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Other Side Of The Coin

2

Comments

  • garym
    garym Member Posts: 1,647

    Hi Sun
    I think the normal follow-up for RCC is a chest x-ray to look for nodules....as we all know RCC can go to lungs and either a renal ultrasound or a CT Abdomen the keep an eye on the other kidney as well as to make sure nothing shows up in the liver. Mine was only 2cm and I simply had the Ultrasound at 3 months and an in office Cystoscopy for the bladder tumor which seems to be completely gone.....for now. Your doctor is thinking why expose you to that extra radiation that you'd get with the CT Chest when nodules can be seen pretty well on a simple chest x-ray. Not to make everyone run away from the CT machine but the amount of radiation you receive during a Chest Abdomen and Pelvis with and without contrast is probably close to a few thousand chest x-rays. We think about radiation as a bad thing, but when medically necessary the best way to think about it is "If you can't see it....it can't hurt you". At 7.5cm I would much rather my follow up be the CT scan rather than the ultrasound. Good luck with the results.

    You hit the ground running...
    MSM,

    I had a feeling you we're going to be a popular guy, but WOW! I have a question related to Sunny's, I'll be having my 3 year CT in December and I won't have had a chest x-ray for 2 years. As i understand it a CT usually catches the bottom of the lungs so my question; is the CT sufficient or should I request an x-ray as well?

    Thanks,

    Gary
  • MedScanMan
    MedScanMan Member Posts: 107
    garym said:

    You hit the ground running...
    MSM,

    I had a feeling you we're going to be a popular guy, but WOW! I have a question related to Sunny's, I'll be having my 3 year CT in December and I won't have had a chest x-ray for 2 years. As i understand it a CT usually catches the bottom of the lungs so my question; is the CT sufficient or should I request an x-ray as well?

    Thanks,

    Gary

    Garym
    Gary

    I surely can't say how often your doctor feels it necessary to have the f/u chest x-ray. That would vary by physician. I can tell you that the base of the lungs that show at the beginning of the CT Abdomen is small. Maybe 3-4cm. Just enough for the technologist to know that he gets a running start to the Abdomen. If you take a big breath on the first pass, more of your lungs will show. The lung seems to move down (as scans go) when a real deep breath it taken.

    Jeff
  • NewDay
    NewDay Member Posts: 272

    Thank You!
    Thanks for joining this board.

    I have a feeling that your insight will be extremely valuable for many.

    Tom

    Thank you too
    You only thought you had retired. It is so good to have your expertise here. I hope we don't run you off with all of our questions.

    Thanks,
    Kathy
  • MedScanMan
    MedScanMan Member Posts: 107
    NewDay said:

    Thank you too
    You only thought you had retired. It is so good to have your expertise here. I hope we don't run you off with all of our questions.

    Thanks,
    Kathy

    Kathy
    You're very welcome. If I can help I will. If I don't know......I'll say so. I did that once today. I almost felt bad that I had no answer but I'm not going to snow anybody here. I'll do my best. It's the only place I can type where I don't get political. You have to come to a place like this to get your faith in humanity restored.......but I had to get cancer to get here...........Funny

    Jeff
  • pjune127
    pjune127 Member Posts: 127

    Kathy
    You're very welcome. If I can help I will. If I don't know......I'll say so. I did that once today. I almost felt bad that I had no answer but I'm not going to snow anybody here. I'll do my best. It's the only place I can type where I don't get political. You have to come to a place like this to get your faith in humanity restored.......but I had to get cancer to get here...........Funny

    Jeff

    Welcome Jeff
    You are a good man! We are lucky to have you with us for this awful ride. My oncologist believes he can get all the information he needs with a chest/abdomen CT with no contrast. He says it is not necesssary to stress out my remaining kidney. While this makes me happy to not have to drink that disgusting stuff, I worry that he might be missing something. I had a 10 cm tumor that had invaded my VC and some mets in my lungs at diagnosis. RCC Stage 4 Grade 4... My scans are every 2-3 months, next one the beginning of September. Am on Inlyta now after Sutent for 10 months. Can't wait to have you interpret my next scan. Welcome aboard. Hope you won't get tired of us.
  • MedScanMan
    MedScanMan Member Posts: 107
    pjune127 said:

    Welcome Jeff
    You are a good man! We are lucky to have you with us for this awful ride. My oncologist believes he can get all the information he needs with a chest/abdomen CT with no contrast. He says it is not necesssary to stress out my remaining kidney. While this makes me happy to not have to drink that disgusting stuff, I worry that he might be missing something. I had a 10 cm tumor that had invaded my VC and some mets in my lungs at diagnosis. RCC Stage 4 Grade 4... My scans are every 2-3 months, next one the beginning of September. Am on Inlyta now after Sutent for 10 months. Can't wait to have you interpret my next scan. Welcome aboard. Hope you won't get tired of us.

    Thanks for the Welcome
    It's not always necessary to drink what you call (that disgusting stuff).....I've heard other words for it, not suitable for this board. But it is simply barium. The same barium you drink when having a G.I. series for a look at your stomach. Just a different consistency. There's one called Scan-C that is made in Canada and tastes a lot better than EZ Cat used by most. I used to order that for my patients. The people I worked for never realized the difference in cost so the hell with them. Patients used to say "this ain't half bad". There are other things to drink but usually only if you're being considered for Gastro surgery. Now that stuff is icky. If your creatinine is lower that 1.4 and your BUN under 20, I wouldn't think your doctor should be worried about the other kidney excreting the injection of nonionic iodine quickly. Since you already have your diagnosis, he's probably right. If all he needs are measurements of the remaining kidney, as well as checking for lung nodules, IV contrast wouldn't be needed. If he (or you) are worried about anything else.......liver, pancreas, anything in the pelvis.....lymph nodes.....etc., then IV contrast is definitely needed. I look forward to hearing what the radiologist dictates in his impression at the bottom of your next CT report. I hope I can help you make sense of it all.

    Be well,

    Jeff
  • DMike
    DMike Member Posts: 259
    Oral Contrat Material
    Hi Jeff,
    I did check on my pelvis CT and it was done. It seems they're working in 2 computer systems at the moment and my doctor was trying to view it on the old system. Anyway, I have the radiology report and it's good!

    I noticed on the reports for chest, abdomen and pelvis it states:
    "Technique: Axial images of the abdomen were obtained following the administration of oral contrast material. Next, axial images of the abdomen were obtained in the arterial and portal venous phases following intravenous injection of contrast medium per protocol. Coronal reformatted images were reviewed. IV Contrast: Omnipaque 350, 120ml, per protocol. Oral Contrast: Gastrografin, diluted per protocol, 32 oz. IV contrast injection rate: 3 ml per sec. Scan delay: 35/100 sec. Scan field of view: 330mm."

    I did not take oral contrast material. Isn't this saying I did? I did have IV contrast. Just trying to be well informed for the next round of CT scans. Thanks so much for your help. --David
  • MedScanMan
    MedScanMan Member Posts: 107
    DMike said:

    Oral Contrat Material
    Hi Jeff,
    I did check on my pelvis CT and it was done. It seems they're working in 2 computer systems at the moment and my doctor was trying to view it on the old system. Anyway, I have the radiology report and it's good!

    I noticed on the reports for chest, abdomen and pelvis it states:
    "Technique: Axial images of the abdomen were obtained following the administration of oral contrast material. Next, axial images of the abdomen were obtained in the arterial and portal venous phases following intravenous injection of contrast medium per protocol. Coronal reformatted images were reviewed. IV Contrast: Omnipaque 350, 120ml, per protocol. Oral Contrast: Gastrografin, diluted per protocol, 32 oz. IV contrast injection rate: 3 ml per sec. Scan delay: 35/100 sec. Scan field of view: 330mm."

    I did not take oral contrast material. Isn't this saying I did? I did have IV contrast. Just trying to be well informed for the next round of CT scans. Thanks so much for your help. --David

    Hi David
    First of all let me say that you really did get a great scan. You had non Ionic Contrast (Omnipaque....best stuff), probably made you warm down below for about 15 second and maybe a little warm in the throat but no nausea. Years ago everybody got nauseous. The technologist not only did a venous and an arterial phase (meaning they were able to measure delayed iv contrast images, but he had the scanner reformat the axial images into a coronal view. That’s like stacking all the images on top of each other to get a complete view of your body from front to back. As far as the oral contrast, it does say that before the non contrast films you drank Gastrografin. This contrast takes the place of Barium.....tastes very bitter and for an Abdomen and Pelvis you would have had to drink two glasses.....then sit for a while and then a final glass before lying down. If you don't remember drinking that stuff (and you would, believe me), then the radiologist made a mistake in his reading. I'm glad they found your pelvis images. I told you they were in a computer somewhere. Hope you're having a good week-end.

    Jeff
  • Texas_wedge
    Texas_wedge Member Posts: 2,798

    Hi David
    First of all let me say that you really did get a great scan. You had non Ionic Contrast (Omnipaque....best stuff), probably made you warm down below for about 15 second and maybe a little warm in the throat but no nausea. Years ago everybody got nauseous. The technologist not only did a venous and an arterial phase (meaning they were able to measure delayed iv contrast images, but he had the scanner reformat the axial images into a coronal view. That’s like stacking all the images on top of each other to get a complete view of your body from front to back. As far as the oral contrast, it does say that before the non contrast films you drank Gastrografin. This contrast takes the place of Barium.....tastes very bitter and for an Abdomen and Pelvis you would have had to drink two glasses.....then sit for a while and then a final glass before lying down. If you don't remember drinking that stuff (and you would, believe me), then the radiologist made a mistake in his reading. I'm glad they found your pelvis images. I told you they were in a computer somewhere. Hope you're having a good week-end.

    Jeff

    CT practice
    Jeff, I'm interested in the differences in practice in CT scanning. I'm confident that I'm in the very best of hands with a large, highly expert multi-disciplinary team, so I'm intrigued that I've had 3 CAP scans so far, with and without Omnipaque, but I've only had water to drink before and after the scans - nothing like barium or Gastrografin.

    (Also, for my rad neph and subsequent open op for a recurrence, I wasn't required to drink anything beforehand, other than water to keep myself adequately hydrated. Do such practices - use of what I seem to remember Fox referring to as Drano - depend on the individual patient's health profile or habits?)

    Your expert knowledge will yet again be much appreciated.
  • MedScanMan
    MedScanMan Member Posts: 107

    CT practice
    Jeff, I'm interested in the differences in practice in CT scanning. I'm confident that I'm in the very best of hands with a large, highly expert multi-disciplinary team, so I'm intrigued that I've had 3 CAP scans so far, with and without Omnipaque, but I've only had water to drink before and after the scans - nothing like barium or Gastrografin.

    (Also, for my rad neph and subsequent open op for a recurrence, I wasn't required to drink anything beforehand, other than water to keep myself adequately hydrated. Do such practices - use of what I seem to remember Fox referring to as Drano - depend on the individual patient's health profile or habits?)

    Your expert knowledge will yet again be much appreciated.

    Oral Contrast/Water
    Good morning.....Normally whenever you have IV contrast you'll be asked to drink water for a good 24 hours so as to be well hydrated and your veins will be easier to stick. As far as Water being used in place of Gastrografin or Barium.....The very hi speed (New scanners) are so fast that even without oral contrast very little is missed in the GI track. The oral contrast is only meant to show stomach, small bowel, large bowel, and recto/sigmoid. When contrast shows in the rectum then the Radiologist feels the exam was complete. Some people are called back for a delayed scan of the lower pelvis if no contrast reached the area. As for water as contrast.....there is a Dr. who knows more about CT scanning than anybody in the country. He's at Hopkins and his name is Dr. Elliott Fishman. I do all my continuing education with him He travels with a lecture team all over the country and does full week-end seminars. Radiologists and Technologists getting their education credits together. I go for my CEU's and the Doctors get their CME's all at the same time. Below is what he says about Water Contrast in place of the others. Also you might find of interest the web site CTisUs.com. It’s his teaching site from Hopkins. There is so much you can see there. Every disease…..every way to scan them……movies to watch. It’s truly amazing. Read below. It may help.

    Jeff

    Recent advances in computed tomographic (CT) technology and three-dimensional (3D) imaging software have sparked renewed interest in using CT to evaluate gastric disease. Multidetector row CT scanners allow thinner collimation, which improves the visualization of subtle tumors as well as the quality of the 3D data sets. When water is used as an oral contrast agent, subtle disease is easier to visualize, especially when a rapid contrast material bolus is intravenously administered. Adenocarcinoma is the most common gastric malignancy and typically appears as focal or segmental wall thickening or a discrete mass. Gastric lymphoma can have a CT appearance similar to that of adenocarcinoma. Both gastric adenocarcinoma and lymphoma may be associated with adenopathy. Gastrointestinal stromal tumors (GISTs) tend to appear as well-defined masses that arise from the gastric wall and may be exophytic when large. GISTs are usually not associated with significant adenopathy. In addition to gastric malignancies, CT can also help detect inflammatory conditions of the stomach, including gastritis and peptic ulcer disease. CT angiography is especially helpful for depicting the gastric vasculature, which may be affected by a variety of disease conditions.
  • DMike
    DMike Member Posts: 259

    Hi David
    First of all let me say that you really did get a great scan. You had non Ionic Contrast (Omnipaque....best stuff), probably made you warm down below for about 15 second and maybe a little warm in the throat but no nausea. Years ago everybody got nauseous. The technologist not only did a venous and an arterial phase (meaning they were able to measure delayed iv contrast images, but he had the scanner reformat the axial images into a coronal view. That’s like stacking all the images on top of each other to get a complete view of your body from front to back. As far as the oral contrast, it does say that before the non contrast films you drank Gastrografin. This contrast takes the place of Barium.....tastes very bitter and for an Abdomen and Pelvis you would have had to drink two glasses.....then sit for a while and then a final glass before lying down. If you don't remember drinking that stuff (and you would, believe me), then the radiologist made a mistake in his reading. I'm glad they found your pelvis images. I told you they were in a computer somewhere. Hope you're having a good week-end.

    Jeff

    Thanks
    Jeff,
    Thanks for your help! You've already taught me so much. I'm glad you're here!
    --David
  • MedScanMan
    MedScanMan Member Posts: 107
    DMike said:

    Thanks
    Jeff,
    Thanks for your help! You've already taught me so much. I'm glad you're here!
    --David

    David
    You're welcome. Let me know if I can make sense of any other "Radiologist speak" you come across.

    Jeff
  • Texas_wedge
    Texas_wedge Member Posts: 2,798

    Oral Contrast/Water
    Good morning.....Normally whenever you have IV contrast you'll be asked to drink water for a good 24 hours so as to be well hydrated and your veins will be easier to stick. As far as Water being used in place of Gastrografin or Barium.....The very hi speed (New scanners) are so fast that even without oral contrast very little is missed in the GI track. The oral contrast is only meant to show stomach, small bowel, large bowel, and recto/sigmoid. When contrast shows in the rectum then the Radiologist feels the exam was complete. Some people are called back for a delayed scan of the lower pelvis if no contrast reached the area. As for water as contrast.....there is a Dr. who knows more about CT scanning than anybody in the country. He's at Hopkins and his name is Dr. Elliott Fishman. I do all my continuing education with him He travels with a lecture team all over the country and does full week-end seminars. Radiologists and Technologists getting their education credits together. I go for my CEU's and the Doctors get their CME's all at the same time. Below is what he says about Water Contrast in place of the others. Also you might find of interest the web site CTisUs.com. It’s his teaching site from Hopkins. There is so much you can see there. Every disease…..every way to scan them……movies to watch. It’s truly amazing. Read below. It may help.

    Jeff

    Recent advances in computed tomographic (CT) technology and three-dimensional (3D) imaging software have sparked renewed interest in using CT to evaluate gastric disease. Multidetector row CT scanners allow thinner collimation, which improves the visualization of subtle tumors as well as the quality of the 3D data sets. When water is used as an oral contrast agent, subtle disease is easier to visualize, especially when a rapid contrast material bolus is intravenously administered. Adenocarcinoma is the most common gastric malignancy and typically appears as focal or segmental wall thickening or a discrete mass. Gastric lymphoma can have a CT appearance similar to that of adenocarcinoma. Both gastric adenocarcinoma and lymphoma may be associated with adenopathy. Gastrointestinal stromal tumors (GISTs) tend to appear as well-defined masses that arise from the gastric wall and may be exophytic when large. GISTs are usually not associated with significant adenopathy. In addition to gastric malignancies, CT can also help detect inflammatory conditions of the stomach, including gastritis and peptic ulcer disease. CT angiography is especially helpful for depicting the gastric vasculature, which may be affected by a variety of disease conditions.

    Oral contrast/water
    Thanks for the informative reply Jeff and the link (which I've started to follow up and shall doubtless delve into further later on). My guys are using the very latest scanners so your explanation makes sense of my personal experience.

    Since we're exploiting your generosity relentlessly, I'll put another question. I won't try to camouflage its naivete, because I think most of us here will have had it cross our minds many times, but I appreciate that it may be a somewhat foolish question with no sensible answer. Anyway, here goes:


    On the thread entitled "Oncologist" Greg asked a question about follow-up and this has elicited a response from John flagging the topic of second opinions. iceman has often advocated consulting a nephrologist in certain situations and the general consensus seems to be that the first line is urological surgery and thereafter oncology.

    How do you see the respective roles of urologists, radiologists, oncologists and nephrologists in determining the optimal monitoring protocols for RCC patients? The information fed back by radiology is presumably primary but is handed over to other doctors. Urologists cover a good deal more than kidneys and may or may not know much about urological oncology. On the other hand, RCC is a less common cancer and many oncologists may not know all that much about kidney cancer. By the same token, nephrologists cover a lot more diseases and conditions than just cancer and may not be well-versed in the more arcane aspects of RCC, e.g. rarer sub-types.

    I suppose it's important to ascertain how much any practitioner of one of these specialties knows about RCC specifically? If it's not actually too stupid a question to address, I'd welcome your thoughts, including what the parameters of individual cases are that would commend who should call the shots on the manner and frequency of follow-ups.
  • MedScanMan
    MedScanMan Member Posts: 107

    Oral contrast/water
    Thanks for the informative reply Jeff and the link (which I've started to follow up and shall doubtless delve into further later on). My guys are using the very latest scanners so your explanation makes sense of my personal experience.

    Since we're exploiting your generosity relentlessly, I'll put another question. I won't try to camouflage its naivete, because I think most of us here will have had it cross our minds many times, but I appreciate that it may be a somewhat foolish question with no sensible answer. Anyway, here goes:


    On the thread entitled "Oncologist" Greg asked a question about follow-up and this has elicited a response from John flagging the topic of second opinions. iceman has often advocated consulting a nephrologist in certain situations and the general consensus seems to be that the first line is urological surgery and thereafter oncology.

    How do you see the respective roles of urologists, radiologists, oncologists and nephrologists in determining the optimal monitoring protocols for RCC patients? The information fed back by radiology is presumably primary but is handed over to other doctors. Urologists cover a good deal more than kidneys and may or may not know much about urological oncology. On the other hand, RCC is a less common cancer and many oncologists may not know all that much about kidney cancer. By the same token, nephrologists cover a lot more diseases and conditions than just cancer and may not be well-versed in the more arcane aspects of RCC, e.g. rarer sub-types.

    I suppose it's important to ascertain how much any practitioner of one of these specialties knows about RCC specifically? If it's not actually too stupid a question to address, I'd welcome your thoughts, including what the parameters of individual cases are that would commend who should call the shots on the manner and frequency of follow-ups.

    A Tough One
    OK....I won't refer back to the other thread you mentioned. The best I can do is tell you what the job is of each physician. (in my opinion). Radiologists are a breed of their own. If you've made up your mind to be a doctor, you have a couple of decisions to make after you graduate from Med School. Internship can be anything, but most of all it will tell you if deep down you're a "person". If the answer is yes because you enjoy speaking to, helping and getting close to patients and their families, then you have many choices. If during your internship you find yourself feeling holier than thou, flying above all the patients that want a simple moment of your time but you're too "good" to give that moment......if you find that you can't go on unless you begin anger management classes so as to bring you back to earth.....then Radiology should be your residency. These people (and I use the term loosely) should never expose themselves to patients and family. They need to come to work.....lock themselves in their room.....put the headset on and begin dictating. Actually the locks on these doors should be on the outside and they should have to knock a few times to be let out......for lunch.....etc.
    As far as I know, all Urologists are trained in general surgery during their urology residency. I never knew a urologist that did not do his own Nephrectomy’s. Sometimes assisted by another general surgeon in case there were other unknown problems but they all spend at least one day a week in the OR.
    Nephrologists are kidney disease specialists. Renal Hypertension, elevated BUN and Creatinine levels and dozens of other renal problems other than the many forms of kidney cancer including RCC. I know some Nephrologists that like to do their own renal biopsy work. They might not trust the Radiologist or their patients might ask them to do it as to not be exposed to another stranger.
    Until my RCC I never had exposure to a Urology Oncology department. The hospital I worked in was a little over 500 beds and specialized in open heart. We had four ICU's. One for cardiac, one for surgical, one for renal (usually end stage dialysis) and one called CVICU. That was the busiest. Post open heart. Ten beds in each unit but CVICU was always filled. When introduced to the Urology Oncology Department at the Miami VA facility this healthcare worker found himself in unfamiliar territory. It had a staff of about twenty people. Doctors from the University of Miami spent two days a week there. The two hospitals practically shared the same parking lot. These very special urologists are in a category all unto itself. This is where you want to be if you're in our position. They're the most up to date on the newest procedures. They do fellowships at other teaching facilities and then return with new techniques. I've never seen anything like it. The attending had three 5th year residents with him at all times and they continuously bounced things off of one another. I felt very secure in their hands. I believe, and many on this board might disagree with me, but the Urology Oncology Department is where we as RCC patients belong. Even post op, because I knew all the doctors in the department I didn't care who came to see me during the day. And.....unlike most places where doctors turn things over to PA's I never saw one.

    Hoped this helped a little. Just my opinion.
    Jeff
  • Texas_wedge
    Texas_wedge Member Posts: 2,798

    A Tough One
    OK....I won't refer back to the other thread you mentioned. The best I can do is tell you what the job is of each physician. (in my opinion). Radiologists are a breed of their own. If you've made up your mind to be a doctor, you have a couple of decisions to make after you graduate from Med School. Internship can be anything, but most of all it will tell you if deep down you're a "person". If the answer is yes because you enjoy speaking to, helping and getting close to patients and their families, then you have many choices. If during your internship you find yourself feeling holier than thou, flying above all the patients that want a simple moment of your time but you're too "good" to give that moment......if you find that you can't go on unless you begin anger management classes so as to bring you back to earth.....then Radiology should be your residency. These people (and I use the term loosely) should never expose themselves to patients and family. They need to come to work.....lock themselves in their room.....put the headset on and begin dictating. Actually the locks on these doors should be on the outside and they should have to knock a few times to be let out......for lunch.....etc.
    As far as I know, all Urologists are trained in general surgery during their urology residency. I never knew a urologist that did not do his own Nephrectomy’s. Sometimes assisted by another general surgeon in case there were other unknown problems but they all spend at least one day a week in the OR.
    Nephrologists are kidney disease specialists. Renal Hypertension, elevated BUN and Creatinine levels and dozens of other renal problems other than the many forms of kidney cancer including RCC. I know some Nephrologists that like to do their own renal biopsy work. They might not trust the Radiologist or their patients might ask them to do it as to not be exposed to another stranger.
    Until my RCC I never had exposure to a Urology Oncology department. The hospital I worked in was a little over 500 beds and specialized in open heart. We had four ICU's. One for cardiac, one for surgical, one for renal (usually end stage dialysis) and one called CVICU. That was the busiest. Post open heart. Ten beds in each unit but CVICU was always filled. When introduced to the Urology Oncology Department at the Miami VA facility this healthcare worker found himself in unfamiliar territory. It had a staff of about twenty people. Doctors from the University of Miami spent two days a week there. The two hospitals practically shared the same parking lot. These very special urologists are in a category all unto itself. This is where you want to be if you're in our position. They're the most up to date on the newest procedures. They do fellowships at other teaching facilities and then return with new techniques. I've never seen anything like it. The attending had three 5th year residents with him at all times and they continuously bounced things off of one another. I felt very secure in their hands. I believe, and many on this board might disagree with me, but the Urology Oncology Department is where we as RCC patients belong. Even post op, because I knew all the doctors in the department I didn't care who came to see me during the day. And.....unlike most places where doctors turn things over to PA's I never saw one.

    Hoped this helped a little. Just my opinion.
    Jeff

    Physicians
    Thanks for that very skilful reply Jeff! The first para is a scream and could well have gone into Gary's Friday funnies thread.

    On the serious side, I draw the conclusion that RCC patients should ensure they have access to the opinion of an oncologist specialising in urology, ideally in RCC.
  • MedScanMan
    MedScanMan Member Posts: 107

    Physicians
    Thanks for that very skilful reply Jeff! The first para is a scream and could well have gone into Gary's Friday funnies thread.

    On the serious side, I draw the conclusion that RCC patients should ensure they have access to the opinion of an oncologist specialising in urology, ideally in RCC.

    Maybe
    Next Friday I'll try and come up with something. But if you want something funny, it won't be about Radiologists.

    Jeff
  • Texas_wedge
    Texas_wedge Member Posts: 2,798

    Maybe
    Next Friday I'll try and come up with something. But if you want something funny, it won't be about Radiologists.

    Jeff

    Maybe
    Looking forward to that already! It's strange though - you gave me the impression that there's something funny about radiologists :)
  • dl650a
    dl650a Member Posts: 37
    Belated welcome to the forum
    Hello Jeff,
    Welocome to the forum, although we really do not like getting new members. I had my nephrectomy in March and will be coming up for my 6 month scan (blood tests and chest X-ray) in September.

    Thanks for your expertise and I hope we don't overload you

    Ed
  • MedScanMan
    MedScanMan Member Posts: 107
    dl650a said:

    Belated welcome to the forum
    Hello Jeff,
    Welocome to the forum, although we really do not like getting new members. I had my nephrectomy in March and will be coming up for my 6 month scan (blood tests and chest X-ray) in September.

    Thanks for your expertise and I hope we don't overload you

    Ed

    Thank you Ed
    Don't even think about overloading. Glad to help, if I can. Hope your next round of exams go real well.
    Jeff
  • DMike
    DMike Member Posts: 259

    Thank you Ed
    Don't even think about overloading. Glad to help, if I can. Hope your next round of exams go real well.
    Jeff

    Rotating types of scans over time
    I go in for my second-6 month post surgery CT scan in one month. Hopefully all will go well.

    I know I'll have a conversation with my new doctor about the type of scan we will do on my third-6 month post op scan in June, 2013. My original doctor, who has taken a new job and is no longer at the university, said he wanted to start rotating types of scans (because of radiation)after the second round. He would change over to MRIs for year 2. I don't know yet if this will be my new doctor's plan but I want to be prepared to answer and ask questions.

    From reading Jeff's post and others it seems like MRIs are just as effective as CT scans with contrast. Am i correct on this? Also, it seems I remember a post that said cost for a MRI can be 2X that of a CT scan. Am I correct on that?

    My goal is to get the best scan I can get to stay on top of the situation and catch anything early. Is moving to an MRI a good idea?

    Jeff, I value your response and those of others who have been through this.

    Thanks, David
  • MedScanMan
    MedScanMan Member Posts: 107
    DMike said:

    Rotating types of scans over time
    I go in for my second-6 month post surgery CT scan in one month. Hopefully all will go well.

    I know I'll have a conversation with my new doctor about the type of scan we will do on my third-6 month post op scan in June, 2013. My original doctor, who has taken a new job and is no longer at the university, said he wanted to start rotating types of scans (because of radiation)after the second round. He would change over to MRIs for year 2. I don't know yet if this will be my new doctor's plan but I want to be prepared to answer and ask questions.

    From reading Jeff's post and others it seems like MRIs are just as effective as CT scans with contrast. Am i correct on this? Also, it seems I remember a post that said cost for a MRI can be 2X that of a CT scan. Am I correct on that?

    My goal is to get the best scan I can get to stay on top of the situation and catch anything early. Is moving to an MRI a good idea?

    Jeff, I value your response and those of others who have been through this.

    Thanks, David

    CT/MRI
    Hi David,
    I never thought I'd see this thread again. I read over what I had written to introduce myself here back in August.......and I'm thinking about the state I was in back then. Thinking of my own situation, I sort of blame myself for my cancers. Having two unrelated cancers pop up at the same time (RCC and Bladder) brings me back to college in the 70's in a three year Radiologic Technology program and how much radiation protection was stressed. Actually during my one year internship at a local hospital here in Broward County Florida, we were scored on that. Over the years I seemed to let it go. I fell into the mindset of "if you can't see it, it can't hurt you". Very bad thinking on my part.....asking an assistant to push certain buttons for my while I covered myself with lead aprons and lead neck protectors just to make a nervous patient more comfortable, at the beginning doing thousands of early morning portable chest x-rays and not fully leading up and not standing back far enough as well as quick shots in the emergency room of gunshot wounds and things moving at a pace so fast when I yelled XRAY....everybody ran ten feet away and sometimes I never even grabbed my lead apron. I never registered a significant amount of radiation on my monitor but the "Compton" or scattered radiation is everywhere for a few milliseconds. I truly believe I gave myself these two cancers. That said.....when being exposed to radiation you need to balance the exposure on one hand and the importance of the information on the other. In a world where ionizing radiation had no effect on human tissue, I would always have a CT scan as follow up imaging for RCC. Today's 64 slice scanners are so fast, you're in and out in minutes. Also most facilities do sagittal and coronal reconstruction of the original images. The amount of information the doctor gets is now overwhelming. Even when I was working, people would ask me, "what's better....a Cat Scan or an MRI"? There is no answer to that. Each has its place. Nothing comes close to MRI scanning when it comes to the Brain, Lower back, shoulders, knees, and imaging of the carotids, circle of willis and other brain angiography. You don't even need contrast to get beautiful images of the carotid arteries as in MRI we actually use your own blood flow in a sequence called "time of flight" to leave no doubt in a surgeons mind if surgery is needed. If you were never diagnosed with any adenopathy, lymph node involvement and you're just getting these follow up scans to make sure another RCC doesn't show its nasty head, then I think alternation each year would be fine. Either way, you're going to do what your new doctor wants you to do. You have some input here, but he or she is going to have their way of doing things. As far as the cost goes, I'm guessing you have insurance so the fact that MRI'S get billed at a higher dollar amount, that shouldn't matter to you. If you're paying out of pocket for all this you can always get a cash price at small diagnostic centers simply by walking in with a prescription. An MRI that in a hospital would be billed out at maybe $4,000.00 would be billed from a diagnostic center at about $1300.00. If you walk in off the street and tell any of these centers that you want a cash price for an MRI of the abdomen (attention Kidneys) you might get the entire test done for 5 or 6 hundred. These places love cash. The variance in pricing is disgusting, I know.... but it is what it is. They talk about waste fraud and abuse in the system.......the Governor of my state Rick Scott, ran a company that had to pay 1.1 Billion dollars in Medicare Fraud.....He took the 5th amendment more than 75 times and the loons in my state made him Governor a year later. Go figure. The great thing for everybody......and so many on this board as I read every day (even this morning somebody posted "because of financial difficulties they had not had follow up testing") well in only 13 months everybody will be allowed to purchase healthcare. Other than my six years in the military, I've spent my entire life in this field and I tell you, anybody who thinks that healthcare in the United States should be a "for profit" system is either evil or never knew anybody who was truly ill and without coverage through no fault of their own. Now that I've lost half of my friends on the board, let me wish you well with your new doctor. Let's hope that he or she realizes that you're the type of person who wants to be involved in his care.....and that you're treated that way.
    Regards,Jeff
  • angec
    angec Member Posts: 924

    CT/MRI
    Hi David,
    I never thought I'd see this thread again. I read over what I had written to introduce myself here back in August.......and I'm thinking about the state I was in back then. Thinking of my own situation, I sort of blame myself for my cancers. Having two unrelated cancers pop up at the same time (RCC and Bladder) brings me back to college in the 70's in a three year Radiologic Technology program and how much radiation protection was stressed. Actually during my one year internship at a local hospital here in Broward County Florida, we were scored on that. Over the years I seemed to let it go. I fell into the mindset of "if you can't see it, it can't hurt you". Very bad thinking on my part.....asking an assistant to push certain buttons for my while I covered myself with lead aprons and lead neck protectors just to make a nervous patient more comfortable, at the beginning doing thousands of early morning portable chest x-rays and not fully leading up and not standing back far enough as well as quick shots in the emergency room of gunshot wounds and things moving at a pace so fast when I yelled XRAY....everybody ran ten feet away and sometimes I never even grabbed my lead apron. I never registered a significant amount of radiation on my monitor but the "Compton" or scattered radiation is everywhere for a few milliseconds. I truly believe I gave myself these two cancers. That said.....when being exposed to radiation you need to balance the exposure on one hand and the importance of the information on the other. In a world where ionizing radiation had no effect on human tissue, I would always have a CT scan as follow up imaging for RCC. Today's 64 slice scanners are so fast, you're in and out in minutes. Also most facilities do sagittal and coronal reconstruction of the original images. The amount of information the doctor gets is now overwhelming. Even when I was working, people would ask me, "what's better....a Cat Scan or an MRI"? There is no answer to that. Each has its place. Nothing comes close to MRI scanning when it comes to the Brain, Lower back, shoulders, knees, and imaging of the carotids, circle of willis and other brain angiography. You don't even need contrast to get beautiful images of the carotid arteries as in MRI we actually use your own blood flow in a sequence called "time of flight" to leave no doubt in a surgeons mind if surgery is needed. If you were never diagnosed with any adenopathy, lymph node involvement and you're just getting these follow up scans to make sure another RCC doesn't show its nasty head, then I think alternation each year would be fine. Either way, you're going to do what your new doctor wants you to do. You have some input here, but he or she is going to have their way of doing things. As far as the cost goes, I'm guessing you have insurance so the fact that MRI'S get billed at a higher dollar amount, that shouldn't matter to you. If you're paying out of pocket for all this you can always get a cash price at small diagnostic centers simply by walking in with a prescription. An MRI that in a hospital would be billed out at maybe $4,000.00 would be billed from a diagnostic center at about $1300.00. If you walk in off the street and tell any of these centers that you want a cash price for an MRI of the abdomen (attention Kidneys) you might get the entire test done for 5 or 6 hundred. These places love cash. The variance in pricing is disgusting, I know.... but it is what it is. They talk about waste fraud and abuse in the system.......the Governor of my state Rick Scott, ran a company that had to pay 1.1 Billion dollars in Medicare Fraud.....He took the 5th amendment more than 75 times and the loons in my state made him Governor a year later. Go figure. The great thing for everybody......and so many on this board as I read every day (even this morning somebody posted "because of financial difficulties they had not had follow up testing") well in only 13 months everybody will be allowed to purchase healthcare. Other than my six years in the military, I've spent my entire life in this field and I tell you, anybody who thinks that healthcare in the United States should be a "for profit" system is either evil or never knew anybody who was truly ill and without coverage through no fault of their own. Now that I've lost half of my friends on the board, let me wish you well with your new doctor. Let's hope that he or she realizes that you're the type of person who wants to be involved in his care.....and that you're treated that way.
    Regards,Jeff

    Hi Jeff.. i had typed out a
    Hi Jeff.. i had typed out a whole reply here and it vanished, so if it shows up again partially written please ignore. LOL

    How are you? I hope you are doing well. It sounds like you are!

    I was wondering if you can answer a question while you are explaining so much here. I am not sure if i should have started a new thread but since I don't have the reports in front of me i guess that this might be ok. If you don't mind.

    My mom 80, had surgery for rcc and two nodes in March after they found the mass in January of this year 2012. She had a follow up scan in August and she had two masses by the surgical clips in the renal fossil one 3cm, one 2 cms. She also had two small spots in her each lung with increaded uptake scattered.

    She had her whole body pet/ct scan again this Monday and now she has more spots on lungs, bigger as it has progressed. She also has something on her duodenum that they say check by scope for a new primary cancer possibiltiy? She also has medustinal activity i guess the odes. Also the two masses she had by her renal fossil have decreased significantly and there is no longer metabolic activity there. The docs said he were sure they were cancer in August but they are shrinking and no activity.

    I am wondering about the duodenum, i mean another cancer? And also what happened to those masses that shrunk? I am glad they shrunk but just don't know what it means.

    I didn't see the report yet but just heard it read briefly over the phone by someone who really couldn't pronounce the words correctly. But the gist of it I wrote down seems like it will stand when i get the report.

    Is there anything that you can tell me? You seem so very skilled and your input is very repected. Thank you in advance regardless.

    Hope you continue to do well!!

    Oh, the whole body pet/ct scan took more than an hour and also her sugar was elevated to 208 and they gave her nothing to bring it down and she was not allowed to take her insulin that morning. The last time it was high they made it go down before it scanned, saying it had to be blow 200, but this time not. I am so confused.
  • DMike
    DMike Member Posts: 259

    CT/MRI
    Hi David,
    I never thought I'd see this thread again. I read over what I had written to introduce myself here back in August.......and I'm thinking about the state I was in back then. Thinking of my own situation, I sort of blame myself for my cancers. Having two unrelated cancers pop up at the same time (RCC and Bladder) brings me back to college in the 70's in a three year Radiologic Technology program and how much radiation protection was stressed. Actually during my one year internship at a local hospital here in Broward County Florida, we were scored on that. Over the years I seemed to let it go. I fell into the mindset of "if you can't see it, it can't hurt you". Very bad thinking on my part.....asking an assistant to push certain buttons for my while I covered myself with lead aprons and lead neck protectors just to make a nervous patient more comfortable, at the beginning doing thousands of early morning portable chest x-rays and not fully leading up and not standing back far enough as well as quick shots in the emergency room of gunshot wounds and things moving at a pace so fast when I yelled XRAY....everybody ran ten feet away and sometimes I never even grabbed my lead apron. I never registered a significant amount of radiation on my monitor but the "Compton" or scattered radiation is everywhere for a few milliseconds. I truly believe I gave myself these two cancers. That said.....when being exposed to radiation you need to balance the exposure on one hand and the importance of the information on the other. In a world where ionizing radiation had no effect on human tissue, I would always have a CT scan as follow up imaging for RCC. Today's 64 slice scanners are so fast, you're in and out in minutes. Also most facilities do sagittal and coronal reconstruction of the original images. The amount of information the doctor gets is now overwhelming. Even when I was working, people would ask me, "what's better....a Cat Scan or an MRI"? There is no answer to that. Each has its place. Nothing comes close to MRI scanning when it comes to the Brain, Lower back, shoulders, knees, and imaging of the carotids, circle of willis and other brain angiography. You don't even need contrast to get beautiful images of the carotid arteries as in MRI we actually use your own blood flow in a sequence called "time of flight" to leave no doubt in a surgeons mind if surgery is needed. If you were never diagnosed with any adenopathy, lymph node involvement and you're just getting these follow up scans to make sure another RCC doesn't show its nasty head, then I think alternation each year would be fine. Either way, you're going to do what your new doctor wants you to do. You have some input here, but he or she is going to have their way of doing things. As far as the cost goes, I'm guessing you have insurance so the fact that MRI'S get billed at a higher dollar amount, that shouldn't matter to you. If you're paying out of pocket for all this you can always get a cash price at small diagnostic centers simply by walking in with a prescription. An MRI that in a hospital would be billed out at maybe $4,000.00 would be billed from a diagnostic center at about $1300.00. If you walk in off the street and tell any of these centers that you want a cash price for an MRI of the abdomen (attention Kidneys) you might get the entire test done for 5 or 6 hundred. These places love cash. The variance in pricing is disgusting, I know.... but it is what it is. They talk about waste fraud and abuse in the system.......the Governor of my state Rick Scott, ran a company that had to pay 1.1 Billion dollars in Medicare Fraud.....He took the 5th amendment more than 75 times and the loons in my state made him Governor a year later. Go figure. The great thing for everybody......and so many on this board as I read every day (even this morning somebody posted "because of financial difficulties they had not had follow up testing") well in only 13 months everybody will be allowed to purchase healthcare. Other than my six years in the military, I've spent my entire life in this field and I tell you, anybody who thinks that healthcare in the United States should be a "for profit" system is either evil or never knew anybody who was truly ill and without coverage through no fault of their own. Now that I've lost half of my friends on the board, let me wish you well with your new doctor. Let's hope that he or she realizes that you're the type of person who wants to be involved in his care.....and that you're treated that way.
    Regards,Jeff

    CT/MRI
    Hi Jeff,

    Thanks for the thoughtful reply. Now, I'll go into my next meeting well informed. The scans are so important but so confusing to a layman. I understand so much more now than I did when RCC entered my life.

    I'm with you on the healthcare issue. In 2014 things will be better!

    Thanks again, David
  • MedScanMan
    MedScanMan Member Posts: 107
    angec said:

    Hi Jeff.. i had typed out a
    Hi Jeff.. i had typed out a whole reply here and it vanished, so if it shows up again partially written please ignore. LOL

    How are you? I hope you are doing well. It sounds like you are!

    I was wondering if you can answer a question while you are explaining so much here. I am not sure if i should have started a new thread but since I don't have the reports in front of me i guess that this might be ok. If you don't mind.

    My mom 80, had surgery for rcc and two nodes in March after they found the mass in January of this year 2012. She had a follow up scan in August and she had two masses by the surgical clips in the renal fossil one 3cm, one 2 cms. She also had two small spots in her each lung with increaded uptake scattered.

    She had her whole body pet/ct scan again this Monday and now she has more spots on lungs, bigger as it has progressed. She also has something on her duodenum that they say check by scope for a new primary cancer possibiltiy? She also has medustinal activity i guess the odes. Also the two masses she had by her renal fossil have decreased significantly and there is no longer metabolic activity there. The docs said he were sure they were cancer in August but they are shrinking and no activity.

    I am wondering about the duodenum, i mean another cancer? And also what happened to those masses that shrunk? I am glad they shrunk but just don't know what it means.

    I didn't see the report yet but just heard it read briefly over the phone by someone who really couldn't pronounce the words correctly. But the gist of it I wrote down seems like it will stand when i get the report.

    Is there anything that you can tell me? You seem so very skilled and your input is very repected. Thank you in advance regardless.

    Hope you continue to do well!!

    Oh, the whole body pet/ct scan took more than an hour and also her sugar was elevated to 208 and they gave her nothing to bring it down and she was not allowed to take her insulin that morning. The last time it was high they made it go down before it scanned, saying it had to be blow 200, but this time not. I am so confused.

    So Much Here
    Hi,
    Let me try and explain a few things. Some of this is out of my league, but let's do some of the easy stuff first. The last thing you typed was your curiosity as to why your Mom's sugar went sky high during the PET/CT scan. If she had just a PET scan it would have been done in the nuclear medicine department. Just like bone scans, thyroid uptake scans, even stress tests done on the treadmill. The radionuclide is the injection used for the PET scan. These radioisotopes are different for each test. This is not my field but I know they use caesium 137, iodine 123 and 131, Gallium and the one everybody recognizes is Thallium as in Thallium Stress Test. In Positron Emission or PET the injection is fludeoxyglucose, and it comes under many names. So that word right there should make you understand why her sugar went up. The main ingredient in the PET scanning procedure comes from sugar. I believe the half life of this isotope is short and the body gets back to normal pretty quickly.
    I don't know the results of her pathology report but I would guess if her original surgery involved lymph nodes then the increase in nodules in the lungs would be the RCC spreading. For me this would be a guess and there are so many people on this board more informed than I am when it comes to metastatic disease coming from RCC. They've been through it, and my knowledge of pathology comes directly from my reading here.
    As for the two masses in the post surgery renal fossa.....if they're going away they might have been some sort of inflammatory process. Maybe two hematomas. I can't think of anything else that would go away on its own. The doctors may have been wrong on that call months ago.
    If she has a mass on her duodenum (in case you don't know.....that's the very first part of the stomach) and mediastinal lymph node activity, there very well may be another primary site here. I look forward to you typing the Impression at the very bottom of her New PET/CT scan. That should pretty much answer all the questions, especially since the Radiologist has a previous exam to compare it to. Best of luck to you.
    Jeff
  • angec
    angec Member Posts: 924

    So Much Here
    Hi,
    Let me try and explain a few things. Some of this is out of my league, but let's do some of the easy stuff first. The last thing you typed was your curiosity as to why your Mom's sugar went sky high during the PET/CT scan. If she had just a PET scan it would have been done in the nuclear medicine department. Just like bone scans, thyroid uptake scans, even stress tests done on the treadmill. The radionuclide is the injection used for the PET scan. These radioisotopes are different for each test. This is not my field but I know they use caesium 137, iodine 123 and 131, Gallium and the one everybody recognizes is Thallium as in Thallium Stress Test. In Positron Emission or PET the injection is fludeoxyglucose, and it comes under many names. So that word right there should make you understand why her sugar went up. The main ingredient in the PET scanning procedure comes from sugar. I believe the half life of this isotope is short and the body gets back to normal pretty quickly.
    I don't know the results of her pathology report but I would guess if her original surgery involved lymph nodes then the increase in nodules in the lungs would be the RCC spreading. For me this would be a guess and there are so many people on this board more informed than I am when it comes to metastatic disease coming from RCC. They've been through it, and my knowledge of pathology comes directly from my reading here.
    As for the two masses in the post surgery renal fossa.....if they're going away they might have been some sort of inflammatory process. Maybe two hematomas. I can't think of anything else that would go away on its own. The doctors may have been wrong on that call months ago.
    If she has a mass on her duodenum (in case you don't know.....that's the very first part of the stomach) and mediastinal lymph node activity, there very well may be another primary site here. I look forward to you typing the Impression at the very bottom of her New PET/CT scan. That should pretty much answer all the questions, especially since the Radiologist has a previous exam to compare it to. Best of luck to you.
    Jeff

    Thank you Jeff for your
    Thank you Jeff for your great wisdom! I really put your brain to work and you came through! When i get the report i will surely come back. I shudder to think she an have another new type of cancer to add to the RCC. It just never ends! Would that be a colon cancer? Not sure.

    Thank you so much again!
  • MedScanMan
    MedScanMan Member Posts: 107
    angec said:

    Thank you Jeff for your
    Thank you Jeff for your great wisdom! I really put your brain to work and you came through! When i get the report i will surely come back. I shudder to think she an have another new type of cancer to add to the RCC. It just never ends! Would that be a colon cancer? Not sure.

    Thank you so much again!

    Not Colon Ca
    It would not be colon cancer. I know it's difficult if you've never been exposed to human anatomy but this is easy for you. The digestive system begins with the esophagus (that's right after you swallow, that leads to the stomach, then on to the small bowel (intestine)through the ileocecal valve and then to the colon or Large intestine. That's the colon.... from there to the rectum. When people have a colon cancer it can be in the ascending colon, transverse colon, descending colon or the recto/sigmoid. The duodenum is at the other end. Stop letting your head twirl trying to understand "Radiologist Speak"..................it will make you nuts. You're going to have the results of a new PET/CT in a few days and your questions will be answered. Good or bad, you're going to know everything.

    Jeff
  • angec
    angec Member Posts: 924

    Not Colon Ca
    It would not be colon cancer. I know it's difficult if you've never been exposed to human anatomy but this is easy for you. The digestive system begins with the esophagus (that's right after you swallow, that leads to the stomach, then on to the small bowel (intestine)through the ileocecal valve and then to the colon or Large intestine. That's the colon.... from there to the rectum. When people have a colon cancer it can be in the ascending colon, transverse colon, descending colon or the recto/sigmoid. The duodenum is at the other end. Stop letting your head twirl trying to understand "Radiologist Speak"..................it will make you nuts. You're going to have the results of a new PET/CT in a few days and your questions will be answered. Good or bad, you're going to know everything.

    Jeff

    Yes, i guess you are right.
    Yes, i guess you are right. My head is swirling and new depression sets in. Didn't think it could get worse. But fighting two different kinds of cancer will blow mom's mind! Thank you so much Jeff. You are very kind to help me. Thank you for being so caring. xxoo
  • vittoria01
    vittoria01 Member Posts: 23
    MEDSCANMEN
    Thanks, your testimony is beautiful, God bless you.
    I would like to ask you a question: you had macrohematuria or microscopic haematuria.?
    I had partial nephrectomy in June 2011 and I always microscopic haematuria.
    I made uroTC, MRI, cytologic examination, urine all NED.
    Sorry, I am Italian and I speak bad English.
    A hug
  • MedScanMan
    MedScanMan Member Posts: 107

    MEDSCANMEN
    Thanks, your testimony is beautiful, God bless you.
    I would like to ask you a question: you had macrohematuria or microscopic haematuria.?
    I had partial nephrectomy in June 2011 and I always microscopic haematuria.
    I made uroTC, MRI, cytologic examination, urine all NED.
    Sorry, I am Italian and I speak bad English.
    A hug

    Hematuria
    Good morning Vittoria,
    When I was 23 and living in England I was in a pretty bad car accident. During my 1 week hospital stay they had found microscopic hematuria. For almost 40 years I've always had that and all my doctors said since I've had it for so long, I probably fall into a small group of the population that when making urine in the kidneys.....some red cells spill over and that's why it shows on the dipstick but never to the human eye. Before my nephrectomy they did a cystoscopy just to have a look around the bladder because for the first time, I actually had a little blood in the urine. That's when they found a low grade 3cm tumor that was very easy to remove. Since then the blood has gone away, but I haven't had a urine test to see if I'm back to microscopic or nothing at all. In your case, I would guess your hematuria came from your renal cell. And now that your cancer is gone, the blood might be gone. If you want to check yourself just go to local pharmacy like Walgreens or any chain drug store where you live and buy a small bottle of sticks. A lot of people who are on low or "NO" carb diets want to be in a state of ketosis. You can check for ketones by dipping a stick in your urine and a little square will turn purple from beige. They have the same little stick to check for blood. Ask the pharmacist for it and do the test and compare it to the colors on the side of the bottle. Hoped that helped you.
    Regards,
    Jeff
  • angec
    angec Member Posts: 924

    Hematuria
    Good morning Vittoria,
    When I was 23 and living in England I was in a pretty bad car accident. During my 1 week hospital stay they had found microscopic hematuria. For almost 40 years I've always had that and all my doctors said since I've had it for so long, I probably fall into a small group of the population that when making urine in the kidneys.....some red cells spill over and that's why it shows on the dipstick but never to the human eye. Before my nephrectomy they did a cystoscopy just to have a look around the bladder because for the first time, I actually had a little blood in the urine. That's when they found a low grade 3cm tumor that was very easy to remove. Since then the blood has gone away, but I haven't had a urine test to see if I'm back to microscopic or nothing at all. In your case, I would guess your hematuria came from your renal cell. And now that your cancer is gone, the blood might be gone. If you want to check yourself just go to local pharmacy like Walgreens or any chain drug store where you live and buy a small bottle of sticks. A lot of people who are on low or "NO" carb diets want to be in a state of ketosis. You can check for ketones by dipping a stick in your urine and a little square will turn purple from beige. They have the same little stick to check for blood. Ask the pharmacist for it and do the test and compare it to the colors on the side of the bottle. Hoped that helped you.
    Regards,
    Jeff

    Hi Jeff... just wondering
    Hi Jeff... just wondering why the ct scan didn't pick up the bladder issue. That must have been a big surprise. Maybe the scoping is the only true way to see into the bladder. Glad it turned out well.