New here; surgery on Tuesday

wifeintexas

Update on hubby

Hi everyone.  I'd first like to thank everyone for the great advice, positivity and compassion.  This entire experience has been surreal, but you all have been extremely informative and welcoming!  

So my husband was scheduled to have the right neprectomy laparoscopically on 12/6/2016.  The morning of the surgery, the surgeon called and said after further review of his CT scan with colleagues, he determined that doing an open would be better because of some concern of the location of the tumor and not getting clean margins.   So, my husband decided to proceed with the open radical nephrectomy with just a few hours to adjust to the change of plan.  The surgery lasted about 4 hours and the doctor came out and said everything went well, he didn't see any disease on the liver or nearby areas. He felt confident that he got clean margins and that we made the right decision to do the surgery open.  He also said the lymph nodes he interacted with did not appear swollen or inflamed which was a good sign, but we would wait for pathology reports on Friday.  

My husband was in the hospital 6 days.  He did well overall with his recovery and pain management, although he did try to not use pain medicine as often as he should have/could have.  He had a PCA for the first 4 days and he hardly used it after day 3. He did great with walking and the spirometer, but had difficulty urinating once the catheter came out. That continued to improve each day.  He was NPO for about 36 hours, then was clear liquids for 48 hours, then full liquid until we were released home.

We received the pathology report on Friday and it was a mixture of good and concerning news.  The tumor was 7 cm, Clear Cell Renal Carcinoma, no lymph nodes were in the sample, so that is unknown.  No evidence of metastisis.  Furhman grade 4.  LVI - Lymphovascular invasion.  Obviously the Fuhrman Grade 4 and LVI are extremely concerning.  

Clear Cell  T: 1b   N: X    M:0   Furhman: 4   LVI

We are looking at various options for pro-active treatment, but right now are just focused on him healing from the 10 inch incision on his abdomen.  

We see the surgeon for follow up on Thursday of this week and then see the original Oncologist that diagnosed him on 12/28.  We have a very good family friend who is a Radiologist at a high profile hospital, so she is contacting colleagues to get us linked up with an oncologist who specializes in Renal Cell Carcinoma.  One of them has already suggested a targeted therapy under the name of Sutent (Sunitinib)

From a recovery standpoint, he is doing great!  Getting around well and trying to get his appetite back.  

Just wanted to update you all and thank you again for your great advice and encouragement.  I'm not sure where we go from here, but I do know that we will arm ourselves with information and be pro-active in his treatment!

Merry Christmas everyone!

icemantoo

Hopefully

Hopefully he will not need further treatment and a neph. is enough.

 

Icemantoo

Jan4you

Thanks for giving this update

Thanks for giving this update. Sorry it could not be laproscopic incisions but he is past this surgery now and on his way to recovery!

Remember, I used a lumbar, velcro wrap (for bad backs) and wrapped it around my abdomen from 2 of my past surgeries.It really helps support those healing tissues and getting UP from a chair/bed. I also put dry ice over my underwear near the incision which gave me more relief than pain meds.

Keep us informed. Sounds like they really tried to get it all!

Hugs, Jan

wifeintexas

Jan4you said:

Thanks for giving this update

Thanks for giving this update. Sorry it could not be laproscopic incisions but he is past this surgery now and on his way to recovery!

Remember, I used a lumbar, velcro wrap (for bad backs) and wrapped it around my abdomen from 2 of my past surgeries.It really helps support those healing tissues and getting UP from a chair/bed. I also put dry ice over my underwear near the incision which gave me more relief than pain meds.

Keep us informed. Sounds like they really tried to get it all!

Hugs, Jan

Velcro wrap

Thanks Jan!  The velcro wrap has helped him tremendously.  I told him about the dry ice but he didn't want to try it.  I made a list of all the great tips everyone shared.  I asked for the velcro wrap on day 3 in the hospital and they gave him one.  He was scared to use it at first but now uses it all the time!

He is really recovering and healing nicely so far. I think his positive attitude and excellent fitness level pre-surgery is definitely making the recovery a little easier.  

dhs1963

wifeintexas said:

Update on hubby

Hi everyone.  I'd first like to thank everyone for the great advice, positivity and compassion.  This entire experience has been surreal, but you all have been extremely informative and welcoming!  

So my husband was scheduled to have the right neprectomy laparoscopically on 12/6/2016.  The morning of the surgery, the surgeon called and said after further review of his CT scan with colleagues, he determined that doing an open would be better because of some concern of the location of the tumor and not getting clean margins.   So, my husband decided to proceed with the open radical nephrectomy with just a few hours to adjust to the change of plan.  The surgery lasted about 4 hours and the doctor came out and said everything went well, he didn't see any disease on the liver or nearby areas. He felt confident that he got clean margins and that we made the right decision to do the surgery open.  He also said the lymph nodes he interacted with did not appear swollen or inflamed which was a good sign, but we would wait for pathology reports on Friday.  

My husband was in the hospital 6 days.  He did well overall with his recovery and pain management, although he did try to not use pain medicine as often as he should have/could have.  He had a PCA for the first 4 days and he hardly used it after day 3. He did great with walking and the spirometer, but had difficulty urinating once the catheter came out. That continued to improve each day.  He was NPO for about 36 hours, then was clear liquids for 48 hours, then full liquid until we were released home.

We received the pathology report on Friday and it was a mixture of good and concerning news.  The tumor was 7 cm, Clear Cell Renal Carcinoma, no lymph nodes were in the sample, so that is unknown.  No evidence of metastisis.  Furhman grade 4.  LVI - Lymphovascular invasion.  Obviously the Fuhrman Grade 4 and LVI are extremely concerning.  

Clear Cell  T: 1b   N: X    M:0   Furhman: 4   LVI

We are looking at various options for pro-active treatment, but right now are just focused on him healing from the 10 inch incision on his abdomen.  

We see the surgeon for follow up on Thursday of this week and then see the original Oncologist that diagnosed him on 12/28.  We have a very good family friend who is a Radiologist at a high profile hospital, so she is contacting colleagues to get us linked up with an oncologist who specializes in Renal Cell Carcinoma.  One of them has already suggested a targeted therapy under the name of Sutent (Sunitinib)

From a recovery standpoint, he is doing great!  Getting around well and trying to get his appetite back.  

Just wanted to update you all and thank you again for your great advice and encouragement.  I'm not sure where we go from here, but I do know that we will arm ourselves with information and be pro-active in his treatment!

Merry Christmas everyone!

He needs to see someone who specializes in rcc

Your husband needs to get to an oncologist who specializes in RCC.  Several years ago, at least, there was a view that adjuvant theropy (that is meds when there is no evidence of disease post nephrectomy) could actually do more harm than good.  RCC is somewhat different than other cancers.

I take it from your name, your are from texas.  I know of two amazing programs:  One at MD Anderson (Dr. Tannir) in Houston, and one at UTSW in Dallas.  For the later, they have Dr. Hans Hammers -- he used to be my oncologist until he left Johns Hopkins in Baltimore.  

I was grade IV stage IV (sarcomitoid differentiation, solo met to the lung).  But, I was treated only with surgery.  That was four years ago.  (diagnosis of Stage IV was 4 yrs to the day). I can personally recommend Dr. Hammers.  (I wish he was still local to me).