CRYOABLATION

CRYOABLATION

Homecare instructions: -You may shower and bathe normally. -Do not drive or drink alcohol if taking narcotic pain medication. -Resume all of your home medications. -Call the Cryoablation Clinic to schedule/confirm your 10 day follow-up appointment AND if you have any questions. -You may also call your urologist’s office if you have questions, (617-732-6325). -If you have fevers > 101.5 F, vomiting, severe abdominal pain, or inability to urinate, discharge or worsening redness at incision site please call your doctor or go to the nearest emergency room.

HOSPITAL COURSE Patient tolerated renal tumor cryoablation surgery without complications. Please see operative report for further details. Post-op course was uncomplicated. Myoglobin POD 0 and 1 less than 1000 and decreasing. MRI done POD 1 reviewed by interventional radiologist and reported to be without concerning findings. At discharge patient's pain well controlled with PO pain medications, tolerating regular diet, ambulating without assistance and voiding. Incision at discharge was without erythema or hematoma. Patient was instructed to follow-up with Dr. Tuncali in 10 days.

Special considerations for these patients:

Uro needs to admit patient under assigned uro attending and place orders for home meds. Usually hold ASA, Plavix, anticoags for 24 hours but best to ask the IR fellow to be certain. Make sure the PAML was updated pre-operatively. Most of the patients do not require narcotic pain meds. If they do, uro is required to write the order and script along with Colace. Check lab results: Myoglobin and CBC. Goal: Myoglobin under 1000, if close to 900 call IR. Treatment consists of alkalinizing the urine with IVF D5W with 3amps Sodium Bicarb rate 150/hr until the next test done the following day.

PATHWAY: -IR writes for their post-ablation recommendations ie: diet, IVF, MRI, Labs (good to make lab order for next day “discharge stat” so they are done prior to MRI and the labs don’t hold up discharge). Make sure IR wrote for foley d/c’d at midnight pod 0. -Uro writes for PAML to orders -Patient is discharged POD1 after cleared by IR usually around 10-11 am once lab and MRI results are back. -We do not need to give scripts unless the patient required narcotic pain meds as mentioned above.

MRI is done morning of POD1 and read by IR. IR needs to give clearance for patient to be discharged. (I usually page whoever wrote the IR orders). Follow-up with Dr. Tuncali in 10 days