Mets Day 156 - Surgery at Hopkins

Here's a report on Friday's surgery at the Weinberg Center at Johns Hopkins. Hopkins is very efficient, more so than GW.  I arrived at 1, and waited less than 5 minutes between each of the pre-op events: check-in, registration review, back to pre-op, nurse review, IV placement, anesthesia review, doctor visit, then into the OR.  Before the procedure, I discussed it at length with Dr. Bivalacqua.  I told him how Dr. Frazier was reluctant to do this surgery because it would increase the risk of incontinence, and how he tried to dilate it on July 30.  I also described how I knew it had been slowly reforming, since I was unable to void normally, and how self-catheterizing was not always successful.  He said that dilation was not effective, and that trying to control the problem with catherterization was not a good long term-solution.  He was confident that surgery would help, but also said that the risks included increased incontinence (about 10%-20%), and that the stricture would re-form.  

After the surgery, we talked again.   Dr. Bivalacqua said that the stricture was above the sphincter, which was good, because the risks of incontinence increase dramatically if they start removing tissue around the sphincter location.  The doc sliced away a bit of the stricture, but was conservative, telling me that he can always take more out, but it's tough to add tissue back in.  He also met with Chelsea while I was emerging from anesthesia, and they had a good discussion about the procedure, and what I could expect.  

When I got home and was getting ready for bed, I found that the OR tech had left three of the EKG stickers on my torso -- one under each arm, and the third by my port.  At least they didn't leave anything inside my body (I think.) 

So now I have a Foley catheter in place, and it will be there for a week.  Ugh. Hopkins still has not starting using the adhesive Foley retention devices that Chicago uses.  Instead, they slapped a large hunk of tape on my thigh, and taped the Foley tube into place so it wouldn't slide.  Not only did they put the tape in a location that is not comfortable, but it's useless if I want to change to a thigh bag.  For as many surgeries as they do, I'm surprised they have not gotten with the program.  When the nurse at Hopkins removed my FOley after my surgery, he was all excited to see that adhesive strap, and kept it to show administration.  

Anyway, the doc says I can remove the Foley myself next week (!), and that no follow-up is needed for now.  I'll probably have Chelsea assist to make sure I don't pull out my urethra because the catheter bulb was not fully deflated.  After that, I will need to self-catheterize 2 times a day for two weeks, then once daily for another two weeks.  The point is to train the stricture to not re-form, which is why the Foley will be in there for so long, and why I'll need to catheterize so frequently.  We won't really know if it has worked for more than a month, and even then, there is a chance that the stricture could re-form, meaning I'd need to do this all over again.  Scar tissue tends to be unpredictable.

I'm not feeling a lot of pain.  There is some discomfort with the catheter, but that's to be expected.  I have the naproxin for non-narcotic pain relief as needed, and I'm also taking an anti-spasm drug to keep the neobladder from overreacting.  It has the interesting side effect of turning my urine bright orange.  Happy Halloween!  I bet that'll scare the little monsters.