Ureter
| Discussion in 'All Categories' started by Shreya Nimonkar - Mar 19th, 2013 2:00 pm. | |
Shreya Nimonkar
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I was having few health problems; I used to get exhausted very soon and had body pain during menses. I even had irregular periods with very less bleeding and clots. I consulted our family doctor for this he guessed it would be rather because of some family stress (my mom in law was at her last days due to Cancer) so he gave some calcium tablets. As this had no effect I again consulted him and he had some blood tests done and also as this was related to my menses he referred a lady gynecologist with whom I would be comfortable. My first visit to gynecologist was on 15th June. She had started initially with some medicines with weekly follow-up. Then after few days she advised me to go for a DNC with prior complete blood tests. As this may clean and clear the problems if at all are related to the same. So I was admitted to her hospital for a day and a DNC was done on 20th of June. And the same was sent for biopsy. The biopsy report said HYPERPLASIA OF ENDOMETRIUM WITHOUT ATYPIA which she explained that the uterus has to be removed or else it may cause cancer. She gave two options for the surgery. The regular general surgery which has quite many stitches and has lots of care to be taken also need more days to recover and the other Laparoscopic method, which is comparatively costly but the easiest & simple and fast to recover comparatively to general surgery. I and my family was not prepared for this as my daughter was supposed to appear for her SSC Board exams. And I was working for a pvt firm where taking leaves was difficult. On this she said we will maintain a track of the menses cycle every month. She gave some medicines and called for monthly checkups. From June 2010 till Oct 2010 I visited her during 4-5th day of my menses. Then in October when I visited her and consulted her she said we have to hurry up for the removal of uterus, as the things are not working as expected. As the diwali vacations were near we decided to get operated (Laparoscopy) during vacation time so that the entire family may not suffer. And the convenient date decided was 11th of November 2010. Some pre operative tests were recommended by her like Sonography, ECG, X-ray, Urine, Blood, Liver function test. All the mentioned tests were done and the reports were absolutely normal to proceed. Even blood bottles also were booked in advance if required. I got admitted (empty stomach) on the 10th November -2011 in the late evening. They kept me on a bottle of glucose (IV). And operation was fixed on 11th November at early morning around 5 - 5:30am as to avoid the load shedding problems. On 11th Nov-10, the on duty sister over there prepared me for the operation by checking ‘BP’ which was absolutely normal. The Doctor had arranged for the anesthetist and the other co-doctor from outside who carried the laparoscopy instruments for operation in Gynecologist’s Hospital. She was not equipped with the instruments of her own to do a laparoscopy. Finally the operation was finished by 7.30 am in the morning But my BP went on a high so I was kept under observation by these 3 dr. After operation I was shifted from Operation Theater to special room where they monitored the pulse rate, BP, and oxygen level. They had to arrange oxygen cylinder at the last moment and they had a provision of this but the cylinder was very hard to open as it was not in use since quite long back. After 2 – 2 ½ hrs i.e. by 9- 9.30 I came out of the anesthesia effect and was being normal gradually. Then the oxygen mask and BP monitor was removed. I was feeling weakness and drowsy .The removed uterus was sent for Histopathy on the same day i.e. on 11th November. I was admitted there for 4 days recovering slowly, I got discharged on 14th November but I was having very severe burps continuously. Even after discharged from hospital. I omitted while eating and had to rush back again to the hospital where Dr did blood and urine test immediately. I was also suffering from constipation, burps and uneasiness. The report said I had a lot of urine infection so she gave me many medicines to take for a month’s period. But no result for the constipation was seen, so she kept on advising urine culture test and blood test many often but nothing worked out. After few days i.e. on 25th December she recommended Urologist for the urine infection problem. We got his first appointment on 27th December. As per his consultation he too had asked for several tests like urine, renal profile, CBC And kept me on medicines according to the reports of above. Meanwhile I also started suffering from stomach ache. After few days he asked me to clear the constipation problem on top priority, by consulting a gastroenterologist. We then visited gastroenterologist whom we consulted on 17th Jan 2011, who again advised Lever function test and gave me some medicines for the same. According to him the constipation problem was not so severe. We then came back to Urologist as the urine infection was still there and stomach pain Was also continuous and becoming unbearable day by day. Urologist advised to do CT scan on 64 slice scanning machine for clear reports. This was done on 26th Jan 2011. Even though going thru the reports he was unable to understand the cause of paining. Urologist then suggested to take a 2nd opinion of Radiologist (Jupiter heart scanning centre- Dadar) on 28th Jan he gave his review in his reports mentioning that lower ureter part dose not appear clearly. According to Urologist there were some unknown obstructions/ strictures in ureter. So on the same day i.e. on 28th Jan Urologist advised us for a cystoscopy with RGP. He had asked me to get admitted in his hospital on 31st January. I got admitted with some preoperative test done like urine, blood, X-ray, sonography, lever function tests were carried out as these were the pre operative tests. On 31st Jan he had done Cystoscopy with RGP in presence of Gynacologist and Doctor who had done my laproscopic operation.The stains were put in both the ureters. My BP was high again in the evening and unbearable stomach pain was still there. I asked him that after paying a handsome bill of Rs.36886 and going thru all this why am I still suffering??? According to Urologist since the stains are new and foreign part is not easily acceptable to the body it may take time. So he advised to shift to Gyanac’s hospital under her observation. On 1st February I was shifted to hospital where I had been for 2 more days. She fixed an appointment with General Surgeon and another doctor Physician at her hospital. Both the Dr did a checkup they were doubtful about some ascitis (urine leakage) but could not conclude firmly. still for a safer side he asked to do TB test (Mountex).which also had a normal report .Even after my discharge from Gynac’s hospital i.e. 3rd February I could not overcome my stomach pain and Burps and constipation. Both the Dr’s kept me on various painkillers. Meanwhile I was doing the blood and urine test continuously and regularly. There was no improvement even after so long treatment and stains, when asked about this to Urologist he was unable to give a firm reply to this. This had started to become a mental tension now as no hope of being ‘fit’ was seen. I have been visiting both the Dr.every alternate days along with my family dr But no sign of improvement was seen. On 22nd March Urologist asked me to see Dr. Senior Urologist of Jaslok hospital.he didn’t give any reference letter but he gave a call and fixed an appointment on our behalf .Dr.from Jaslok hospital advised a CT Scan at Jaslok hospital. After the ct csan was done on 24th March-2011 he spoke to Urologist and recommended for a surgery (either of BOHARI and open surgery) I was having swelling all over my body, but as Urologist was out of station for 2-3 days, I could meet him only on 28th March 2011. Urologist was shocked to see me in this condition and he immediately asked me to go for a surgery in an institution like Jaslok ,Bombay hospital, Saifee. I requested him to remove the stains as I felt the stomach ache may be because of the same but Urologist said that now it is impossible and this may be a crime now. He gave many options to go for a surgery (with estimated huge amount of bills) but he was not giving any assurance about my health recovery. Again we went back to Gynac for her advise where she too insisted me to contact sion hospital immediately. Early morning on 29th March—11, we went to Sion hospital and consulted HOD and Deputy head of Urology dept- Sion Hospital. I was admitted to the hospital immediately. On the very next day i.e on 30th March PCN was done. A surgery in which both the stains were removed and urine was by-passed thru both the kidneys. HOD said he was doubtful about my right kidneys function so he was not sure about the same.he recommended to drink plenty of water and to go for individual kidney function test(Renogram test) at Tata hospital..This was done on 8th April 2011 and report was satisfactory. HOD and the other Doctors team planned for a surgery on 10th April 2011. Since they were unaware of exact location of the strictures and cause of the stomach pain, they said it could be decided only on operation table. Operation was carried out for 9 hours because of this they were not able to stitch the stomach as it was swelled out. The dr gave temporary stitches on outer layer of the skin and shifted me to ICU where I was kept on ventilator. HOD called my husband and explained the operation procedure he had done which was the only option. here were strictures in middle of both the ureters. so they cut 20cm of the intestine and made a tube form of it and attached to the ureter. Intestine was so stucked up due to urine leakage so the Dr struggled very hard to mobilize it. After two days I was shifted to special room to avoid various types of infections. After one week i.e.on 18th April 2011, they operated again for 4 hours & the final stitches were put. Now life long I have to pass urine after every 2 hrs and should not hold or control it at any cost as it will directly affect my kidneys. I was kept under observation for till 15th May 2011 and got discharged on 16th May 2011. During this period many tests like color Doppler, blood, barium x-ray ,sonography, urine test were carried out . I was in Sion hospital for 50 days After discharge a regular weekly follow up was advised by the Dr. which have been following from last 11 months. Now I have been advised by the Dr’s to keep a regular follow ups every two months for life long period. In this phase I and my family have faced lots of mental, physical, financial problems. I have lost my sleep and job as well. |
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re: Ureter
by Sadhana -
Mar 31st, 2013
9:59 am
#1
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Sadhana
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Dear Shreya M.Nimonkar I have discussed your case with our doctors. Your case is extremely rare and your complication is due to injury of Ureter during Hysterectomy. Most probable remote injury due to electrosurgery. In this situation we can not help you as you need followup through out your life and for regular checkup and symptomatic treatment time to time. The best thing would be you should remain with the team which has treated you. We apologize for our inability to fulfill your expectation and inability to serve you. With regards Sadhana Coordinator - WLH |