Plumbing Issues and the Story of an Unexpected Hospital Stay

Get comfortable because this is a monster update from a very busy few days...

We had two doctor appointments yesterday with our new Oncologist and our new Urologist.  Things were going well until we started discussing some acute changes in the production of one of Stephanie's tubes – the pelvic drain to be exact.  About one week ago the drain was declining production, which is expected.  After that the drain began to steadily produce more and more each day.  

Both of our new doctors instantly collaborated and decided that there could be another leak in her urinary plumbing causing more urine to enter the pelvic cavity and ultimately the drain.  The good news is that Stephanie is not sick and is feeling well or as well as you can feel with two drains attached to bags on her leg and a port in her shoulder.  

We are now admitted at University Hospital.  The resident for the Urologist, Dr. Edwards, visited us and explained to us the plan for her stay. Early this morning (Saturday) two different CT scans were done that allowed them to assess where the leak was.  They clamped her nephrostomy tube before the CT and used this as a mechanism to investigate where urine is flowing.

This morning at 7:30 AM they set out to do a cystogram to ultimately fix her plumbing issue.  We did not get much sleep at all last night due to our late admit, visitors, and surgery prep.  During the procedure they planned to investigate the anatomy of her plumbing, place any stints they could if necessary and essentially fix or develop a plan to find where the urine was leaking.    

The procedure lasted around one hour and it went very well.  The Urologist learned that the urine was leaking from the original ureter opening in her bladder. Where her right ureter was obstructed, he found a cut in the ureter very close to where the ureter enters and drains into the bladder.  As a result, when her bladder fills up, the urine seeps out of the ureter hole, into her pelvis, and out of her pelvic drain.  

The doctors decided that they need to relieve the bladder of urine so the ureter opening will heal.  They placed a catheter into her bladder to drain the urine for at least one week.  The urologist believes this will allow the ureter opening to heal and ultimately fix her "leaky plumbing."  To be safe he wants to keep her in the hospital until, at least, Monday morning to observe the production of urine from her pelvic drain.  

In addition, the additional CT's gave the doctor a better look at the mass on her right kidney.  He believes the mass is not the first priority right now and he recommends that we observe the mass for 6 months to determine if it grows or progresses in any way.  He suggested that if the mass is malignant, the rate of growth for kidney cancer is extremely slow and it often takes up to two years to double in size.  Currently her mass is 1 cm in diameter which is considered very small.  As a urologist and oncologist, he feels that it is safe to observe the mass and avoid another procedure to remove it for at least 6 months.  Another reason to delay the removal of the mass is the fact it could irritate the abdomen area where Stephanie needs to receive intraperitoneal chemotherapy; the therapy that ultimately has the best prognosis for her type of cancer. 

Both her urologist and her OBGYN Oncologist agree that she can and should start IV chemo as soon as possible this week and they will be working over the next two days to schedule and set up her first treatment.  

From my perspective, the entire process has been excellent with our two new doctors.  They are addressing issues at breakneck speeds and everyone is collaborating extremely well to help Steph fight the cancer and heal her injuries from the debulking surgery.  

I will try to catch up on some other happenings while we have down time in the hospital so check back soon for more posts.