u/Fantastic-Option-260

Hello,

(Male, 40's, robot assisted (Da Vinci) partial nephrectomy, 6cm mass)

I'm about 2.5 weeks out of surgery and feeling much better.

I'm getting some really inconsistent messages from my teams concerning recovery and have some basic questions I was wondering if anyone might have more experience of?

- I have 6 wounds from the operation 19 days ago Staples removed 7 days ago. All still covered with island style stick on bandages.
When can I actually take these bandages off?

- Once I have taken these bandages off. When am I allowed to take a bath again?

- I have heard completely different opinions on the level of physical effort I should under-take during recovery. One set said I can gradually increase effort over my 7 week recuperation and by the end I'm essentially "normal". Others have said I should avoid any heavy lifting or mild gym work for at least 3 months following surgery to avoid a risk of hernia. What have you been told?

Hi,

I really wanted to get a teacher's opinion on this, but the r/TeachersUK reddit will only allow working teachers to post there (I work in an associated industry)

I've noticed pupils counting as SEND/receiving SEND support have now reached an average 20% of class size in state schools.

I'm interested if any teachers have an idea on why this is/why the numbers are so high (I don't remember it being anything like this when I was in school)?

For example do you think it's:

• Better diagnosis (classes always contained this percentage but it wasn't known)
• Higher incidence (something is causing more kids to need SEND support)
• Poverty etc (something is giving kids a need for SEND support outside of a genetic diagnosis)
• Miss diagnosis (some of these pupils don't need SEND support but are requesting it)
• Something else.

I do apologies if this is a frequently asked topic, but I have searched this (and the teachers) reddit for "SEND" and "SEND Diagnosis" and not found it.

Thanks for your time.

I've been pondering the normal myriad of posts about "end stage capitalism" and "no hope for young people" and "brexit issues" etc.

It dawned on me that, if you look at British culture (I'm not sure globally) the real oddity in recent history has been the "middle class".

Throughout most of our history there have largely been 2 sections of society (if we leave out royalty, clergy etc):

• A rich "haves" (landowners, mill owners etc) and
• A poor/serving "have nots" (peasants, workers).

Following WW2 we had an un-precedented situation where great wealth (and a need to build), led to the emergence of the "middle class".

A new large layer of society that didn't "own" the machinery of wealth (infrastructure, land), but yet somehow still had extraordinary wealth and were able to live a lifestyle never seen before (the "two cars in every garage" situation).

I wonder if actually what we're actually seeing is a (historically "natural") re-balancing of this situation and the erosion of this anomalous situation where a large swathe of the population (who don't own some of the main instruments of wealth), oddly had wealth and great quality of life.

Instead we're seeing a (historically natural) return to the "haves" and "have nots" (don't own land or a mill... you're going back to being a worker/peasant).

What do you think about this Brits... do you think we've just complaisantly accepted the existence of a "middle class" and actually we're returning to "peasantry"?

Hi Peeps,

I had a robot assisted partial nephrectomy 1 week ago (UK), and just starting to turn the corner (I hope).

I thought (before I forget), I'd briefly list some thoughts and tips that I either didn't appreciate, or would have really helped me if I'd known in advance, just incase it helps future people prepare for this sort of surgery.

Obviously this is my experience, other people may disagree.

Hospital Stuff:

• Overnight bag - I massively over-packed (a couple of changes of clothes etc) which made it annoying to find things and for the teams to cart my bag around. Remember you won't be wearing regular clothes after surgery (a gown instead) and won't be functional enough to use toiletaries (deoderants, shaver). If I were doing this again, I'd just bring a phone, charger, iPad, and one set of clothes.
• Clothes - I fortunately predicted this, but your waist is significantly wider when you leave the hospital due to swelling. Make sure your set of clothes you bring to leave in are larger than usual
• Contact Lenses - Fortunately I predicted this, but I ususally wear daily contact lenses. Don't do this as you will be in no state to reposition, remove or replace them. Bring glasses instead.
• Visitors - Again your experience may differ, but I was a complete wreck in the hospital and wish I hadn't asked for visitors other than my partner, as you get tired almost instantly when talking. You're only there a day, so get them to come round after you're back at home.

Getting Home:

• Possible sign for rear window - I was in so much pain leaving, my partner had to drive extremely slowly over bumpy bits of the road and sharp corners. You may not have this issue where you are, but if I'd known, I would have considered sticking a paper sign to the rear of the car saying "Transporting patient from Surgery, may go slow around corners" as some drivers were being a little aggressive.

Recovery:

• Shoulder pain - The shoulder pain from the injected CO2 is almost the worst part of the pain. It's doubly bad as you have to use your arms to assist any sort of movement due to your stomach wounds. Microwaveable Oat Bags were incredible at relieving this pain. I can't recommend enough buying 2 x microwaveable oat bags (and testing the correct time to get them to a very warm but not painfully hot temperature) in advance.
• IPad gimbal arm thing - For the first few days (the worst) you'll have to adopt some very odd positions in bed to be in as least pain as possible. This makes it impossible to get a good view of an iPad and your arm will be too painful to hold it. Buy a cheap gimbal arm (flexible arm) off ebay for a tablet, as you can then have it positioned somewhere you are able to watch it.
• Thermometer - I can't believe I didn't think of this, but make sure you have a working, validated thermometer at home. You will swell and get hot and need to know if it's a normal part of healing, or an infection. Checking your temperature regularly is a great way to do this.
• Pee in the sink! - Debatable (and possibly only for guys), but you're supposed to be very aware of your pee in the first few days (check the blood and small clots reduce quickly). I found peeing in the sink with plug in for first few days was great. It's obviously not hygenic and needs cleaning afterwards, but meant you could monitor it closely and be sure it was improving/no issues.
• Being careful with healthy food - Obviously you'll want to eat healthy food when back, but take care to avoid foods with legumes, beans, lentils etc in the first few days. It can create wind, which is fine normally but painful after surgery.

Again, purely personal views based on the experience of one non-clinican, but hope this helps someone at least as something to consider.

Hello,

Background:

40s male, otherwise healthy.

I had a robotic assisted partial nephrectomy Wednesday morning.

The Dr said it was harder than expected but successful with the tumour being “highly vascularised and sticky”.

Left hospital for home on Thursday afternoon.

It is now Saturday morning (72 hours later).

First 2 days we’re genuinely the most uncomfortable I’ve been in my life (mainly shoulder and stomach pain).

Today I’ve felt much better and able to walk around my house and sit up in a chair rather than bed.

One bandage has quite a lot of yellow (iodine?) around the staples and very mildly itchy but not painful, but all others look clean and white

Question:

I know some bleeding when you pee in the first few days is normal, especially with a partial, but when is it concerning?

In the daytime it will look within the parameters the Internet suggests (like a rose wine) but the morning pee definitely has quite a lot of blood in it (like 1/4 red wine and 3/4 lemonade with a noticeable swirling red sediment at the bottom).

I’m hoping this is just night stuff clearing out. I’ve never spotted anything thicker than a mm in it, just red sediment.

There is no pain peeing and my side feels warm not hot and other than the very mild itching on one bandage, they seem fine.

Pain is much better today with only pain on coughing or getting up.

My nurse contact is on holiday until Monday so plan to ring them and ask, but unsure if its worrying or not before then?

Thanks for your help.