General anaesthetic with poor kidney function

[Dirock]

Hi

I have had GPA for 6 years and live pretty well now on a kidney function of around 25% (this having gradually increased from 2% when diagnosed). I have always enjoyed hill walking with my partner and with my local walking group. However for the last year I have had intermittent claudication in my left leg - tests have now shown that I have a 12 cm length of artery which is completely blocked. Keyhole surgery to insert stents is not an option meaning an arterial bypass is the only surgical solution. I have been offered this (although it isn't medically necessary at the moment) - on the basis that it is interfering with my lifestyle. I would dearly love to get back to pain free walking again but am nervous about the operation. I wondered whether any of you with poor kidney function had had this done and what the outcome was - I certainly wouldn't want to further jeopardise my kidney function. An alternative is to try to increase my exercise level (which is already reasonably good) to encourage new blood vessels to form/enlarge. I have started on this regime already but again a question - has anyone conquered their intermittent claudication pain by exercise alone? Look forward to hearing about your experiences.

[PMRpro]

As far as I know it rarely achieves what we might regard as a cure - it can improve the distance you can walk significantly though.

discover.dc.nihr.ac.uk/cont...

and of course the extra distance to pain is an average, some people will have achieved more. You can but try.

Do you have a renal consultant? Have you discussed it with them?

[Dirock in reply to PMRpro]

Hi thanks for your response. Yes I have a renal consultant and am just composing an email to her as I am not due in clinic again until April. I know she won't be keen but I will ask the question! Thanks for the link on exercise - will read with interest.

[PMRpro in reply to Dirock]

It was my husband's field in a past life - so I know about exercise being the first approach. But it is slow. All the best!

[Dirock in reply to PMRpro]

Thanks PMRpro

I am giving exercise a good go at the moment so we will see whether it results in an improvement.

Diane

[michichgo]

I'm going to comment on the general anesthetic part of your post, as I have no experience with claudification.

My kidney function ranges from 25-30%, never higher. I've underwent two hip replacement surgeries, both under general anesthetic, and experienced no negative kidney issues.

Wishing you improved health.

Michele

[Dirock in reply to michichgo]

That's really useful thanks Michelle. Our kidneys sound on a par!

Diane

[michichgo in reply to Dirock]

I thought the same thing! I was never as low as 2% function. Did you require dialysis? That would be even more frightening. Hope things clear up for you soon.

I personally feel this disease does a lot more damage to our bodies than most doctors realize. In the past five years, a number of somewhat-significant health issues have arisen, for me. It gets tiresome, really, but "chin-up" is the attitude that keeps me going on the right path!! Be well.

[Dirock in reply to michichgo]

Hi Michele

Yes I was in hospital for a month in 2012 (all over Christmas!) and had regular dialysis and 7 plasma exchanges. I had a 9% kidney function by the time I left hospital and it has very gradually crept up to its current level. It was very scary particularly as I have had 2 close relatives die of the same thing - I thought I was going to follow. So I am very grateful to the team in Manchester who brought me back from the brink and for the relatively normal life I lead. But yes the side effects of the disease or drugs do keep surfacing to keep the me on my toes! Take care

Diane

[michichgo in reply to Dirock]

My goodness, what a remarkable comeback!!!!!! You could add that to your resume of life!

[Glenville]

I've been told I need a new knee because of large doses of steroid but can't be put under so I'm having an epidural or similar basicly I will be awake not looking forward to it but just grin and bear it my kidney function is around 25% regards Glen.

[PMRpro in reply to Glenville]

I had knee surgery (not a replacement) with a spinal anaesthetic - the metal was put in in Italy where there was no sedation, just a load of dishy Italian doctors who wanted to practise their English, didn't even get time to listen to the music DVD I'd chosen. It was fine, When the metalwork was removed in Scotland I again had a spinal - but was given temazepam so I slept through the lot. I was totally tee-d off!!!!

[Dirock in reply to PMRpro]

Thanks Glen

Maybe I will be offered some options too.