The aftermath of meeting the Urologist!

Where do I start? He did not introduce himself, but I had found him on the Dalahousie website, and there was a photo fo him, so I knew what he looked like.  He assumed that the people in front of him were the ones related to the paperwork – I presume.  He said he was going to check the scans, and I asked if I could come too, that I needed it to be real, confirmed, and he said he would bring them back to show me.  My Right Kidney is small, and the tumor is almost bigger than the rest of it, and he said if you had to choose this would be the one to remove. The left kidney is picture perfect, just like in all the anatomy pictures, and large in comparison. He was very short shrift, it’s a tumor, it’s got to come out, we will do it laprascopically, and then you can get on with life.

I pretty much forgot my list of questions.. Doh! I did ask if it was Cancer - he said there was very little doubt. I asked about the mark on the liver, he circled the word ‘hemangioma’.. I asked would he be checking, and he said no not at this time. I asked was it likely to be related – he said highly unlikely. He said the regular scans will pick up on it if it is something to be concerned about. He actually asked did I want bad news.. he said I was among the 95% that have the kidney out and that is the end of it.  But it was like pulling teeth, the whole process. I asked did I need to see the Oncologist, and he said ‘what so that they can tell you it has to come out too’.   I asked how long it was likely to have been there, and he said they normally grow about 1cm a year, so possibly 4 years, which is while we were still in France. I asked what would I need to do afterwards in terms of meds, and he said I wouldn’t need any. He does want me to have a chest X-ray so he can see the to half of the lungs, and I will go get that done on Monday.

He said he wanted me in for the op in a few weeks time, and then I asked will I be able to go to Toronto for Thanksgiving, and he was nodding no.. so then I said my sister asked if you can do this after, and he said yes of course, enjoy Thanksgiving and we will see you straight after. Then I was worried and kept asking was he sure, and he said positive, a few weeks will make no difference.

So one of his specialties is laprascopic surgery, and he said he would only do radical if they couldn’t get a kidney out, or if they nicked a vein and needed to stop the bleeding.  I asked how long I would stay in, and if he can do it this way a couple of days, and the recovery time is ‘not long’.. so I do not know what that means.. ‘not long’.

Jerry was touching my arm for us to leave the room, the Dr was stood up ready to leave the room.. and I wasn’t done yet.. and my list of questions was still there, but leave we did.  After I was cross for the next hour of the journey home, because I didn’t get anything from him to give to Human Resources at work.  But I know I have time to get that sent to me.

So the consult was not what I expected, and guess what – I do not have oedema, I have 20 pounds of something else.. might just be age catching up with me. He did make a joke that maybe I would lose 20 pounds when he removed the kidney.  At least now I have a focus for the next month, a diet, haven’t needed one of them in about 7 years if not longer. So all this complaining about oedema to my GP, and the heart specialist got me to this guy, who agrees with the others, you do not have oedema –  but the complaining found this, so one has to be grateful for that.

Posted under Gemma A S.

2 Comments so far

  1. mary giannini September 22, 2008 1:59 am

    RED ALERT!!! RED ALERT!!!

    Have another opinion on the liver “hemangioma” found on your scan. My brother also had that and 5 months after his radical nephrectomy was found to have multiple liver, lung and lymph mets. Have them remove the spot on the liver during your surgery. He will have to bring in a specialized general surgeon to assist.

    I am concerned with urology surgeons. I think they have a blind spot when it comes to the fact that they won’t be the sole cure with the surgery. Go to a renal cell oncologist asap.

  2. Greg Lance-Watkins September 27, 2008 1:41 am

    Hi,
    I question whether Mary Giannini is making the most responsible of comments – no attempt to establish further details, no consideration of track record to date, yes there is always a possibility of mets with RCC but that Gemma’s Doctor & Surgeon have defined the tumour as confined and agreed the liver ‘spot’ is in fact a ‘hemangioma’ lets go with that.

    The surgeon does not feel a need to palpate the liver. Yes RCC is ALWAYS fraught but I consider your comment and obvious hysteria to be little more than an hysterical knee jerk reaction. Mary your brother may well have had multiple mets at the time of his op – you have not made it clear that his hemangioma was misdiagnosed was/is it still an hemangioma?

    I submit there are better ways to pass on a warning based on your personal experience based on information your brother may or may not have communicated to you.

    Please consider the consequences of such an interjection – consider the status and options of the patient – consider the calibre of medicine they may or may not be receiving.

    Mary – what would be your reaction if I wrote to you and said ‘Oh your brother had a dud doctor who obviously hadn’t a clue and he would be fit and well if he had had a good doctor but move on if your brother isn’t dead yet he soon will be, by the way have you seen ‘The Kite Flyer’ it is a good film and will give you something to do’.

    Yeah I forgot to think of how you might feel getting such a message!

    It may interest you to know that it had already been discussed whether it would be a good idea to have an open nephrectomy to investigate – the consultants opinion was that he was sufficiently certain of his Dx. to go for laparoscopic and be aware of the potential problem and keep an eye on it.

    Sorry to be rather harsh but I consider your remark to have been needlessly irresponsible.

    Regards,
    Greg L-W.

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