I've Lost my Lymphocele and I am not Quite Sure What to do About it

You deserve an update.*

It’s been nine months since the fated let’s-give-a-third-kidney-transplant-a-try-gee-wouldn’t-that-be-fun surgery. And now, these nine months later, I’ve given birth. Well, lymphocele birth, that is. I’ve given birth to a lymphocele but I am not quite sure what I’ve done with it. It’s all very embarrassing. Have you seen it? It’s not like it can just disappear. It has to be around here somewhere, right? Gosh, I’m so forgetful sometimes.

Perhaps I should clarify. Since its insertion into my abdomen last July, this kidney has had an unwelcome companion, the lump o’ lump lymphocele. These two have each fought for abdominal space,** and unfortunately, the lymphocele won out, with the lump o’ lump rather unceremoniously wrapping itself above, behind and below the poor kidney. What once was a somewhat (re: thirty-five percent working) happy organ transplant swiftly became an unhappy, swollen-with-backed-up-urine one. To ease this hydronephrosis,*** a nephrostomy tube (aka: neph tube) was deftly poked into the kidney to relieve the pressure. The plan was to have this neph tube for three days.

Unlike the Easter story, however, day three of having the neph tube and the accompanying pee-bag came and went without much fanfare. And most definitely no angels. Instead, I would be stuck with the tube ‘n’ pee-bag for the next eight months.

In a desperate attempt to rid myself of this lymphocele and the ensuing piss-bag dangling off my leg, last December I agreed to a lymphocele marsupialization surgery. It was a difficult procedure. Further, it did not seem to do the job. I now found myself in a worse condition than prior to this surgical intervention. My creatinine soared to 335. I did not feel well.

With the lymphocele not going away, and the kidney suffering because of it, the final option to deal with the lump o’ lump was presented: I would undergo multiple ethanol injections into the lymphocele, in hopes that the alcohol would cause the lump to ‘dry out’ and seal itself closed. Funny enough, this did not sound like fun to me. I did not like the idea, and by this point, was slightly skeptical of any proposed treatment.

I asked the transplant clinic for a second opinion regarding the lymphocele. I could not be offered one, as it turns out Dr. Slice and Dice is the only such specialist in this province. Thank you, Manitoba.

So I contacted the Mayo clinic in Rochester, MN.

An appointment was quickly set up for the middle of April. Oh, and then! Riding on the hope of getting another opinion from the medical team at the Mayo clinic, came the later email that oh-so-casually mentioned a required minimum $50,000 US retainer prior to my appointment.

Ha.

(And that’s when I got down on my knees and thanked God once more for the tenacity of good ol’ Tommy Douglas and his gumption in getting socialized medical care introduced into this country).

Sean, frustrated by this ongoing ordeal with both the lymphocele and the neph tube, and learning of the $50,000 US retainer requirement required by Mayo, in turn, called the MB nephrology clinic and kindly but firmly requested an inter-provincial referral. Thankfully, such a referral was tentatively set up with a specialist in Edmonton, AB.

But each doctor -- Dr. Slice and Dice, the Mayo team as well as the AB specialist -- did not wish to proceed further with my case until another abdominal CT was completed. This was ordered by Dr. Slice and Dice for early March.

I then inform the Mayo clinic that I cannot yet confirm those April dates, and hope that they hold them for me until that time. The Alberta specialist appointment is likewise left dangling. Any decision is awkwardly deferred, pending the outcome of the dang CT test.

March rolls in. I have the CT scan. I wait for results.

March 16. I see Dr. Slice and Dice. We view the December pre-marsupialization surgery CT scan. It shows Mr. Lump o’ lump strong and working his way around the kidney. We then look at the newest CT scan. The one done in March. And that’s when we see it: the lymphocele is missing.

The lymphocele is missing!

The following day, I undergo one more nephostogram x-ray and then the neph tube is capped off. Today, I still have the (shortened) tube but I no longer have a piss-bag. My left leg is not requiring a daily tensor bandage. I do not have a lump o’ lump above, around and underneath this kidney. I am not sure what to think, but for the first time in months, I find myself cautiously optimistic.

Here’s the deal. Perhaps the December surgery worked after all. Perhaps it just took time for the lymphocele to fully drain. Perhaps it was, at hearing the news of the resolved lymphocele, what one of my excited-at-the-news nephrologists quietly hypothesized: perhaps this is a work of divine intervention. I don't know. I like the idea of divine intervention. But I likewise know the Divine to be wildly creative and resourceful. I think he**** is and was able to use a combination of all three: the surgeon's hands, the natural draining of the lymphocele, and what we know as a bend in natural law. I can only surmise. 

So I’ve lost my lymphocele. If you happen to see it, please say ‘hello’ from me and my kidney, and then leave that dang lump wherever it is found. I really don’t need it back. Thanks.

 

*Sean said that I ought to write an update and not just draw a random illustration (see last week's post) of Mr. Lump o’ lump saying goodbye to this kidney. He’s right, of course. You deserve more than a doodle. I sometimes forget that you are not all in my head. 

**unlike the kidneys you are born with, transplanted kidneys are placed in the abdomen. I now have three in there. It's getting to be a bit of a kidney party, I'd say.

***hydronephrosis:  a fancy-dancy medical term meaning a swelling of the kidney due to backed-up urine. Laymen’s definition: basically a urine-filled kidney balloon.

****I'm using the personal pronoun of 'he' for God due to ease of writing. I do not assign male or female identity to the Creator (read: I do not think he has a penis).*****

*****yes, I just used the word 'penis' in my post. In reference to God. Yikes. At least it is only in the footnotes. That doesn't really count, right?