I AM NOT A DOCTOR and I don’t play one on tv, so I put this before any surgeons who may read this blog.
A BLOCKAGE WAS found in the left ureter (see image, below). The obstruction was about one centimeter (slightly less than ½ inch) in size.
One surgeon decided he could remove the blockage via the urethra.
In the end, he failed.
He did manage a biopsy that indicted the blockage was cancerous (malignant).
Unnecessary surgery?
Since he was unable to remove the blockage, he ordered a second surgery, this time by another surgeon who had experience in “pin hole” (“robotic”) surgery. This surgeon is to remove the blockage after I undergo a few more tests.
Having paid a call on a nephrologist I was told I am to undergo an MRU; that's an MRI that focuses on the Urinary tract with aid of a dye and a catheter. The test may take up to an hour; can I lie still that long? A challenge.
The initial surgeon warned that the next surgeon will decide to remove the blockage either robotically or with a scalpel.
(As I already have a 12 inch scar from an open AAA, one more scar in area not normally exposed [by me] is of no consequence. The AAA and following hernia repair may cause the next surgeon some concern, but in this case, I have confidence the cutter will do OK.)
Since the second surgery is not in a normally exposed area (e.g., face, arms, chest) and since the surgery leaves minimal (or no) scaring, in my opinion as the patient this procedure should have been done initially.
My PCP reminded me that it is not surface scars, it is internal scaring from previous surgeries — the AAA (ibid.) and a hernia repair a year later — that may concern the surgeon and will help deteremine access type: pinhole or scapel.
If, following the surgery to remove the blockage a biopsy determines the blockage was malignant, THEN follow-up treatment (as necessary) is appropriate.
I suffered more than a week with painful and bloody urination; my family was inconvenienced, and the government (read “taxpayers”) was stuck for a hospital bill and, in my not at all humble opinion, an unnecessary surgery.
- On the bright side, the hospital is a teaching hospital so some student doctors got a chance to see a procedure.
This scrivener is not totally ignorant of medical practice. I worked in both (U.S.) military and civilian hospitals “back in the day.”
My local family practitioner, equivalent to a PCP in the U.S., is aggressive, albeit he focuses on one issue at a time.
Another opinion
My Son-In-Law’s sister works in a kidney cancer facility. According to her (as related to me), the reason the blockage was allowed to remain (vs. being removed) is because the surgeon did not know (a) if the blockage was malignant and (b) the extent of the malignancy.
Having had a skin cancer removed by a MOHS procedure — excise, check, excise some more until an excision is cancer free — I understand the concern.
BUT, the first surgeon inserted a bypass. This tells me that the entire left ureter could have been removed and replaced by a man-made ureter with no ill-effect. Had the cancer spread to kidney or bladder, then more surgery might be in order, but that would be determined by post-op tests to assure the surgeon “got it all.”
I will have to undergo the tests in any event.
Time’s Top 10
According to Time magazine — if you trust the media — I was, and am to be again, a patient in one of the “worlds top ten” hospitals.
I will gladly state that the care I got on my first session in the hospital was almost excellent. The personnel were caring and professional.
- The “almost” is because I have Type 2 diabetes and my sugar levels should have been checked after every (largely inedible) meal. They were not and, to the best of my knowledge, I received zero diabetes medications during my stay. While I “donated” what seemed to be at least a gallon of blood — 14 vials at one drawing — apparently no one thought to order an A1C test. A1C is one of the critical tests for Type 2 diabetes.
A post hospitalizaation A1C showed only a slightly elevated number, great considering I have been off diabetes medication for more than three weeks.
The hospital may indeed be “top ranked,” but as with most institutions, there always are “oops.” In this case, I give the facility a low grade for employing a surgeon who failed to recognize his limitations.
Nice enough person, but in the end, he put me through what this patient considers and unnecessary procedure.
For all that, I repeat that I am not a doctor and I never played on on tv.
Updated 16 Jun 2021
PLAGIARISM is the act of appropriating the literary composition of another, or parts or passages of his writings, or the ideas or language of the same, and passing them off as the product of one’s own mind.
Truth is an absolute defense to defamation. Defamation is a false statement of fact. If the statement was accurate, then by definition it wasn’t defamatory.
Web sites (URLs) beginning https://tinyurl.com/ are generated by the free Tiny URL utility and reduce lengthy URLs to manageable size.
No comments:
Post a Comment