Home > Health, Random > And Yet Another Surgery

And Yet Another Surgery

September 26, 2012 Leave a comment Go to comments

I’m headed for another medical first for me: 2 surgeries in 1 year.  The first surgery I had this year was when I had my dialysis fistula tied off in April (along with the associated debacle in the hospital several days later).

The previous April, I had surgery on my left foot due to an infection in my foot bone (osteomyelitis) as well as a deep tissue infected from a foot ulcer, and the associated debacle 3 weeks after THAT surgery that put me in to the hospital with Acute Renal Failure from an interaction with my Tacrolimus (I was prescribed Fluconazole for the Candida Parapsilosis in my foot, which caused my Tacrolimus levels to go to 33, leading to ARF).

I just now got back from the Podiatrist, and had the persistent ulcer on my right foot debrided, and given Cipro for the beginning of a cellulitis.  It never really healed well from the cellulitis I had last month, and started “acting up” again over the past week.  He told me I probably have a multiple organism infection, which if not treated, would most certainly become much more problematic, especially given my immunosuppression.

This is all a direct result of my Charcot Marie Tooth peripheral neuropathy.  The muscles in my leg have deteriorated over my 49 years, and although I use a fitted lower leg orthotic, there is a lot of pressure on the outside of my foot, which caused an ulcer.  It will never probably heal well, so my Podiatrist suggested I talk to my Orthopaedic surgeon about reconstructive surgery on my right foot.  I had it done on my left foot last year, and I’ve had no problems at all on the left since my surgery.

I knew this was coming, and although I’m hesistant to do it, I know I need it, and will have it done.

But, there will be 2 conditions I set before having it done (doctors HATE to hear that).

First and foremost, I will insist on a PCA pump, aka Patient Controlled Analgesia.  When I had my left foot done, the Anesthesiologist wouldn’t do a nerve block (rightfully so, being that I have neuropathy).  Thus, I ended up getting “bolus” doses of Morphine and Dilaudid, with much nausea/vomiting and poor pain control.  They did this because they planned on only an overnight stay, but it ended up that I was in for 2 days.  I had PCA for my kidney transplant and gastric bypass, and had excellent control of my pain with little to no nausea.

Second, I will have the Transplant Surgeons consulted while in the hospital to avoid any errors that put my kidney at risk.  They are the ones who manage my Tacrolimus, so they will be the ones to ensure that my kidney is safe.  After my hospitalization this past April when they gave me too high a dose of Vancomycin, I want somebody watching over the meds I get.

So for now, I’m hoping the Cipro helps, and will hopefully get an appointment to see Dr. Cush within the next several weeks.

As for my readers, feel free to contact me via the comments section.  There are people from around the world who read this blog, and I’ve had questions in the past, particularly about BK Virus treatment.  Thanks for reading and following.  I hope someone finds my posts helpful.

  1. Roxanne
    November 28, 2012 at 11:54 am

    Jeff, I had a kidney transplant 5/12. Had rejection. Everything ok, then BK virus occurred.
    It is in my bladder–causing pain with urinating. They want to do another biopsy (will be the 4th one in 6 months) to see if it is in my kidney. But my creatine is good and my prograf level the same. Having some difficulty with my coordinator because she likes to answer questions and make decisions either without talking to the doctor or letting me talk to the doctor.

    I am 59 years old and knew I had PKD since I was 16 so I am well versed with dealing with doctors, asking questions, etc. Am having some frustration because decisions are made with little imput from me, and then I get resentment when I insist on having questions anwsered.

    Quess I need to let off some steam. Thx

    You certainly have had a tough time. I love your spirit!

    Best of luck,

    Roxanne

    • December 7, 2012 at 4:03 pm

      Roxanne,
      Great to hear from you. Unfortunately, there isn’t a whole lot of info out there on BKV, as it’s something that they are just now monitoring for, AND there is no specific treatment protocol. Easing up on the immunosuppression is the first thing to do, along with close monitoring. I’ve taken several courses of Cipro, which didn’t do much, was taken off CellCept and kept on Tacrolimus only, and then put on Leflunomide. I had to go off of the Leflunomide due to nerve toxicity, but finally, I just last week had a negative BK urine. (I was first diagnosed with BKV in July 2009; my transplant was May 3, 2008)

      DON’T BE AFRAID TO ASK QUESTIONS. You as the patient need to be informed about what is going on with your kidney. If you aren’t comfortable with what you are being told, insist on speaking with the doctor. I think the best way to approach this is to schedule an appointment with the doc and coordinator, and express your concerns.

      I’m fortunate in that I’ve been in the healthcare field for over 25 years now, and have the experience and knowledge to have a basic idea of what is going on, although transplant/nephrology is not my “specialty”. With all of the technology and advancements in medicine, it is important for you, as the patient, to have an understanding of what is going on, and the treatment team should provide you with the information you need before decisions are made.

      I rarely refuse a treatment, but I’ve gotten to the point that I will not allow anything UNTIL I have an explanation and understanding of what is being done. Nurses and doctors are human, and therefore, mistakes can happen. You having the knowledge of your disease process and treatments will go along way to prevent errors and ensure that your kidney lasts.

      Good luck, and keep in touch!

      Jeff

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