Monday, October 21, 2013

Stone, Surgery and Recovery

This tale starts in late June with extreme abdominal pain that, for at least four hours, I was convinced was just severe gas pain.  I was sweating and shaking and curled up in a ball, and eventually asked Jen to get me to the emergency room.  Well, x-rays, urine samples, and a contrast CAT scan later, and I was told that I had a Kidney stone descending into my bladder.  That was 4mmx2mm, and too small for them to try to do anything specifically for.  They gave me some really effective pain medication, and told me to follow-up with their Urology clinic.  Jen and I left the ER around 7AM, and I missed a day of work.  Within a day, the stone had passed, and I was feeling much better.

I tried to get to the Urology clinic that the hospital had suggested, and I couldn't get anyone on the phone (Jen also tried), so I was a bit stuck.  Jen went into the annual best doctor's issue of New York magazine, and found a doc who works out of Mt Sinai.  I ended up with an appointment at the beginning of September.  I asked the local hospital to forward my medical records, and waited.

During this time, I read up on Kidney Stones, and adjusted the things in my diet that are safe to adjust without knowing which of the seven types of Kidney Stones I was having  (my blood pressure is lower, now).  During this time, I had a few other instances of kidney stones passing (one, even, on the right side).

When I arrived at the doctor's office, the local hospital had never forwarded my records, and time had passed, so the doc had to basically start over, and ordered a new CAT Scan.  I went back the following Wednesday (to another part of Mt. Sinai) and got the new Scan, and then, after another two weeks, I was finally able to see the Doctor (I was fit in, but didn't have an actual appointment time).

The Doctor's appointment on the 25th of September was very interesting.  They showed me a 25mm (and inch wide) Staghorn (meaning grown into the various valleys of my kidney) Kidney Stone, and said it had probably been growing there for several years.  And... the local hospital E.R. had clearly missed it.  The Doctor tentatively scheduled me in for the 8th of October to have it removed, and sent me off for a different doctor, to get a pre-surgical clearance.  I was able to get in there on the 27th, got some chest X-rays to verify that my heart was ticking proper, and then I waited to find out about the firmness of that date.  I didn't find out for certain about the surgery on the 8th until they called me on the 7th.

The surgery itself was slow to get started, but eventually happened.  I was VERY nervous about this, being my first time under general anesthesia, but ... I did wake up.  The entire surgery was done through a single tube inserted from my left flank into my kidney (this part was done about an hour before the surgery, and under just a local anesthetic.  The estimate was that I'd be in the operating room for 1 hour, and instead it took 2 hours and 15 minutes.  The Doctor said to Jen, "chasing bits of stone into all sorts of nooks and crannies", or something near that.  I'm repeating it third hand, at least.  Which suggests to me that this thing was even more spread out than the CAT scan had showed.  Anyway, when I woke up my first thought was, "Oh, I guess I am going to survive this."

I stayed in the Hospital overnight, and got two morphine shots; though, I only remember the second one.  By morning, I was feeling better.  I had two catheters, one was the tube that had been put in to support the surgery itself, directly into my kidney, I went home with this one.  The other was removed fairly early on Wednesday (in front of an audience of 8 nursing students), I was too groggy to even feel embarrassed.  By that evening, I had done the required walking, and they sent me home, with an appointment to have the tube (and bag) removed the following Monday (14th).

Walking around with a tube sticking out of my side, and carrying a bag of urine is a surreal state of being.  I was tired and if I walked for more than about a block, my muscles would cramp up around where the tube was sticking out of me.  I was also worried about people bumping into it.  So, I ended up staying home a lot.  There are pictures, but I'm not planning on grossing anybody out with them.

On 14 October, I went in to have the tube removed.  So the tube that was in me was a catheter. That is, it went from inside my kidney to outside of my body, and handily hooked up to a bag. This means that when my kidney finished with liquids, and ejected urine it would go through this catheter. From my right kidney, everything continued to work as normal, kidney, bladder, urethra, toilet.

I had joked with some people that, by the description of the doc, they would clip a tether, pull the tube out of me, and send me home...

...I had that wrong. They did put two very thin pieces of gauze over the hole and taped it on before sending me home. The implications of this should not have been surprising, but they took me a bit off guard. Pardon, but this is gross, and I can't really help it.

Knowing that there would be "a little leakage" (my dumb head was just thinking bloody discharge), I smartly asked Jen to buy us some Chux. I mean, it seems crazy that they would send me for an 1 plus hour ride home with two strips of gause if my kidney is still pumping out 1.8 liters of urine per day (as measured from the bag over a week). But this, they did, and to suggest that the gauze and the Chux were insufficient, would be a nice way of putting it. Remind me to get the car steam cleaned.

Over two nights, Jen and I tried some different things to hold the deluge, and each failed in its own interesting way resulting me waking up cold, scared and wet.  We eventually settled on Pampers taped to my side, which were the most effective but still not 100%.

Some time before 11AM on Wednesday, the hole in my kidney finally healed enough for me to unstrap from the diaper. Also, there was an immediate flood of pain as (and I was warned about this part) surgical detritus flushed towards my bladder. It was not "all better" for me quite yet, but with a dry back, sanity begins to return, and I would be able to get the much needed post surgery rest that I'd been lacking up until that point.

Since Wednesday the 16th, I've been feeling progressively better each day, until today, when I am finally well enough to return to work.

The fallout of this is that I have Uric Acid type kidney stones.  This means, I get coffee back, but it also means that I cannot have more than six ounces of "animal protein" per day.  Chicken, Pork, Beef, Fish, even eggs are high in these chemicals called Purines.

2 comments:

  1. Damn man! I'm sorry you had to go through that but I'm also very happy to see you're making it and your character and zest is still enact! I also can't help but admire and commend the love between you and Jen. Major props to her for sticking by your side (no pun)!! You're always in mine thought brotha!!

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    1. David Lee! I'm glad you saw this update, and thanks for the kind commentary. Yeah.. Jen's a keeper.

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