Getting used to alternative plumbing

This is the dressing.  Nurse Dereka has gotten very good at it and thank goodness we didn't know in November that it would still be operative in January!




This is the basic plumbing set-up.  Two kidneys, two ureters, one bladder.  John's left ureter is blocked.  I added this because Eliza was unable to picture this piece of innards.


When I blogged two weeks ago, I mentioned that we expected some follow-up from the physician leading the charge with John's case.  We got a call the very next day and were bidden to return to Boston on the 2lst.

  Our doctor is the elegant and splendidly named Aria Olumi and we like him very much.  This despite the fact that he is quite guarded about what might be going on with John.  He suggests that the ureter problem is probably not connected to the bladder problem, being very close to the kidney and relatively speaking very far away from the bladder.  He showed us the pictures from the most recent contrast study.  It does not look to him like cancer but it might be (his words).

So, the next step, to take place on 5 February, is to return to Boston.  On that visit they will remove the stent from the ureter and examine the flow using constrast.   If by some miracle the ureter works properly both stent and tube will be gone.   If the ureter is still constricted they will replace the nephrosomy tube but not the stent.  In that case, the kidney will simply be drained by the nephrostomy tube.  Without the stent, Dr. Olumi will be able to take a better look-- not with dye but with a scope.

We questioned him about possible alternative scenarios but he skillfully avoided saying anything speculative.  He simply told us that future steps would depend upon what he sees with the scope.  We also questioned him about the delay with the BCG chemo for the original cancer and he was reassuring that we are well within the parameters of effective treatment.

 It was a very civilized trip compared to some of the others-- an appointment at 10:15, no procedures, out by 11:30 and home before 2:00.  One might question why we had to drive to Boston at all for a consult that could have taken place by phone but then one remembers that physicians cannot bill for phone consults.  And, he did show us pictures.