My Kidney Operation in Thailand
Author One Week After Kidney Operation
Dealing with a Kidney Tumor
After the discovery of a large mass on my left kidney on March 25, 2015, I didn't waste any time in scheduling an operation to have the large tumor and kidney removed. About one month later on April 26, I had the kidney and tumor removed in a four hour operation at Bumrungrad International Hospital in Bangkok, Thailand.
The finding of this large later to be confirmed cancerous mass on my left kidney was quite a shock and surprise to me. I had been experiencing no symptoms such as abdominal or back pain or blood in my urine. The abdominal ultrasound which showed the large mass was suggested by my general practitioner at Bangkok Hospital in Udonthani as part of health screening.
In this hub, I recall my thoughts, feelings, and actions before the kidney operation and in the immediate few days following my operation.
Tumor on My Left Kidney
Finding a Large Tumor on My Kidney
At the suggestion of my general practitioner at Bangkok Hospital in Udonthani, I had an abdominal ultrasound taken on March 25, 2015. I will always remember this date because the results of this ultrasound revealed that I had a large mass growing on the upper part of my left kidney. I should have suspected something was wrong when the doctor doing the ultrasound uttered the word "yaai" meaning large in Thai as she was scoping my abdomen.
When my GP discussed the finding of a large mass while reviewing the ultrasound results, I was initially in a state of denial. After consulting with another doctor, my GP advised that I have a CT scan done the next day, March 26, to confirm the presence of a mass on my left kidney.
After undergoing a 30-40 minute CT scan on the morning of the 26th, I returned to see my GP that same afternoon to see clear pictures of the size and location of the tumor. There was no denying now that I had a large tumor about the size of a softball on my left kidney.
My GP strongly urged me to consult with a urologist about treatment for the tumor. As I sat conversing with the doctor, it finally hit me that I most probably had a cancerous tumor on my kidney and needed to immediately deal with its treatment. I had no time now to feel sorry for myself.
Taking no action against the tumor was not an option because the mass was quite big and there was no guarantee that it would stay contained in the kidney before spreading to other organs in my body.
A radical nephrectomy or removal of the whole kidney and mass was strongly recommended by the GP as the best and only sensible course of action. Chemotherapy or radiation treatment would most probably not work.
On March 31, 2015, I visited Bumrungrad International Hospital in Bangkok and consulted with a urologist and surgeon who had received the latest training in laparoscopic surgery in the United States. Dr. Kittinut reviewed my CT scan pictures and strongly urged that I have the kidney and tumor removed as soon as possible. April 26 was set as the date of the operation assuming that I passed all of the heart investigations prior to the operation.
My Echocardiogram Investigation
Heart Investigations Prior to My Operation
On April 25, the date before my scheduled operation, I returned to Bumrungrad International Hospital's Heart Center for some heart investigations. Prior to signing off on okaying me for a kidney operation, cardiologist Dr, Chutikorn had to make sure that my heart was in good operating condition.
Dr. Chutikorn did this by first examining some drawn blood and then determining my bleeding time through a procedure which measured my partial thromboplastin time and prothrombin time. Next, an EKG was taken of my heart.
Finally, due to my age being over 70, I had to undergo the full investigation of an echo-cardiogram which displayed my systolic and diastolic function, size of my left and right ventricle, aortic root size, check of my heart valves and pericardial effusion.
After the cardiologist examined all of my test results, I was okayed for the kidney surgery scheduled on the 26th.
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Pre-Operation Experiences - Morning of April 26, 2015
After a restless night in a Bangkok hotel room, I awoke a little before 4:00 a.m. to have an extremely light breakfast and then take my hypertension medication. I had to get up this early because I could have no food or drink for eight hours prior to my scheduled operation at 12:00 noon.
At 7:00 a.m. I arrived at the Admitting Center of Bumrungrad Hospital. Following what seemed like an eternity of filling out consent, insurance, and other forms, I was given a hospital identification wristband and finally taken to a hospital room at 8:30.
During the next two and one-half hours, my wife was allowed to accompany me in the hospital room before I was wheeled down on a gurney to an ICU room outside of the operating rooms on the fifth floor.
During this time period, I had to first take off my shoes and all of my clothes before putting on a one-piece operating room gown. I had to also remove my glasses, watch, and dentures.
Next, I was given an enema of a 1,000 cc solution to clean out my bowels.
Finally, an attending nurse put an IV into my hand and started running a 1,000 cc glucose solution through my veins.
At 11:00 a.m. I finally was moved from the hospital room to an ICU room for final pre-operation preparation. After a nurse measured my blood pressure and put an operating room cap over my head, I had meetings with the cardiologist, anesthesiologist, and urology surgeon who would be removing my left kidney with tumor.
The cardiologist saw me first and asked me how I was feeling before listening to my heart and lungs. He told me not to worry about anything and assured me that I would easily get through the operation.
A female anesthesiologist saw me next and definitely took my mind off of the operation by telling a very funny joke about males wearing urinary catheters.
Finally, the surgeon saw me and explained what he was going to do during the operation. My first incision would be at 12:25 p.m. Dr. Kittinut then told me to relax and not worry about anything. When not talking to the doctors, I was able to watch TV, relax, and definitely take my mind off of the operation.
My Kidney Operation
Memories of the Operating Room and ICU
At high noon, I was wheeled on a gurney through a maze of corridors in the operating room complex until finally reaching the operating room designated for my kidney operation. After being transferred from the gurney to a simple flat slab, I remember having both of my arms tied down. The anesthesia must have really been potent because that was the last I remembered of the operating room until I came to in an ICU room about three and one-half hours later.
As I regained consciousness, I saw my wife and the surgeon standing in front of me. I remember being in a lot of pain and wanting to sit up. Although I was somewhat disoriented, I can recall Dr. Kittinut showing me a picture of the tumor and kidney on his cell phone. I also remember talking to my mother-in-law on a cell phone held by my wife. It was surprising that the first words I spoke after coming out of the influence of the anesthesia were in Thai and not in English.
As I finally became totally aware of my surroundings, I felt and noticed that I was wearing a urinary catheter, and also compression cuffs on my legs to prevent thrombosis or clotting of the blood in the legs.
I must have been given a painkiller, because the only real pain I could feel was in my back caused by lying on a rigid hard slab for three and one-half hours.
An IV was pumping glucose and antibiotics into my body, and I had a cuff on my upper right arm which automatically inflated on the hour to measure my blood pressure.
That night I was unable to sleep very much due to the pain in my back, hourly measuring of blood pressure , and the constant chatter of nurses who had their break room next to my ICU room.
Recovery in a Bangkok Hospital Room
Bumrungrad International Hospital's Flower Garden
Bumrungrad Hospital Nurses
Recovery in Room 926 April 27-May1
At 11:00 a.m. on Monday morning, April 27, I finally was transferred from ICU to a semi-private hospital room on the ninth floor.
During my first day in the hospital room, I had very little mobility because I was constantly hooked up to an IV and wearing a urinary catheter. Since I couldn't eat solid food until the evening, I received both glucose and antibiotics through an IV.
I was, however, able to stand up early in the afternoon and walk a little through the hospital room and in the outside corridor.
By mid afternoon on Monday, I was finally able to receive guests and talk on my cell phone. My good friend living in Bangkok came to visit me early in the evening, and I also received calls from my son and a British friend in Udonthani. My wife was also able to be with me all day until 10 p.m.
On the second day, Tuesday, I regained a lot of mobility with the removal of my urinary catheter and the discontinuing of constant feeding of glucose through an IV. I was now receiving only antibiotics through the IV.
My cardiologist and urology surgeon were checking on my recovery and wound healing every day. I was also having blood tests every day to check the function of my good remaining kidney.
Besides taking deep breathing exercises, I was able to walk around the corridor on the fifth floor and also go out into the garden on the sixth floor.
My wound was hurting less; however, I still had not had a bowel movement since the morning on the day of the operation. I was given a laxative in hope that I would soon start becoming regular in bowel movements.
On Wednesday, Dr. Kittinut had the results of my tumor tissue examination. Although the tumor was cancerous, the doctor was confident that he had removed all of the tumor with the kidney, and that the cancer had not spread to other organs.
I was still getting antibiotics through an IV and could not pass gas or have a bowel movement. The doctor gave me more medicine for gas and more laxatives. This did not immediately help because in the evening I requested an enema to relieve the pain and discomfort of not passing gas or stool.
During the day, I was sitting up almost all of the time and getting to know my hospital roommate from Bengladesh. He was a young man who had just had an operation to remove a tumor behind his eye.
Thursday, April 30, was my last full day in the hospital. The doctor was tempted to release me on this date, but we decided it would be best for me to spend another day in the hospital. I was eating regular food now and finally starting to pass gas. I was still also getting regular antibiotic injections through an IV.
On Friday, May 1, both my cardiologist and urology surgeon cleared me for discharge from the hospital before 11:00 a.m. Both doctors, however, told me to take it easy in physical activities for at least two months and to come back for outpatient appointments and a blood check for kidney function on May 7. I was given a number of different medicines including antibiotics for five more days, a pain killer, laxative, hypertension medication, and pills for my prostate to facilitate urination at night.
On May 7, 2015, I had outpatient appointments with Dr, Chutikorn and Dr, Kittinut. Dr. Chutikorn strongly advised me to monitor my blood pressure twice a day and to double the dosage of my prescribed medication if my readings exceeded 140/90. Dr. Kittinut noted that my remaining kidney function still wasn't normal but that this often happened when one kidney was removed. He also arranged for me to return to the hospital on August 1 for a follow-up whole abdomen ultrasound.
I am hoping and praying that all of the cancer was removed in this operation, and that with a positive attitude I will enjoy many more years in Thailand with my wife and other loved ones.
Latest Update to Summary
On August 1, 2015, I returned to Bumrungrad Hospital in Bangkok for a follow-up complete abdominal ultrasound. The results of the ultrasound showed that there was nothing suspicious in my body. I also had a chest X-ray which was negative. A blood test showed that my kidney function still wasn't normal but slowly improving.
On November 21, 2015, I returned once again to Bumrungrad Hospital for another complete abdominal ultrasound, chest X-ray, and blood work. All results were normal; however my kidney function still wasn't normal but slowly getting better. On May 14 of 2016, I am scheduled for another ultrasound and more blood work. Hopefully the results will be good and I will be able to help my sister on her farm at the end of May and in June while my brother-in-law has a back operation and recuperates.
© 2015 Paul Richard Kuehn
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