Dr. Elio advised me to undergo Cystoscopoy Retrograde Pyelography. At first,  I was thinking twice if we will still proceed with the procedure but I decided to continue it to completely diagnose what causes the dilation of my ureter. Since we went home last June 27 for the 40 days memorial of our Dad,  I asked my Mom to come with us in the city to accompany me during the procedure.

Five in the morning of Tuesday, June 30, preparation for the procedure begins. I ate as early as 5am because I was told to fast (again and again) for 8 hours before the procedure. 7am, my Mom and I are already in St. Luke’s Medical Center for admission; processed papers and finally I got a room. It’s just that it was a ward because there’s no available semi-private room.

Oh No! I can’t tolerate staying in the room (even my Mom) with 4 patients who have severe illness. One with cancer, the other undergone operation, the 2 others  I don’t know. It feels like I get more sick staying there. I don’t even want to lie on my bed, even my Mom. So I called the attention of my nurse to transfer is a private room. We really can’t take the environment any longer.

Simple conversation with Mommy. We laughed at little things – our observations, experiences, anything! I really miss being with her. Maybe if I’m not hospitalized, I wouldn’t have time like this with my Mom.

11am, my nurse have to give me dextrose so I have to change my clothes with patient robe. The pain started when the first needle was inserted in my left hand and it was bulging so they have to remove it and do it again with my right (ouch!)

12nn, the Operating Room staff came to take me to the OR. ‘T was My first time to ride a stretcher and I felt nervous ‘coz this is also my first operation ( at least I am conscious ). My Mom with a prayerful heart walked with the staff to bring me their and she was told that they will just bring me back to the room after the procedure.

Inside the OR, I saw a lot of medical equipments for monitoring patients condition. Nurses, doctors, come to talk to me one after the other to brief me on the procedure that will be done. After about an hour, liquid for sedation was injected and few minutes after I was brought to the main room; I fell asleep; lost my consciousness and the procedure was done. Then, I woke up the staff told me, we’re bringing you the the recovery room.

With half of my body numb (since Regional anesthesia, spinal to be specific was used), waaah! I can’t move my hips and my legs and got back of being asleep as I force to do it. After four hours, finally I can feel my lower half and was able to move my legs so Iwas brought to my room (this time a private one ) with my Mom worrying why it took so long for me  to be backand Vin waiting. Our dear Ms. Aly and my Ate also came to see me.

It really feels different having our Mom around. She take cares of me so well from urinating, fixing my hair and my clothes, changing my undies, preparing my food, giving me my water, handing my phone and the tv remote control, plus all the advices and words of faith, everything! I just can’t imagine how could it be without my Mom in this critical procedure.

Afternoon the next day, I was discharged from the hospital together with my Mom still and this time with Sir Jorge. Thanks to Intellicare, our HMO service provider. It shoulders the more than Php70K bill. I only paid P2K plus for the excess in the room that I stayed.

Bonding with My Mom

I still need rest to recover so I spent one more day at home with my Mom.

She prepared our food (that I miss about her. She’s good in cooking).

She nagged at me when I opened my laptop (haha!).

She washed our clothes (after so long time, because I’m not used of asking her to wash them since I was in grade 1 and I really feel shy asking her to do it unless she volunters) *happy*.  For the first time, I felt being dependent to her (since we were taught of being independent kids).

We looked at old photographs, we recalled memories of our Dad, we shared stories of life. It was really fun and I felt so happy spending the day with my most loved Mother.

I remember the words I told her, “ngayon nga lang ako maglalambing sa’yo”. And it feels great having her to kiss before going out the door, hugging her when I arrive and embracing her good night.

Yes, I got sick and I don’t like it. But this moment, unfortunately I was sick is very precious and memorable to me. Special times spent with a dear Mom, the best one!

Description

The procedure is carried out in order to obtain a diagnosis for patients with symptoms such as recurrent infection, pain, bleeding, difficult or frequent urination.
Cystoscopy is a procedure which is carried out using an endoscopic instrument to visualise the lower urinary tract which includes the bladder and the urethra (tube draining the urine to the outside).
Cystoscopy is usually carried out as a day surgical procedure and generally speaking admission to hospital overnight is not required but may be necessary if further procedures are carried out. The need for admission will be discussed with the patient after the procedure has been completed. This is necessary in fewer than 1 in 3000 patients.

Procedure
The procedure is usually carried out under a general anaesthetic with a rigid instrument. That is, the patient is completely asleep. Sometimes the procedure may be carried out under regional anaesthesia where the patient is given an injection into a vein to induce drowsiness and another injection is placed in the patient’s back so there is no feeling or pain below the waist.

FLEXIBLE CYSTOSCOPY
Alternatively if it is proposed to carry out a Flexible Cystoscopy, the patient is usually wide awake with no sedation and a local anaesthetic jelly is injected down the urethra in order to reduce sensation. This is done without the use of a needle.

Advantage
The advantage of Flexible Cystoscopy is that fasting is not needed and sedation, or anaesthesia (regional or general) is not needed.

Disadvantage
The disadvantage of Flexible Cystoscopy is that if there is a lesion present which might require removal or biopsy, (sampling) then that may not be possible to be carried out using the flexible cystoscope, and it may be necessary for the patient to return at a later date and have a general anaesthetic in order for the lesion to be removed with a similar rigid instrument.

Cystoscopy & Retrograde Pyelogram
A thin plastic tube is passed through the cystoscope and up the ureter to the kidney where dye is injected to show the lining of the kidney and drainage down the ureter on X-ray. This is carried out to help diagnose any abnormalities in the “pipes”.

Before the Procedures
Your admitting nurse will take down the patient’s history and prepare the patient for theatre.This may include:
Collecting a sample of urine before the procedure.
A shower with careful attention to the genital area. NB. soap only, no powder or deodorant.
Dressed in theatre attire.

Consultation by the Anaesthetist and pre-med given if ordered.
Nursing staff will escort the patient to theatre.
The patient will continue to remain fasting until after the operation which means nothing to eat or drink, including lollies and chewing gum.
There should be no smoking prior to the anaesthetic.
Generally thepatient will fast for 4 to 6 hours pre-operatively.

Post Procedure
When the operation is over, the patient will spend a short time in the recovery room where the nurses will monitor the patient closely until awake or feeling is regained in the legs (if a spinal anaesthetic has been given).
The staff will take the pulse, blood pressure and temperature regularly for the first couple of hours. This is routine.
There may be an IV (drip) in place which is providing liquid until the patient is able to drink normally.
There may be some bleeding in the urine but it is usually of small amounts as a result of the manipulation and will settle spontaneously with a high fluid throughput.
Occasionally there is some discomfort on passing urine and this may be helped by Ural or Citravescent.
The patient will be reviewed prior to being discharged from Day Surgery and the findings, diagnosis and proposed plan of management outlined. It is often a good idea to have a carer with the patient who is driving home to be present at that time in order that some drowsiness associated with the anaesthetic does not affect understanding.

Referring Doctor
The referring Doctor or General Practitioner will receive a report on the procedure, recommended treatment and follow-up within 24-48 hours after the procedure.

Follow Up
An appointment for review at the consulting rooms will be made prior to discharge.
Precautions & Guidelines – Admission to hospital
The patient must bring all medications to hospital at the time of the admission. No medications should be ceased unless the patient is instructed to do so by the Doctor. The patient must bring all X-ray films if requested in order that the procedure may go ahead.

From: Cairns Urology

After presenting the result of Ultrasound to Dr. Elio, he recommended right away that I have to undergo Extracorporeal shock wave lithotripsy (ESWL). However, I need another examination called CT Stonogra to check if I have other stones formed in my Ureter and bladder.

So immediately, I went to the Intellicare’s Office to seek for approval. Thank God! CT Stonogram and ESWL is approved. So I don’t have to worry on the expenses. Immediately I got my CT Scan schedule

After knowing that I have kidney stones, I have already prepared myself for this. I have set in my mind that in any way the stones should be removed – though I prefer the woundless procedure (that’s ESWL).in

I feel like I have a fever for two days so my Boss told me that I can take a sick leave. So I decided to see a doctor because my back is aching, below the ribs. I had urinalysis, CBC and ultrasound the next day.

I have normal urine, normal blood creatinin but in the ultrasound it was found out that my right kidney is swollen and it has two stones formed – one is .8cm and .9cm. Dr. Embry prescribed me medicines (and my antibiotic is so expensive..another haissst!).

I still have another examination, X-Ray of the KUB (IVP). Hopin’ that the medicine worked and I don’t need a surgery.