Todd's Journey

The story of my cancer journey

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Update on Surgery for Stent Replacement

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Stent replacement surgery went well yesterday. The Surgeon replaced both of my stent with newer, larger ones to help with the flow of urine from my kidney to bladder. We are hoping that the stents, being larger, will help to bring down my creatinine levels so I can restart my immunotherapy.

This is the first step in determining why my creatinine levels have gone up. There are two other reasons it may be rising. One is the antibiotic I am on can also increase creatinine, but it's a low possibility. The second is the immunotherapy itself.

The reason I had neph tubes originally and stents now is because my cancer had been obstructing the flow of urine from the kidney to the bladder which means it was backing up into the kidney. Before I had the stents put in and the neph tubes taken out, my creatinine was at 140.

Three days after the stents were put in, my creatinine level dropped to 139 (so relatively stable). On the same day that reading was taken, I had my first immunotherapy session. After that session, my creatinine level jumped to 171. After my second immunotherapy session, it jumped to 191. They postponed my third immunotherapy session. My creatine did rise a bit after that, but to only 196.

So as you can see, if the stents don't reduce my creatinine, and there is no obstruction issue with my ureters, it may very well be the immunotherapy sessions that are increasing my creatinine.

Nonetheless, my urology oncologist may consider completely removing the stents if it's found that there is no obstruction that is causing my kidneys from functionning normally.

Will keep you all posted, and thanks again for all the support and emails you keep sending me. You cannot know how much is has made a difference in my success at beating the cancer.

Update on upcoming surgery.

- Posted in The Journey by with comments

Had a very good conversation this afternoon with Dr. Morash, who is my Urological Oncologist and Primary lead in my Cancer treatment journey.

He believes there are a few possibilities as to why my creatinine levels are going up. One may be the stents, two it may be the antibiotic I am taking called Trimethoprim, or three it may be the immunotherapy itself that is causing the rise.

The simplest thing to do right now is to replace the stents and see if that improves drainage from the kidney to the bladder, ultimately reducing my creatinine levels.

If the stent replacement does not work, we will try removing the Trimethoprim and see if that reduces the creatinine levels.

If that doesn't work, then we may have to look at going back to nephrostomy tubes. Which could end up being a permanent requirement. But that decision is still a little ways down the road.

I am hopeful we won't have to go back to the nephrostomy tubes, as it severely affects my quality of life and makes travel something of the past for me.

We will see after Thursday if the creatinine is coming down.

Will keep you posted.

Neph tubes gone!

- Posted in Uncategorized by with comments

Procedure went well this morning. The nephrostomy tubes were removed, and stents were inserted. They seem to be working fine so far, and I seem to be slowly getting back to normal urination.

I do have a bit of pain right now but that is irritation caused by the catheter that was temporarily in place.

The pain should get better over the next few days.

Update on go forward plan

- Posted in The Journey by with comments

Hi Everyone,

Happy New Year!!

Tomorrow I will be going in for a cystoscopy followed by a potential stent insertion. The whole experience should take about an hour, and I will be out for the procedure.

Since completing my chemotherapy, my urological oncologist has not been able to adequately look at the inside of my bladder. Tomorrow he will do so and determine how well my ureters are draining from my kidney to the bladder. If they look relatively good, he may be able to remove the neph tube, and allow the kidney to drain into the bladder on it's own, or he may insert a stent from the kidney to the bladder along my ureter to assist in the draining, and then remove the neph tube.

The default option for tomorrow will be to insert stents into both my kidneys to the bladder, and to remove the neph tubes.

The stents might then come out in a few months if I can't tolerate them, or the draining continues to improve.

I will post a message to you all on Wednesday to let you know how it all went.

Upcoming Surgical Procedure - Neph tubes

- Posted in The Journey by with comments

Hello All,

As you probably know, I am to undergo another procedure on January 2nd to determine if my neph tubes can be removed.

Speaking with Dr. Morash today (my urological oncologist) the plan is to enter the bladder to take a good look of the lay of the land. Previously the cancer tumors in my bladder were blocking (or partially blocking) the ureters which did not allow the urine from my kidney to drain into my bladder.

The three previous resections of my bladder attempted to remove as much of the tumor as possible, but they were not able to get at any tumor that was in my ureter. In fact, during those surgeries they were not able to even see the entrance of the ureter from within my bladder.

The hope now is that the chemotherapy, which was highly successful at reducing the tumor and node sizes in my lungs and elsewhere, will have reduced the size of any potential tumor that was in, or around, the ureter entry into the bladder.

The plan is to see if they can identify (see) the entrances to my left and right ureter, and assess if the flow of urine from my kidney is entering my bladder. They can do this using dye to watch the flow.

If the flow appears good, they may put in some stents (temporarily) to ensure the flow remains ok, which would allow me to remove the nephrostomy tubes.

It is also possible that the flow would not be great, in which case the stent would help, but if not enough, the neph tube would have to remain in place.

The goal of the procedure on Tuesday is to try and remove the neph tubes (or at least one of them) to allow me a bit more freedom and convenience in terms of quality of life. They may be able to do this with stents, or if the flow is very good, they may not have to place stents at all.

We won't know what the outcome of my neph tubes are until after the procedure on Tuesday. If I am lucky, I will wake up from surgery with no tubes, or at least one less tube. I will update everyone on Wednesday or Thursday next week.

Wish me luck!!!