Wednesday, November 9, 2016

Kidney Stone

I recently had my first, and hopefully only, kidney stone.

I would like to start by apologizing to anyone in my life who may have previously had kidney stones and for whom I did not show appropriate sympathy and support.

I had no idea it was even possible for them to be so bad. No idea.



Here’s my experience:

*******************

On Friday, the 21st I awoke with a slight pain in my right lower quadrant. Pain level 1-2. Annoying, but nothing more. I was expecting my monthly visitor any day, so my initial thought was some weird sort of cramp.

My husband & I had plans to attend a Homecoming Alumni Reunion for my university, which was also supposed to be our fancy night out for our anniversary. He took a vacation day from the fire house. We had this booked for months and I was really looking forward to it.

By the time we left my pain was maybe the 3 – 4 range. Worse. Still annoying, but not bad enough for me to even consider changing our plans.

During dinner, the pain escalated to the 6-7 range. While listening to the speakers, I contemplated how much longer I could stay. I really wanted to hear a few of them that hadn’t been up yet, and there were old friends I spied across the room, but hadn’t had a chance to see yet. But I couldn’t ignore the pain, and I told Jason we needed to leave.

At this point I’m still thinking maybe we just go home and I lie down. But in the car the pain worsened. I tend to be a “wait it out” kinda gal, but I tried to think of what I would tell my sister if she called and asked me what to do.

“I think you should take me to the hospital.”

And so we went. As we waited on triage, my pain intensified. 8…9… I’m not one to take the pain scale lightly, it will be rare for me to tell you my pain is ever over a 5 or 6. But that day? I hit a 9.

They gave me some pain meds to dull the pain while trying to assess my condition. Most of us seemed to think it was likely appendicitis. I think this was mostly because my pain was exclusively in my belly, no back pain at all, which is common with kidney stones. Also, ends up if you’re a man and have right lower quadrant pain it’s pretty much either appendicitis or kidney stones. If you’re a woman though? The doctor listed off about 20 different possibilities: appendicitis, kidney stones, ovarian cyst, ectopic pregnancy, etc, etc, etc.

We were fairly certain of the answer though once they got my urine sample. I could tell by looking at it that something wasn’t right. Sure enough, there was quite a bit of blood in the sample. Most likely diagnosis changed from appendicitis to kidney stones. I was sent off for a CT scan which confirmed I had a 7.5 mm kidney stone lodged in my ureter (the tube that connects the kidney to the bladder).

Apparently this is considered a “huge” kidney stone. I got lots of sympathy and better pain meds after that. Truth. I was also admitted.

I awoke the next morning feeling much better. Pain was almost non-existent, at a 1, maybe a 2. I could definitely feel that something was going on, but it wasn’t bad at all. The nurses seemed relieved, but a little confused. An X-ray later that morning explained why my pain was all but gone: the stone had floated back up into the kidney. No longer lodged in my ureter, it no longer caused pain. In fact, by the end of the day my pain was completely gone. They discharged me Saturday evening with some Vicodin to take as needed and an appointment to have a lithotripsy (using sound waves to break up the stone) at the urologist’s outpatient facility on Monday.

Monday I headed to the outpatient facility. It was not a good experience. Registration went fine, I suppose, and getting set up. Met the doctors. The procedure went well. But coming out of anesthesia? Well, it always takes me a long time. That day was no exception. I don’t know how long really. I know one of the nurses was extremely rude, ignored my cries of both pain & nausea, and refused me pain meds because I “just need to calm down”. I eventually told her off, she left, and I got another nurse. Funny thing, if you actually treat your patient’s pain & nausea, and treat them with a tiny bit of compassion, they are able to calm down much sooner, and start to come around better. Even so, even with a nicer nurse that addressed my needs, it was still made very clear to me & my husband that I was not coming out of the anesthesia quickly enough to suit them. This was never made more clear than when I was sent home in a hospital gown, because I wasn’t able to dress myself yet.

You read that right. They asked if I could stand up and get dressed, I told them no. I vaguely remember kind of falling back onto the bed as they stood me up. They put me in a wheelchair, handed my husband a bag with my clothes in it, and wheeled me out to the sidewalk in front of their building in a hospital gown and panties. Waited for Jason to pull the van around, and loaded me in the car that way. Nice, huh?

Over the next two days I passed bits of stone. Tiny. Like sand. Honestly didn’t even feel them most of the time and only knew because they had asked me to strain my urine and keep the pieces.

That Thursday I had a follow up appointment scheduled with my primary care physician. I had been feeling better, so decided to drive myself. At this point, it was just Jena & myself. My parents kept Jillian for me while I was recovering, and we thought if anything Jena would be a helper for me. Jason went back to the firehouse for the first time in three shifts.

I had mild pain that morning, but nothing bad, and nothing more than I was expecting. I had had pain off & on since the lithotripsy anyway. However, on the drive home from the doctor, my pain rapidly escalated. It’s kind of ironic. Went to the doctor, told him I was doing well, pain was minimal, everything looks good, then on the drive home my pain skyrockets. It was difficult to drive.

Got us home and laid down. Called Jason & my mom to let them know. Called Jason again and told him to head home please. He’s an hour away.

My pain goes up even more. I start vomiting from the pain. My poor little eight year old is bringing me a bucket to puke in and listening to me moan & wail in pain. I call Jason back and ask how far away he is. Twenty minutes. I beg him to hurry.

Honestly, when I knew he was that far away I probably should have called 9-1-1. As the wife of a first responder, I don’t take that lightly, but I really should have. The pain was that intense.

I called Jason back. How far away? Five minutes. I tell Jena to get her shoes on and get my purse. I slip on some flip flops, grab a bowl for vomit, and stumble out to the minivan. We wait for Jason to arrive. He pulls in, jumps into the van, and we take off.

Things become a blur at this point. I know I vomited a few more times on the way to the hospital. I know Jason signed all the forms at the emergency room because I wasn’t able. I don’t remember going for any tests, but I must have, because at some point we were told that a 2x3.5 mm piece of my original stone had lodged in my ureter. Again.

Got some good pain meds, fell asleep at some point, was admitted at some point. Slept off & on.

One of the urologists came to see me the next morning. He gave me my options:
·         Be discharged with some better pain meds and try to pass the stone on my own, not knowing how long it would take
·         Stay in the hospital and have it removed surgically

I chose the latter. Having already been hospitalized twice for this thing, I didn’t want to be discharged only to end up back in the hospital after another day or so.

Surgeon came to see me later, and surgery was scheduled for that evening.

I’m so glad I did. After the surgery, when the surgeon came to speak to my family, he informed them that my ureter narrowed to an extent that it would have been physically impossible to pass the stone on my own. He removed the stone, looked around to confirm there were no more stones, and inserted a stent to help keep my ureter open while it was healing.

I again took a long time to come out of anesthesia. This time I was at the hospital though, so no one kicked me out. I was in recovery for roughly three hours. I vaguely remember the nurse telling me over and over to take deep breaths. I think my pulse ox kept going low.

By the time I got back to my room it was after 9pm. Pain was minimal. Discomfort from the stent was pretty high, but that was to be expected. And I had to pee literally every 20-30 minutes. Also to be expected, although the nurses did inform me that I actually do have a small bladder. Fun. By the morning I had managed to stretch out time between bathroom breaks to 45 minutes.

Was released the next day and told that I could expect “mild discomfort” from my stent, and zero restrictions on my daily life. Free to resume life as normal.

{{ insert hysterical laughter }}

The discomfort from this stent was awful. Awful. Horrible. The worst feeling you can possibly feel without crossing over into pain. I felt it inside me 24/7. There was no way to get comfortable. None. By basically living in a recliner I was able to get comfortable enough to make it tolerable. That’s about it. Urinating was the worst. I was able to stretch it out to about an hour between bathroom breaks, right at two hours if I was sleeping. A little less than an hour if had recently eaten.

Truly a horrible experience. I have no idea how they can call this “mild” discomfort, or how they can say you can resume normal life. I kept think how if I were still working outside the home I would be forced to either drain my vacation time or take as much Vicodin as allowed and try to muddle thru the work day, and still not sure it would be possible. Seriously, awful.

Originally my doctor wanted me to have the stent for 10 days, and remove it under general anesthesia. After my second day home, I called the nurse and talked with her about how much discomfort I was having. She assured me it was normal (so, again, why do they tell you it’s “mild” discomfort?!?), but said she’d talk to the doctor. She called me back the next day. He agreed to remove it after only 7 days and under a local anesthetic.

Yay!!!

I powered thru a few more days, then went in for the removal.

It was so easy!

Seriously. From the time they started until the time they finished was only seven minutes. It took longer for the nurses to take my vitals and get me checked in as a same-day surgery patient than it took to do the procedure. They used a local anesthetic in the form of a numbing cream, and consequently what I felt was essentially as much discomfort as a yearly gynecological visit. Some pressure, little bit of a pinching feeling, little more pressure, done.

I honestly have no idea why they would put anyone under general anesthesia for this (assuming they had no other complications). I’ve heard it can be a bit more uncomfortable, and possible a little painful, for men because they have a longer urethra, but I’m still not convinced it would be worth the risks of undergoing general anesthesia.

I immediately felt much better. There is still some (actually) mild discomfort when I urinate, or when I stretch. I occasionally get a crampy feeling in the general bladder area, it gets worse if I’ve been walking, better when I sit. Other than that, I feel back to normal. It was an amazing difference having the stent out. I feel like myself for the first time in the past two weeks.

{{ side note: I’m currently watching Parks & Recreation via streaming Netflix, and this episode Ben just got diagnosed with kidney stones. Irony. Ha. }}

On a side note, I’ve been struggling with daily gastrointestinal problems for over six months. Every day. It got to the point where no over-the-counter meds were controlling it. Have an appointment with a GI in two weeks for some testing because my primary care couldn’t figure out what was going on, all his tests were normal. Since this kidney stone issue came up, I’ve had ZERO issues. I think it’s still too soon to tell, but I’m hopeful that maybe somehow my gastro issues were related to my kidney stones and now everything will be resolved. Crossing my fingers!

Thanks for checking in everyone! Hope you never, ever have kidney stones!

Thursday, October 6, 2016

Health Update

Yesterday was a blur of hospital appointments.

Couple of issues going on. I was trying to deal with them one at a time, but it appears that is just not how it's going to be.

First of all, I had a mammogram. A little over a year ago my routine mammogram revealed spots on my left breast. Probably benign, but warranting follow up. Three mammograms later, and they're telling me it's still "probably" benign. Apparently they standard of care is to follow up with repeated mammograms for two years. If there is no change within two years, then it's considered safe and I go back to routine yearly mammograms. Obviously if there is change, then we start a whole new ball game.

Secondly, I've been having gastrointestinal issues for quite a long time now. Months. Started out as occasional nausea, then more frequent, some bowel issues, heartburn... you name it and it's gastro, I had it. I treated with various over the counter meds. I tried cutting out different foods. The meds helped ease the problems somewhat, but nothing really seemed to really help. Over the past few months it has become more and more frequent, and more severe, until now I'm sick every single day, and the past few days the nausea in my stomach has turned into a dull ache in my abdomen. As in, painful. I finally gave in and saw my doctor.

My gastrointerologist couldn't see me until November, so I went to see my family doctor. He's not sure what's going on, but he's leaning toward the problem being my gall bladder. I have a CT and bloodwork scheduled for next week, a follow up appointment with him in a month, and a referral to my GI after all. He also gave me a prescription to help with the symptoms to take as needed, and I have to say I do think they are working. So that's a positive, I guess.

And then there's my metabolic disorder and related weight issues. It's been roughly a year since I had to discontinue my endocrine meds. I did meet with a couple of doctors, including the surgeon about the the surgery my endocrinologist wants me to have. Unfortunately, my insurance company won't cover it, period. You see, it's a bariatric surgery. Vertical Sleeve Gastrectomy, also known as VSG or Gastric Sleeve.

Briefly, the reason my endocrinologist recommends this procedure is a little backwards from the usual reason, and is the reason it has to be this bariatric procedure, as opposed to others. You see, the part of the stomach that is removed during the surgery is the part of the stomach that creates some of the hormones and other chemicals that are out of whack for me. It is for this reason that this is the optimal choice for me.

In fact, in what was for me a surprising additional confirmation for me to have this procedure, at my yearly gynecological visit earlier this year, my gynecologist also recommended the procedure, having no knowledge that another specialist had already done so. The reason? Well, my weight for starters. But... he specifically noted that because of the change in hormones induced by the VSG, there's a good chance it would also help improve some of my gynecological issues as well.

My husband is on board. The more I learn about the procedure the more I'm convinced it is the best choice for my long term health. Unfortunately my insurance company seems to disagree. So... we're waiting for some financial items to fall in line, and hopefully we'll be able to proceed early next year.

In the meantime, I now weigh more than I have ever weighed in my entire life, and am bigger than I have ever been. In fact, even though I know expecting a big result is futile, I've started utilizing meal replacement shakes just to keep my waistline from growing further, mostly because I can't afford to expand my wardrobe again. It's depressing, I hate the way I look. But I keep trying to look to the light at the end of the tunnel and know that a year from now my weight, and more importantly my health, should be much improved.

So, that's about it health wise. Seems like there's a lot going and nothing going on all at once.

How are all of you doing?

Saturday, September 17, 2016

Kids Update

Well, here I am. Fall schedules are in full swing.

We started with Classical Conversations this year. and go to community on Tuesday mornings. Soccer practice Tuesday & Friday evenings. Gymnastics class Wednesday afternoons. Soccer games on Saturday mornings.

It's busy, but doable.

We recently got Jena's results from the Iowa Test of Basic Skills. To summarize:
    - age wise she should have just started 2nd grade
    - grade wise she just started 3rd grade
    - her composite grade level equivalent is 4.4, with all of her stanines in the 8 - 9 level, and her NPR in the 95-99 percentile for all subjects

She is excelling in soccer. She was a star goalkeeper last season, and this season she has just continued to improve. In addition, she has started playing as striker a bit and has done fairly well in that position as well. Her coach has made several comments about how much she has improved on the field since last season. Jena loves the sport, and as much as she enjoys striker, goalkeeper is what makes her smile.

We also started her in gymnastics over the summer. She had been asking to do it for a while, then her pediatrician recommended it because she is a bit delayed in her gross (and fine) motor development, so we decided to go ahead, despite the added cost & expense. I have to say, it has been well worth it. Her motor skills have already improved greatly, and I honestly attribute much of her improvement in soccer to her ability to this improvement. She has more control over her body's movements, just in general, and several extended family members have commented on it. As an added bonus she loves gymnastics as well, and has made it her goal to make the gym's competitive team. As a result she spends a lot of her free time in the front yard working on her skills.

I have to say, I have been quite impressed with my little 7 year old's dedication to excelling in both sports, and the work she has put in on her own to that end.

We've only had two weeks of Classical Conversations so far, but so far I am quite impressed. The facts she is learning, the manner in which it is presented, the fact that she enjoys learning history, geography, & science; it's been quite nice. Science has always been the subject that I felt least able to teach well, and not only do they learn facts, but they do an experiment each week on community day, so that is a huge load off. Jena enjoys the way they present facts so much that she took it upon herself to memorize all the U.S. Presidents using their songs, and has already succeeded!

I started doing one preschool lesson each day with Jillian as well, and she already knows most of her colors and maybe half of her letters. Numbers are a bit of a struggle. She is still essentially non-verbal, but I have a feeling a language explosion is right around the corner, as she's added 3 words to her vocabulary in the past week.

I think that's about the only major updates for now. Hope all is well with all of you! As always, thanks for checking in!

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