A nephrostomy is an artificial opening created between the kidney and the skin which allows for the drainage of urine directly from the upper part of the urinary system (renal pelvis). A nephrostomy is performed whenever a blockage keeps urine from passing from the kidneys, through the ureter and into the urinary bladder. Without another way for urine to drain, pressure would rise within the urinary system and the kidneys would be damaged. Nephrostomies are created by surgeons or interventional radiologists and typically consist of a catheter which pierces the skin and rests in the urinary tract. Urine is collected in an external bag which can be emptied as often as necessary. The most common cause of blockage necessitating a nephrostomy is cancer, especially ovarian cancer and colon cancer. Nephrostomies may also be required to treat pyonephrosis and kidney stones.
Another patient had a colon cancer as well and this gentleman had anemia due to all the chemotherapy he received. His blood was so thin it looked almost pink.
Anemia (American English) or anaemia (Commonwealth English), which literally means "without blood," is a deficiency of red blood cells and/or hemoglobin. This results in a reduced ability of blood to transfer oxygen to the tissues, and this causes hypoxia; since all human cells depend on oxygen for survival, varying degrees of anemia can have a wide range of clinical consequences. Hemoglobin (the oxygen-carrying protein in the red blood cells) has to be present to ensure adequate oxygenation of all body tissues and organs.
The three main classes of anemia include excessive blood loss (acutely such as a hemorrhage or chronically through low-volume loss), excessive red blood cell destruction (hemolysis) or deficient red blood cell production. In menstruating women, dietary iron deficiency is a common cause of deficient red blood cell production.
Anemia is the most common disorder of the blood. There are several kinds of anemia, produced by a variety of underlying causes. Anemia can be classified in a variety of ways, based on the morphology of RBCs, underlying etiologic mechanisms, discernible clinical spectra, to mention a few.
Different clinicians approach anemia in different ways; two major approaches of classifying anemias include the "kinetic" approach which involves evaluating production, destruction and loss, and the "morphologic" approach which groups anemia by red blood cell size. (Schier) The morphologic approach uses as its starting point a quickly available and cheap lab test as its starting point (the MCV--see below). On the other hand, focusing early on the question of production (e.g., via the reticulocyte count) may allow the clinician to more rapidly expose cases where multiple causes of anemia may coexist. Regardless of one's philosophy about the classification of anemia, however, methodical clinical evaluation should yield equally good results.
