The nitty-gritty

I find it sort of funny, or at least ironic, that all of us (you out there as well as me and Mark) are feeling such joy and relief after Monday’s meeting. It’s almost as if we think, “Oh thank God, that’s over with,” when in reality, whatever was inside Austin’s body last week is still there today. He still might have cancer. Or not.

We do feel good. Enormously relieved. Even though the facts didn’t change, even though no one looked at the slides and said, “Oh wait, now we know what it is,” even though everything remains the same, it sure doesn’t feel that way. Just to have the prospect of surgeries and dialysis no longer looming over our heads (for today, at least) is a huge gift.

But, as promised, here are the nitty gritty details we learned in our Monday conversation, all of which fed into our decision.

You may remember that we thought our next step would be to do a needle biopsy, even knowing it may not result in a definitive diagnosis. Turns out the doctors said it had about a ten percent chance of giving us a definitive answer. Ten percent! Because of the “thing’s” location and because of the fact that they’d be stabbing a fluid sack and trying to draw out cells from the solid portion inside it, they thought it was sort of a waste of time. Even if it is cancer, learning that from the biopsy is unlikely. And our actions moving forward wouldn’t be impacted by the results in a major way because those results would most likely have put us back in the uncertain place we are now. So that was deemed an unnecessary step to take.

We also discussed the possibility of doing an open surgical biopsy, where they begin a surgery without knowing whether to take out the mass or take out the kidney or just look around and then sew him back up, until they’re actually inside and can biopsy a section of the shadow. If the mass grows and we do decide to operate, this is what will automatically happen anyway. But to do that now would put him at great risk. Because he’s had so many surgeries (one kidney-sparing that removed four tumors plus three surgical biopsies on that particular kidney, not to mention the surgeries on the other, long-gone kidney), there’s a ton of scar tissue and adhesions that have formed. For instance, one part of the kidney has sort of suctioned on to the spleen and any surgery could sever that currently harmless connection and make the spleen bleed out and need replacing. The kidney itself could fail due to excessive blood loss because of all of the scar tissue that would need to cut through to even take a look in there. So again, at this point, it’s not worth it.

Another thing, and this one is promising, is that this shadow might be a urinoma. A little pocket of pee. When they raised this as a possibility, I exclaimed, “Oh, it must be that! A pocket of pee is just so Austin!” Because there is obviously urine in the kidney (apparently just floating around in there), when they did his main surgery, they might have sewed up some pee into a little ball, called a urinoma. Ha. How do you like that for modern medicine?

That’s about it. We’re scheduling an ultrasound for next week and just keeping our fingers crossed. And we feel good.