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Radical Nephrectomy on 08-11-11

RobFrom1956
Posts: 13
Joined: Aug 2011

Hi all,

I am supporting a loved-one who will be having a radical nephrectomy on August 11th. Can anyone share some tips, advice, experience with me? Anything you'd like to say is fine by me. The patient is 64, male, and had colorectal cancer in 2006 - went thru operation/chemo/radiation in 2006/2007.

Don't be afraid to post any info....I'm a big boy now :)

Thanks in advance,

Rob

icemantoo's picture
icemantoo
Posts: 1568
Joined: Jan 2010

Rob,

I had my surgery (Radical Nepherectomy) on 8.1.02 at age 59 and I am doing fine now. In order to respond openly and honestly about your friend can you give us some information about his tumor; size, type, etc. so that I and others do not respond inapropriately.

Best wishes,

Icemantoo

RobFrom1956
Posts: 13
Joined: Aug 2011

Thanks for your response! OK, I will get the details of his tumor as you suggest. Are there any size "parameters"? For example, a tumor of "size X" is more likely to metastasize..?

Also, how long was your post-op hospital stay? We are expecting 4 to 6 days.

Thanks, and God Bless.

Jamie1.3cm's picture
Jamie1.3cm
Posts: 188
Joined: Jan 2011

The small tumors generally don't metastasize. What is small? I'd say 4cm or smaller. But I know several larger ones that just never metastasized. The largest one I've read about this summer was 33cm. And typically -- although I've seen exceptions -- kidney cancer is a very slow growing cancer, like colon cancer.

I'm guessing they're planning on the radical (total) nephrectomy because they want to do it laproscopically? Sometimes you can get by with a partial nephrectomy, but it usually involves a more complicated surgery. If he has his surgery done laproscopically, he'll recover more quickly with less pain. But his choice of surgery depends on the size and location of the tumor. Be sure to have the doctor give a medical reason for the type of surgery planned.

It's important to know that people live just fine on one kidney.

Be sure to have the house ready for when he returns. I recovered quickly: Had surgery on Monday. Went home on Thursday. But that was considered fast for my open surgery. But when I got home, I was certainly in no condition to change sheets any time soon, carry in cat litter, or things of that nature. Stock up. And you might want to think about a shower chair. A shower with a hand-held head is also helpful.

If he needs more pain meds, don't hesitate to ask for them. Encourage him to speak up and be honest about his pain level. There are no extra points for stoicism.

How long before he really feels like himself again depends on the type of surgery he has. I'm 8 weeks post-op, and I swam laps tonight. The first 6 weeks were pretty rough, though.

Expect a follow-up ct scan the first 6 months to a year after surgery.

RobFrom1956
Posts: 13
Joined: Aug 2011

Thanks very much Jamie1.3cm...THAT is great information. If anyone else has ANY info, please don't hesitate to tell me (the good, the bad and the ugly).

Rob

donna_lee's picture
donna_lee
Posts: 410
Joined: Feb 2009

Hi Rob-
I won't bore you with lotsa details, as I have posted a number of times under "donna_lee". I was 63 at time of first surgery, 64 at recurrence and 65 at the second recurrence.
The surgery takes it's toll on the body, as does the anesthesia. One kidney has to learn how to handle everything. Digestion has slowed down. I remember finding a noodle in my hospital broth and thinking that I was on solid food.
If Dad is on meds for BP, cholesterol, or anything else, make sure the primary care doc knows and monitors him regularly. Cut back on salt, if he hasn't already, take plenty of fluids, try to stay nourished. Liquid dietary supplements such as Ensure, Muscle Milk, or even a milkshake seemed to go down when I was getting my digestive processes back.
Mild exercise-walking, getting out of a chair, personal hygiene tasks, going to a park for a picnic and sitting in the sunshine-will probably be the extent of exercise the first week or two. After that there will more than likely be a few days of feeling great, a plateau, and then an uphill improvement. This will alternate for several weeks until he says he's doing well and hasn't been so tired lately.
I have only had tests and surgery. No Radiation, no drug therapy, as neither is effective at "curing" kidney cancer. Thus far, my mets have all been able to be excised surgically, and the organs or nodes were ones I could live without.
Your dad is lucky to have someone like you by his side. I would encourage you both to find an "in-person" cancer support group. They are a benefit to both the patient and the caregiver as you both are going through parallel processes, but maybe not at the same time.
Best wishes, and give Dad a hug.
Donna

RobFrom1956
Posts: 13
Joined: Aug 2011

Good info for sure. I'm curious about the "living on 1 kidney" theme...I have to think that some lifestyle/health changes would be in order. I figured that the sodium intake would need to be restricted and all "maintenance meds" would need to be monitored.

I am so happy that we have the internet to share these things. It is a true blessing.

Rob

Jamie1.3cm's picture
Jamie1.3cm
Posts: 188
Joined: Jan 2011

When I had this discussion with my doc (although I did get to keep my kidney), he said there were no big lifestyle changes for one kidney. He said some people are born with only one kidney, so it's never been a hugely problematic situation. The only two revisions he mentioned was cutting back on salt -- because salt increases blood pressure and high blood pressure takes its toll on the kidneys -- and avoiding too much protein, but not to the point of having to be a vegetarian or anything like that. Just don't over do it because protein can be hard for the kidney to process as well.

Anna Bery
Posts: 19
Joined: Jul 2011

Hey,

I wish you and your dad good luck. The great news is that his tumor is so small and usually this type of tumors don't metastasize.
I am supporting my mom who was diagnosed with stage IV kidney cancer. It's pretty tough because now her cancer metastasized to her liver, right muscle and back bones. She is suffering from severe back pain and hopefully tomorrow she will undergo an operation to her back to relieve her pain.
What I can suggest is just to find an oncologist who specialize in kidney cancer, not all of them do because its relatively rare, and follow up with him closely having CAT scans at least once in 6 months. Any new developments like pain or discomforts should be addressed right away because it may make a big difference.
Again, I wish you a BIG good luck

Vagusto's picture
Vagusto
Posts: 86
Joined: Aug 2011

Hello

I'm hoping the surgery went well for your loved-one. I had my kidney and tumor ( size of my fist...don't remember measurement)
removed almost two years ago at age 46. I had to make sure that i i didn't over eat, or it was very painful. As a result, I lost
30 pounds! :) So, don't over eat and realize that it takes a long time to completely heal. I had flank pain for over a year.
Take Care
Valerie

rae_rae's picture
rae_rae
Posts: 267
Joined: Oct 2010

Good advice! After five days of ice chips I was told I could order anything off the hospital menu. I carefully studied it for an hour because it all sounded so good. I ordered a turkey dinner, ate about half and was up all night in horrific pain-even the pain meds they gave me didn't help. I wish someone would have warned me!

niprut
Posts: 23
Joined: Jul 2011

Hi Rob,

I hope the op goes according to plan. A little bit of the "ugly" for me was the amount of pain and discomfort I went through from constipation and trying to move my bowels. They say don't strain but I tell you I had no choice and the body went through more than it should have after surgery. In the end my urologist tripled the recommended dose of a product ordered by the doctor and finally I got some relief. My bowel had been in spasm on and off for about two days. They say this can be caused by the pain relief medication. If I had known side effect of medication I may not have pushed the button so freely to alleviate the initial pain. Make sure all is done to avoid constipation if this is to be an issue.

Hope this helps,

Jo

RobFrom1956
Posts: 13
Joined: Aug 2011

The surgery went very well...they removed the kidney with the RCC but did NOT need to remove the adrenal gland. Surgery was performed laproscopically (sp?) on Thursday morning (Aug. 11th) and my brother was out of the hospital by Saturday noon!

So, he's home now and recovering. Pain is an issue of course, and he'll be on medication for that for a while. He didn't sleep very well in the hospital (who does?) and so will be catching up on that.

His biggest problem was gas and gas pain, just as some of you said. And, yes, the constipation is an ongoing problem (he's had trouble with that for many years) so they gave him some stool softeners.

Anyway, thanks from the bottom of my heart to all who responded to my original post!! Best of luck to you and God Bless you.

Ljordan00
Posts: 3
Joined: Aug 2011

I just posted a question about my mother's post surgery pain/constipation/gas pains and loss of appetite. Rae Rae gave me some great advice about making my mom eat small portions of food on a regular basis throughout the day.

I started this with her today. The multiple tiny meals throughout the day and mild exercise (walking a couple of blocks and back)did help (along with a 200mg tablet of Vicodin of course)but still, she ate more today than she has since her surgery. Her weight has been dropping dramatically, so it's really important that she keep eating and this was a way to do it while keeping her gas pains at a minimum.

Prepare some easy to eat meals that are somewhat on the bland side. Homemade soups, yogurt, smoothies, fruits high in iron like cherries, apricots, and prunes, water, etc. .

RobFrom1956
Posts: 13
Joined: Aug 2011

In the course of my research I found some articles that recommended a moderate protein intake because it (protein) works the kidney pretty hard. Has anyone adopted a low-protein diet? Are there any side-effects from a lower protein diet?

Gas and gas pain have subsided but constipation is still a problem. My brother is taking Mirolax and stool softeners...we'll see how that works.

My best to all!

ams123
Posts: 71
Joined: Aug 2011

I have not had my tumor removed yet - surgery is Sept 9th, but I have changed my diet to lower my protein. I was eating 60 to over 100 grams of protein a day (I am a runner and am training for a half marathon, well I was), now I try to keep it in the 50's. To do that I have cut most animal products out of my diet. Both my surgeon and my nephrologist said it would be a good idea to lower the protein and watch the sodium as well. If you drop the protein too low you can lose muscle mass. Try .8 grams of protein for every kilogram of body weight.

Linda

RobFrom1956
Posts: 13
Joined: Aug 2011

Wow, I love *specific* information. OK, I will tell my brother to try 0.8 grams of protein per every kg of body weight.

ams123
Posts: 71
Joined: Aug 2011

Unfortunately I am very familiar with the "kidney diet" since my father went into kidney failure at age 53. I'm glad the information is helpful.

Linda

ejneary's picture
ejneary
Posts: 64
Joined: Mar 2010

Here are the things that helped me get through that period...

1. Someone there at the hospital to take notes on what to do when you get home, what meds you should be on and how often...
2. Someone at home when I got there.
3. A walker (needed it for a week afterward) and I was 45 at the time!!!
4. An elevated toilet seat with handles (Believe me, don't skimp here!!!)
5. Plenty of pain meds and an alarm clock that goes off when it is time to take them (You DO NOT want the pain to get out of control because it is hard to get back on top of it)
6. Puddings, tapioca, jello, easy stuff to eat
7. LOTs of liquids (Iced Tea, water, club soda and cranberry juice)
8. TV remote close by the sofa or chair
9. Rent a medical chair if you can afford it (The kind that sits you all the way up to standing and that you can lay flat in)
10. movies (I couldn't read because of the pain meds but got bored easily)
11. Hibi cleanse to wash the wound with for the weeks after the surgery
12. fresh gauze for the wound
13. Keep the meds refreshed...

Good Luck

RobFrom1956
Posts: 13
Joined: Aug 2011

Beautiful post...I like bullet or numbered lists. One question...what is a "Hibi cleanse?"

- Rob

ams123
Posts: 71
Joined: Aug 2011

is a shower chair, and preferably a stall shower so you don't have to step over the side of a tub.

Linda

Jamie1.3cm's picture
Jamie1.3cm
Posts: 188
Joined: Jan 2011

It's usually the pain meds that cause the constipation. So, it should resolve itself after you taper the pain meds. Well, back to wherever he was before in that regard. Walking and tapering pain meds should help.

BG
Posts: 85
Joined: Jun 2011

They prescribed a stool softener for me, and I really did not have any issues through the pain management. I also increased my raw vegetable, fruit, and cooked vegetable intake while decreasing my red meat and total meat intake.

I've carried on the above practice, with the exception of the stool softener since you can only tske for a week or per doctors orders, and I feel much better.

Brent

RobFrom1956
Posts: 13
Joined: Aug 2011

Yes, walking seems to help with the constipation. The stool softeners are helping a little, but my brother had to drink some magnesium citrate (which you can buy at CVS or Walgreens for a couple dollars) to get some "results".

I think he will start tapering the pain meds soon, so that should ease the constipation a bit.

ejneary's picture
ejneary
Posts: 64
Joined: Mar 2010

This is a pre-surgery body cleaner that they usually tell you to shower with the day of surgery. I actually bought several bottles after surgery to keep my wound clean. It is anti-bacterial and worked well in keeping my wound area clean so that no infection set in.

http://www.hibiclens.com/

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