Passed Out and Now Have Abdominal Pain After Robotic Partial Nephrectomy

Tesla1

I am a fit  56 year old male and on May 16, 2017 I underwent a robotic partial nephrectomy to remove a 4 cm renal cell carcinoma from the upper pole of the left kidney.  Recovery up until post-op day 9 on May 25th was going very well and was walking several miles per day....feeling pretty good. On post-op day 9 I was sitting in my recliner watching TV after finishing a frozen pasta dinner and got a pain in my right abdomen. I stood up to stretch it out and immediately got queezy and realized something was about to happen. Within a few minutes I was very dizzy, light headed, and had visual disturbances including light hyperintensity. Next think I remember was waking up after passing out and manged to call 911 as I was alone. I remember the paramedics asking me why I was so wet which was due to extreme perspiration during this episode. I only got a bit queasy and never threw up. 

To make a long story short, I spent the next 2 nights in the hospital with right sided abdominal pain. They performed chest X-rays, CAT scans of the chest and abdomen with contrast, 4 seperate blood draws for blood chemistries, abdominal ultrasound and  an echo cardiogram. The only thing found was on the CT scan where there was a moderate amount of mixed density fluid in my abdomen. One doctor said it was a combination of new and old blood but my surgeon said that it was normal fluid accumulation from the surgery. All other tests were normal. One thing that I thought might be significant was that I noticed that when I rolled over to my left side for the echo cardiogram and then rolled back onto my back, the right sided abdominal pain was mostly gone. However, it did return later. Was this moving around the fluid in my abdomen. My surgeon and other doctors tell me they just don't know why I passed out and now have abdominal pain. The predominant theory is that the fluid and blood in my abdomen caused the pain which made me shoot up out of my chair and created a vasovagal response and caused my to pass out. However, I had very little abdominal pain before the episode. Currently, 2 days after the episode and I have a level 3-4 pain across my abdomen?

Anyone have a clue what happened to me? My only exercise during recovery is walking and I've done a lot of that but as far as I know the only repercussion of walking too much is fatigue and delayed recovery. 

Despite the setback above, we did get some incredibly awesome news that makes all the above seem miniscule in comparison. The pathology became available while we were in the hospital and it was a Oncocytoma. 

Thanks for any help. 

 

 

 

 

icemantoo

A couple of thoughts

Tesla,

 

Sound like a possable Vertico incident. See a nuerologist for a consultaion. Thats what I am going thru 15 years post neph.

 

 

Icemantoo

Jed the Humanoid

You might have been overdoing

You might have been overdoing it with surgery just over a week before. Walking several miles a day is a lot so soon following surgery. I remember recovering quickly, but couldn't imagine doing that much walking.

I had an incident about 5 weeks after my partial nephrectomy. I thought I was pretty healed, so had the bright idea of driving my car to the south coast and back on the same day. It ended up being 10 hours of driving. The next day I just felt really wrong and thought I had food poisoning. It got so bad that I was collapsing and for the first time in my life an ambulance was called. Later that evening in hospital I had trouble with my tongue which kept wanting to come out and I was hyperventilating. An immediate injection stopped that and later was able to go home. I think it was food poisoning, but my wife thought it was the terrible idea of randomly driving all those hours. Probably both. Looking back it was a bad idea and I recovered with some rest. Even if healthy, I don't think I would do it again.

Maybe try not to overdo it so soon, your body needs time to adjust and heal. My surgeon told me to do as little as possible for a month.

dhs1963

you have the classic vaso-vagal reaction
I used to get that periodically. It is called fainting.

Tesla1

Icemantoo, I didn't get the

Icemantoo, I didn't get the spinning or tilting sensation that is common with vertigo.

Dhs, did you also get abdominal pain preceding the episode? I still have new abdominal pain away from the surgical site 3 days later. 

 

JerzyGrrl

Pain and lightheadedness

Tesla, pain and lightheadedness visited me unexpectedly and unpredictably after my surgery. Sometimes when I'd stand up quickly, I'd feel as though I was going to faint (fortunately I generally managed to stop it from going any further by not continuing my motion and hanging on to something). Also, pain showed up where I didn't think it ought to be after I thought it shouldn't be there or anywhere. It just "was." Obviously my body's timetable wasn't quite what I thought it should be. Not to mention, the more I stressed about it, the worse it got.

Sounds as though you got a good work up at the hospital. It's just as good to know what something isn't as to know what it is. The perspiration thing could be for any number of reasons, but it's not uncommon to sweat when swooning or post-nephrectomy, and you can check both boxes, so there you go. At this point it looks as though one of your superpowers is NOT jumping out of a recliner in a single bound. No need to wrap yourself in bubble wrap, but take it easy and maybe hang up your cape for another month or two. After being opened up, having your innards moved all around, stuff taken out and your kidney refurbished, then moving your innards back in place and closing up things on the way out, your body is still saying, "Dang! This has been a heck of a workout and I'm STILL HEALING!"

Take care - 

Jan4you

Yes, what it might be is Vaso

Yes, what it might be is Vaso-vagal syncope (fainting) That Vegus nerve is in the abdomen and goes up to the neck into the brain. Its a pretty long and big nerve. Or your BP suddenly dropped which can make you feel faint or actually faint. 

A follow up with primary or cardiology may be recommended. What is your surgeon saying? Do you have BP issues at all?

Hopefully this is one time thing and you are on the mend now. Still, it can be scary, especially when alone.

Keep us informed. We're here for you~

Healing hugs, Jan

 

Tesla1

Average BP is 118/79 so no

Average BP is 118/79 so no issues there. 

Surgeon says everything looks normal.

Thanks for the replies. Keep em coming!

 

 

 

Jan4you

Good BP ! But I mean, AT THE

Good BP ! But I mean, AT THE TIME you fainted, it can drop as a result of Vaso Vagel syncope.

Glad you are on the mend!

Jan

Tesla1

BP Dropped to 85/65 by the time the paramedics arrived.

Probably much lower when I acturally fainted. All other vitals were OK. 

foxhd

I need to

pay attention to how I am feeling to not frequently pass out. My systolic can range from 80 to as high as 180. And those are the numbers I catch. It probably gets worse. Mine is from the cabo. You still have a lot of physiology to stabilize to reach the new normal homeostasis. You can experience a range of stressful organ adaptations after a functioning kidney is vanquished to the lab. Pain, weakness, anemia. Then your remaining kidney is pushed beyond what it has always done. If I was in charge I would make everyone expect a minimum of 3 months to 9 months before resuming full lifestyle. Some people need a year. Yes there are some of us that did it in a month but it shouldn't be expected.

Tesla1

Systolic 80?

Thanks for all the replies.

Fox, how do you feel when your systolic is 80?

Jerzy, The "bubble wrap" comment made me laugh. Thanks for that!

foxhd

When hypotensive

I get dizzy and light headed. I have to fight off passing out. I adjust my dose of avapro to correct bp.