Living Donors Online Message Board
Living Donation Discussion and News => Living Donation Forum => Topic started by: shelley on August 08, 2011, 09:36:25 PM
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On Wed. I'll have my only conversation with my surgeon pre-donation. I plan to ask him about things I've learned here at this forum; i.e., tying off the left adrenal gland, who will fix my incisional hernia if I get one, and does he use Weck Hem-O-Lock Ligating Clips.
What else should I ask him? What do you wish you would have asked your surgeon?
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Some questions to consider: https://livingdonorsonline.org/Questions.htm
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Besides all the important health/surgery related questions you seem to already have, ask your doctor if he would take a picture of your kidney. I didn't think my surgeon would take my question seriously, but he was more than happy to take pictures for me. Well, I think a nurse was the one taking the pictures. It was awesome to see the picture of the moment when he handed my kidney to my husband's surgeon. It just made the whole experience real for me.
Good luck to you, this is an amazing journey!
Angelica
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APV- I think you should put that photo on the Christmas Card.
You could ask what percentage of times he/she has to convert to an open procedure.
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Some questions that were important to me:
- How many times they have done this procedure?
- Who will be the one actually doing the nephrectomy...the surgeon themselves or a Resident/Fellow? I am glad I asked this because it would have been the Fellow and I asked if he (the surgeon) could please be the one to do the procedure.
- I asked him to describe the entire process. He brought up my CAT scan on the screen and showed me exactly what he would be doing, what gets separated, tied off, etc. I also learned he would do a hand-assisted laproscopic surgery.
Good luck!! I felt so much better after meeting with my surgeon.
Julie
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On Wed. I'll have my only conversation with my surgeon pre-donation. I plan to ask him about things I've learned here at this forum; i.e., tying off the left adrenal gland....
Shelley,
I'm due to meet my surgeon soon, too (I think). I also plan to ask about the adrenal gland (being tired long-term is not so appealing to me, given my normal schedule). When I was hospitalized overnight last month for my testing, I asked the head transplant nurse, who did not seem to have any idea of what I was talking about.
Try to be as well-informed as possible, and be prepared (how, I don't quite know) for some defensiveness. Many docs are primed to resist any patient who begins by saying, "Umm, I read on the Internet that...." I haven't decided exactly how I'm going to phrase it, but I plan to be matter-of-fact, and ask the surgeon exactly how he knows what circulation actually remains for the adrenal gland after surgery, and how, if at all, the transplant center tracks its living donors' adrenal function.
Last week, I asked my transplant coordinator about ordering a baseline test of my adrenal function prior to surgery (an idea I came across somewhere on LDO, I think), and she seemed pretty unenthusiastic, saying that I can raise all these issues with the doctor when we meet. Fair enough. But, nobody can give me any idea of when that will be (I don't have a date for surgery yet, either), and I don't like the possibility that all this will be rushed through at the last minute.
That's one reason I'm planning to make an appointment with a nephrologist (not affiliated with the transplant center) to ask these kinds of questions. I probably should have done it sooner (though, of course, not every nephrologist is very familiar with living donor follow-up). It's not that I mistrust the transplant center. I do trust them. But keeping me well-informed is not their strong suit, and anyway I'd like access to my own information (plus a second opinion), beyond whatever information they get around to doling out to me.
Good luck, and keep us posted!
Snoopy
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Thanks to you all for these excellent questions! Angelica, I AM going to ask if he'll take a picture of Sidney, that's a great idea. Julie I WISH I could meet him in person before the surgery and have him show me on the screen like yours did. Unfortunately I'm coming from Indiana to Seattle and he can't meet with me ahead of time. Snoopy, you've refined my adrenal gland question very well, and I never thought of asking if/how the hospital tracks adrenal gland function.
I hope he's prepared to be on the phone for quite a while! What with that LDO question list and all these others, he better pull up a chair.
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Make certain to ask; post-op, who the contact will be for any questions you or your PCP about follow-up exams, post-op complications, about 1 and 2 year checkups, etc...
Good luck friend
Scott 8)
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Hi Shelley,
Ask for your pre-donation GFR, creatinine, and blood pressure. Ask what kind of numbers you can expect going forward. Write these things down and keep records so that you can note/report any future changes/fluctuations.
Wishing you good health and abundant happiness!
Laura
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Surgeon Says!
He's done over 800 nephrectomies since 1993, 450 of them are donor nephrectomies. Impressive.
He says not to worry about the adrenal gland; that it's attached in quite a few ways and blood supply to it will not be a problem even if the vein is cut. Also that even with the loss of one adrenal, the other one swells in size within 2-4 weeks and takes over. It's only if both adrenals are gone, that people start to feel it.
He doesn't do hand-assisted anymore, says the bikini-line incision gives quicker healing. Is hand-assisted a thing of the past?
I was surprised by how much I've learned at this website. So much of what he told me would happen to me, I already knew because of all of you. ♥
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Hi, Shelley.
Thank you for the update! I was happy to hear his comments about adrenal circulation. I expect to speak to a nephrologist next week; if I hear something else, I'll keep you all posted.
Be well, Snoopy
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Sounds as though it was a productive talk. I hope you're more at ease after the Q and A. Good luck and thanks for the update.
Scott 8)
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1) How soon (once I leave the recovery room) can I try to get up and walk?
2) How soon will my appetite return? (mine didn't return for about 2 days)
3) How much urine should my body produce during the 24 hours AFTER the surgery?
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I believe mine will be hand assisted. I have been told that there will be a couple of small incisions for the cameras and a larger horizontal incision below my belly button for the surgeons hand.