The right adrenal gland is absent
Thank you for your service
My health odyssey started on December 4, 2021, when severe abdominal pain landed me in the ER. An ultrasound and a CT scan showed active bleeding in my abdominal cavity. This information wasn’t enough, though, for the doctors to diagnose or treat. So they admitted me for observation. Their biggest concern was uncontrolled internal bleeding. Fortunately, the bleeding stopped on its own and I was discharged four days later when my hemoglobin levels returned to low normal.
At this point, even though I felt weak but okay, I was far from healed. There was still no diagnosis or treatment plan in place. It took multiple doctor visits and scans over the next months to determine that a tumor arising out of my right adrenal gland needed to be removed.
We learned the adrenal mass was cancer in late February 2022. At the same time, we learned my left lung had a small active nodule. Saving that story for a separate post. I was ready that day in February for the surgeon to do his thing on the adrenal mass. Alas, I needed to get set up with an oncologist first, as he would now be calling the shots. He ordered a biopsy in mid-March to gather more intel.
Everyone was ready to act in late March when we ran into scheduling challenges. The procedure required two surgeons, and scheduling them and the hospital and the staff presented a hurdle.
The adrenalectomy was complicated by the location of the tumor. From the vascular surgeon’s pre-procedure notes:
RIGHT ADRENAL MASS, most likely malignant. May be primary or metastatic.
The recommendation from medical oncology is open excision and treatment as though it is a primary.
The lesion is high under the liver. Control of the superior abdominal IVC is not likely from an abdominal approach. A thoracoabdominal approach is needed to obtain control of the retrohepatic cava. The lesion is likely to require IVC crossclamp and excision of part of the wall of the IVC to perform curative resection.
I have reviewed the images with the patient and her husband to demonstrate my concerns about vascular control.
A thoracoabdominal incision with rib excision and incision of the right hemidiaphragm with placement of a chest tube will be necessary. They understand the potential for bleeding, infection, muscle eventration, numbness or nerve pain. Need for transfusion is likely depending on extent of tumor.
That first surgery finally took place on April 11, 2022, eighteen weeks after my visit to the ER.
The wait was excruciating, but the bottom line is that the surgery was successful. Adrenal and tumor with margins cut out. Me, exhausted but alive, stable, and awake.
My CT results from the recent scan on November 12, 2022, included the line:
The right adrenal gland is absent.
Of course my right adrenal gland is gone. I wanted it gone. The surgeon needed to remove it. Still, I’m a little sad that it had to be sacrificed.
Most people have two adrenal glands, one on the right and one on the left, sitting atop the kidney. These endocrine glands produce a variety of hormones. Like our kidneys, we can usually live just fine with one.
Whoa, reading all that sounds scary but you are here to tell all about it. Makes me think you have a reason to be thankful this year❣️
Sorta glad now that I had so many months of ignorance. And I thought scheduling a lab test was a bother. "Oh poor me. Getting a convenient appointment is Soooo hard".