Stable tumor and a kidney stone

Last week found us back at UCLA twice, first on Wednesday for Susan’s scheduled MRI and oncology visit.  Thankfully, her brain tumor is stable once again; the scan showing only minor changes and nothing to indicate tumor growth.  Dr Nghiemphu extended her next evaluation from six to eight weeks.  The watch and wait phase continues. 
 

We returned Friday for Susan’s abdominal CT scan and confirmed she has a 1.4cm kidney stone.  We met with two urology associates, Drs Brison and Schulam, who outlined our options for treatment.  Since the stone is fairly large, we focused on the middle-of-the-road treatment called uretoroscopy, where the doctor inserts a scope into the ureter and kidney to break up the stone with a laser and gather the pieces for removal.  We ruled out a lesser treatment of external shockwaves that would pulverize the stone but leave pieces perhaps too big to pass, and will also avoid a more invasive surgical treatment the doctors think would be overkill.
 

Still, the uretoroscopy requires several treatments at two-week intervals and leaves a drainage shunt in place that can be irritating and uncomfortable.  Dr Schulam demonstrated great compassion in asking Susan how she’s holding up with her complicated health situation.  He was open to defer treatment in case she’s weary or overwhelmed.  Susan, ever the gracious fighter expressed her willingness to proceed with, “Well, you have to do what you have to do.”  But given the likelihood of having to endure six weeks of shunt discomfort when the stone may not present any real trouble, Dr Schulam recommended waiting until mid-summer, getting another scan, and tracking any changes.  Meanwhile, if the stone blocks her urinary tract and begins to cause infection we’d know right away by the onset of persistent pain and would do the procedure at that time.  We felt comfortable with this approach; and I like the idea of giving Susan a respite from treatments so she can get stronger.  Meanwhile, we pray for her overall healing and restoration of her body. 
 

When they do the uretoroscopy to zap the stone, they’ll also do a routine check of her bladder for cancer or other disease, a customary practice that kills two birds with one stone while getting another stone out.  I knew I could work that line in there somewhere.