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Thread: Rplnd???

  1. 07-14-12, 08:16 PM #1
    Dakota12
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    Rplnd???

    What happens before, during, and after the RPLND? I am having surgery to remove lymph nodes at the level of my left kidney. How big will the incision be...etc. If you could, share with me some of your experiences like: recovery time, energy level, pain...etc. Thanks guys.

    NEVER GIVE UP,
    Dakota
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  2. 07-14-12, 09:14 PM #2
    youngster
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    I'm not sure if I had nodes removed up to my kidney but I'll give you a rundown of my experience:

    Pre-Surgery:
    Liquid diet begins two days before surgery. You all need to do "bowel prep" by drinking some liquid. STAY NEAR A BATHROOM!!!

    Day of:
    Pre-surgery stuff is same like any other surgery. The surgery time varies but I was knocked out total for about 9 hours. I have a 12 inch incision from my sternum to below my belly button. I spent my first night in the ICU.

    Post surgery:
    Spent a week in the hospital. Nurses will have you walking two days after surgery (still amazes me they got me out of bed). Didn't eat solid food until my last day in the hospital. Depending on your doctor, you will be on a minimal fat diet for 2-4 weeks. Zero-fat Hebrew National Hot Dogs are a lifesaver!!! Truthfully, I didn't have a desire to eat fatty food for 3 weeks and slightly cheated my last week). I lost 20 pounds in 5 weeks (sadly I have gained 15 of it back in the two months since).

    It took me 3 weeks to somewhat feel like myself. By Week 4, I felt 95% normal.
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  3. 07-15-12, 09:33 AM #3
    Dakota12
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    Why such a large incision? That is a much larger incision than I expected. I was told by others that I would be in the Hospital for about 3 days (shorter than your experience) but with about a 4 week recovery like you. I don't know if this has much relevance but I have 4 enlarged lymph nodes. Thank you for the info.
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  4. 07-15-12, 11:47 AM #4
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    zak0691
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    My incision is roughly 10 or 11 inches. The lymph nodes in question are in the retro-peritoneum, meaning they are towards your back/spine area. The large incision makes it easier to get to them as they must pull out your intestines and things which are in the way. The lymph nodes in question are also in quite close proximity to the aorta and vena cava (some may even be on the artery or vein, I believe) and as those are the largest artery and vein, respectively, in your body they want as much room to work as possible.

    I can post pictures of my incision scar shortly after surgery if you like. I've also got pictures of it 3 months and 6 months post surgery. You can just google RPLND though and find some examples.

    I was in the hospital for 6 days. They had me walking a few hours after the surgery believe it or not. Couldn't eat anything for the first couple days while the bowels were adjusting back into place. The pain wasn't all that bad except for walking the first day or two. I had a lot of back pain though which was honestly worse than the incision as the bed was really uncomfortable and I have back problems.

    It took me about 6 weeks to fully recover. IIRC my surgeon said at 2 weeks I'd be walking fine, at 4 weeks I could jog, and at 6 weeks I could run. That seemed to be pretty true. Couldn't lift anything more than 5lbs until 4-6 weeks as well.

    Also they will likely go ahead and remove all of the lymph nodes in question regardless of whether they are enlarged. I had 22 nodes removed and only 1 was positive for cancer.
    I/O - Jan 3rd 2011 (Diagnosis) 95% embryonal, 5% mixed (trace teratoma)
    CT Scan - April 2011 (Relapse) 1.8cm enlarged node
    RPLND - May 10th 2011, 1 node positive for embryonal carcinoma
    2x BEP - Began June 20th 2011, ended July 25th 2011
    CT Scan - November 17th 2011 (Clear), February (Clear), May (Clear)
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  5. 07-15-12, 11:49 AM #5
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    S P
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    Click the link in my sig for my RPLND thread.
    Steve - http://www.caringbridge.org/visit/stevep
    February 2011 - DX Stage IIB, 90% Embryonal Carcinoma, 10% Yolk Sac
    Mar-May 2011 - EPx4 per Dr. Bosl at MSKCC, administered locally in DC
    6-Jun 2011 - post chemo CT shows one lymph node at 1.4cm remaining
    22-Jun 2011 - RPLND with Dr. Sheinfeld at MSKCC, all 51 nodes removed negative
    Dec 2012 - 1.5 YEARS ALL CLEAR!
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  6. 07-15-12, 04:32 PM #6
    Dakota12
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    Thanks!

    Thank you guys so much. This has been extremely informative, and helpful. I have surgery tomorrow at 1:30 @ IU medical center.

    NEVER GIVE UP,
    Dakota
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  7. 07-15-12, 06:33 PM #7
    val
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    Hi

    Just wanted to wish you best of luck.
    Val

    Brother (23 when diagnosed) : Dianosed 14/09/2009, testicle removed, Non sem diagnosed. Tumour markers 36000 before op and dropped to 17000 after operation.. Chemo started end of september 4 x BEP. Tumour markers normal at end of chemo. RPLND 26 Feb 2010 No cancer found.

    Latest Appointment May 2013- CT and markers normal
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  8. 07-16-12, 04:40 AM #8
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    S P
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    Good luck today!!
    Steve - http://www.caringbridge.org/visit/stevep
    February 2011 - DX Stage IIB, 90% Embryonal Carcinoma, 10% Yolk Sac
    Mar-May 2011 - EPx4 per Dr. Bosl at MSKCC, administered locally in DC
    6-Jun 2011 - post chemo CT shows one lymph node at 1.4cm remaining
    22-Jun 2011 - RPLND with Dr. Sheinfeld at MSKCC, all 51 nodes removed negative
    Dec 2012 - 1.5 YEARS ALL CLEAR!
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  9. 07-16-12, 07:24 PM #9
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    Tarc79
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    Hope all goes well. Let us know how you are doing.
    Jan '11 - Stage IIIc, Mets in lungs and liver, abdo 7*7, pulmonary embolism
    Right I/O AFP 13,000, bHCG 110, Scrotal Hematoma
    Vena Cava Filter placed
    4*BEP, self-injected Lovenox
    AFP 20 end of 4*BEP
    May '11 - RPLND @ Indiana U - inferior vena cava dissected, necrosis, AFP<5
    Filter Removed
    Surveillance (blood & X rays) and all clear for 24 months
    April '13 - AFP 26 , went up to 46 in a week, Negative CT Scan, Ultrasound and head MRI
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  10. 07-16-12, 11:09 PM #10
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    CancerSux
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    Hope surgery went well today! If it was with Foster (at IU), he is one of the world's best, so you were in good hands there with him or anyone he has trained.
    Tracy
    Cancer pharmacologist, caregiver blog here
    Wife to Kel, dx 12/30/11 Stage IIIc (poor) embyronal, AFP 13700, 10x11 cm retroperitoneal mass, 1 cm^2 lung met
    Left I/O 12/31/10.
    4xBEP 1-4/11, AFP=22, 5*7 RP mass, tx failed
    1.5 x VeIP 5-6/11; tx failed, AFP/b-hCG rising
    Salvage RPLND @Indy 6/29/11, metastatic mixed germ cell tumor with yolk sac, seminoma and teratoma
    Remission! AFP steady since 9/2011; 1.5 years ALL CLEAR
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  11. 07-17-12, 09:53 AM #11
    Geoff
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    Hope your surgery went well.
    7/15/11 Right I/O
    90% EC, 10% Seminoma, LVI, CT scan and Chest x-rays clear
    8/22/11 RPLND, all clean
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  12. 07-18-12, 07:11 AM #12
    Dakota12
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    It's done

    This is Dakotas mom, I'm typing for him:
    I'm in Day 2 of recovery from my RPLND. Dr. Beck, not Foster ended up doing my surgery- Dr Einhorn said he was equally qualified, Dr Foster was on vacation. My recovery has gone well thus far- my surgery from the time they took me from pre-op till arriving in recovery was 4.5 hrs. My 1st 24 hrs was focused on pain management & getting moving: i was expected to take a few steps & instead walked a lap through the hall twice. I was allowed a clear liquid diet in my 2nd 24 hrs & just continued to rest. This morning brought the beginning of my 3rd 24 hr day & good news- i get to eat REAL food, have my epideral & catheter removed, and am expected to get moving even more. If all goes well, doctors think i may be released tomorrow.

    NEVER GIVE UP,
    Dakota
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  13. 07-18-12, 08:16 AM #13
    Geoff
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    Great to hear he is recovering well.
    7/15/11 Right I/O
    90% EC, 10% Seminoma, LVI, CT scan and Chest x-rays clear
    8/22/11 RPLND, all clean
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  14. 07-18-12, 08:49 AM #14
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    DBR82
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    Sounds like your doing great Dakota, keep it up!
    5/1/12 – TC Detected
    5/7/12 – Left I/O - 100% EC
    6/5/12 – L-RPLND
    7/16/12 – EPx4 Begins
    9/21/12 - EPx4 Completed - Surveillance Begins

    blog – http://brett-tc.posterous.com/
    twitter – https://twitter.com/Brett_Robinson
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  15. 07-18-12, 08:17 PM #15
    1luckyball
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    Good to hear Dakota. Sounds like a good start to a quick recovery
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  16. 07-19-12, 07:21 AM #16
    Dakota12
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    Tody I get to go home! I had all the hoses, tubes, and wires removed yesterday and today I am being released. My pathology report has not come back yet and Dr. Beck did not keep track of how many nodes he removed. Hopefully the pathology comes back good. I have about a 13" incision that starts just below my sternum, goes down around my belly button, and goes about another 2.5". It has healed rather well but I am in a lot of pain. They are increasing my oral medicine because the stuff I am taking now only helps for about 2 hours (it is supposed to last 4). I will keep you all posted as to how my recovery goes.

    NEVER GIVE UP,
    Dakota
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  17. 07-19-12, 08:56 AM #17
    Sparty
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    Good to hear Dakota. You'll want to keep a pillow pressed against your stomach for a little while, especially when traveling. Protein, vitamin D (sunshine), vitamin C , bromelain (pineapple extract), and Zinc will help your incision heal. The nursing staff is great there (Jaimie and Andrea were my regulars) and they'll get you out in good form.
    Left I/O 4/30/12
    Path: 100% EC
    CT 5/15/12 - one node swollen 22mm
    RPNLD - 6/13/12 at IU
    2 of 14 nodes involved; dimensions: 18 mm and 8 mm
    Path: 80% EC, 20% teratoma
    Surveillance
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  18. 07-19-12, 04:34 PM #18
    Dakota12
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    Okay, I need help with this one. My nurses are not letting me go home now because I can't pass gas. I haven't passed gas or went #2 since sunday. What can I do to make myself pass gas? Is this common?
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  19. 07-19-12, 06:33 PM #19
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    Davepet
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    I don't think there is much you can do. Your intestines have had a fair amount of handling & it can take a while for them to work properly again. They want to keep you where they can monitor you until everything is working properly.

    Dave
    Jan, 1975: Right I/O, followed by RPLND
    Dec, 2009: Left I/O, followed by 3xBEP
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  20. 07-19-12, 06:44 PM #20
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    DBR82
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    I know the frustration, Dakota. They kept me for the same reason. My advice, don't worry about it. If it's making you tense, it'll make it harder. Gas will come out, and when it does...
    5/1/12 – TC Detected
    5/7/12 – Left I/O - 100% EC
    6/5/12 – L-RPLND
    7/16/12 – EPx4 Begins
    9/21/12 - EPx4 Completed - Surveillance Begins

    blog – http://brett-tc.posterous.com/
    twitter – https://twitter.com/Brett_Robinson
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  21. 07-20-12, 07:06 AM #21
    Dakota12
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    Well I got to go home yesterday after all 😃. I didn't pass gas but they took a listen to my intestines and said I had movement and that I sounded fine. I did however accomplish "gas passage" today . Pathology came back and said that they took 17 nodes, 3 of which contained pure EC. Dr. Beck says I have about a 75% chance that it will never come back so I am on surveillance now. If it comes back I will go through 3xBEP. This is my situation up to date. I will keep everyone posted as things unfold. Thanks!

    NEVER GIVE UP,
    Dakota
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