[haylee_beutler]

As most of you "regulars" know, i recently posted a topic about my 22 mm stone. I read many other stories on here in order to gain some answers to my questions.

I have now had my procedure to remove my stone. Like many of you, i had lots of questions about this PCNL (perc) surgery that i was unable to answer so i am posting my story on here for others to read. There are many events of my surgery left out. If anyone has any questions about my surgery or costs, please email me at [moderator note: e-mail address has been removed] I will be happy to answer any questions that you may have. Here is my story.......

MY STORY
by: Haylee Beutler 12/14/2008
PCNL (percutaneous nephrolithotomy) surgery done Nov 6th 2008

Wednesday Nov 5th.
I pre-checked into the St. Marks Hospital in Salt Lake City. This included paperwork of my health history, family health history, medications, anesthesia form, questionnaires and of course blood tests. Unfortunately I had not had my blood taken very much in the past so I didn't realize that I’m not a very easy blood giver. It took 3 nursed 35 minutes to get 3 vials, after trying 4 different places.

Thursday Nov 6th.
I arrived at the hospital Ambulatory department at 7:30 in the morning where i was immediately shown to a room and changed into my surgical gown. (These are the most awkward gowns, but at least the socks were comfortable) My husband and my mother and stepfather also accompanied me to the hospital with my films (X-rays, CT scans and KUB). After waiting in that room for about 30 minutes, Jason from the Radiology Department rolled my bed down to their department where they prepped me for the first part of my procedure, which i personally considered the worst part of the entire surgery.
He informed me, “Once I checked into the hospital for surgery, I gave up my right to walk. Instead they would push me everywhere”

They put the IV in my arm at this part of the procedure then they had me lay on my stomach on a special table. I saw 4 different screens. (I’m not sure if this was fluoroscopy or if this was a certain type of x-ray) They prepped my back and then gave me a "conscience sedater" through my IV. This kept me awake but I wouldn't remember most of the procedure later. Then they proceeded inserting the nephrostomy tube in my back to my kidney and I believe it went down my ureter and into my bladder. This hole in my back provided the main access for the surgical part of my procedure. I was told I was in the radiology department for about 1 hr. 15 minutes then they wheeled me back to my original room to wait till the surgery.

After about 15 minutes of waiting, I experienced horrible pain. The tube in me was causing horrible cramping/pain in my bladder area and it constantly felt as if I needed to urinate. I did get up a few times to use the restroom before surgery but it did not help. Finally they wheeled me into the pre-op room. In this room they just had me waiting until they were completely ready for me. I do remember telling someone that I was in a lot of pain and I wanted to be put out as soon as possible because the pain was horrible. . I didn't wait in that room long before they took me to the surgery room. My doctor introduced himself to me again and a few of the people there with him. The anesthesiologist also introduced himself also. I remember them undoing part of my gown and getting me ready to transfer me from the bed to the surgery table, but I don’t remember anything else. I was still a little loopy from the "conscious sedater" they had given me earlier so even though I was in a lot of pain, I was really groggy. I think I had actually fallen asleep before they put me out with the anesthesia

My surgery was scheduled at 10 o'clock A.M. for 1.5 hours, but my family told me that i was in the surgery room and recovery room a lot longer than that. Dr. Gange was really nice to inform my family of the surgery progress. He informed them that the access to the stone made it a little difficult, but he was confident that he got most of it out of my kidney, although I bled a little bit more than he had expected. I do remember finally waking up in my regular room at about 4:00 PM. I was really groggy for the first 24 hours and I do not remember much. I did not have much of an appetite. They had me on a very light appetite the first time I ate, and then I was able to eat regular food after that. But I wasn't actually able to eat very much at all. I had no appetite. I also didn't drink enough the first 24 hours so they had me on a double drip in the IV. I had a bag attached to my back which drained blood and urine and I had a bag attached to my catheter which drained urine and sometimes a little blood as well. The nurses monitored these closely. But I was not producing much urine. My nurse was pretty worried so the first night they irrigated my bladder in case there was any blockage. This seemed to help. (I really have to thank my good nurses and CNA's who had to empty these bags)

Friday, Nov 7th.
I remember them taking my blood a few times on Friday. I had lost of lot of blood so instead of getting out of the hospital on Friday, like planned, my doctor put me on bed rest and they kept the catheter in me. That was a relief to me though, because I was really weak and I did not feel very comfortable moving at all. It took all my strength to move on my side so they could change my bandages.

After forcing more liquids and more food down me, I progressively started to feel better late Friday afternoon. They decided to take the catheter out so I could get up and walk around and go the bathroom myself. I felt so proud be able to walk my 2 rounds around that floor of the hospital. It was still really hard to get in and out of bed. It was painful to stretch and it also took about 5 minutes to unhook me from everything. I had boots on my feet that prevented blood clots and I also had oxygen and my tube out my back. I definitely didn't get out of bed unless I absolutely had to use the bathroom or unless I really wanted to walk around.

Saturday, Nov 8th. (Discharge day)
They kept doing blood test on me Friday and into Saturday to make sure I didn’t need to have a transfusion. Doctor Gange came and checked on me Saturday morning and told me he was going to release me considering I felt as well as I did. I ate breakfast Saturday morning and instantly became really nauseated. I vomited everything I ate, but the nausea did not go away. My body also began to feel worse. I was really dizzy and light-headed every time I stood up. After the nurses contacted my doctor, we decided it would be best to stay a little longer in the hospital. I kept eating and drinking lots of fluids and by 6:00 PM I started to feel better so I was able to check out of the hospital.

My heart seemed to race and it was sometimes hard to get a full breath so I made sure to do my breathing exercises the hospital instructed in order to break up the mucus in my lungs and help me breath better. I did this about every hour and within the first 24 hours, I was almost breathing normally.

At time of check-out, they sent me with many new bandages and tape, then gave me clear instructions to empty the bag and keep my incision on my back clean and bandaged up. I went into the hospital with myself and the clothes on my back and I left with literally 2 full bags of stuff. My nurses were very nice to explain everything really clearly and make sure I had EVERYTHING I would need.

Sunday Nov 9th.
When I left the hospital, I stayed in a hotel room until my follow-up appointment because I live about 3 hours away from my doctor. I regret getting a room with a high bed. It was really hard to get in and out of the bed. For the first few days, I really had to force myself to get out of bed and walk around. But the more often I did it, the faster I felt better. (As long as I wasn’t pushing myself to hard)

Monday, Nov 10th.
I survived through Sunday. Monday was my follow-up appointment and also my tube removal at the hospital. (Do not wear white clothing to the tube removal) I went back to the radiology department at the hospital where I laid down on my stomach on the table. The prepped my back and injected die into the tube through my back. I couldn’t see much on the screens, but they did tell me that they didn’t see any more stone fragments and I was able to have the tube removed. They cut the majority of the tube off and explained to me that it would not necessarily be painful, but there would be a lot of pressure. I definitely braced myself for the worst because the thought of them pulling a tube out of my back without any numbing medication or pain medication did not sound very pleasant to me. There was a little bit of pressure when they pulled, but it did not hurt at all. Once it was removed, I felt a lot better. I did not feel bloated and most of my bladder pain instantly went away.

I was informed that they normally do not have to stitch up the incision because it is usually only a couple centimeters in size, but mine was a little larger and the Radiology Tech, Jason ended up stitching it. He numbed it well and did a very good job. There were about 5 stitches in all. But the funnest part of the surgery was yet to come. After I left that appointment, I went back to the hotel for some much needed rest. I didn’t realize that even though my back was stitched up, there was still a hole to my kidney that had not sealed itself up yet. I drank lots of water and laid down for a nap. When I woke up and rolled over, I felt warm liquid run all down my back. Most all of the fluid that had once drained into a tube, was now running down my back and soaking my clothes. Having to deal with wet shirts and clean bandages every hour was definitely the worst part of the surgery. This only lasted about 2 – 3 days, and then my back was left to heal normally.

That same Monday, I also had a follow-up appointment with my urologist Dr. Gange. It was a very basic and routine appointment. He asked me how I was feeling and made sure I wasn’t having any complications, then he scheduled another appointment and KUB x-rays for me in 3 months to make sure I am still “stone-free”.

I was feeling really well now that the tube was removed from my back. Even though I wasn’t near healed up I felt so much better already. I traveled 3 hours to get home and began recovering immediately. I was told to take it really easy so I spent most of the time lying on the couch watching re-runs on TV and playing games on my computer. I had to be really careful I didn’t do too much to myself.