9. December 2011 06:00
Alex3 by FreddieBrown
And so, unexpectedly swiftly, I find I am to present myself at Addenbrooke's at 07:00 this Saturday to be admitted for an open partial nephtectomy (following the recent diagnosis of suspected kidney cancer).
Laparoscopic vs open surgery
I have avoided hospital all my life so far, so the sudden prospect of major surgery is a little daunting. I discussed various surgical options with my consultant – I was attracted by the idea of laparoscopic surgery, but perhaps only because my inner geek was interested in having a robot involved in the procedure (the hospital has a da Vinci Surgical System). The chief advantage of the laparoscopic approach is that it is less invasive and therefore tends to have a shorter recovery time – and exhibiting perhaps a dry sense of humour the consultant observed I was probably “keen to get back to the gym”.
However, in my sort of case the Cambridge team tends to favour open surgery. This is in part because they can dump ice into my body cavity during the operation, so that the (cooled) kidney remainder dies a little less as a result of the necessary ischemia, but also because of the “endophytic cyst” that has been found in the centre of the kidney. Ah yes, that cyst. The doctors seems sure this is nothing to worry about, since many people develop simple (fluid-filled) renal cysts at some time. However just to be sure the surgical team will perform an ultrasound scan on my exposed kidney to confirm whether this cyst really is as simple as it appears, and if not – cut it out. Given that I am learning that doctors are practised in the art of gradual disclosure, I feel a little nervous about this.
Radical vs partial
There was also the question of whether to have the whole kidney removed (radical nephrectomy), or just the diseased part. The thinking here is that for smaller tumours (such as mine) it is better to preserve some kidney, and so some kidney function, where possible. This is not so much based on direct clinical evidence – since one kidney always takes-over so over effectively when the other is removed this would be hard to measure – but on logic: if something else goes wrong with the remaining kidney later, it is surely better to have preserved whatever one can.
Faced with various discomforts ahead, I decided I needed to treat myself to some compensatory camera equipment, and plumped for a second-hand Nikon D700. This is a camera that Nikon is about to discontinue, but has many points in its favour:
- It’s now been around long enough (since 2008) that second-hand ones are available at reasonable prices.
- It’s a “full-frame” camera, with all the attendant benefits that brings – particularly in ultra-wide lens choice, which intereste me.
- Unlike some Nikon models this has happy colours.
- It’s so well-established that supporting software (such as my favourite RAW converter, DxO Optics Pro) is thoroughly de-snagged.
I’ll post some more thoughts on this camera when I’ve had a chance to use it more, but in the meantime … Merry Xmas!