Marifran Korb

Tag: urologist

My Relationship With Cancer, Part 16

by on Oct.21, 2014, under Overcoming Cancer

Huge things have been occurring. Since my lungs are a risk factor in any surgery that may be necessary, I am doing what I can to heal without it. Primarily, I have been enjoying life, receiving reiki and practicing meditation. Besides, I use Low Dose Naltrexone and take many supplements.

When I made an appointment with another urologist, I asked if she did partial or complete nephrectomies. There is no way of telling from internet information. The nurse I spoke with me assured me that this doctor does both. I needed to ask since one urologist, Dr. B, kept me going to see him for two years before admitting that he “was not allowed to do complete nephrectomies (cutting out the whole kidney), only partials.” Due to the location of the tumor, I knew from the start that I am not a candidate for partial, meaning taking only the tumor and leaving the rest of the kidney.

After six weeks of waiting for this appointment, today I saw urologist Dr. R. She told me she does neither type of nephrectomies. Happily, she stated that the doctor in her group who does complete neprectomies is Dr K, who happens to be the first urologist I saw four and a half years ago. He is the one who told me it was necessary to have surgery immediately. He told me the date he had schedule my surgery, without consulting me.

Meanwhile, Dr. R said my only option was surgery, despite my risks. There was no discussion of surgery benefits vs. risks, so I mentioned a few risks I knew. 1) For healthy people there’s only an 87% chance of surviving and 13% chance of not surviving. There’s a very good chance my 38% capacity lungs will not withstand the three-hour operation. 2) Most people in otherwise good health who get complete nephrectomies due to cancer will die within ten years. This is due to increased risk of cardiovascular health. My heart is already compromised by my lungs.

When I stated this, Dr. R acknowledged that it was true, treating these as insignificant details. She clearly expected me to go to Dr. K for surgery.
My response was: “If I wanted to see Dr K, I would have made an appointment with him. I would have said yes four and a half years ago.”

In Cincinnati, it appears the urologists are in three groups: The Urology Group, the UC Group and the Christ Hospital Group. I have been to at least one doctor in each group. So I came home and made an appointment with yet another urologist. The earliest appointment is over a month away. In case I have to resort to surgery as my last option, I got assurances that this new doctor does complete nephrectomies. Wish me luck.

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My Relationship With Cancer, Part 14

by on Dec.30, 2013, under Overcoming Cancer

Due to irreconcilable differences, the surgeon and I parted ways. A week ago, I met with my urologist surgeon for a consultation so I could ask questions. My husband Ed attended the meeting and neither of us liked what we heard.

The main disagreement was that Dr. W. planned to remove my adrenal gland along with the kidney. Never did he reveal that until I asked about it. He insisted I don’t need the adrenal gland since I have two. I said I want to keep it to help my lungs. Without acknowledging my point, he said: “I don’t want to be bothered with that little thing.”

Though I did not say that the adrenal gland was a deal breaker for me, immediately I did say I would have to reconsider the surgery. Dr. W. seemed unconcerned about my hesitation.

Though I had told him of the COPD that I’ve had since age 14, the surgeon said he wasn’t doing anything different for my lungs during the three hours of surgery since he “can’t imagine any problem.” He did not talk to the pulmonologist as I requested. There’s more, but those were the most problematic issues.

It is sobering to realize that surgeons can do things without your permission. They can justify it and get away with it. Had I not read about the frequency of kidney surgeries resulting in loss of the adrenal gland, I would never have known. Whenever I would discover it, the damage would have been done and it would be too late. Then the surgeon can say: “I was only trying to protect you.” I want to have the choice to say yes or no to the risk. I want to be included in the decision, so that if the adrenal gland is fine, I want it saved.

Hoping to bridge the gap between the surgeon and me, my daughter Ilona spoke to the doctor. She quoted a study that said if a kidney tumor is less than 8 cm, the adrenal gland should remain in the body. Dr. W. said he knew of the study and he thought the tumor could spread to the adrenal gland anyway, despite my smaller than 4 cm tumor. In other words, he knew better than the study and he would do as he pleased. His real motivation came when he spontaneously said to me: “I don’t want to be bothered …”

Already I had been through many pre-op tests this month, including a nuclear scan, and a CT scan with contrast that I drank and contrast in my veins. After seeing the surgeon, I cancelled the pre-op blood tests. Interestingly, I had scheduled lung function tests for this morning. The pulmonologist got sick and it was rescheduled for January 9. If I were still planning on surgery, I would need the lung function tests and it would be very difficult to schedule them before the surgery date of January 6. The lung function tests would have determined definitively whether or not my lungs could handle the surgery.

Looking forward to having this all over with, I was prepared to be recovering for three months. Totally, I was ready to put all the searching, all the questioning, and all the recovering behind me so I could greet the spring with a new tumor-free body.

Yet, I have to see everything that happens as part of my path to wellness. All I know for sure is I will not be having surgery next week. While I sort out what my next move is, I am as surprised as you about the twists and turns in this story.

Clear that I am making the right decision in this moment, I eagerly await what opens up next. Meanwhile plenty of parties are planned for New Years Eve and New years Day. I will enjoy them all. Wishing each of you a healthy and happy 2014.

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MY RELATIONSHIP WITH CANCER – Part 9

by on Aug.31, 2011, under Random Writings on Relationship

Since the last ultrasound, I have been enjoying life to the hilt. In April, Ed and I moved to a great home with trees and flowers all around us. A family of deer frolic through our woods. Never far away, rabbits, squirrels, and chipmunks visit our patio often, even when we are relaxing by the fountain in the fish pond.

Last week I had an ultrasound on my kidneys. The bad news is that it is not smaller. The good news is that it is no bigger than it was. Today I went to see urologist Dr. B, my second opinion doctor. Now he is telling me that surgery could be in the future for me sometime.

The reason? My parents were long-lived and it’s possible I could live to be 90. While happily that is a number of decades from now, there are no statistics on the number of years a kidney tumor can be safely watched. According to Dr. B, it has not happened before.

In the past, doctors took out any kidney that had a tumor. Now they try to take only the tumor and leave much of the kidney. There’s no statistics or research information on what will happen over the years for someone who is expected to live as long as I am. In my situation, there are not a lot of people that have been watched over a long time. So I suggested that I would be the first. That’s a valuable contribution. Right?

“Your possible years left are a whole career for a doctor. Some young doctor will be following you and have to pass you off to yet another doctor. And no doctor wants to do that.” Dr. B conjectured this as if that was a bad thing. It is not for me.

Dr. B said I should think about surgery in a few years. I reminded him of his assertion a year ago that I could live with the tumor. He answered that he is giving me the other side of it now. Hmm.

Reminding him that a year ago he claimed that patients with kidney surgery can die a decade earlier than the national statistics, Dr. B responded that it is true when one whole kidney is extracted. Given that he thinks he can take out my tumor despite it’s delicate position near the blood supply, he downplayed the danger. We did not get into the problem of my lungs. I’m still thinking about this turn of attitude. For now, we agreed things will stay the same.

Meanwhile, I will continue to live fully. Enjoying every minute, I am not slowing down.

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MY RELATIONSHIP WITH CANCER: Part 1

by on Nov.13, 2010, under Random Writings on Relationship

As with any relationship, this one continues to evolve.  Surprises occur, some I like and some I don’t.  Cancer doesn’t care about my opinion.  It just is.  Or is it?  One thing I know for sure: I’m in this to learn.  This crash course in life has provided enormous opportunities to widen my scope.

No advanced doctorate degree could be more intense.  My cancer education has been on a physical, mental, emotional, and spiritual scale.

It started with a routine chest CT scan six months ago.  The radiology department had scanned from chest to kidneys.  Three weeks after the scan, I managed to get an appointment to hear the scan results. “Look, you’ve got cancer in both kidneys,” exclaimed my pulmonologist.  Excitedly, she pointed to a screen with black, gray and white marks on it.  I took her word for it. Not sharing her enthusiasm, I didn’t react.

There was no time to talk about my lungs on that visit. Rather, there was a flurry of activity around scheduling an abdomen scan to see the kidney more clearly. Within a week it was confirmed that I needed a specialist.

My history kept me calm and objective.  In 1991, I had been diagnosed with lung cancer. I had been coughing up blood from my lungs, something that was not new.  After a CT scan, the pulmonologist at the time, told me I needed surgery to remove my whole right lung.  I took the CT scan to a second pulmonologist who said: “Yes, it could be cancer. And with your lungs, the surgery could kill you.”

Since I said no to that first diagnosing doctor in 1991, he actually called my husband and enrolled him in the idea of surgery for me.  Figuring I could die if I did, or die if I didn’t, I refused.  Nothing bad happened as a result.

With that experience in my background, I decided not to worry about anything until I knew for sure.  The thought of having two cancerous kidneys would at times shock my mind, and I would remind myself that I did not have any physical pain. I knew I had to focus on the possibility the CT scan was wrong.

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