J: When second is better than first…

My second lung biopsy was successful. The practitioners-that-be have poked, prodded and pondered and concluded that my lung tumours are secondaries.

This is good news. If this had been an independent primary cancer, then they would have had to think again about the treatment plan. As is it “almost certainly” secondary (nothing is 100% with this cancer caper) , then the right thing is to get the kidney out, as per plan (May 5th).

I passed the pre-op

Last week I had my pre-op assessment. There had been some doubt about whether I would be fit enough for the 4 hour nephrectomy. The pre-op was fine and luckily I was also able to get an appointment with an anaesthetist (it’s their ultimate say-so as they are the ones charged with keeping you alive under the knife) and she said I was good to go, so that was a big relief. She has booked me a bed in the intensive care unit to be on the safe side. That means I get more nurses which can’t be bad.

The urologist is happy

We met Simon Evans, the urologist, on Monday. He is happy with everything. He’ll do the operation with a colleague and says I’ll be the first one of the day. Fresh team! Then I’ll be kept in for about 4 days.

After about a month, when I’m fit enough, they will start me on chemotherapy. Often secondaries improve spontaneously once the primary tumour is removed. The chemo will be tablet based so it does not sound too bad.

I mentioned to Simon Evans that I still had a persistent slight headache/’flu like feeling. He is booking me in for a brain scan as there is a tiny risk of secondaries in the brain. But it is much more likely to be caused by kidney malfunction. He got me a calcium check of the blood which is fine.

The lung consultant is happy

Today we saw Dr. Walters. He ran an ultrasound of my lungs and there are still pockets of fluid but they are not increasing. He sees no need to see me before the operation, which is good. If the fluid should return he’ll see what he can drain off a few days before the operation, but with luck that won’t be necessary. He says it is not uncommon for the fluid to dissipate post removal of a kidney tumour.

I’ve been having some slight burning-type pain in my left lung lately, near my sternum. It’s not bad enough to take pain killers, except at night but was giving me a little concern. In particular I was worried that Dr. Walters might decide I needed chemo now and pull the operation. But he seems quite relaxed about it and just said that lung pain can be referred in strange ways (the area of discomfort is away from the tumours). The tumours themselves have grown since the initial scan, but that does not worry him either.

I am happy

Without a plan I’m never a happy man. But now we have a plan and the op is just a few weeks away. After 8 days in a row at Bath hospital (half of that for my other half) we can now have time off! I’ve been feeling like I’m on an exclusive zero hours contract with the NHS.

I’ll do another post when I have the brain scan (date awaited) but don’t expect that to be exciting. So the next major news should be when I am free of that kidney.

In the meantime I can focus on getting fit for the knife. The lovely Mr. Evans further endeared himself to me today by calling me slim! This was when we discussed the challenges which obese patients increasingly present to surgeons. First time anyone has called me slim for some years and I have to assert that he was being generous. But, by some chance prescience of planning, I lost a couple of stone between November and February, thanks to the famous five:two. But in recent months, while my weight has been stable, I have not done much to keep fit. Dr. Walters says that unless I really overdo it I need not worry about exercise kicking off more fluid production. This afternoon I managed to walk three miles without getting very puffed, so I was pleased with that and will have to see how far I can up the ante in the coming weeks. Lucky that spring is here, which will make it easier!