Friday, June 10, 2005

A Radical Nephrectomy

On Monday, June 6, 2005, the doctors came to get me for my surgery. The procedure is called a "radical nephrectomy", which means that they are going to remove an entire kidney. I was in surgery for the entire morning, but there were no complications. They took me out of surgery and sent me off to the ICU for the next two days. I don't really recall anything that happened those days. I do not recommend that as a way to forget your troubles, however.

They told me that my kidney weighed 15 pounds and was 10 cm x 20 cm x 30 cm. This is bad, since a normal (non-cystic) kidney is the size of your fist (see below). So, it was a necessity to remove this giant kidney from my body, even if it meant that it would reduce my kidney function. After the surgery, my serum creatinine dropped down to 6.5 (which was an improvement from the 9 it was when I was admitted to the hospital).

According to http://www.nhpress.com/pkd/kidney/kidney.html:
In the average adult, each kidney is only about 4-5 inches long and about two inches thick (this is about the size of a human fist). Each kidney weighs about 4-6 ounces.

The doctors also told me that I was going to need surgery to give me dialysis access. They call what this surgery would give me an AV Fistula. Basically, they tie an artery and vein together in the forearm. The extra blood flow from the artery causes the vein to grow larger and to become tougher. Since dialysis requires that your blood be removed, filtered, and then replaced, you have to have both vein and artery access for the dialysis needles. The doctors always use a single vein for this access, if possible. The best type of access that can be created is an AV Fistula (which is all natural). There is no graft or stint that has to be put in, which means a quick recovery time from the surgery and that the fistula will have a long life (as there is nothing artificial to wear out). The surgery was scheduled for June 13.
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