Kidney Disease and Surgery

[treesarecoo]

I was wondering if a person needs surgery of any kind and has chronic kidney disease, what the recovery will be like. People with CKD cannot take pain meds so how on earth would they be able to take the pain during recovery of a surgery?

[Charlene_Coxhead]

So I had a tonsillectomy recently and complications which was horrendous and never experienced pain like it coukdnt even swallow so theay wanted me to have a feed tube but refused but had fluid for 10 days.

I was put on oxycodone as this is the chosen painkiller and then for helping with swelling it was steriods.

I'm on haemo dialysis. Paracetmol are ok just never anti inflammatories. Speak to your renal consultant as different renal consultants say different stuff. I've k now some on morphine and tramadol but my doctor says no.

Hope the surgery goes ok and you can get some help from the professionals.

[Hidden]

I was scheduled for a Cholecystectomy three days ago but my cardiologist had to clear me first. He ordered a nuclear stress test and as a result of that, he ordered the surgery canceled. He ordered an echocardiogram which I had done on the day the surgery was to be performed. I don't see him until next Wednesday, so I'm unsure of the results. However, during this whole thing, we did discuss the medications for the stress test and he assured me that the two medications used would not have any impact on my kidneys. I had to contact the surgeon and we also discussed pain meds for the removal of the gallbladder. If they could do the procedure laparoscopically the meds would be something like hydrocodone for a few days and there would be no impact on my kidneys. If they began laparoscopically but had to switch to open surgery the pain would be greater and longer. He also assured me that with my current GFR and my average over the last two years I would be able to tolerate the stronger meds for a short duration. I checked with my nephrologist, who is new to me, and the three of them (cardiologist, surgeon, and nephrologist) assured me that there will not be any problems.

So, based on that, the surgery needed, and your current GFR, as well as labs over the past six to twelve months, have your physicians confer with each other and present you with the options.

I will be with my cardiologist and we will hold a conference call with the nephrologist and the nurse from the surgeon's operation team on Wednesday, and I'll get the information from them and then make my decision.

If the issue is with something to do with my heart the decision will be easy. Transplantation of any kind is not an option, so if I should go into ESRD, I can live with dialysis, but not if I ignore the heart issue.

Nothing about a chronic issue is easy and you have to make choices and live with the results of that decision. Be sure to ask your involved physicians about the choices and options available and then make the decision that gives you the most peace of mind. Best of luck.

[Jayhawker in reply to Hidden]

I just had a stress test for transplant eligibility testing. I'm in renal failure and, as you likely recall, not yet on dialysis.

They used an IV to produce the effect of accelerating my heart without me using the treadmill. The medication they injected with the IV was "renal-friendly." Thus, there is an IV option they can safely use for stress tests when tasing persons with chronic kidney disease.

Hoping your appointment goes well on Wednesday. I had to have a gall bladder removed in July of 2011. I certainly felt MUCH better following that surgery

Jayhawker

[Hidden in reply to Jayhawker]

I was surprised at the Stress Test. I had one many years ago and the treadmill test went well. This time I expected the same, more or less. They used a drug called Cardiolite twice on two different tests, no treadmill. The second test they used another drug called Adenisone. They did warn me of potential side effects of the meds, chest pressure, shortness of breath, and/or sweats. I had none of them. There was more wait time between the tests to allow the drugs to circulate than I expected. The entire test took three hours. The follow-up Echocardiogram took less than 15 minutes. I was hoping to go biking today but I had to cancel that. I'm stuck being a couch potato. I can' t wait for it to be Wednesday. I think.

[Jayhawker in reply to Hidden]

Interesting, I did have wait time between the stress test components this past Tuesday. The whole thing start to finish took 6 hours for me; although there was a 90 minute break in the middle of it where I was able to go home and get something light to eat for lunch.

I believe I heard the nurse say that they we're using Cardiolite with my stress test. She was talking to the technician when sharing this information. But they definitely did not administer anything but that one IV solution.

My echocardiogram was also very short. It was done about 2 weeks before the stress test so I have the results from the echocardiogram already but not the stress test.

I hope your results come out alright!

Jayhawker

[Bassetmommer NKF Ambassador in reply to Hidden]

Here's hope for you Mr. Kidney that their findings are something easily correctable or non-existent.

I went through all those tests and was worried sick about them. I had gained a lot of weight and was having terrible times on the drug for my psoriatic arthritis. I waited with great anxiety as my father had bad arteriosclerosis and I thought this was what was wrong with me. I went back to the Doc for my follow-up and was told...I have a heart like an ox, strong and healthy. I replied good because I am built like one and we all laughed. What was wrong with me was ALL due to the medication and all the symptoms went away when I switched drugs.

My husband went through the same procedures last year and after all that and an angiogram, they concluded because he carries so much weight on his abdomen that that was what caused the irregularities in the test results. There wasn't any blockage. They gave him diuretics to take off some of the water and he lost a few pounds..... end of story. Except paying for the tests....

I hope your situation turns out well. Let us know how you make out.

[Zazzel in reply to Hidden]

Will be thinking positive thoughts for you Mr Kidney that all comes out well for you.

[flanderscycling]

I've had Kidney disease for two years now and I've never heard anything from my Nephrologist about avoiding pain meds other than NSAIDS. You can still take Tylenol (Acetaminophen) and several others. I recommend talking to a doctor that can provide you more detailed information.

[WYOAnne NKF Ambassador]

NO NSAIDS is true for after a transplant too. I recently had surgery on my L arm, same arm I had AV Graft in for hemo. Had to remove graft and repositioned ulna nerve. I was on hydrocodone for a week. Most pain meds have Tylenol in them so are kidney safe.

Good luck Mr_Kidney! Will be thinking of you on Wednesday.

[ILMA54]

I am a 55 year old male with Stage 5 kidney disease (GFR ~ 15).

Interestingly, I had surgery last Monday to repair an inguinal hernia. It was an open repair as I had previously had two hernias repaired laparoscopically. Following surgery, I was given Tylenol with hydrocodone to manage the pain.

I tend to tolerate pain fairly well (was my 7th or 8th surgery in my life), and while it was quite painful when I tried to move around if the pain meds wore off (felt like my incision was being stabbed), I only needed two hydrocodone the first day, and one each the 2nd and third. I also used extra strength Tylenol some on the 2nd day, but was off almost all those meds within 3 days.

The other thing that helped was to follow doctor's orders to relax, so I stayed home from work all week (worked some Thursday and Friday), and I will go back to work tomorrow.

All said, it was no worse than any other surgery I had.

Two additional comments (based in part on some of the replies).

I was evaluated last year for a kidney transplant, and I had to undgergo the treadmill stress test. Could not tell you what dye they used for the test, but I had no issues with it, and I need to schedule another test before Dec. 1 as part of this year's evaluation.

Also, in order to be on the active list, I will need to go off Eliquis and onto Warfarin. That will require me to bridge over using Lovanox. Although the recommendation is that people at my level of kidney function not use Lovanox, my primary relied on the advice of my nephrologist, who said he has not problems with me using it for a few days to bridge over. He has been great throughout and I trust his input explicitly (though I do double check).

Checking with your nephrologist for guidance always pays off. When I had my first blood clot in 2013 and was hospitalized out of town, they tried to bridge me to blood thinners with heparin (GFR was in the 20s at that point). Finally, after three days of this, they decided I could tolerate the Lovanox, and I was given the Lovanox and sent home ($17,000 later).

My point is that doctors who are unaware of your prior history will always be very conservative (as they should be), but by engaging your nephrologist, who should know your history well, it is far easier to navigate these types of issues smoothly.

Hope that helps.

Regards,

[steve680]

I think anyone with kidney disease should always consult their nephrologist before any surgical procedure or before taking any medication, even over-the-counter. Most kidney damage comes from long-term use of a medication, such as NSAIDs. Even long-term use of laxatives can cause kidney damage. Be safe.