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Just waiting to be "processed" by the admittance service. In fact, I've just been called in by Annika to get the necessary papers, for the "warder" to be called, and for me to be taken to the room.

See you when I get back!


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Location:Hospital San Jaime

All systems "Go"

I had a chat with the anaesthetist yesterday and all is set to have the operation to remove the left kidney and ureter next Monday morning, 26 November.

I have to be at the hospital at seven-fifteen in the morning (07:15!)—it's enough to make you ill.

Still, I should be first in the queue and therefore also be served first. Like being at the butcher's in so many ways! (300gr. of kidney, please…)

Actually, I used to quite like steak and kidney pie (though not so much the pudding). Well, I liked the steak bit; I used to leave any kidney I found on the plate. Faggots and peas, lovely.

Through the Keyhole

All the results are now in from the procedure that was carried out at the beginning of last week. The cytology report of tests carried out on samples taken from the inside of the left kidney speak of abundant malignant neoplasia cells, with the one-word conclusion, "Carcinoma" (cancer).

Yesterday and today I spoke to the doctors invloved and the decision has been taken to remove the left kidney and ureter. This will be done through means of what is politely referred to as keyhole surgery, though the keyholes are still quite large, as can be seen in this video (not for the squeamish) of a similar operation, though on the right side.

If you like long words, the operation is called a nephroureterectomy, a word which would probably win any Scrabble match.

The date of the operation must still be fixed, depending on approval from the insurance company.

Good news, bad news

We had to be up early on Monday morning in order to be in time for my appointment at the hospital at 07:15. Yes, that's a quarter past seven in the morning!

We arrived on the dot and were surprised to find that the admitting staff were there, too (last time we had to wait about twenty minutes for them to arrive), and that all was ready and waiting, so that withing about ten minutes we were on or way up to the room.

Shortly after entering the room the nurses were there with their razors, ready to shave me in all sorts of places: I was still in my ordinary clothes! So, out of the street clothes, into the operating gown, lie on the bed, scrape, scrape, scrape, ready to go down to the theatre area, here comes the orderly and off we are. Things have never moved so fast in Spain, I can assure you.

And it didn't stop there, for I had hardly arrived at the waiting area, when a nurse was already trying to find a vein in my hand (always difficult) and the anesthetist was asking questions. I don't know much of what happened after that, as I was given sedation: I vaguely remember being lifted up in order to have the epidural injection in my back, but that's about it. Next I know, I was in the recovery area and shortly after that I was back in my room with full plumbing (both the room and myself).

The procedure that had been carried out was a ureterorenosopy: looking up the ureter and into the kidney. The kidney couldn't be reached about a month ago, so a ureteric stent had been in place since then. This time, presumably thanks to the stent, the kidney could be reached and examined.

What was found is both good and bad news.

Good because nothing was found.

Bad because nothing was found.

The doctors had expected to find the tumour in the kidney. Had they done so, there was a chance it could have been removed there and then. Even if it were too large to remove immediately, knowing its location would have meant that an operation to remove it could have been planned. Now, hoever, things are rather more problematic. As I understand it at the moment, either the tumour is a flat one, which is more difficult to locate, or the tumour is elsewhere.

In any case, the doctors involved are having a meeting about the case this week and I shall know more about the possible courses of action next week.

I feel a lot better after this procedure than after the previous one. The stent has been removed, so I am much more comfortable. There is already no more blood in the urine (last time it took a full week for visible traces of blood to disappear) and I have far less pain when going to the toilet.

So it's not all bad news after all.

A Date to Remember and Sand

Sand brushed from just a few tiles

We went to the hospital this morning to see if we could get any news about the next procedure. Of course, all was in hand and they would call me back this afternoon to let me know when it would take place.

To be fair, they have just called back and I must first go in next Tuesday for a blood coagulation test and to speak to the anaesthetist, in preparation for the actual procedure, which is then planned to take place on 29 October.

A day to remember! Not especially because I shall be yet again in an operating theatre, but because it will be our 41st wedding anniversary!

Meanwhile, the rest of Spain seems to be having plenty of rain, but here only a few drops have fallen from what is admittedly an overcast sky. The drops fell as we were driving back from the hospital, but there were insufficient to even give one swipe with the windscreen wipers.

Last night it rained in a different way, with lots of very fine almost red sand having fallen whilst we were sleeping, so that we were met this morning with a light dusting of sand over the tiles, the car, the windowsills… heck, everywhere where it could possibly land. Apparently there have been some very nice sunsets in the north of Europe because of the amount of sand of Saharan origin that is flying around in the atmosphere. Well, there's less of it now, as a lot fell in Guardamar.

Sand from around the car

Still waiting

Haven't heard anyhting from the hospital yet, so I still do not know when the next procedure will take place.
It's not an ideal situation, not knowing when you will have to go back into the hospital. Not that I am especially looking forward to going in again: the procedure itself isn't a problem, as I shall be anaesthesised, but the recovery is initially painful and continues to be unpleasant to say the least.
At least I shall (I hope!) be rid of the stent that was put in last time. It is uncomfortable at the best of times and I am constantly aware of it.

A failure

As reported previously, I had to go to the hospital on Tuesday for a procedure known as a uretroscopy. It was hoped to be able to pass through the left ureter into the left kidney and thereby perhaps find the tumour that is producing the malignant cells.

Things, however, did not go as planned.

The camera was able to enter the ureter easily enough and could be moved about half way along that tube. But then the ureter was for some reason constricted and the camera could not be moved any further, so that the kidney could not be reached. Several attempts were made, but all with no success. It was therefore decided to place a stent in the ureter. Hopefully, this will expand sufficiently to allow the camera to pass freely to the kidney at a later stage.

As a result, I shall have to return to the hospital in two to three weeks time in order to undergo the uretroscopy procedure again.

On a more positive note, the right ureter seems to be perfectly clear. Samples were again taken from that area to check for the presence of malignant cells, but that is more precautionary than anything else. Also the opening to the left ureter and the first half of that tube are clear of tumours.

In case you are wondering, the uretroscopy procedure was carried out under epidural anaesthetic. The procedure itself was therefore quite painless, though afterwards, once the anaesthetic wears off, there is a level of discomfort, as a catheter remains in place all during the night. After removal of the catheter, the pain when urinating is quite significant, though can be controlled to a certain extent with pain-killers. I also feel some discomfort in my left side, though if this is a result of the work carried out during the procedure, or because of the presence of the stent, I do not know.