July 31, 2012 (Tuesday) -- Today Mom had the robot-assisted surgery on her right side to hopefully correct whatever issues were preventing her from doing peritoneal dialysis. (The procedure was talc pleurodesis, previously described here.) To keep your anatomical bearings straight, this surgery went into her chest cavity on her right side, above the diaphragm. This is the area where the lungs are, which is where the fluid from peritoneal dialysis should not go.
My sister Amy took Mom to the hospital this morning to check in, and she called me just before 10:00 AM with an update:
- Her blood pressure was really good when they took it at the hospital this morning, and she has lost some more weight. (Most likely due to getting rid of the excess fluid.)
- Her creatinine level is now 6.2, compared to 5.1 last week. (Lower is better, so that's not good. It's another indication of failing kidneys.)
- Her potassium level is critically low, so they may need to give her a potassium substitute. (She's on a low-potassium diet, so I found that confusing.)
- Her blood level is low, so she may need a blood transfusion during surgery. (Blood transfusions can complicate future transplant prospects, so hopefully a transfusion won't be necessary.)
I went to the hospital around lunch time and the surgeon spoke to me and Amy in the waiting room around 1 PM after the surgery. He said he was able to get a good look at everything. He didn't see any holes or tears in the diaphragm, so he applied some sort of sealant over the diaphragm which I suppose would plug up any small holes he was unable to see. The procedure with the surgical talc also went fine. He said there was very little extra fluid in there compared to what the x-ray showed last week, so the increased dosage of furosemide has been working.
He expects her to be up and moving a little bit tonight, and she will probably be able to go home tomorrow. Training for peritoneal dialysis can start again in about two weeks after a follow-up visit with him. He did not sum it up like this: "Patch her up with a little Fix-a-Flat and some talcum powder, and she'll be good for several thousand more miles."
I went to see her in the hospital the night of the surgery, and she was sitting up eating dinner. She was moving kinda slow and had some discomfort at the surgery site, but she had been able to get up with assistance and use the restroom. She was released from the hospital the following afternoon (Wednesday, August 1). I think she convinced them she was ready to be released because she was offered a sponge bath that morning, which she declined.
Her recovery after this surgery wasn't exactly a stroll in the park. She didn't take any pain medications after Wednesday, but there was still some lingering pain and it was several days before she could take a deep breath. I suppose that was due in part to the inflammation and scarring process taking place between her right lung and inner wall of her chest cavity, and partly due to the pain from the incisions where the instruments were inserted between her ribs on the right side. Speaking of incisions, although recovery from this robotic-assisted surgery was likely much less painful than the traditional method of spreading the ribs apart to take a good look, Mom will tell you that the robot was not all that gentle. At the bottom of this post is a picture I took of her right side on August 4, four days after the surgery. (Yes, she wanted me to post the picture on the blog.)
=== Blog News ===
I came across two interesting things while Googling the phrase "fibrinogen amyloidosis" recently. First, it's no surprise to find postings from this blog in the search results, but I was surprised to find the first paragraph of a recent post copied over to the web site www.aboutkidneydialysis.com. It was the post from December 12 titled "July 1 through July 23 - Gearing up for peritoneal dialysis training." The direct link is here. From what I can tell it looks like that site automatically searches for web pages that have certain key words like "dialysis" and copies them over in part or in full. Maybe there is a human involved to filter out stuff that doesn’t apply, since that certainly wasn’t the first post where I mentioned dialysis. They did provide a link to the original post on this blog, so that’s nice.
The second thing I found was a blog of someone in Norway. In the comments of an entry from March of this year a commenter had mentioned that his or her girlfriend's brother was diagnosed with fibrinogen amyloidosis, and he has been told he is the first person in Norway diagnosed with it. I replied with a link to this blog, but whether or not the person who commented reads it is anyone's guess. (The blog has had some hits from Norway in the past, and some recent hits since I posted the comment on that blog.) To all our readers from Norway, velkommen!
=== The Picture ===
Finally, here's the slightly graphic picture I mentioned earlier, of Mom's right side on August 4, 2012.
|Photographic Evidence of a Robot Attack|
These are the locations where the instruments were inserted into Mom's chest cavity for robotic-assisted surgery. I think I see a total of four incisions. No, that lowest one is not her belly button. Her belly is to the right in this picture and her back is to the left. I don't know why that one is indented so much. It looks like the outer layer of her skin is being pulled tight against a rib somehow.
Next up: Recovering from surgery, and transplant news