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A Fascinating Discovery or “How to Lose a Kidney in Nicaragua”

By Amy Bushnell

As a rule, I do some light yoga primarily for the stretching and to limber up my back. Many times I especially do lower back practices to keep the dull pain away. It has not been bad just occasionally a twinge here and there.

Darrell and I visited friends in North Carolina this fall and upon our return I caught the respiratory thing everyone seemed to have. Raging cough, chills, fever, etc. The coughing got so bad that I thought I pulled a muscle in the back or bruised a rib or two. This went on for a couple of weeks. A week before Halloween I got a call that my brother in law had passed away and the memorial service was in a week. I knew I could not fly in my condition so went to the doctor for relief. He said I had a throat infection and put me on antibiotics and prescribed a cough elixir. Sure enough, in a week I was able to fly without embarrassing myself by hacking the entire trip.

Upon my return I was still feeling poorly but waited a week to revisit the doctor. I explained that I may be a little overanxious since the passing of my brother in law and two other friends but I had a pain in the breastbone area and wanted to get it checked out. I was thinking maybe I had gall stones or something going on with the pancreas which worried me as my mother had passed away from pancreatic cancer and she wasn´t much older than I am now.

The doctor made an appointment for me to have an ultrasound for the next day. The Dr. was very thorough but spent a lot of time on my left side in the back. He asked if I had had kidney issues and I said yes, I have had stones in the past and passed at least 10 in my lifetime. He gave me the report, saying there was a problem there: a blocked ureter and several stones and what looked like a nonfunctioning kidney.

The next day I revisited my doctor after first getting a urinalysis showing an infection. My doctor read the report, we discussed options on removing or dissolving the stones but first I had to get rid of the infection. Result another round of antibiotics. After 10 days, I had another urinalysis which still showed the infection. The doctor then gave me two shots and prescribed a round of 8 shots to be given one each day. This was a pretty strong antibiotic. It messed with my head, my equilibrium and sense of well being.

So now we are into December. I had a full spectrum urinalysis which showed infection. I really did not want to hear that. Also my back started to hurt. The doctor said we had to get rid of the infection before we proceeded with any other treatment. Okay, another round of antibiotics and some other stuff that I do not recall. My doctor was going to go out of the country for the holidays for two weeks. So this round of treatment was for 10 days then wait a week and get another urinalysis. In the mean time I feeling even worse and felt I need to see a specialist or urologist. I texted my doctor about a recommendation and I also asked several friends for their doctors´ name as they had work done recently.

It was the holidays….I called three of the doctors….one had his phone disconnected, two others were also away for the holidays. Even their staff were away so I could not make an appointment in advance. By this time, my doctor returned. He read the results of the urinalysis (infection) and I explained that I was feeling worse. We made an appointment for a CT Scan the next day. I was to get the results in two days. So three days after the CT Scan I revisited my doctor.

The results and report were alarming to me. It showed necrosis and severe displacement of the tissue as well as the stones. My doctor said it was time to see a specialist, urologist and he recommended another doctor from Vivian Pellas hospital in Managua. He made the appointment for the next afternoon.

I met Dr. Neira there and was very impressed by him. He was so professional, no nonsense in his delivery. I was put at ease immediately and we made plans for the removal of the kidney as soon as possible.

Monday morning I went to the hospital for pre-op tests for blood and urine. Then went for an EKG. I will say, even after 14 years of living here my Spanish is not stellar and there was some instructions lost in translation. So I fasted for too long and the EKG doctor said he could not perform the EKG because I hadn´t eaten or had water for over 20 hours. I begged and he said well, we had to wait for the other test results, so we sat in the waiting area for an hour or more for the results to come in. Voila…EKG.

The next day I had an appointment with Dr. Neira to learn the particulars of check in, money matters, etc. We decided to do the operation the next morning, Wednesday, at 9:00 am. We arrived an hour earlier for additional blood work and to sign releases for transfusions, etc. I was put in a wheel chair and taken to my room. The nurse delivered towels, a gown, soap etc.

Darrell and I sat there chatting and reading and waiting for zero hour. The nurse walked in about 45 minutes later and was aghast that I had not showered and changed into the gown. I quickly washed with some corrosive soap and was then wheeled away to the OR.

The surgery was to last about 2 or 2 and half hours and to start soon. More doctors were there, checking vitals, making sure they had the correct side. In pre-op I was alone for about half hour then all of a sudden the place was full with so many other patients and doctors.

I do not recall going under. When I started to come to I could not move and my voice did not work. A few minutes later I wheeled to my room. After leaving the OR I was surprised that it was dark outside. T should have been no later than 1 or 2 in the afternoon. I knew Darrell would be anxious if it was already dark. Primarily because he does not like to drive at night and especially from Managua. We entered my room and the look of relief on his face was profound but I still could not talk. He stayed for about another hour or so then went home.

Dr. Neira talked about what they found and the reason the surgery took so long. Apparently the tissue of the kidney morphed into something like spider webs and attached itself to everything around it. So even though the thought was to be laparoscopic it was a combination because of the extra tissue. The doctor said this could have been going on for 4 or more years and yet I as asymptomatic. If I had not gotten that terrible cough and the resulting pains, I would never have known and this would have killed me.

So I am eternally grateful to Dr. Neira. He is a fine surgeon. I am grateful for all the well-wishers and prayers sent my way. They certainly keep the spirit up. I am grateful for Darrell who will go to then ends of the earth with me.

I am going to work tomorrow, not sure how long I will last but I have to try. Got lots of plans and can´t keep me down for long.

Amy Bushnell

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