centimeter growth NOT being metastatic. I’ve been doing a little research and apparently kidney cancer is very treatable by surgery as long as it hasn’t spread. If it spreads then it is not very responsive to radiation or chemo. We are hoping and praying that this puppy is small and totally confined to the kidney and can be removed and forgotten about. Otherwise the outlook isn’t that great. No cure just some experimental drugs to try.

I’m at peace with whatever the Lord has for me but naturally I wouldn’t mind another 20-30 years of being a problem to my kids. More to follow I’m sure.