Sometimes doctors talk like Popeye; they have a normal voice that they use to describe your condition, etc. But they sometimes use a voice that's kind of under their breath for little parenthetical bits of information (alternatives to treatment, possible side effects, consequences...) You must pay very close attention and listen to both voices (to know whether Popeye really expects to be repaid next Tuesday for a hamburger today.)
Results of Renal Scan:
Split function is 81% Right kidney and only 19% left kidney. This indicates a poorly functioning (or non-functioning) left kidney.
My urologist/surgeon says this is probably due to blockage where ureter is attached to the neo-bladder. Probably a side effect of the surgery since function was normal before surgery and reduced after. This is commonly caused by scar tissue forming around the area where the ureter was stitched onto the neo-bladder but he is surprised that this blockage hasn't caused me more discomfort and, was his primary reason for discounting it prior to now. He said that this usually causes severe back pain similar to the pain and cramping caused by kidney stones. I have had no pain above some mild aches that could be attributed to stiffness in my back muscles.
Urologist/surgeon gives two options:
1. We do nothing and wait and see. Continued blockage will probably cause left kidney to shut down completely and 'go away'. This would be okay (people typically do very well with just one kidney) except that neo-bladder may put too much stress on one remaining kidney and may need to be removed to save the right kidney.
2. Schedule radiology surgery to place a stint in through back and down through left kidney and ureter and then into neo-bladder. During this procedure they would insert a balloon-like device into the area where the blockage is and inflate this to break up any scar tissue. The Stent is then left in place for 4-6 weeks to maintain the passageway while the connection re-heals. Stint should have no effect on my activities.
Up until now it seems that a Creatinine count of 1.7 was a 'concern' but not serious. Now he said it indicates only one kidney is active. Again, the lack of pain normally associated with this sort of problem with the kidney complicated this diagnosis.
Of course I chose #2. I asked; "Why wouldn't I?" He couldn't give me any reason not to. So he started the process of scheduling a radiologist to perform the surgery. It would be the same drill as a colonoscopy (without the yucky drink): a local anesthetic and an IV for pain medication - up and out the same day. No biggie, except for the tube hanging out my back but that shouldn't be a problem.The procedure is called a uritic stent with a nephrostomy [more information on this procedure]
They will be inserting an 'antigrade stent' which goes in through the nephrostomy tube - in my back - which is then capped off until the stent is removed.
It's all a surprise to me too:
I have been feeling great - up until now - and I'm just getting used to using this new NEO-BLADDER. Now, for the first time, I am told that I MIGHT have to give it up? This is sobering news. I have become rather attached to this thing and even though it can still be a problem, I would really hate to lose it. And I would really hate to be forced to get a bag after all this!! I don't believe this and I have complete confidence that once the plug is removed my left kidney will recover completely.