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by
Clayton E. Cramer

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June 19, 2013 - 3:00 pm

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I just had a very unpleasant experience – a kidney stone – and one that I hope to help you avoid.  The experience is a major health issue for Americans. These cause more than a million visits to health-care providers each year, of which 300,000 are to emergency rooms. If you have ever seen the bill for an emergency room, you know that everything is way more expensive there. Think of this article as not only an attempt to save you great misery, but also to save both public and private funds.

I was in an Enterprise Architecture class (a type of computer geek professional training) on Wednesday, and by the end of the day, I was not just bored; I was in pain in my lower right abdomen. At first I thought that lunch was trying to make an early escape, but a visit to the men’s room didn’t help. And the pain was getting worse – way worse.  I was also beginning to get chills.  Based on the location I assumed that it was appendicitis, although it certainly came on faster than I would have expected.

I left the class early, intending to drive to my doctor’s office, but in five minutes, the pain had become so intense that I did not think it likely that I would be able to safely drive there.  Fortunately, I was a block or two from one of the several excellent hospitals we have in Boise.  I had taken my wife to this particular hospital for outpatient shoulder surgery a few weeks ago, so I did not have to think too long about where it was – and with the pain that I was suffering, thinking was not something that I was strong on doing.

I pulled into the emergency room driveway, honked my horn, because I was not sure that I was going to get inside by myself, and within seconds, there was someone there with a wheelchair, and a valet parked my car.  By this point, the pain was so intense that I was starting to vomit – and in less than 30 seconds, I was on a bed; within another minute or two, there was a nurse, than a doctor examining me. The doctor asked questions, poked and prodded, and concluded that my problem was probably a kidney stone. While waiting for a CT scan, the nurses inserted an IV, and put in some serious painkillers – and this took it from inexpressible pain to just suffering.shutterstock_33673135

The CT scan confirmed what the doctor guessed: a 7 mm kidney stone at the top of the ureter, the tube that leads from the kidney down to the bladder.  A typical adult ureter is 3-4 mm in diameter, so you can see why having a rock lodged there hurts like you can’t believe. Worse, the blockage can lead to urinary tract infections; this is more than just extreme discomfort.

The ER gave me more painkillers, and prescribed Flomax, which relaxes the ureter so that it is a bit larger.  Small stones can sometimes pass as the ureter expands, but 7 mm?  Not likely — at least not without a lot of time and a lot more painful episodes. The instructions on the discharge paperwork told me to make an appointment with a urologist the following day “without fail!” When I was in having surgery the following day, my wife ended up talking with the wife of another kidney stone sufferer who had delayed calling the urologist – the second visit to the ER in three days finally made him do so.

We are fortunate in Boise that we seem to have lots of doctors relative to the number of patients.  While I had to do a bit of calling around, I was able to get scheduled with a urologist Thursday afternoon – and by wild coincidence, the same urologist that treated my daughter’s kidney stone problem a few months before.

Dr. Spencer did the surgery Thursday evening at 6:40 PM.  The procedure is a bit horrifying to read about, but I am hoping that it will be an incentive to do what experts recommend to avoid kidney stones, so that you don’t have to go through this.  Dr. Spencer ran a stent through my penis, into my bladder, up the ureter to the kidney.  With the stent in place, he then inserted a tool (a very small tool) that let him examine the stone, then play Space Invaders inside my kidney, zapping the stone with a laser until it was nothing but tiny fragments that would pass easily.shutterstock_132288125

The stent is still in place; after five to seven days, I am supposed to smoothly pull this stent out at home.  The pharmacist who filled the prescriptions for after-surgical drugs has personal experience with this: he says plan on taking two of the controlled substance painkillers before trying this.  In the meantime, there is a piece of plastic sticking out of my more manly parts, and urination stings a bit, because the stent is irritating everything.  Are you scared enough yet of all this to pay attention to how to avoid this?

There are four different kinds of kidney stones: calcium, uric acid, struvite, and cysteine.  There are both dietary and hereditary causes, but the one dietary solution the National Institute of Health promotes is more fluids:  “Drinking enough fluids each day is the best way to help prevent most types of kidney stones. Health care providers recommend that a person drink 2 to 3 liters of fluid a day. People with cystine stones may need to drink even more. Though water is best, other fluids may also help prevent kidney stones, such as citrus drinks.”

During the consultation, my urologist observed, “It’s raining stones!” He was awash in patients with kidney stones, perhaps because of the sudden onset of hot weather here in Boise dehydrating people. Even during normal weather here in the intermountain West, it is surprisingly easy to not get enough fluids. Yes, it is a bit of a nuisance to drink enough water. But trust me: you don’t want a kidney stone, nor do you want to go through this surgery.

****

images courtesy shutterstock / Sebastian Kaulitzki / Africa Studio /  remik44992

Clayton E. Cramer teaches history at the College of Western Idaho. His most recent book is My Brother Ron: A Personal and Social History of the Deinstitutionalization of the Mentally Ill (2012). He is raising capital for a feature film about the Oberlin Rescue of 1858.

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All Comments   (20)
All Comments   (20)
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The good news is that, contrary to what the pharmacist told me, removing the stent wasn't all that painful. Trick to making it okay:

1. Full bladder.

2. Warm shower.

3. Urinate in the shower while pulling out. Relaxing the muscles that control bladder emptying means that nothing is fighting removal of the stent.

A few hours later was somewhat painful -- enough to require an oxycodone -- but that was just the irritation causing by removing this piece of plastic.
1 year ago
1 year ago Link To Comment
Hasn't anyone in Boise heard of ESWL? It means EXTRA CAPORIAL SHOCK WAVE LITHOTRIPSY! It does not use the water bath thingy. It is a machine that has two large globes on the ends of a half circle arm. They put you on a table with a curved cut out in the side and position your body so that the affected kidney is over the cutout. Then the device is rolled into position so one globe is above your body and the other is below and positioned over the kidney. Sound waves are then directed at the kidney and they break up the stones so that they can be passed normaly. Have had it done 6-7 times with no adverse effects. Also had the stent inserted to help the stones on their exit trip. Not fun!
1 year ago
1 year ago Link To Comment
ESWL has limitations. The first one being the size of the stone and the second one being location. A third is whether or not the patient has recently had other surgery especially abdominal surgery. His stone was on the borderline for size. I just had a 7 mm stone taken care of with ESWL. His stone was already lodged in the top of the ureter. That right there, plus the size would have made them lean towards the laser procedure.
1 year ago
1 year ago Link To Comment
Kidney stones aren't just painful.

The wrong one in the wrong place can block the kidney and damage it. Kidney failure is not a good thing.

Drinking an alcoholic beverage does no harm, and can actually do some good. Alcohol is a diuretic, flushing more fluid through the kidneys.

BTW, there is some evidence that men who have frequent sex have a lower risk of prostate cancer. Perhaps flushing out the prostate gland by ejaculation flushes carcinogens out of the prostate.
1 year ago
1 year ago Link To Comment
Anybody ever see that episode of "Deadwood" where Al has a kidney stone? That was brutal. Makes me glad I live today and not way back when.
1 year ago
1 year ago Link To Comment
Are there any pundits out there who consider Vodka to be a fluid. or even a liquid for that matter?
1 year ago
1 year ago Link To Comment
If you are a heavy snorer, you might have Sleep Apnea. Your body reacts to a constricted airway by making efforts to remove water from the lungs, so it kicks the kidneys into high gear, dehydrating you. This can cause high mineral content in the urine, perfect to grow crystals.

I had a number of stones before I started CPAP and none since.
1 year ago
1 year ago Link To Comment
The old folk remedy is cranberry juice.

My brother was diagnosed with a kidney stone, sent home with painkillers and scheduled for a procedure. I asked if he had *tried* drinking some cranberry juice. No. He went out, got some cran-apple, and - passed his stones, apparently, a few hours later.

Your mileage may vary.
1 year ago
1 year ago Link To Comment
Thank you for writing this, I will be reading to dh at the first opportunity.
1 year ago
1 year ago Link To Comment
Whoa... I had a kidney stone about thirty years ago and a gall stone about five years ago that led to my having my gall bladder removed - easily the two most painful experiences of my life - which reminds to go have a drink of water.
1 year ago
1 year ago Link To Comment
Twenty or so years ago, I was repeatedly suffering attacks of kidney stones. When I last consulted a doctor on them, he recommended that I drink lots of fluids dayly, and keep the system well flushed. I asked him;
"Is it okay to drink beer?"
He said, "Oh, beer is one of the BEST things you can drink!"
I have been religiously following that doctor's advice ever since. And haven't had any more kidney stones ever.
1 year ago
1 year ago Link To Comment
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