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  • After The Rplnd...

    hi everyone,
    now that Brian is coming close to the RPLND, can you tell me what to expect right after the surgery? how will he look? im so afraid to see him with tubes and stuff will he be awake when i see him? i know everyone is different and all hospitals are different, but i am so scared to see him that way.

    dawn
    Fiance Brian, dx:stage IIIC non-sem 4/18/07
    mets to lungs,liver,abdomin,large tumor near kidney
    hcg was 176,000!
    completed 1 rnd of TIP(had bad reaction to taxol)
    BEPx3 until 7/13/07
    7/26/07 post chemo ct-scan shwd shrinkage & fewer lung tumors
    10/17/07 @ MSKCC Liver FREE of cancer! necrotic & small focus of teratoma.
    AFP & HCG normal
    12/7/07 RPLND,right orchiectomy @ MSKCC
    12/18/07, rcvd pathology,all clear! no cancer!
    2/11/08 -Lung surgery dne @ MSKCC
    ALL CLEAR

  • #2
    Right after the surgery, they will call you to tell you to come up to the waiting room. They may (they did with us) ask you to wait in a smaller waiting room so Dr. S can come in and speak to you.

    You will have to wait about an hour after Dr. S talks to you to be able to see him. He will be in recovery, awake but very out of it. His entire body will be covered with blankets and so will his head. You will see no tubes but he will look a bit puny. You will only be able to spend a few min with him and then he will wheeled into his room.

    He will be wearing a hospital gown and he will have a few tubes coming out of his stomach (but they will be hard to see) and he will have a tube coming out of his penis. All tubes will be hanging out of his hospital gown and draining into a plastic container below the bed. You will see the tubes draining but not see them coming out of his body (unless you lift his gown)

    He will be awake after he gets moved into his room and he will be in pain. When he lays still the pain will be better, but moving out of bed will be tough. He will have pain meds and he can use them when he needs to. Walking will be very important, even though it will cause him pain.

    Keep a cold wet wash cloth handy and when he goes to move, put it on his forehead. The cold will draw the pain away. Sounds silly, but I promise it works. As he walks, keep the wash cloth cold and keep putting it on his head and the back of his neck. carry some cold water with you if you have to.

    He will want to drink but don't allow him. Swab his mouth out with some applicators they will give you. Once he can sit up, have him fill his mouth with ice, and spit it all back out. This will help. Also have him brush his teeth as often as you can...not letting him swallow the water of course. It will keep his mouth fresh and less dry.

    I took warm wash cloths and wipped Boyce down twice a day. He loved the warm one on his face, made him feel clean. I also brought lotion and rubbed his feet and legs. I also rubbed lotion on his hands and arms. He enjoyed it and it kept him from getting stiff.

    Don't eat or drink in front of him. It is just not fair and will make him want a drink even more. Bring a robe for him to wear so he is not showing his hiney to everyone on the 5th floor .

    You both will do great. I am proud of you!

    M.
    Co-survivor with husband Boyce, Diagnosed 7-11-06, orchiectomy right testicle on 7-12-06- Stage 3A: Mixed germ cell tumor with inguinal seminomatous and kartotypic carcinoma. One tumor over 10 cm, second tumor 4 cm, Chemo 4xBEP: Bi-lateral RPLND Dec 2006, nerve sparing but left sterile.
    Current DVT
    Current testosterone replacement therapy, Testim.

    "You must abandon the life you planned, to live the life that was meant for you" ~wisdom I have learned from my family on this forum

    Comment


    • #3
      Originally posted by Margaret
      Right after the surgery, they will call you to tell you to come up to the waiting room. They may (they did with us) ask you to wait in a smaller waiting room so Dr. S can come in and speak to you.

      You will have to wait about an hour after Dr. S talks to you to be able to see him. He will be in recovery, awake but very out of it. His entire body will be covered with blankets and so will his head. You will see no tubes but he will look a bit puny. You will only be able to spend a few min with him and then he will wheeled into his room.

      He will be wearing a hospital gown and he will have a few tubes coming out of his stomach (but they will be hard to see) and he will have a tube coming out of his penis. All tubes will be hanging out of his hospital gown and draining into a plastic container below the bed. You will see the tubes draining but not see them coming out of his body (unless you lift his gown)

      He will be awake after he gets moved into his room and he will be in pain. When he lays still the pain will be better, but moving out of bed will be tough. He will have pain meds and he can use them when he needs to. Walking will be very important, even though it will cause him pain.

      Keep a cold wet wash cloth handy and when he goes to move, put it on his forehead. The cold will draw the pain away. Sounds silly, but I promise it works. As he walks, keep the wash cloth cold and keep putting it on his head and the back of his neck. carry some cold water with you if you have to.

      He will want to drink but don't allow him. Swab his mouth out with some applicators they will give you. Once he can sit up, have him fill his mouth with ice, and spit it all back out. This will help. Also have him brush his teeth as often as you can...not letting him swallow the water of course. It will keep his mouth fresh and less dry.

      I took warm wash cloths and wipped Boyce down twice a day. He loved the warm one on his face, made him feel clean. I also brought lotion and rubbed his feet and legs. I also rubbed lotion on his hands and arms. He enjoyed it and it kept him from getting stiff.

      Don't eat or drink in front of him. It is just not fair and will make him want a drink even more. Bring a robe for him to wear so he is not showing his hiney to everyone on the 5th floor .

      You both will do great. I am proud of you!

      M.

      will he have a tube coming out of his nose? yikes
      Fiance Brian, dx:stage IIIC non-sem 4/18/07
      mets to lungs,liver,abdomin,large tumor near kidney
      hcg was 176,000!
      completed 1 rnd of TIP(had bad reaction to taxol)
      BEPx3 until 7/13/07
      7/26/07 post chemo ct-scan shwd shrinkage & fewer lung tumors
      10/17/07 @ MSKCC Liver FREE of cancer! necrotic & small focus of teratoma.
      AFP & HCG normal
      12/7/07 RPLND,right orchiectomy @ MSKCC
      12/18/07, rcvd pathology,all clear! no cancer!
      2/11/08 -Lung surgery dne @ MSKCC
      ALL CLEAR

      Comment


      • #4
        He most likely will have an NG tube (a tube put into the stomach via the nose). I had one, it really wasn't too bad, just gave me a bit of a sore throat.
        Fish
        TC1
        Right I/O 4/22/1988
        RPLND 6/20/1988
        TC2
        Left I/O 9/17/2003
        Surveillance

        Tho' much is taken, much abides; and though we are not now that strength which in old days moved earth and heaven; that which we are, we are; one equal temper of heroic hearts, made weak by time and fate, but strong in will; to strive, to seek, to find, and not to yield.

        Comment


        • #5
          Originally posted by Fish
          He most likely will have an NG tube (a tube put into the stomach via the nose). I had one, it really wasn't too bad, just gave me a bit of a sore throat.

          OH NO THAT IS WHAT HE WAS AFRAID OF, HE DOESNT WANT THAT NG TUBE.
          Fiance Brian, dx:stage IIIC non-sem 4/18/07
          mets to lungs,liver,abdomin,large tumor near kidney
          hcg was 176,000!
          completed 1 rnd of TIP(had bad reaction to taxol)
          BEPx3 until 7/13/07
          7/26/07 post chemo ct-scan shwd shrinkage & fewer lung tumors
          10/17/07 @ MSKCC Liver FREE of cancer! necrotic & small focus of teratoma.
          AFP & HCG normal
          12/7/07 RPLND,right orchiectomy @ MSKCC
          12/18/07, rcvd pathology,all clear! no cancer!
          2/11/08 -Lung surgery dne @ MSKCC
          ALL CLEAR

          Comment


          • #6
            Most likely he will have a tube in his nose, and he will probably complain of a sore throat. I remember my brother was sooooo thirsty after words, but, couldn't drink, so i was able to just keep wetting his lips with a cloth. He will have tubes in his stomach for drainage, a catheder (can't spell). My brother was hooked up to a morphine drip that he controlled, don't worry, he can't give himself too much medication, he may just fall in and out of sleep. His incision is going to be pretty long. We knew the results within the week we were there, so hopefully you will too. i do remember it's important to get him up and walking as soon as possible to get everything working again, and that he pass gas.
            Dawn, as scary as this all is for you and for him, he will get through this hurdle, like the other ones he's faced. let's pray this is the last of it
            Krista
            Brother Diag. 10/05 Non-Sem.
            Right I/O 11/05
            Surv
            4XBEP 8/06
            RPLND 12/06
            2X VIP 1/22/07
            Only completed 1 Rd.

            Comment


            • #7
              Dawn -

              Margaret really summed everything up very well. Rob was different; his surgery was six hours long (not the norm) and when I saw him he was still on a ventilator. They had him in recovery for about 8-9 hours and I was allowed to visit for ten minutes every hour. You will wait on the first floor during his surgery, and a nurse liaision will give call your name and give you updates while you wait there. Then they will call you when it is time to go up and talk with Dr. Sheinfeld.

              Rob looked okay, just a bit puffy from the fluids they used to during surgery. His color was actually fine.

              The NG tube is very important. It stops fluid and air from entering the stomach, which will be very very sensitive to anything after the surgery. Brian might still be on pain meds when they remove it, so he may not remember it fully. Rob doesn't remember it at all and they removed and replaced it TWICE after surgery.

              The cold washcloths help tremendously. I remembered that Boyce and Margaret suggested them, and why it works is a mystery, but I ended up constantly keeping fresh cloths in a tray of ice for Rob. Also, Brian's legs will be velcroed into those compressor thingies so he doesn't get blood clots. They itched Rob's legs like crazy. I would scrub his legs with a warm washcloth and massage them with lotion.

              If you can't get a robe for him, two gowns put on facing opposite directions will work just as well. But something from home would probably be more comfy.
              Rob and Stacy
              DX: 3/10/05, AFP: 15,047, L I/O: 3/28/05, Yolk sac tumor & teratoma, Stage IIIC, 3xBEP & 1xEP: 4/4/07 - 6/25/07, AFP: 14, RPLND 8/10/07, w. left kidney removed. 10/19/07, AFP: 1.9

              Comment


              • #8
                Originally posted by sldl1106
                Dawn -

                Margaret really summed everything up very well. Rob was different; his surgery was six hours long (not the norm) and when I saw him he was still on a ventilator. They had him in recovery for about 8-9 hours and I was allowed to visit for ten minutes every hour. You will wait on the first floor during his surgery, and a nurse liaision will give call your name and give you updates while you wait there. Then they will call you when it is time to go up and talk with Dr. Sheinfeld.

                Rob looked okay, just a bit puffy from the fluids they used to during surgery. His color was actually fine.

                The NG tube is very important. It stops fluid and air from entering the stomach, which will be very very sensitive to anything after the surgery. Brian might still be on pain meds when they remove it, so he may not remember it fully. Rob doesn't remember it at all and they removed and replaced it TWICE after surgery.

                The cold washcloths help tremendously. I remembered that Boyce and Margaret suggested them, and why it works is a mystery, but I ended up constantly keeping fresh cloths in a tray of ice for Rob. Also, Brian's legs will be velcroed into those compressor thingies so he doesn't get blood clots. They itched Rob's legs like crazy. I would scrub his legs with a warm washcloth and massage them with lotion.

                If you can't get a robe for him, two gowns put on facing opposite directions will work just as well. But something from home would probably be more
                comfy.


                YIKES!! I AM SOOOO AFRAID TO SEE BRIAN ON A VENTALATOR!!! I DONT THINK I CAN HANDLET THAT IS THIS ALWAYS THE CASE?
                Fiance Brian, dx:stage IIIC non-sem 4/18/07
                mets to lungs,liver,abdomin,large tumor near kidney
                hcg was 176,000!
                completed 1 rnd of TIP(had bad reaction to taxol)
                BEPx3 until 7/13/07
                7/26/07 post chemo ct-scan shwd shrinkage & fewer lung tumors
                10/17/07 @ MSKCC Liver FREE of cancer! necrotic & small focus of teratoma.
                AFP & HCG normal
                12/7/07 RPLND,right orchiectomy @ MSKCC
                12/18/07, rcvd pathology,all clear! no cancer!
                2/11/08 -Lung surgery dne @ MSKCC
                ALL CLEAR

                Comment


                • #9
                  It'll be OK

                  Hey Dawn,

                  I don't have any memory of a nose tube at all, so M would have to say if I even got one.

                  Nobody is going to come out of an RPLND and look anything like good. It is a major surgery, and Brian is going to look like he's been through one. There are others on the ward as well, and they are all urologic surguries as well, so everyone looks pretty rough. I know that I looked awful, but I was in so much pain that I really didn't care at all, and neither did M. He'll have the catheter and drain tubes hooked up to a mobile IV pole so he can walk around. They're gross, but you gotta have em. Good news is that they hurt very little coming out.

                  The washcloths helped immensely. Also, sometime around day 3 or so, he may be able to shower. I did not ask about that, so I ended up over 5 days with no shower, and...there's just no other way to put it....I was Rank! So ask about a shower and when he can have one.

                  No water for him. None. No. Not a sip. Zero. Got it? It was the hardest part for me to get through, but my willpower paid off when I had no complications at all from the surgery. Sheinfeld is Veeerrrryyyy conservative. I was 5 days no water. I would rinse my mouth and spit like at the dentist, but it is not worth cheating, so please don't.

                  Ventilator - I was not on one, and is is not comon to need one, but if Brian is on one, it will be OK. Hopefully you all will find comfort in knowing that you are having the Best RPLND Surgeon on The Planet (BRPLNDSOTP) working on you. - IMHO

                  Discipline is the key and he'll need you to be strong for him. The pain is intense, but he'll have a morphine pump that he can use. It made me sleep so I used it sparingly, and was off of it on day 3, but if Brian needs it longer, then he'll have it. This is not a time to be in any unneccsary pain. The pump is there, so press the button, OK?

                  Have him walk and walk and walk. For me, I tried to get up every couple of hours and walk at least a lap around the ward (17 laps per mile, if I recall). It hurts like Hell, but 1) it will get his bowels moving and 2) it will build some strength and 3) You will both meet other patients and careivers as you walk your laps that will totally relate to your situation. That's how I met Danny and Mikey. Hi Guys!!

                  You will need to get away from him at times and he'll appreciate the solitude (I certainly did). Let him catch up on his Maury Povich, Jerry Springer, etc. Even in recovery, I was in better shape than the guests on those shows. - No offense to any readers who are alumni of such shows.

                  And that's it. It's a miserable few days, but unlike chemo, he'll feel better each day. He'll get the best care in the world, and you will be an important part of the care team.

                  This is not a time for him or you to be too proud to ask for help or to ask questions The nurses and docs there have been through this hundreds of times, and they will share that experience with you all. Stay strong. This is a milestone event is his treatment. Say these words - "It is worth it." Repeat as necessary!
                  Stage III Non-Seminoma- 7/11/06
                  Right I/O 7/12/06
                  Completed 4x BEP 11/06
                  Bi-Lateral RPLND (Dr. Shenifeld)- 11/27/06
                  Surveillance since then

                  When you think about it, what other choice is there but to hope? We have two options, medically and emotionally: give up, or Fight Like Hell.
                  Lance Armstrong.

                  Comment


                  • #10
                    Jason 8 hrs after RPLND.
                    Attached Files
                    Son Jason diagnosed 4/30/04, stage III. Right I/O 4/30/04. Graduated College 5/13/04. 4XEP 6/7/04 - 8/13/04. Full open RPLND 10/13/04. All Clear since.

                    Treated by Dr. Rakowski of Midland Park, NJ. Visited Sloan Kettering for protocol advice. RPLND done at Sloan Kettering.

                    Comment


                    • #11
                      I remember being wheeled up to my room after I was well enough to leave the recovery room. The thing I remember most is getting to my room and the orderly lowering the bed he wheeled up there on. He continued to lower the bed but since it was so close to the other bed it wasn't going down, (yup you guessed it) until he moved it away and BAM the bed dropped about a foot with me on it. Oh the pain. Was not on pain killers yet since I had just been taken from recovery. My nurse asked me if I was ok and of course me the tough guy said yes I am fine. But damn did it hurt. I'm sure she knew, it was probably written all over my face. Not but a minute later I was given morphine.
                      If you look for the truth outside yourself, it gets farther and farther away. ~ Tung-Shan
                      If you love life, don't waste time, for time is what life is made up of. ~ Bruce Lee
                      Please sponsor me for the 2011 LiveSTRONG Challenge Philadelphia.
                      My Blog

                      Diagonosed 1988. Left I/O - 3 rounds of chemo
                      Relasped 1989. RPLND - 3 rounds HDC - Bone Marrow transplant.
                      There is Army Strong, There is Live Strong and then there is me. Crazy Strong

                      Comment


                      • #12
                        Originally posted by dadmo
                        Jason 8 hrs after RPLND.

                        OH MY GODD!! THAT PICTURE IS SO SCARY, I CRIED WHEN I SAW IT WAS HE OK HERE DADMO? I DIDNT EXPECT TO SEE THAT
                        Fiance Brian, dx:stage IIIC non-sem 4/18/07
                        mets to lungs,liver,abdomin,large tumor near kidney
                        hcg was 176,000!
                        completed 1 rnd of TIP(had bad reaction to taxol)
                        BEPx3 until 7/13/07
                        7/26/07 post chemo ct-scan shwd shrinkage & fewer lung tumors
                        10/17/07 @ MSKCC Liver FREE of cancer! necrotic & small focus of teratoma.
                        AFP & HCG normal
                        12/7/07 RPLND,right orchiectomy @ MSKCC
                        12/18/07, rcvd pathology,all clear! no cancer!
                        2/11/08 -Lung surgery dne @ MSKCC
                        ALL CLEAR

                        Comment


                        • #13
                          Dadmo will chime in, I'm sure, but as an outsider who has had the pleasure of meeting Jaymo, I will let you know that he is a young man in tip-top shape, as affable and bad-ass as can be, and healthy all-around (and Joel Sheinfeld did his surgery several years ago).

                          Brian will be in great hands. Yes, the surgery is quite major, and there is no way to sugar-coat it. Nevertheless, it is a validated, reliable procedure with a high success and cure rate. Although my pathology doesn't warrant it, if I ever had the need for the procedure, I wouldn't think twice about having Joel Sheinfeld do it.
                          "Life moves pretty fast; if you don't stop and look around once in a while, you could miss it." -Ferris Bueller
                          11.22.06 -Dx the day before Thanksgiving
                          12.09.06 -Rt I/O; 100% seminoma, multifocal; Stage I-A; Surveillance; Six years out! I consider myself cured.

                          Comment


                          • #14
                            Hi Dawn,

                            I can remember being terrified when we were told my son, Brian, was going to have to have the surgery. Thanks to this site, I had a pretty good idea of what to expect. I'm sure if you've taken a look at Jason in the photo posted by Dadmo, you probably got the shivers, but now you can prepare yourself. And honestly, it isn't as bad as it looks. We were talking to Brian a few hours after he was out of the OR and he even laughed, gently of course, at a joke I made. The NG tube was out the next day and he was walking. He said he had been more bothered by the catheter than the NG tube.

                            Dawn, it will almost be harder for you than it will be for Brian. He'll have the benefit of prescribed drugs!! (I recommend Vodka for you!!)

                            Diane

                            Comment


                            • #15
                              I'm sorry if that photo scared you but there is no way to sugar coat what will be done. You just have to remember that Sheinfeld is a master and everything will be fine. As for Jason he's been cured for 3 years and is doing quite well. His cure was right out of the text books. This may seem like I'm making it up, but 12 hrs after that shot he was standing and walking a bit.

                              Here's a shot from 2 1/2 days after the operation
                              Attached Files
                              Last edited by dadmo; 09-10-07, 09:13 PM.
                              Son Jason diagnosed 4/30/04, stage III. Right I/O 4/30/04. Graduated College 5/13/04. 4XEP 6/7/04 - 8/13/04. Full open RPLND 10/13/04. All Clear since.

                              Treated by Dr. Rakowski of Midland Park, NJ. Visited Sloan Kettering for protocol advice. RPLND done at Sloan Kettering.

                              Comment

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