Sunday, August 3, 2008

Kidney Stones (part 3)

The first time I had trouble with a kidney stone, I went to the emergency room around 2 in the morning, was released to go home around 5am, and the stone passed around midday. The second time, however, the lithotripsy did not break up the stone but just knocked it out. It took a week to pass. The kidney stone had to work its way into the ureter, a very small bio-tube that connects the kidney to the bladder. The stones often obstruct and stretch ureter which causes the severe episodic pain which is felt, as previously mentioned, in the lower abdomen and groin. It is the worst pain I have ever experienced. On top of the pain and discomfort, there is a embryological link with the kidney and the intestines and the vomiting center is stimulated and nausea and vomiting make a very bad situation worse.

My hope is that the stone passes after the treatment because if it doesn’t, the urologist will have to take a more invasive approach. The thought of a laser being threaded up to the kidney is not a pleasant one.

Last Sunday, a week ago today, I woke up and felt pretty good. The family was getting ready to go to church and I went downstairs and sat in front of my computer. When I stood up I felt a twinge of pain and although my first thought was for the worse, I convinced myself it was nothing. By the time I went upstairs I told my wife I would not be going to church. Three hours later, we were back at the emergency room.

I have been to the emergency room several times for this now, that even in my pain, I know what is going to happen. I fill out a form and show proof of insurance. I am brought back to see a nurse and a physician. The nurse takes vital signs and the doctor gets briefed on my medical history by asking dozens of questions . . .the first one is, “how are you doing?”. My pre-programmed response of “I am doing ok” is challenged with “you cannot be doing okay or you would not be here”. After my self diagnosis is confirmed the doctor gives me a brief overview of what they are going to do for me.

I am walked over to another room and a male nurse comes in to chat. He starts an IV and then says he will be right back with some relief. I have no idea what he comes back with . . several vials that are injected direct into my IV. He tells me that he is going to give me a pain killer that will go right to work. I am warned that I may feel a slight burning sensation but it will pass and I am going to feel a heavy weight on my chest. I have no idea what he put into me but it works. It was a rocket ride of sorts and I can fully understand why there are drug addicts now. To go from intense pain to euphoric pleasure and then sudden peace with my situation is a remarkable experience. I am wheeled for an MRI and also for X-rays where it is later confirmed that I do have a 4mm stone working its way from my kidney to my bladder.

I am released from the hospital that afternoon. It will take three days for the stone to be caught in the strainer. There are several more but the fragments are small and it is my hope they can all just pass without incident. My long term hope of relief is temporal, at best. I have read that the recurrence rates are estimated to be around 10% per year, totaling 50% over a 5–10 year period and 75% over 20 years. I am also told that men are affected approximately 4 times more often than women. As my father in law is fond of reminding me, growing old is not for sissies.

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