Moment of silence - and then move on.

 One kidney has shut down. The other is holding it's own.

I met with my Urologist to discuss the results of the renal scan and the nephrostomy 'treatment'. He removed the tube and the bag. I asked my questions. He answered. 

To me, it seemed like a long time to carry around this nephrostomy bag that wasn't really collecting anything. The tape that was holding it to my back was peeling off - even the reinforcements that I'd added were getting weak - and I was getting a rash. So it was a great relief to get the tube taken out - but then again, not so much. My Urologist explained that he wanted to give the kidney the best chance to improve it's function by removing any restriction to drain off produced urine.  This back pressure - if there was any - could have been caused by either an obstruction (return of scar tissue blockage) in the ureter or by the "normal" functioning of the neo-bladder.

According to the renal scan my right kidney is now functioning at about 9%. Two years ago it was 19%. With this small a production this kidney may be more prone to infection building inside. So as we go forward, I should note any unexplained fever and/or back pain. Again, this kidney is not hurting anything by staying where it is but if it starts causing problems it should come out. This is a laproscopic procedure and not much fuss.

I pick up on words and reactions (body language) from technicians, nurses, and doctors. Perhaps too many. Too sensitive. A "Good luck." or a "Is that all all we're doing? (like "aren't we going to do more?"). I don't know.

I guess I've accepted the loss of this left kidney. So I turn the conversation to the remaining kidney. "The elevated creatinine means that one is not working right either, is it?"

"Creatinine is little high but that isn't the most important measure. The electrolytes [he recited a couple other tests that had been a little high and are now back withing range] and acidity are more important. This is what requires dialysis. Your levels are fine on those tests."

I talked about some difficulty in peeing at night - before bed or when I wake up. "Sometimes it takes a lot of work - and pressure - when I know there is more to come."

"Is it all the time?"

"No, every now and then."

"Some patients learn to self-cath."

 That shuts me up. "No, not that often."

I reminded him; "You said neo-bladders, by their nature, are hard on kidneys. Should we be talking about getting rid of the neo-bladder? Like putting in a port and start using a bag?"

"Oh, I wouldn't do that. I'd just do a [foley] catheter at this point. No need to make another port. And the remaining kidney is doing fine. We're a long way from that conversation."

He said he'd put in orders for blood work every month and have ultrasounds every [three months?] to watch this right kidney. Maybe my concern for my "remaining" kidney's welfare has made him a little little more concerned as well. Justifiably so??? Do doctors get so focused on this organ or the other that they loose the big picture - like life and death. I don't believe that for a minute but it's still good to talk and share feelings and fears.

We're a team here.

Before I go I want to say that I don't mean to make out my doctor to be uncaring or insensitive. Quite the opposite. He is very attentive to my concerns and questions. He is a vary positive person. Very up-beat and every meeting leaves both me and my wife feeling satisfied and encouraged. He is a very nice person. He has an excellent 'bedside manner'.

And I feel fine. My wife says; "You feel fine." (Implication is; "Stop whining.") Okay.