Having A Nephrectomy – What? Why?

So, the day that Steve Jobs died I found out that I’d be probably having my right kidney removed. The funny thing was, I never even thought I had any kidney issues. Turns out I have a congenital thing called an UPJ obstruction:

Ureteropelvic junction (UPJ) obstruction is a blockage in the area that connects the renal pelvis (part of the kidney) to one of the tubes (ureters) that move urine to the bladder.

UPJ obstruction generally occurs when a baby is still growing in the womb. This is called a congenital condition (present from birth). Most of the time, the blockage is caused when the connection between the ureter and the renal pelvis narrows. This causes urine to build up, damaging the kidney.

So my right kidney (nicknamed Krueger) has been underperforming for years because of this and now can only do 26% of the work. Left kidney (still unnamed) has grown larger and has been working very hard for a very long time.

So how did I find this out? Well, I was sort of feeling beat and run down and had just been diagnosed with high blood pressure. My doctor wasn’t sure what was going on, so ordered a CAT scan. Here’s part of the scan:

CAT Scan

On the scan, my doctor saw that my right kidney looked smaller and my left one looked bigger. She decided to send the scans to a urologist. The urologist figured out what was going on pretty quickly and sent me to have a nuclear medicine test. In this test, they shoot nuclear poison stuff into your vein and you can watch how fast your body moves it through your system. Krueger (right kidney) didn’t do so well. In the renogram below, you can see that the poison is filling up really fast at the right kidney (on the left side as the camera was taken from under my body)  and that left kidney finally just takes most of it eventually.

Nuclear medicine

laparoscopic nephrectomyFascinating stuff right? So the deal is, because Krueger isn’t doing enough work, there’s not a good reason to try to save him. Years of this UPJ issue has caused him some big damage so dude needs to be removed.

This Thursday (November 10, 2011)  I’m going to have something called a laparoscopic nephrectomy to remove the kidney. So instead of a big slash across my side, I’ll most likely just have 4 poke holes and a slit where they slide out the kidney. Here’s a diagram where they’re taking out the left kidney. It should take about four hours for the doctors to do this.

So, the weird thing is that I don’t feel any pain or discomfort from Krueger, so it sort of seems strange to go through a major operation when I don’t feel horrible to begin with. That aside, I might be able to maintain a normal blood pressure again, which would be a good thing.

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