Persistence

Met with my Oncologist last week as a follow-up to the CT scan I’d had the week before.  He had already called and given me the results of the scan so the appointment with him was more a formality and an opportunity to have a full blood lab done on me.

There was one minor change in the report though.  When he called he told me that the radiologist had noted a slight hydronephrosis of my left kidney.  At the appointment though my oncologist reread the report and told me he had misread it the first time and that the hydronephrosis was noted as mostly resolved meaning essentially it was so slight as to not warrant attention.  Go figure.

I think hydronephrosis is going to be a thing with me the rest of my life.  When I think about all the reconstructive surgery they performed on me when they removed my bladder and understanding the barest minimum of plumbing concepts (stop laughing), it occurs to me that when I go horizontal, as in laying down, I get a slower flow of urine out of my stoma.  Imagine a straw attached to a bottle of water.  Now when you hold the bottle upright with the straw at the bottom the water inside the bottle will flow out rather well at whatever flow capacity the straw will allow.  Now, if you lay the bottle on its side with the straw sticking out horizontally there will be flow but at some point the flow rate will slow down as the downward pressure of the water remaining in the bottle lessons.  Eventually the flow will stop together even though the bottle still has water in it because the entrance to the straw is at or above the level of the water.

Well so it may be with my plumbing.  My kidneys empty into the neo-bladder the surgeon built for me using a length of my small intestine.  The other end of the neo-bladder exits my body next to my navel.  The exit is called a “stoma.”  Over the stoma I have a plastic bag to collect my output which I have to empty from time to time.  When I’m sitting or standing the flow rate from kidney to receptacle is at optimum efficiency.  That’s how it was designed to be.  Yet when I’m laying down at night all the design dynamics are changed.  At that time there is no doubt that some of my urine collects in the neo-bladder without being evacuated from my body and may well back up into the kidney resulting in hydronephrosis.

While going through chemo therapy I had an ongoing battle with a series of kidney infections and a relatively bad case of hydronephrosis.  Hey, things get infected, they swell up constricting all the little pipes and such.  But I’m not in chemo now and my body seems to have regained its ability to fight off those little nasty critters.  But it isn’t infections that are causing the hydronephrosis now, it’s just how things are designed.

Perhaps I should learn to sleep standing up?

In other news I haven’t been sleeping well as of late.  I’d love to claim that I don’t know why but unfortunately I do know why.  I’m trying to wean myself off the sleep aids I was given during chemo therapy.  I used to be able to nod off quickly at bedtime without any help at all.  Then along came chemo which hosed things up and necessitated something to help me sleep.  Chemo is over now and I want to get back to a life where the most I need is the occasional Tylenol or Advil.  No prescribed stuff.

It’s going to take time though and I have to be persistent in getting to where I want to be.  I went several days without the sleep aids and was pretty much miserable.  The last two nights I caved in and took the aids in order to get some much needed rest but the oddest thing has happened.  Yes, they help me close my eyes and keep them closed and, according to Marvina, I’m in a deep sleep.  I’ve even had dreams.  Still, I am absolutely exhausted as if I’m not getting any real rest.

I guess I’ll have to toughen up and suffer through the sleep deprivation until I’m off the pills.  Hopefully it won’t take long.