3 months post-op questions

One Lucky Girl

Hi everyone,

Due to a hectic work schedule I unfortunately haven't been able be here much lately. Three months ago I had Da Vinci robotic surgery to remove a 1.9 cm tumour from the top of my left kidney (Stage 1, Grade 2). The surgery went very well with no complications. About one month ago I started back to the gym. I have realized, however, when doing exercises for core strength (e.g. Pilates), I still have a very specific rather sharp pain in the area of the surgical site. I am quite sure (even though my surgery was laparoscopic) that muscles were cut in this area. Abdominal excercises have always been really easy for me, but I'm struggling somewhat at the moment. Can anyone tell me whether these cut muscles will eventually completely regenerate and if so, how long it generally takes?

Also, like others have reported here, I am finding fatigue at the end of the day (and sometimes in the afternoon) almost overpowering. I literally hit a wall where I can barely function (even conversation is too much). It actually scares me a little. Given that the tumour was tiny and that I feel great otherwise, should this still be a problem at three months post-op? Does anyone have any insight as to why this fatigue occurs?

BTW, the first MRI is next week, but I am imagining a NED :-)!

Thank you so much in advance for your thoughts.

Limelife50

i wiil go out on a limb
lucky girl from all my research and also conferring with my doctors just about all RCC tumors under 3cm almost never ever spread mets. of course there are certain exceptions when it comes to certain locations of the tumor, but i am sure you would have been imformed if your tumor was in a not so favorable location,other than that with yours being a low grade and the size of yours i would guess you have a 99.999999 percent of getting a NED report and yes you are one lucky lady.

garym

Fatigue etc...
OLG,

Fatigue seems to be pretty common for many of us. Anemia and vitamin B-12 deficiency have been discussed as possible causes, both are pretty easy fixes I believe. Remember, even Da Vinci should be considered major abdominal surgery and full recovery can take several months, sometimes up to a year. The soreness in your abs should subside over time, but you probably are over doing it and need to limit exertion to a comfortable level, then gradually build back up over an extended period of time.

I am certain you will be doing the NED happy dance next week, let us know how it turns out so we can celebrate with you.

I hope this helps,

Gary

Texas_wedge

Questions
Glad you're back - been missing you.

I hope our resident pro, Fox, will answer you on the pain and muscle regeneration issues.

On the fatigue issue, apart from Gary's suggestion (over-doing it - what with a hectic work schedule and the gym) I would have thought you shouldn't be suffering as much fatigue as you've described. I'd be inclined to discuss it with your GP and, if he/she thinks it necessary do a bit of investigation in case there's anything that needs attention. I'm sure it wouldn't be anything to do with the RCC and that you'll soon be inviting us to celebrate your NED.

One Lucky Girl

Texas_wedge said:

Questions
Glad you're back - been missing you.

I hope our resident pro, Fox, will answer you on the pain and muscle regeneration issues.

On the fatigue issue, apart from Gary's suggestion (over-doing it - what with a hectic work schedule and the gym) I would have thought you shouldn't be suffering as much fatigue as you've described. I'd be inclined to discuss it with your GP and, if he/she thinks it necessary do a bit of investigation in case there's anything that needs attention. I'm sure it wouldn't be anything to do with the RCC and that you'll soon be inviting us to celebrate your NED.

Been missing you too!
Been missing you too!

Today is a national holiday here and I took my first day off in four weeks (also worked through weekends). I slept late then went for a walk in the sunshine along the top of a mountain with my husband and little dog. It's a clear day and the views were spectacular. I have to say, life just doesn't get much better. I have 3 more days off to look forward to before getting back into my work and I'm sure that will really help. Yes, I really am incredibly lucky/blessed in so many ways.

I am hoping that you're right Gary and that it's just a question of trying to take on too much too soon. To be honest, I do have a tendency to do that. I know that my iron levels are good because I had a total dose iron infusion in January. A blood test 6 weeks later confirmed that my iron is actually a little bit higher than the recommended levels. B12 also checked out okay in January. It is true, however, that I haven't been sleeping great. My rational brain knows that kidney cancer is past tense for me (the urologist himself practically did a happy dance at our follow-up, and that's something in the Germanic culture :-). But my reptile brain still wakes me up in fear at 3:00 a.m. (I'm sure this too shall pass with time).

Just to be sure, I will address the fatigue with my GP when we meet next Wed to discuss my NED.

Fox, I would love your input on the abdominal muscle regeneration issue. I can't seem to find much definitive on this online and as Tex says, you are our resident expert! So, if you're not too busy riding your Harley or streaking through your neighbourhood... (oops! I meant running like a streak...)!!!

I wish you all as great a day as the one I've just had.

foxhd

One Lucky Girl said:

Been missing you too!
Been missing you too!

Today is a national holiday here and I took my first day off in four weeks (also worked through weekends). I slept late then went for a walk in the sunshine along the top of a mountain with my husband and little dog. It's a clear day and the views were spectacular. I have to say, life just doesn't get much better. I have 3 more days off to look forward to before getting back into my work and I'm sure that will really help. Yes, I really am incredibly lucky/blessed in so many ways.

I am hoping that you're right Gary and that it's just a question of trying to take on too much too soon. To be honest, I do have a tendency to do that. I know that my iron levels are good because I had a total dose iron infusion in January. A blood test 6 weeks later confirmed that my iron is actually a little bit higher than the recommended levels. B12 also checked out okay in January. It is true, however, that I haven't been sleeping great. My rational brain knows that kidney cancer is past tense for me (the urologist himself practically did a happy dance at our follow-up, and that's something in the Germanic culture :-). But my reptile brain still wakes me up in fear at 3:00 a.m. (I'm sure this too shall pass with time).

Just to be sure, I will address the fatigue with my GP when we meet next Wed to discuss my NED.

Fox, I would love your input on the abdominal muscle regeneration issue. I can't seem to find much definitive on this online and as Tex says, you are our resident expert! So, if you're not too busy riding your Harley or streaking through your neighbourhood... (oops! I meant running like a streak...)!!!

I wish you all as great a day as the one I've just had.

abs
....keep up that humor OLG!...Fatigue. Well discussed. I'm beginning to think about all the patients I have seen through the years for re-conditioning after trauma or surgical procedure. Our system has a way of dialing down our full function until we have really fully recovered. We have a life long body memory of how things have been. Get injured or have an organ removed, and our system goes into protective mode. It knows things aren't normal. So our performance is neuro-inhibited. Add to that some of the drugs we are on and no wonder we feel weak and fatigued.

Regarding our abs, there are a couple issues. One is potential for nerve damage. May be small but we all have evidence of this as I believe we will all agree that we have some tenderness, numbness or other sensory change along their scars. It can be large as some here have had problems with muscular denervation and progressing hernias or bulges due to damage. Most of us are somewhere in between.

Secondly, our abdominal walls have various layers of muscle with striations running in different directions. Therefore scarring, adhesions, and potential nerve injury can affect function, strength,tolerence and sensation. So,..cont with doing what would be "normal" ex. routines, and variations, maybe add some desensitizing deep massage. Then maybe with time, things will either return to normal or the permanant change becomes the new normal. And life goes on.

One Lucky Girl

foxhd said:

abs
....keep up that humor OLG!...Fatigue. Well discussed. I'm beginning to think about all the patients I have seen through the years for re-conditioning after trauma or surgical procedure. Our system has a way of dialing down our full function until we have really fully recovered. We have a life long body memory of how things have been. Get injured or have an organ removed, and our system goes into protective mode. It knows things aren't normal. So our performance is neuro-inhibited. Add to that some of the drugs we are on and no wonder we feel weak and fatigued.

Regarding our abs, there are a couple issues. One is potential for nerve damage. May be small but we all have evidence of this as I believe we will all agree that we have some tenderness, numbness or other sensory change along their scars. It can be large as some here have had problems with muscular denervation and progressing hernias or bulges due to damage. Most of us are somewhere in between.

Secondly, our abdominal walls have various layers of muscle with striations running in different directions. Therefore scarring, adhesions, and potential nerve injury can affect function, strength,tolerence and sensation. So,..cont with doing what would be "normal" ex. routines, and variations, maybe add some desensitizing deep massage. Then maybe with time, things will either return to normal or the permanant change becomes the new normal. And life goes on.

Ever consider writing a book?
Hi Fox,

Thanks so much for the thoughtful answer. You have a real talent for presenting information clearly and eloquently. Having read what you say about the body "going into protective mode" makes me feel much better about not yet being as athletic as before the surgery. It also helps to explain the fatigue, which I really hope will improve with time (I will check that out on Wed.).

What you say about the abs is interesting. Again, I am one of the lucky ones because the damage, even if permanent, is minimal and I can live with it! But understanding it better helps a lot.

I bet you have a book in you!

PS I won't say OLGLY because it looks too much like UGLY ;-)

foxhd

One Lucky Girl said:

Ever consider writing a book?
Hi Fox,

Thanks so much for the thoughtful answer. You have a real talent for presenting information clearly and eloquently. Having read what you say about the body "going into protective mode" makes me feel much better about not yet being as athletic as before the surgery. It also helps to explain the fatigue, which I really hope will improve with time (I will check that out on Wed.).

What you say about the abs is interesting. Again, I am one of the lucky ones because the damage, even if permanent, is minimal and I can live with it! But understanding it better helps a lot.

I bet you have a book in you!

PS I won't say OLGLY because it looks too much like UGLY ;-)

Book?
.I'll tell you what, with all the scars,(even in a bikini),I would never use the word ugly for anyone. OK, maybe. But I think OLG stands for , "One Looks Gorgeous."...I have been told repeatedly that I explain things well.... I think I can reduce the clinical into the practical...It is a self serving way to get patients to "buy" in to a plan of care. If I can get comprehension, then compliance, my job is done. I no longer have to treat patients. they follow my coaching, and treat themselves. I only need to be there to monitor and modify individual and specific programs. Funny, I've been asked many times about writing a book. But I am into the practical. Not research. My experience is worth something. But it can be tough to back it up with scientific evidence. However, it would be about "Reflexive Inhibition" and retraining motor programming...There. Now I've said too much.

One Lucky Girl

foxhd said:

Book?
.I'll tell you what, with all the scars,(even in a bikini),I would never use the word ugly for anyone. OK, maybe. But I think OLG stands for , "One Looks Gorgeous."...I have been told repeatedly that I explain things well.... I think I can reduce the clinical into the practical...It is a self serving way to get patients to "buy" in to a plan of care. If I can get comprehension, then compliance, my job is done. I no longer have to treat patients. they follow my coaching, and treat themselves. I only need to be there to monitor and modify individual and specific programs. Funny, I've been asked many times about writing a book. But I am into the practical. Not research. My experience is worth something. But it can be tough to back it up with scientific evidence. However, it would be about "Reflexive Inhibition" and retraining motor programming...There. Now I've said too much.

Go for it!
I don't believe you have a self-serving bone in your body and your patients would probably jump over the moon if you asked them to. That said, your expertise combined with your compassion, humanity and personal experience are all the ingredients you need (okay, I do get the scientific evidence requirement). Your topic sounds very interesting. Maybe next you could write a book about knocking cancer on its a**.

Got the MRI over with today, planning the bikini beach vacation tonight -- scars or no scars!

Okay -- OLGLY ;-)

foxhd

One Lucky Girl said:

Go for it!
I don't believe you have a self-serving bone in your body and your patients would probably jump over the moon if you asked them to. That said, your expertise combined with your compassion, humanity and personal experience are all the ingredients you need (okay, I do get the scientific evidence requirement). Your topic sounds very interesting. Maybe next you could write a book about knocking cancer on its a**.

Got the MRI over with today, planning the bikini beach vacation tonight -- scars or no scars!

Okay -- OLGLY ;-)

Bikini
Thanks...and wear that 'kini with pride. Nothing but a beauty mark. I've got to believe there will be nothing but jealousy