written on November 14, 2014
The stent came out last Thursday (Nov 13). Last Monday, my transplant nephrologist told me the anticipation of the surgery would be worse than the surgery itself. That was mostly true.
Turns out there is some pain, even though everyone – doctors, nurses, friends, other patients – all assured me I wouldn’t feel anything, maybe some discomfort. I guess I am just a sensitive guy then, because there were two painful moments. And in the interest of letting others know what the procedure is like, let me go into some specifics.
I had the procedure done in a urologist’s office, by two urologists (both male) and a nurse (female). Sometimes the procedure is done by an interventional radiologist (the person who runs the CT scanners or x-ray machines). Either way, it’s typically an outpatient procedure and since it’s performed in an office setting, and not a hospital (with an interventional radiologist, I think you’d be in a hospital setting), you can’t get any sedatives. So you’re on your own as far as relaxing goes.
They brought me into the doctor’s office and took my vitals (my blood pressure during the day is running around 120/67 these days – still higher when I wake up (like 130/90) but during the day it’s amazingly low!). Then they did an ultrasound of the new kidney. That caused a little squeamishness on my part – they had to push on the incision with the cold jelly. Yikes! It wasn’t so bad, but the anticipation of that freaked me out a little. Then they took me across the hall to the Procedures room and had me strip from the waist down and put on the gown.
Next the nurse came in to disinfect the area and give me some lidocaine (a topical numbing cream). They disinfect with something called Betadine, which is a red liquid similar to iodine. I point this out because she just swabbed it everywhere and poured a small amount over me. It leaves a nice red stain on skin wherever they put it – which, when it dries, can easily be mistaken for blood.
Next, the lidocaine. Now, everyone gave me the impression that they just rub a bunch of it around the area where the camera goes in. No. They have a huge plastic syringe full of the stuff (no needle, more like a children’s toy syringe) and the nurse rubbed some around the opening of the urethra and then she inserted the syringe and stood there while she slowly pushed the plunger in. It feels weird and cold and it stings a little. It took a few minutes for her to empty the syringe – it’s a lot of the stuff. Then she had to clamp the end of the urethra, so nothing spilled out, which I could totally feel. I still hadn’t looked between my legs to see anything, but I could tell something was weighing me down. The worst part of this was the feeling that something was going in to an area where normally things only come out.
She left me alone for about five minutes so the lidocaine could take effect. Five minutes is just not enough.
After the five minutes passed, the doctors and the nurse came in. They grabbed the camera unit, hooked an IV bag of saline into it (they need to fill the bladder with water as they go in, to make sure they have room to grab the stent) and then they thread the grabber mechanism into the camera tube. The nurse grabbed hold of the urethra (notice I’m not using the p-word in this post – see my entry HOSPITAL for way too much information about said p-word) and then the doctors inserted the camera.
They did not wait, even though I was freaking out, asking for a minute to calm myself down. Nope. They just grabbed and went. It felt weird to have the camera in the urethra, but it wasn’t painful. The pain came when they pushed through the bladder sphincter – the muscle that keeps the contents of the bladder in. I’m guessing the lidocaine didn’t have enough time to numb the sphincter muscle, so I definitely felt that. And then I felt the pressure as they pushed water into my bladder. I looked over the nurse’s shoulder at the TV monitor, and watched as this little stringy thing was floating around in the white void of my bladder. The doctors announced they were going to grab it, which I saw them do. Then the announced they were going to pull it out and they did. Fast. I felt the pinch as it came out, but it wasn’t that bad. It hurt a little, but that was it. It took less than a minute from when they first went in to when they pulled it out. The nurse held up the stent for me to see – it was crazy long and much thicker than I expected it to be. But it was out!
They told me to expect to see some blood in my urine for probably a day or two, and as long as I kept peeing a normal amount, everything would be fine. Follow-up in a few weeks and we were good to go.
I sat there for a couple of minutes in shock. My p-word was completely numb and wouldn’t react. Between my legs was a huge wet spot with red splotches everywhere. My first thought was oh my gosh, blood! Then I realized, nope, just the betadine. I slowly got dressed and met up with my dad and we left.
I did have blood in the urine until Friday morning. Surprisingly, it never really hurt to pee. I expected it to, but other than some pressure issues the first few times, I’ve been going normally (by pressure I mean you can feel the build-up of the urine before the sphincter relaxes and the flow starts). The most unexpected part was walking back to the car and feeling better in my lower abdomen. I could definitely tell that something had been removed. And it felt amazing.
I asked the doctor before I left about the hematuria from the long walks. He said it was most likely the stent banging around the bladder, knocking off red blood cells as I went. He said it was all perfectly normal. I went for a long walk on Sunday to test it out, and there was no more blood in the urine. Awesome!
So my nephrologist was correct – the anticipation was much worse than the actual procedure. The doctors told me I could film the procedure with my camera phone if I wanted to, but unfortunately I was freaking out way too much for that to have happened. I did mange the pictures of the camera unit and the stent though – had to have some sort of record of what I went through!
Now I only have the catheter in my chest left. I asked in clinic Friday morning if I could have it removed on Friday, because a clot had formed in the line on Wednesday. Since I’m going to have to go to the hospital to get it cleaned out, I figured it would be better to try and have it removed. Unfortunately, they didn't have a slot open so I've had to live with the clot in the line ever since. Luckily it hasn't gotten worse, and today is the day it's suppose to be removed. It's been difficult sleeping the last few nights because I'm getting very excited about having this tube pulled out. I don't even care any more if it's going to hurt - it's time to get rid of it. I just hope the minor pains I've been feeling in my chest go away once it's removed. I think they will - the pains feel like I pulled a muscle in the chest. I would feel the same pains over the summer, so I'm just going with the idea that it's the catheter causing them. I'll find out later today.
I'm almost back to normal. Wow - what a long road it's been. It has all been worth it though, just to get to this new kidney and how great I'm feeling. Hopefully no more than a few more minutes of pain this afternoon and then back to the showers!