Monday, July 10, 2023

My Kidneys

 Eversince I retired in 2018, I had been seeing two different kinds of doctors for the past two years as a result of my being diabetic for more than twenty years – an endocrinologist, Dr. Lu, who takes care of my endocrine disorders which is the primary doctor who takes care of my diabetes and my thyroid seventy five percent of which has already been removed in 2003.  The other doctor, Dr. Guiang,  is a nephrologist, who takes care of my kidney as they started weakening since the beginning of the 21st century.  

My HMO, which is a carry-over of my employment at DLSZ, was due to expire in sometime in May, 2023 as I am to turn 65 years old in September.  Our contract says it can only be extended till that age.  When I told my doctors about this, they agreed that I might as well take advantage of it and to run all possible tests before it expired.  Following the suggestion, I had an ultrasound of my upper and lower abdomen and my thyroid not knowing these would start a battery of tests that will give me quite a scare and my first brush with the Big C. 

The tests yielded that my thyroid is acting up again.  The result said that it has formed calcification which means that the risk of malignancy is quite high.  I was advised to undergo a Fine Needle Aspiration Biopsy but even then, I have decided that I will just have to undergo another surgery and have my thyroid completely removed.  I thought that would have been the end of my worries not knowing that it has only just begun.  The ultrasound of my abdomen turned out that I have developed complex cysts in both of my kidneys.  I immediately reported this to my nephrologist who advised me to have a CT scan.  I had the CT Scan at the Medical City and it yielded that what I have at the left was Bosniak Type 1 which is okay and that they just have to monitor it annually.  The right kidney was the problematic one because what I had was Bosniak Type 4 which has at least a 90% risk of being malignant.   I was advised by my doctor to see a Urologist immediately to address this.  As some sort of appeasement, my nephrologist, showing me several diagrams, said that normally these cysts are taken out partially and that if taken away, will be the end of it. Emboldened by this possibility, I immediately went to the Urologist to have these checked - but he was not available. I was only able to see him after two weeks. 

My meeting with the Urologist was not pleasant.  Without any pause or introduction, he said flatly that the tumor was at the center of the kidney and the only possible way is to take the kidney out in its entirety.  What really bothered me was his statement that this might mean I will have to start undergoing dialysis, something I have dreaded from the time I was told that my kidneys were weakening several years earlier.  My head began to spin and I saw my world crumbling down.   I immediately told my nephrologist of this development and seeing how worried I have become, she gave me the assurance that dialysis was not automatic.  The kidney function should at least be at 15% before one has to go on dialysis.  Mine was at least at 48%.   Much later, I would have an imaging of the function of both kidneys and it showed that the right, which was to be taken away, was at 52% while the remaining one was at 48%. It was just my luck that it would be the better one that has to be taken out but it is what is.

It was at this time that I sought to have a second opinion.  I went to another Urologist, this time at the Medical City, Dr. Joel Aldana.  Now, upon seeing the position of the cyst, he said he was going to discuss it with his anesthesiologist and see the possibility of an ablation, a surgical procedure that partially burn off the cancer from the source. That gave me a glitter of hope.  He asked me to return a week after he had discussed my case with his team.   The following week, I went to see him again and this time he said that neither ablation nor partial surgery is possible due to the location of the cysts.  The kidney really has to be taken out.  He said that we can have the procedure done at St. Luke’s, BGC.  Asking him for an

 

 

estimate of how much the procedure would cost, he said aroung Php500,000.  When he saw the price blew my mind, he offered that my second option was the Philippine General Hospital where he said it will be almost half of the price.  I discussed this with my wife and both of us not knowing how it will be at the PGH, it being a government hospital and all, decided to have my surgery done at St. Luke’s for after all, the retirement pay I got from my previous employer is still intact.  My doctor got a schedule for me to have the procedure done on April 25, 2023. Seeing that it was only two weeks before, he ordered me to see a cardiologist for clearance.  I did and after having a battery of tests, it turned out that there is a deviation on my right lung due to my thyroid which is acting up again.

I was referred to a pulmonologist who ordered that I have a CT scan of my chest, among others.  Before I could do that, I had to secure a clearance from my nephrologist to have it done since the procedure would require a contrast, a dye that would show the organ to be scrutinized .  I went to Dr. Guiang only to be told that she won’t be available for the whole week as she was attending a convention of nephrologists.  That meant I would not find any from anywhere as they were all in that convention. To find one was like looking for a needle in a haystack. We had to cancel my scheduled surgery until I have obtained the necessary clearance that it would be okay that the anesthesia tube won’t stand in the way.  After a week, I was able to get the needed clearance from my doctor so I immediately went to St. Luke’s for the CT scan. The contrast, which is some sort of a dye that would  make the target organ be visible is not pleasant. I knew it would cause me itchiness albeit not being allergic to it.  Just the same, I had the CT scan and after a week got the result that it won’t be a problem. I was advised to see an ENT for clearance.  I went to one who said it will be okay as he sees it would not be a problem – and yet, he added to be sure, to have someone insert an instrument down my throat to see the opening!  Since he categorically said in his clearance that he saw no obstacle as to why it would cause a problem from his professional point of view, I showed it to my urologist.  True enough, he wanted to be sure and have an ENT view the interior of my throat.  I went to another ENT, who, put an instrument down my nose all the way down to my throat.  I was given the go signal.  Armed with a clearance from the ENT, I  went back to the cardio to get my clearance from her.  However, realizing that my tests show that I have a slightly fatty liver, she asked me to get another clearance from a Gastro.  I did as told although I knew that in order for a fatty liver to be considered high, the number should be at least three times the upper limit. Mine was not even double.  Anyway, I got the clearance and went back to the cardio who finally released her own clearance.

It was at this time that I decided to have my surgery done at the Philippine General Hospital (PGH) as my HMO has, by this time, expired.  I was contacted by my Uro’s secretary who told me that my schedule will be on July 3 and that I should go there two weeks before to get a reservation. That gave me plenty of time to go to Calatagan, Batangas and do the school’s graduation stage.  This gave me some money plus the painting commissioned by its Principal, my good friend, Henry Magahis was my income for the month. 

One morning, I received an email from DLSZ asking me if I wanted to renew my HMO. I thought they may have made a mistake forgetting that I cannot renew anymore. I read the email carefully and surprised that the school had decided to extend the benefit for five more years. I will continue enjoying the benefit till I turn seventy. Great!!! It just might turn out that I won’t be paying anything for this operation with it being done at the PGH.  All that delay might have proven to be a blessing after all.

Although I had to pay for a higher premium, I immediately went to the bank to pay for the renewal of my Health Insurance.  Everything seemed to be falling in the right place.  So, on July 19, two weeks before my confinement, I went to the PGH with my wife to reserve for a room.  As instructed, I had to be confined a day before the operation.  Unfortunately, I was told there was no room available on that day. 

 They had a vacancy the day prior, July 1. So, I grabbed that, paid for the reservation and was on our way.  Again, that worked like a blessing as it gave me more time to prepare before I went under the knife.  Days before the procedure, I remembered my friend, Doc Emer, who taught at the UP Medicine which used the PGH as its hospital. I contacted him at his Instagram account and told him of my plight.  It was then that I learned that he knew my Urologist - his classmate in Med school.  He had to go abroad on the day of my surgery and will be back days after when I have gone home.  Just the same, he promised to endorse me to my doctor.  This turn out to be another blessing as I found out from my Insurance provider that my doctors are not accredited and that I would have to pay the Professional fees from my own pocket. Maybe I can get a discount.

On July 1, we were taken to the hospital by my son, Mizel. We were met there by Dennis Lopez, the nephew of my eldest sister by marriage.  He worked at the hospital and promised assistance with whatever we would need.  I was admitted around 11 am, three hours after we checked in.  I was taken to room 708, which was surprisingly big. I would have gotten a much smaller room for a higher price had I gone to either St. Luke’s or the Medical City.  It was immaculately clean.  The only misgiving I had was I waited for lunch, only to be told that it has been delivered already.  An apologetic nurse offered to help me order food from outside.

Soon, doctors were coming to the room to do their routine interviews. Then, one of them asked me about the blood donation.  It then dawned on me that I had forgotten about the order to have someone donate blood, just in case I needed it.  My two sons could no longer donate blood as they have already done o together with Mizel’s brother in law, Jeartley.  This was recent which disqualified them to be donors, until three months have elapsed. 

My son, Mizel,  to the rescue again.  He is an active member of the JCI and one of their programs is helping out with the Red Cross.  He asked around and found there was of my blood type at the Port Area branch of the organization.  He made arrangements to pick two units the following day.  That settled, I had nothing to worry about anymore.

I woke up the following day and since I was the first patient to undergo surgery at the time, I was picked up from my room at around 5 am.  I patiently waited while they were all busy preparing the operating room.  I noticed a beautiful woman helping to prepare the room.  When I got to see her name plate, it turned out she was part of the anesthesiologists.  Everybody was busy preparing the sterilized room, machines being prepared while I remained lain on my bed.  One by one, the doctors arrived. I was rolled in the operating room and soon, Dr. Aldana who was to perform the operation greeted me.  It was at this time that I was assured that everything would go well.  I was asked to lie on one side, hold my feet together in some sort of fetus position as I was being told by the beautiful young woman that they were putting me to sleep.  As expected, I was roused from my deep slumber at the recovery room after I was told I was under for four hours.  It was all over and I never felt a thing.  It was there when I saw the beautiful young doctor again looking at the records. She approached me and muttered that they are taking me back to my room.  It was there that I gathered enough courage to talk to her.  “Miss, there is something I want to get off my chest.” Without batting an eye, I told her, “You are very beautiful!”  She smiled and said something I could no longer remember.  I was wheeled back to my room after what seemed to be about less than an hour. 

Two days after the operation and I was given the go home order. This is quite fast and I am on my way to a fast recovery. There are a lot of people I have to thank for making this event of my life pass like a breeze. My expression of gratitude will never be enough but all I can do is give my sincerest appreciation to the doctors who performed the operation, anesthesiologists, resident doctors, the medical staff, the nurses, orderlies of PGH who made sure that I was comfortable and safe. I would like to thank my friend, Dr. Emer Faraon,  for giving a shoutout to my Urologist, Dr. Joel Aldana, my former student, Dr. Raphy Arada who endorsed me to his resident friends, Dr. MKristoff Delos Reyes, Dr. Nats DelCarmen, my nephew, Dr. Manny Glorioso, Dr. Pau Gonzaga and Dr. ED Ecle for patiently explaining and helping me understand what I was going through from the discovery of my ailment till my operation. I give special thanks to my former student, Cong. Bryan Revilla and his people at the Agimat Party list for offering financial assistance, my eldest sister, Rosalinda Delos Santos Lopez and her in-laws especially Dennis Lopez and Andrew Lopez Cacnio for their invaluable assistance during my stay at the hospital, her son Renato Jun Lopez, my children who gave me their full support, especially Mizel for driving us to and from the hospital and acquiring the blood from the Red Cross, my friends, Raymond and wife Angie Cadlum, my very close friends, Ollie and wife Catherine V. Marcelo, my former principal, Alfred Sagum who took time out to come visit me, Aura Gonzales-Trinidad for the fruits she sent my way. I would like to thank the more than 450 virtual and personal friends here and abroad, who liked, hearted or gave out virtual hugs and/or commented on my post right after my surgery – my prayer warriors from the very start. Lastly, I thank my wife for staying with me all throughout the entire procedure.

 While I am still waiting for the result of the biopsy, I was told by my doctor that the complex cysts in my kidney seem to have been contained inside and could not have spread which means I do not have to undergo chemotherapy. Today is my third day after the procedure and I am now at home and on my way to a speedy recovery, comfortable, and in high spirits.

 

 

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