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    #16
    So they biopsied it or it looks very specific as "cancer"? That being said- get the mass out- my mother died from renal cell cancer because she was diagnosed too late and it had spread to her lungs.
    She was a nurse- every ache she complained of was "menopause, or stress, or nerves". We pick up alot of early renal cancer and it is totally curable with surgical removal. If it is small - is this an area that does the robotic surgery- then very small incision but either way have it out, other than possibly a big incision and 2-3 weks of soreness you should be fine. WE giured she had it for almost 20 years- usually slow growing- which is good.
    Because we do yearly renal ultrasounds we pick up alot of kiidney tumors/cancer and they area taken out or treated in some way. This is one of the best cancers to have- not that it can't return- it might but not like others.
    You can function with a small part of kidney removed or even the whole thing if the other kidney is working well and you defintiely want to make sure that kidney stays healthy.
    Yes, it is surgery but get your troops ( family, friends, short term extra paid caregivers , church, neighbors etc..) to have it done and have help while you recover. You will be great after that and won't have to worry about- just test every 6 months to one year then yearly.
    You can google kidney tumors/cancer and easily get more information. Ask surgeon specifics about surgery and recovery.

    CWO
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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      #17
      Originally posted by triumph View Post
      Just wondering if a biopsy was done to determine surgery is needed. Also, how big is the "mass". I guess I'm saying has doctor told you enough information so you can be more comfortable about the need for surgery?
      Careful planning for after-surgery care would help - even if a short stay in rehab is needed. I would make sure the doctor/surgeon knows what you need for disability-related after care in case you need their support/orders for care. In my experience their 'routine care' does not include the unique needs of paralysis.
      8cm and yes. I'm trying look into after care planning which is why I am posting this.

      After a kidney removal can I even do a transfer? The way my house is set up the transfer from the chair to toilet takes a lot of strength and strain.
      Last edited by xsfxsf; 11 Aug 2019, 8:04 AM.

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        #18
        I would not be focusing on transfers, but on contacting family/friends ASAP for a care team for after surgery. It seems you will want personal care at home or go to a rehab center. I can't imagine doing transfers right after surgery like that - train your helpers to do that.
        Let us know what you come up with.

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          #19
          It depends- are they removing the entire kidney or just the cancerous part- or depends on what they find when they go in. unless robotic or minimally invasive will have long incision even if small incision(s) needs to be careful especially the first 2 weeks but after 6 weeks you defintiely should be able to transfer and back to normal. You need to get more specific information from your surgeon. Unless someone has had similiar in the last several years you cannot compare what they did or couldn't do after surgery. There are different options now compared to even 10 years ago depending on the results of scans , location, and surgeon.
          Sometimes surgeons will tell you the restrictions but a "translation" reL to normal SCI activity i.e. transfers, doing own bowel program, etc.. has to be considered. You want a quiet environment in a hospital- wear ear plugs. Even if in isolation, you can be put in a room with someone with same organisms- like MRSA +. we fill up the room. I don't think most post op hospitals do that but... and don't be afraid to ask questions and ask for specifics. After you get specific restrictions we can probably be more specific.

          CWO
          The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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            #20
            My urologist has me doing semiannual renal/bladder ultrasounds? Is that unnecessary? It does possibly identify something six months early though.

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              #21
              Biopsies are rarely done for renal tumors, as it is difficult to do a needle biopsy in that location, the risk of bleeding even from a needle biopsy is high due to the highly vascular structure of the kidney, and because even a benign tumor requires resection.

              As far as your recovery, you should really use a lift for transfers after your surgery. Safer for you, and safer for your caregivers. If you don't want to buy one, they are available for rent. Of course that means you need to have a bed that a lift will fit under, ideally with no carpet in that room. Similarly, a rolling commode chair that you can roll over the toilet instead of doing a transfer in the bathroom would be a good idea.

              For planning ahead for surgery and hospitalization, here are a few suggestions:
              • If possible, go to a hospital that has all private rooms. This is the trend in new hospital construction, both for privacy and better infection control.
              • Ask your surgeon to order you a low air loss mattress for your hospital room to prevent pressure injuries.
              • Have your surgeon write an order to turn you every 2 hours (sad to say that nurses would require an order like this, but that may be the case).
              • If possible, do an extra bowel program the night before surgery to prevent a bowel accident on the surgical table.
              • Ask the surgeon about how the operating table will be padded during your surgery. Long surgeries especially can put you at significant risk for intraoperative pressure injuries. Dolphin makes the best OR table pad, but few hospitals have them. For renal surgery, you will likely be placed on your side with the table adjusted as in the diagram below. This can put a huge amount of pressure on your trochanter and lateral knee and shoulder.
              • Be sure you are placed on a good pressure reducing surface in the post-operative recovery room. Dolphin pads are also available for recovery room gurneys, but again, are rarely available.
              • Be sure you are turned in the recovery area, and ideally avoid positioning again on the side down during the surgery initially.
              • If you have an indwelling catheter, either SP or urethral, be sure you don't get put onto the routine protocol of pulling catheters on hospitalized patients immediately after surgery. Many places have such protocols in place that are initiated by nurses who may not really be aware that this should not be done for those with a neurogenic bladder. Your surgeon should write an order to leave the catheter in place for the duration of your hospitalization.
              • Be sure you have a plan with the surgeon for medically managing any autonomic dysreflexia that can occur in the post-operative period due to incisional pain. They should write prn orders for medications to be used to control this if needed.
              • During the post-operative period, if possible, have your usual caregiver come into the hospital to do your bowel care (in bed). The nurses will very likely not know what to do, and may even refuse to do your care the way you need it.
              • Insist that they use a lift to get you out of bed, and that you get transferred to your own wheelchair, not a hospital wheelchair or "geri chair" which will not fit you, nor have appropriate cushions. You should get out of bed the day after surgery, the same as an ambulatory patient after surgery.
              • Don't hesitate to question anyone touching you if they have adequately cleaned their hands before touching you. Ideally, observe them doing so. If they are insulted, too bad. You need to protect yourself.


              (KLD)
              Attached Files
              Last edited by SCI-Nurse; 12 Aug 2019, 10:39 AM.
              The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

              Comment


                #22
                I should also add that if you really need rehab (ie, therapy) after surgery to regain your strength, you won't get much at a sub-acute (ie, nursing home) type "rehab" center. It would be much better to arrange appropriate assistance at home, and get a home health agency PT/OT referral for a couple of weeks post-op.

                (KLD)
                The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                Comment


                  #23
                  Originally posted by crags View Post
                  My urologist has me doing semiannual renal/bladder ultrasounds? Is that unnecessary? It does possibly identify something six months early though.
                  We only do this annually, but if you have a previous history of renal tumor, hydronephrosis, or stones, then every 6 months would not be excessive.

                  (KLD)
                  The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                  Comment


                    #24
                    Originally posted by SCI-Nurse View Post
                    I should also add that if you really need rehab (ie, therapy) after surgery to regain your strength, you won't get much at a sub-acute (ie, nursing home) type "rehab" center. It would be much better to arrange appropriate assistance at home, and get a home health agency PT/OT referral for a couple of weeks post-op.

                    (KLD)
                    Thank you very much for the detailed and helpful information. That said, I have to admit that the prospect of an operation and convalescence concerns me. I have many days now where I feel fine. It worries me that some operation would knock me off kilter and I’d be sick for a long time. I wish I knew what my quality of life and prognosis exactly would be if I did nothing. The mass has grown a few centimeters in the last year which is one reason the doctors suspect that the mass might not be benign. Really if I were to have done something I should have done something when it was much smaller and the kidney would not have needed to have been removed, but I had been leery of operations for a long time. For what it is worth my doctors are displeased by my decisions. What I want is physical comfort and as normal a lifestyle as possible, at least some days. I had cancer once as a child and all the crazy treatments, operations, and tests were worse than the cancer.
                    Last edited by xsfxsf; 15 Aug 2019, 8:43 AM.

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