Tuesday, March 22, 2016

Attack of the Nephrolith

Because I was eating a second portion of roast beef at nearly midnight on Saturday night, I assumed the sudden pang I felt in my lower left flank was simply due to overdoing it, so I slowed my pace accordingly.

But the sensation intensified as the night wore on, and after retiring for the evening I found myself either unable to sleep or waking up every couple hours to visit the washroom.

Laying in the dark, I started to wonder if it might be serious. A year ago, Island Mike had acute appendicitis, so on my next urination peregrination, I brought the iPad along to double check the symptoms. After discovering that the appendix was on the opposite side of my discomfort, I was at once relieved and apprehensive; if not my appendix, which organ was acting up? Sleep, evasive all night, eluded me from that point on as I wondered and worried.

By the time it was light outside, I was visiting the bathroom a couple of times an hour, and had resolved to visit the medicentre. Seeing Mike's wife Kelly, a practicing nurse, awake while I was on my way to the upstairs lavatory, I asked her opinion.

Like me, she ruled out the appendix, and thought the issue seemed too high for my gall bladder, but agreed with my suspicion it might be my kidney. She also suggested bypassing the clinic and going to the hospital, for faster access to the imaging that might be needed for my diagnosis.

After saying goodbye to the remaining Geekquinox guests and thanking Pete for another wonderful evening, Audrey and I made our way to the Sturgeon Hospital in St. Albert, since it is both close to our house in Castle Downs and usually less busy than the city hospitals. Despite it being only about a 40 minute trip, we still had to make a pit stop midway, and even then I needed to go again by the time we got to the emergency room.

I resisted the urge to bypass the admission desk for the washroom, correctly assuming that they would want a specimen bottle filled. The nurses were quick and sympathetic, noting that my blood pressure was pretty high, but suggesting much of this might be due to the circumstances of my discomfort.

They got me the standard issue dignity-resistant hospital gown, and admitted me to an intake room with a stretcher and chair. Audrey diligently waited with me for the first hour, but had to return home to the girls by noon. The hospital does have wifi, and I'd had the foresight to bring the iPad with me (as well as a charger, just in case) so I was halfway through the the 4th episode of season 2 of Daredevil when the doctor was finally able to see me. To my surprise, I recognized him, and said "Hello, Dr. Stan."

He looked up quizzically from my charts with a cocked eyebrow, and in his lilting accent (West Indies maybe?) asked how I knew his name. I told him that he had looked after my Mum, the nice Newfie lady, when she broke her arm back in December. He smiled at that, and asked how she was doing.

When I told him that not only had her surgery and recovery gone well but she hadn't had a cigarette since then either, he nodded sagely, and said, "You see, everything happens for a reason."

He asked me a few questions about the pain I was having, pressed and prodded me a little bit, and said, "I think we are probably dealing with a stone, so we will get you a CT scan to make sure. You are probably looking at another hour and a half or so," he added apologetically.

"I'm in no rush," I assured him. Honestly, despite the horror stories I had heard about kidney stones, I had been bracing myself for all manner of bad news, from diabetes to cancer to acute renal failure. When Dr. Stan had come through the curtain of my intake room, I had half expected him to say, "We've called your family in case we can't find a transplant in time; are your affairs in order?", so by those standards, a kidney stone was still getting off pretty light.

They moved me to the patient care area, a medium-sized room with about a dozen comfy chairs separated by curtains. I finished episode 4, tried fruitlessly to nap, and when the nurse came by to check my blood pressure again, she said the doctor should be with me before too long. When I explained that I hadn't yet had my CT scan, she shook her head, apologized, and took off to see that I got one.

Not long afterwards, a technician came and led me to a room containing a massive scanner. I had changed back into my civvies because it was easier than carrying them, but now had to wrangle my way back into the drafty gown. I lay down on the bed and armature that lay before the circular scanner, which reminded me a little of The Guardian of Forever from the old Star Trek.




This was my first experience with Computer-assisted Axial Tomography (and no, I have no idea why they stopped calling them CAT scans), and I was too busy marveling at it to be particularly apprehensive. Once they had me lined up properly and my hands in the right (non-pinchy) places, the armature effortlessly swung my ample frame into the aperture for scanning, and all I had to do was follow the breathing cues given by the soothing robot voice.

After getting changed back into regular clothes, I went back to the Patient Care area to see that business had picked up considerably while I'd been away; my #7 seat was now occupied, and only three or four of the dozen chairs were still free.

Thankfully I didn't have to wait too long before Dr. Stan returned. "We're gonna send you home," he said, beckoning me to follow. I attempted to toss my gown into a linen basket we passed, noting I needed to return and get it all the way in, as he led me to a wall display and pulled up my scan.


I have a hard time guessing the scale of the article in question from this image, but picturing this stony formation tumbling around my insides, the first image that came to mind was not from a good movie:
"It's the size of Texas, Mr. President."

"There's the stone, and we are just gonna let it pass," Dr. Stan asserted. He outlined the meds that would aid in the process and help me deal with the discomfort which was to come, then told me they were going to take an X-Ray to localize the stone even further, just in case. Then I would be free to go.

I retrieved my gown from its perch on the side of the linen hamper and made my way to the Diagnostic Imaging Centre, changed once again, clambered onto another stretcher, and enjoyed receiving more roentgens. Two days later, this radiation has not produced any discernible superpowers; it's unreasonable of me, but yeah, maybe I am a little disappointed. After the x-ray, Audrey came to collect me, and we headed to the pharmacy to get my prescriptions filled.

Returning to work, I advised a handful of people about my situation, in case I succumbed to the allure of my prescribed Tylenol 3s and was unable to come to work at some point later in the week. I was grateful for their sympathy, but explained it could have been much worse, even within the kidney stone subset. You see, it turns out there are things called staghorn calculi, which, well, if the name didn't give it away, the picture should make things crystal clear:


Like I said, lucky.

It turns out one of my new teammates is a font of information about kidney stones, having developed a staggering 14 of them during a bedridden pregnancy. She advised me to drink plenty of lemon juice and water, and to ingest apple cider vinegar bills in aid of reducing the size of the offending mineral formations, counsel I took to heart that very evening.

Pain is a pretty subjective thing, but I wanted to get an idea what to expect when The Passing comes to pass. My colleague told me about how the lady in the hospital bed next to her was constantly asking for pain medication and not receiving it, so she was a little self-conscious when she called the nurse over and asked if she could get her dosage raised.

When the doctor acquiesced, her neighbour was incensed, screaming how unfair it was that my coworker could get more drugs but not her, and the doctor was not having any of that. He strode over to the other bed, and essentially told her, "This patient is in far more pain and discomfort than you are and is doing a way better job of managing herself, which is why she can have more painkillers. You should be grateful you don't have her kidney stones, when all you have to worry about is coming off heroin addiction."

Yikes.

At this point, I describe my current level of discomfort as akin to having swallowed a leprechaun with a black belt in tae kwon do and wearing heavy cowboy boots. The worst part is knowing that at some point in the not too distant future, the little blighter will be getting his hands on a pitchfork and blowtorch. Until then though, it does help to remind myself how much worse it might have been.

2 comments:

  1. Yee-ouch! Hopefully the worst of the pain won't be too bad, and I'm glad the symptoms weren't caused by something more serious.

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  2. Yikes!! Thankfully it is not something more serious AND the pain started after geekquinox. Feel better soon!

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