Few questions for fellow warriors

Back atcha Joe....You made my day.

Wendy

Fabulous, thank you again!
I'll use the provided data to do some search on my own when I get a chance.

Did I say that I love you yet? :-*

Best regards,
Joe

Hi Joe,
I was as glad as you when I found the articles referenced below, both recent and by smart researchers, both agreeing on the important part - which I excerpted from the first one. As for digging...I hardly dig these days as I let journal updates come to me and sift through them. Filing them is more like it!

Here's to champagne breakfasts!
Wendy

Upper urinary tract tumour after
radical cystectomy for transitional cell
carcinoma of the bladder: an update
on the risk factors, surveillance
regimens and treatments
Kristin M. Sanderson and Morgan Rouprêt*
Urologic Oncology, Department of Urology, Keck School of Medicine, University
of Southern California, USC/Norris Cancer Center, Los Angeles, CA, USA, and
*Department of Urology of la Pitié-Salpêtrière Hospital, GHU Est, AP-HP,
Faculté de Médecine Pierre et Marie Curie, University Paris VI, and CeRePP
group, EA 3104, University Paris VII, France
J O U R N A L C O M P I L A T I O N©2 0 0 7 B J U I N T E R N A T I O N A L | 1 0 0 , 11 – 1 6 | doi:10.1111/j.1464-410X.2007.06841.x

Upper tract Urethelial Recurrence Following Radical Cystectomy for Transitional Cell Carcinoma of the Bladdre: An Analysis of 1,069 Patients With 10-Year Follow Up Kristin M. Sanderson, Jie Cai, Gustavo Miranda, Donald G. Skinner and John P. Stein From the Departments of Urology (KMS, GM, JPS) and Preventive Medicine (JC), Keck School of Medicine, University of Souther California, University of Southern California/Norris Cancer Center, Los Angeles, California
Journal of Urology Vol.177,2088-2094, June 20 2007

Wendy,

this is fantastic response - where did you dig this out?
You made my day, literally, I love you!
Wow... This was sitting on my mind like a shadow...

As per the other two questions, I have to say that the overall "sick" feeling improved greatly since I posted the question. My surgery lasted 12 hours - so obviously I still have ways to go. The scrotum situation is slowly getting better, too. Guess I'm just little inpatient. Mainly I miss my work, and going nuts here at home, and paying to much attention to my "masacred" plumbing

Again, thank you for your response.
I feel like opening bottle of champaign - and don't care if it's 7:30 in the morning!

Dear Joe,

I was looking for info about the risk involved with a positive ureteral margin before I gave an answer, and discussed it with someone knowledgeable on the subject. Your question #3: I'm happy to report think your doctor is right!

About feeling crummy all the time...couldn't it simply be from getting such a big surgery? I had a simple mastectomy (well....simple...simple...)and felt horrible for at least 3 months (though radiation contributed I'm sure). I have heard others report that for every hour spent on the OR table, people need a MONTH to fully recover. could be true...surgery is a big deal and takes a toll on our bodies.

The scrotum trouble...happens to some guys, unfortunately, but will pass unless an infection needs treatment.

Here is an excerpt from an excellent article about upper tract TCC which touches upon positive margins, and tells me what I needed to know: positive ureteral margins don't effect survival, like your doctor said!
If you need translation of the medspeak, just ask:


URETERIC MARGIN
The impact of a positive ureteric margin noted
on frozen-section analysis (FSA) or in the final
pathological specimen has been the subject of
debate. High rates of false-negative results
and a lack of association between FSA and
subsequent UUT-related mortality have
fuelled the debate [17]. The most recent
evidence indicates that TCC involvement of
the ureteric margin is associated with a
greater risk of a secondary mUUT-TCC [metachronus...means secondary upper tract recurrence] but
does not influence the rate of recurrence at
the uretero-ileal anastomosis, or overall
survival [8,20]. Furthermore, achieving
negative FSA margins via sequential resection
of the ureters did not eliminate the risk of UUT
urothelial tumour relapse [20]. Currently,
there is little evidence to support the need for
routine intraoperative FSA or the need to
'clear' all evidence of microscopic disease
before uretero-ileal anastomosis.

Good luck with things.
Wendy

"1) For about three weeks now, there are times in day when I feel very miserable. It's not the internals - it's this overall feeling, hard to describe it. Sometimes I also get nauseus when this comes. "

Have you considered that this might be a low blood sugar feeling? If you eat a little, and it goes away, that might be something to consider. I am not saying DIABETES...I am just saying that you might need a little food to bring you back to normal. This is common, and even might be called "hypoglycemia", but the low feeling and nausea sound to me like that.

I have had this problem for years, and finally got it pretty much cleared up by eating lots of complex carbohydrates instead of sugars. Like oatmeal and whole wheat bread instead of white bread and dry cereal without much fiber. This stays with you longer and evens out the internal problems.

Again, I am not diagnosing, just suggesting that this might be something to consider.

Let us know what you hear about these things!

Stephany in Iowa