A Day in the Hospital (and Another Date Identified)

Today I met the surgeon and team that will be doing the surgery. Overall I am very happy with who will be doing this - very much interested in this type of surgery and also has a history doing it as well.

My appointment was early in the morning so I went on the way to work. I first met with one of the doctors on the team (Dr. Don I think). We went over my history again and he showed me an image of the CT Scan - essentially the right adrenal gland (the good one) looks kind of like a slug but the left looks like a golf ball.

Dr. Biehl then came in to go over the procedure and answer questions. The procedure will be attempted laparoscopically but they may have to make a game-time decision to do an open surgery. This can happen if there is a blood vessel in the way or some other kind of complication.

I will be admitted the day before to take an IV in order to get properly hydrated. The surgery (officially known as an adrenalectomy) will take 2-3 hours. I will spend the night in ICU in order to monitor my heart/cardiovascular system. Then another 2-3 days in the hospital and then another 2-3 weeks before I can be fully back to normal (meaning back to full exercise).

An interesting note is that this will involve removing the entire adrenal gland and not just the growth. It has taken over too much of the tumor at this point. This answered my question of "why do you call this an adrenalectomy when an apendectomy is removing the appendix?" (point of fact - this was the answer to that very question from me).

In order to make sure I do not have a larger condition known as Multiple Endocrine Neoplasma the doctor ordered another CT Scan but to run my full chest and through the pelvis (the last was just my abdomen) as there are glands in those areas where other tumors might hide. He also wanted some additional blood tests, and EKG, and a heart echo.

I next met with the anethesiologist - top rate guy. He is the doctor that is going to control my meds before and of course during the surgery. So, we'll up the dosage about every two days from here on out.

Oh, oops, I forgot - I will be having the procedure 2/22. That's in just 13 days.

So, by the time I get to the operation I'll be on 60-80mg or more of the alpha blockers per day. A few days before he will also put me on a beta blocker to help control my heart. The beta blocker has a regulatory effect on the heart so the heart rate will not spike. And I will be drinking liquids like nobody's business to compensate for the lower blood pressure - gatorade perferred (or other sports drink) to get the electrolytes. He expects me to gain 10-15 lbs. during this time just in water weight.

During the operation I will be under a general anesthetic (administered through IV) and will also have an epideral. He will also have an IV in my neck in order to be able to specifically control my heart.

This all points to this being a very serious procedure (make sense - we are balancing a very delicate and crucial system in my cardio system). This also reminds me a bit of my job in some ways - the doctors have a pattern in their history to follow, ie other surgeries they've done and specifically adrenalectomies. They need to gather as much information as possible including how strong my heart is thus explaining the tests. In that spirit I will be keeping track daily of my BP to make sure it's lowering.

So, after this I went downstairs (to the anesthetic department) to get my EKG and (horray!) have some more blood drawn for more tests. Thus ended my trip to the hospital - about 2 hours in total.

But, I then returned in the afternoon for my heart echo (aka ultrasound). Very uninvasive and quite interesting actually (I have never seen an US before). Pretty cool software as well behind the scenes. So, you get to watch your heart beating from all different angles. The purpose here is to make sure the heart has no damage as can happen in cases of increased adrenaline over time.

So, not a bad day in the hospital overall. The diagnosis is complete and I have my team picked out that will do the surgery and this is the right group. The fact gathering has begun as well and I have my CT Scan tomorrow.