Second Opinion Results
Well........ not so much has changed.
Met with a doc doc today that I thought was going to end up being my surgeon. Turns out he doesn’t do Nephs any more. He looked at my scans and agreed that it should come out sooner than later though. This was a bit of a surprise to me. He said that once you get to 3cm, the potential for Mets is higher. I had thought 4 was the magic number. Regardless, he says it should go sooner than later.
Guess that means I’m officially off active surveillance.
He also said that the placement of the mass is close to the center (But still on the outside). Being that close to the center may make a partial neph tricky. He thinks its still possible but will be tricky. We thought it was Higher up and further away from the major blood vessel area.
After I explained what was happening with my work life and how crazy it’s about to get, he sent an urgent note to the new doc to try to get me in ASAP. Until then, we are going with a scheduled appointment in 2 weeks. From there, they say that the actual surgery COULD be as early as week later. All this waiting around is driving me nuts! Not so much about the tumor. I know that’s coming out. Not knowing what to do with work is killing me.
I am in charge of a major part of a multi property project that comes to fruition in mid June. I have been working my butt off on this thing for a year. Now we are talking about contracting a temp replacement to run the project in my place........ because we can’t nail down firm plans. Frustrating and disappointing. Don’t get me wrong..... i know it could be MUCH worse. Im just whining. I like to whine.
I guess God decided I needed a lesson in patience. I would politely ask him too move on from this lesson but I’m afraid with my luck the next lesson would involve a lightning bolt. 
Comments
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It must so disappointing to
It must so disappointing to have worked so much and so hard for a project and then having this interfere. I totally get it. OTOH, you'll feel so much better once it's out. And yes, I agree; it's best to avoid the lightning bolt
All the best to you!0 -
icemantoo said:
Allow time for recovery
Lance,
Whenever it is scheduled you will be ready. While you may be able to do some things after a few weeks getting back to full speed may take a few months or longer.
icemantoo
I have no illusions. It isn’t going to be easy. But the silver lining is that the decision has already been made. This cancer is getting evicted whenever the surgeon says and that means there is one less choice I have to make.
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Don't delay.
Best decision I made was to take it off as soon as possible. I've been resting better, and overall feeling better. Within constraints, of course.
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Game on
Hey Lance... Your going to be in excellent hands. Follow the medical team advise. When you wake up from the procedure the team did what has to be done and you can't control that. You can control Post Op. Line up help because its not fun but not as bad as your imaging. Your going to feel bad but it gets better. I was fortunate to be retired so that work thing wasn't a concern for me. If I may add, even the Greatest Rock&Roll Band was just sidelined for a medical procedure. If your job assignment could move along for a couple of weeks without you then be like Mick. For you and your loved one's this procedure should be priority 1. Sending calming thoughts at this stressful time.
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I waited a month and a half
I waited a month and a half from diagnosis to surgery. Mine was 3cm. My Urologist said to "hold my horses" because its a slow growing tumor. I had to arrange family to come up from california here to Oregon and so.. Needed to schedule asap and wanted this parasite out of me! I'm glad you got your second opinion. Everything will fall into place, and so will work.
Take care,
Steph
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You're in the right place for
You're in the right place for support! And your mindset also appears to be right on. The toughest part is the part leading up to surgery. Wishing you a successful surgery and quick and full recovery with a cancer free future!
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Hi Lance. Ok, I can't figure
Hi Lance. Ok, I can't figure out how an appointment got set up for you with a doc that doesn't do nephrectomies? What is his specialty? Just urology but no surgery? I'm glad you are handling that well, and I realize you did get a second opinion, which is always a step in the right direction. So, congrats on that accomplishment.
I have this feeling that you will do really well post surgery. My husband had a radical open nephrectomy and he is much older than you. He's such a worker bee, he was taking all kinds of phone calls for business while in the hospital. At least it distracted him. He wasn't physically at work for 2 weeks, but he was on the phone daily. To each his own. I think one month off with no contact would be ideal.
Another question. Is your tumor growing outside the kidney, or is it inside and centrally located? I don't understand close to the center but on the outside.
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I co! Take care of yourRetcenturion said:Game on
Hey Lance... Your going to be in excellent hands. Follow the medical team advise. When you wake up from the procedure the team did what has to be done and you can't control that. You can control Post Op. Line up help because its not fun but not as bad as your imaging. Your going to feel bad but it gets better. I was fortunate to be retired so that work thing wasn't a concern for me. If I may add, even the Greatest Rock&Roll Band was just sidelined for a medical procedure. If your job assignment could move along for a couple of weeks without you then be like Mick. For you and your loved one's this procedure should be priority 1. Sending calming thoughts at this stressful time.
I concur! Take care of your health first!
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PCP Scheduleda_oaklee said:Hi Lance. Ok, I can't figure
Hi Lance. Ok, I can't figure out how an appointment got set up for you with a doc that doesn't do nephrectomies? What is his specialty? Just urology but no surgery? I'm glad you are handling that well, and I realize you did get a second opinion, which is always a step in the right direction. So, congrats on that accomplishment.
I have this feeling that you will do really well post surgery. My husband had a radical open nephrectomy and he is much older than you. He's such a worker bee, he was taking all kinds of phone calls for business while in the hospital. At least it distracted him. He wasn't physically at work for 2 weeks, but he was on the phone daily. To each his own. I think one month off with no contact would be ideal.
Another question. Is your tumor growing outside the kidney, or is it inside and centrally located? I don't understand close to the center but on the outside.
My PCP scheduled the consult. The doc used to do them and was in fact one of the docs on the cutting edge of the CC robotic partial neph development. Since the CC has brought on more Urologists on and trained them in this procedure, he has stepped away to focus in other areas of Urology that interests him. Somehow my PCPs office didn’t know that and hence the appointment.
I wasn’t disappointed though. Since my initial treatment plan was active surveillance, this doc confirmed my suspicions that it was in fact better to take it out now. I am also happy to have the referral and the opportunity to meet with the new doc. I have been reading up on him and he is active in this Urology field (Amongst a few others).
The location of my mass appears to be growing almost like a little golf ball centered out of the Renal Cortex. The growth appears to be going both away from the kidney on the anterior side as well as inside toward the renal pelvis. What I had originally thought was that it was centered close to the the top of the organ where the renal cortex is thicker (however slightly down from the adrenal glands).
This doc pointed out that it’s closer to the middle of the organ where the cortex is thinner putting it closer to the major arteries and veins (as well as the renal pelvis). As the mass would grow, I assume that would make it all that closer to Mets to the arteries via the renal pelvis. I would hope that would be a long time down the road but without knowing the grade, there’s no way to know for sure. Either way, I could theoretically have it out this month instead of waiting till July just to take a picture of it and hoping for the best (which is what the first Urologist reccomended).
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Add me to the list of beingLanceHeal said:PCP Scheduled
My PCP scheduled the consult. The doc used to do them and was in fact one of the docs on the cutting edge of the CC robotic partial neph development. Since the CC has brought on more Urologists on and trained them in this procedure, he has stepped away to focus in other areas of Urology that interests him. Somehow my PCPs office didn’t know that and hence the appointment.
I wasn’t disappointed though. Since my initial treatment plan was active surveillance, this doc confirmed my suspicions that it was in fact better to take it out now. I am also happy to have the referral and the opportunity to meet with the new doc. I have been reading up on him and he is active in this Urology field (Amongst a few others).
The location of my mass appears to be growing almost like a little golf ball centered out of the Renal Cortex. The growth appears to be going both away from the kidney on the anterior side as well as inside toward the renal pelvis. What I had originally thought was that it was centered close to the the top of the organ where the renal cortex is thicker (however slightly down from the adrenal glands).
This doc pointed out that it’s closer to the middle of the organ where the cortex is thinner putting it closer to the major arteries and veins (as well as the renal pelvis). As the mass would grow, I assume that would make it all that closer to Mets to the arteries via the renal pelvis. I would hope that would be a long time down the road but without knowing the grade, there’s no way to know for sure. Either way, I could theoretically have it out this month instead of waiting till July just to take a picture of it and hoping for the best (which is what the first Urologist reccomended).
Add me to the list of being impressed with how you are so proactive in your care! Your knowledge of the situation is remarkable, and you haven't even had your surgery yet. I completely agree to get it out as soon as you can be scheduled. Don't put your job before your health. I think you will be surprised at how quickly you can get back to being involved with work...even if it's just for a few hours a day at first. Honestly I think it's better to have a pile of movies and books and just relax as you recover.
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Thanks but it’s a curse
I picked up on something I see Docs do and maybe it’s a curse. By looking at it clinically, it separates emotion from the situation for me. Helpful today but I’m sure it will catch up with me someday and that I’m heading for one hell of an emotional reckoning. Until then, it’s working to keep me moving. It also helps that I find medical subjects oddly fascinating. Especially when I’m the subject. I can’t explain why but I have always been like that about my health. I was like a curious student all during my appendectomy situation.
On the work front, we have begun talking to freelance contractors who may take my place in my absence. I have also been writing up all of the details that will need to be attended to. It’s quite impressive and the silver lining is that it’s opening the door to discussion about bringing on full time help for me in the future. I don’t think my leaders had any idea just how much they were piling on my plate.
I was running through this list with an industry friend that we are considering to help out. After going through everything on the list, he made a joke about my situation that got a laugh so loud from me that I think I actually felt my appendix surgery scars sting bit. I have a weird and sometimes morbid sense of humor. I have even challenged some friends that the more inappropriate they make the jokes the better. It takes the edge off of the situation and helps both of us address what needs to be addressed. It may not work for everyone but it keeps my spirits up.
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Hi Lance
I hope your surgery is scheduled soon. I think the best weapons for this fight are knowledge and humor. You will find so much help, hope and humor on this site from so many wonderful people here. All the best wishes and prayers for you. Let us know your progress.
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Lance, I would like to offerLanceHeal said:Thanks but it’s a curse
I picked up on something I see Docs do and maybe it’s a curse. By looking at it clinically, it separates emotion from the situation for me. Helpful today but I’m sure it will catch up with me someday and that I’m heading for one hell of an emotional reckoning. Until then, it’s working to keep me moving. It also helps that I find medical subjects oddly fascinating. Especially when I’m the subject. I can’t explain why but I have always been like that about my health. I was like a curious student all during my appendectomy situation.
On the work front, we have begun talking to freelance contractors who may take my place in my absence. I have also been writing up all of the details that will need to be attended to. It’s quite impressive and the silver lining is that it’s opening the door to discussion about bringing on full time help for me in the future. I don’t think my leaders had any idea just how much they were piling on my plate.
I was running through this list with an industry friend that we are considering to help out. After going through everything on the list, he made a joke about my situation that got a laugh so loud from me that I think I actually felt my appendix surgery scars sting bit. I have a weird and sometimes morbid sense of humor. I have even challenged some friends that the more inappropriate they make the jokes the better. It takes the edge off of the situation and helps both of us address what needs to be addressed. It may not work for everyone but it keeps my spirits up.
Lance, I would like to offer two pieces of advice. I don't know how old you are, but I was diagnosed when I was 47 years old. From reading your comments, we seem a bit similar in that we are dedicated to our work. For me, I think I was a little too dedicated for my own good. I went for surgery in July of 2014. It was an open partial nephrectomy (I will comment on that next). One of my clients was in the middle of some intense negotiations where I was the subject matter expert. Five or six days after my surgery, the client asked if I could attend a meeting as part of the negotiations. I agreed. I could barely sit upright, and the car ride to the meeting was agony. I felt every bump and pothole. The negotiation wound up in the other party suing my client. A lot of good I did attending the meeting. To boot, about 18 months later after a change in management at my client, our account was abruptly terminated. So much for giving my all to the client.
Five years later when my oldest son is a senior in high school and will be leaving for college in the Fall, I think about if I should have spent more time with my children and less with my work. I always felt I had a good work/life balance. We vacation three times per year, and I coaches their baseball and soccer teams from elementary through middle school. But now that my oldest is an adult, it does make me wonder. And the kick the nuts I received from my client after years of working my **** for them left a bitter taste in my my mouth. Nowadays, I push back or refuse projects when I feel that we don't have the time and/or staff to complete the project. I never would have done that 5 years ago. Make sure you make enough time for yourself and allow yourself time to heal.
I saw also that your first urologist used to be a specialized with robotic surgery. I also saw that your tumor may be in a difficult location. My tumor was in a very difficult location. The surgeon who did my partial nephrectomy at MSKCC only does open surgeries. He is a bit of a relic in this regard, but he was adamant that a robotic/laparascopic surgery would not be appropriate in my case. I don't know if you have discussed or explored that option.
Hope none of the above came across as too preachy. Sorry if it did. Best of luck to you. You seem like a good dude.
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