Rants and Rambles

I started the most recent, and perhaps last, cycle of my chemo Wednesday. I’m scheduled for a PET (more detailed than conventional CT) scan in a couple of weeks preceeding my “normal” 3 week office visit. That will provide the most current and accurate status of my Lymphoma. The projection is that if (or when) I reach a state of remission I’ll then only be needing these tests at 3 month intervals (at least to start).

As if the “normal” cycle of medication and side effects aren’t bad enough, and they are I assure you, the situation due to the safe useful life of a ureter stent has to compound problems. The stent needs to be removed and replaced with a new one after about 6 months. It can collect “salts” and other minerals in the urine (like those that form kidney stones) and cause complications like more blockage or difficult removal. So I just had pre-op and surgery appointments for that procedure last Thursday and Friday.

To begin with, the pre-op went well; a urine sample (expected, since it is a Urologist I’m seeing) and an x-ray (equally obvious to sort of re-map the territory). What followed in the office was a bit more difficult. I was given options! The x-ray showed the main Lymphoma mass impacting my kidney had shrunk further, by a significant amount. Not gone but sufficiently reducing pressure on the ureter that it would probably allow normal drainage of the kidney if the stent was simply removed (Opt. #2). The original “plan” was to simply replace the stent (Opt. #1) which could be described as “the safe choice” as it left protection in place (in case the ureter was still too week or the mass to invasive despite the appearance in the x-ray). The situation surrounding the kidney performance would simply move unchanged to the “back burner” for as much as another 6 months if needed, as we continued to concentrate on the Lymphoma. An option #3 involved removing the stent and a quick test using a dye with tilting me toward an upright position while still under anesthesia. This would provide some idea of the condition of the drainage, but I’d be in no condition to consult on whether to replace or leave out the stent; defeating the attempt to involve “the patient” more in treatment decisions. Did I mention that simple removal, whenever it would be done to the “final” stent, would not be done under general anesthesia? For some reason I still don’t care for that one, no matter how inevitable it must be. Option #2 of course included the potential of future replacement if it was discovered (by whatever test result or other unhealthy condition should befall me) that it was necessary.

I selected the original, option #1. A new stent is in place.

The result is that I’m now also temporarily catheterized because they found some scaring, perhaps from the original procedure. There’s been some blood in my urine and swelling so they put in the catheter to effectively do the same for my urethra as the stent is doing for my right kidney ureter, though much more on a temporary need basis (I hope). I’m supposed to remove that myself!