Todd's Journey

This morning I went for a scheduled ultrasound as part of the Oncologists investigation into the rise in my creatinine levels.

One of the possible reasons for the rise in creatinine is diminished kidney function due to obstructions in my ureters blocking the flow of urine from my kidney into my bladder. Or my bladder is not draining/emptying fully.

The ultrasound will be able to show how all that is functionning.

The results showed that my bladder was full when I started, and after having gone to the washroom, it was almost completely empty. This means my bladder is functionning properly and draining fully.

The results also showed that my kidneys were normal size, and not inflammed meaning there is no back up of fluid into the kidney.

No other abnormalities were seen or detected during this scan.

This result will help confirm that my creatinine leves are rising most likely due to the immunotherapy itself, which they are now trying to stop by putting me on steroid treatment.

Not out of the woods yet, until my creatinine gets back to normal, but definitely progress being made.

Bloodwork was completed earlier this morning, and it appears that my creatinine levels went up AGAIN.

It is now becoming more and more clear that my ureters, bladder and kidney draining is NOT the source of my continued creatinine increases. So in some small sense, that's a good thing.

The bad news is, the increase in creatinine is likely being caused from the immunotherapy sessions. Immunotherapy continues working in your body for months after a session. The only way to stop the immunotherapy from continuing to work is to administer high doses of steroids.

The administration of steroids brings on it's own set of challenges, especially in terms of water weight gain, and significantly elevated blood glucose levels. However, these are temporary until the end of the steriod treatment.

I do not know what the next option will be from the oncologists, but it is likely to stop the immunotherapy. At that point they may look at maintenance chemotherapy, which is lower dose chemo, spread out over a longer period of time, to help keep the cancer from returning.

Will keep you posted.

Hello all,

I was supposed to be in immunotherapy today, but the Medical Oncologist wants me to go in and have a couple bags of saline fluid put in me to help clear out my kidneys.

I will then have a new creatinine test tomorrow to see if it's gone down at all.

I am also scheduled now for an ultrasound on February 26th so they can see how my kidneys are flowing to the bladder and if the kidneys are inflammed at all.

Will keep you posted.

Hi All,

Bad news today. Despite changing out the ureteral stents last Thursday, it appears my creatinine levels are even higher than before. They are now coming in at 285 umol/L. The previous reading was 196 umol/L.

In some cases it may take some time for the creatinine to go down, however they are likely going to postpone my immunotherapy again until they can get the creatinine levels moving in the right direction.

Is a setback for sure. We can hope that they find the source of the creatinine level jump, since it appears that drainage from my kidney to my bladder is not obstructed.

It is possible that my kidney has been acutely damaged (with the insertion of neph tubes, and now stents) or from the immunotherapy itself. It could mean I have permanent kidney damage that is not repairable.

The next step the Doctors will look at is:

1. Removing the stents completely and allowing the natural flow from my kidney into my bladder. (The stent would cause a slower drain as it's a smaller tube inserted in my ureter) Removing the stent may allow for better draining of the kidney.

2. They may try giving me a small dose of steroid to counter a bit of the effect of immunotherapy to see if it results in less damage to my kidney and lower creatinine levels.

3. They may take me off of immunotherapy altogether, and switch me to a different (chemo like) medication.

Will keep you all posted.