Wednesday, June 8, 2011

Can you say Nephrostomy?

Minor surgery to remove blockage in uriter going into neo-bladder that may be causing left kidney to swell and begine to lose function. This is done by placing a nephrostomy in my back, inserting a small baloon and using this to break up the scar tissue in my uriter (like an angioplast? ) A stent is then placed from my kidney into the neo-bladder to hold the uriter open. the nephrostomy tube is left coming out of my back but it's capped off and non-functional. 

May 11, 2011 I had above procedure. I was barely put under in the Radiology Operating Room at St. Mary's Hospital. I didn't feel a thing and remember kind of being there but not so much until they said it was all over and time to get up. It's the same sedatives they use for colonoscopy (Fentanyl and Versed). Good stuff. The surgeon said everything went fine. There was almost no flow when he first looked. He 'blew out' the scar tissue blockage and now there is great flow from that kidney. The kidney stent has been placed and a small tube remains in my back. The nurse gave me some extra dressing and it was back to the room to get dressed and leave.

Back to work.
I was scheduled to umpire that night but it was rained out. I was thankful for that as I was still pretty sore. I did umpire the next night and it went fine. I worked the plate so I wouldn't have to run too much. Running seemed to agrivate the nephrostomy - bouncing up and down. I had the weekend off but was back at it every night the next week.

Pain and ...
The first weekend after surgery the Nephrostomy was causing quite a bit of pain. Of course I wasn't taking it easy but they said I could resume normal activities. I called the doctor on Saturday (nurses on call) and they assured me that what I was feeling was normal reaction to having this thing in my body. Like a sliver it agrivates the skin.

The following Tuesday we went to urgent care because when we changed the dressing it seemed like an awful lot of green puss. The doctor said this was probably normal but took a culture to make sure there wasn't something dangerous in the mix of normal skin bacteria. The culture came back normal.

Friday night I came home from my ball game, ate dinner, and noticed that my shirt was wet in back. I looked at my hand and it was full of blood. My wife but a big hunk of gauze and we headed for the ER. The doctor called in a Urologist who took a look at it and put her finger on it - HARD!! She applied pressure for about a minute and the bleeding stopped. She decided to place one stitch to insure it didn't open again. I was thankful for this since I had a double header the next day. She said the blood vessels in the skin can bleed profusely and I must have done something to break this one. I did umpire on the bases that evening which caused me to run a lot - but I didn't feel any pain other than the normal soreness from jostling the tube. 

Follow up with Urologist.
Blood tests showed my numbers are improving slightly. My chlorine is a little high and my CO2 is a little low which may mean a slight acidosis (not uncommon to Neo-bladder). Not worried yet.

He showed us the images from the installation of the stent showing how it had opened up the tubes (with a balloon) and how the die began to flow into the bladder.

He want's to leave stent in for 4-6 weeks to insure the healing doesn't re-close the tube - callous doesn't reform.

Removing the stent.
Back to the Radiology O. R. but this time just a quick check with injected dye - pulling the stent - injecting more dye - pull the nephrostomy tube. All this with no anesthetic and no pain!!
Surgeon said dye is flowing like gangbusters. They just put on a little dressing to cover the wound and send me on my way.