NaBlogWriMo 6 & 7: One Stent Up, Two Stones Back

Yup, actually installed in my body.

I started this intending to talk a little about my most recent bout with kidney stones. The most frustrating thing (for me, anyway) about kidney stones is that they are mostly preventable. Even though they are noted as a potential side effect of bariatric surgery, avoidance is simple: adequate hydration. Every time this happens to me, as I moan and groan and wait for things to start flowing again, a single thought occurs to me: “Did I hydrate enough today?”

And the answer, invariably, is “NO.”

But, as I told the story, it kept growing. And growing. And growing some more.

Thus, the tale that was supposed to be produced last Friday spent 3 days being written instead. It is now longer than some short stories I have created.

So, get yourself comfortable, and check your squeamishness about bodily functions at the door.

A Painful Burning Sensation

Our tale begins back on July 6 of 2018. On our way home from a family visit in Santa Fe, I noticed a mild pain in my back. I didn’t worry too much about it – I had just spent the last 4 days in the car, courtesy of the 4th of July holiday.

As it turns out, I should have worried about it.

All day long, the pain increased, and no amount of stretching would alleviate it. As the pain worsened that evening, it occurred to me that I might have a bigger problem. I hadn’t urinated once, all day.

This continued for the next 48 hours.

Finally, during a visit to the dentist’s office, the real pain struck. That oh so familiar sensation, like an ice pick being shoved through the abdomen. I had developed another kidney stone. (Though, in hindsight, not going to the bathroom for two days probably should have been a clue.)

The visit to urgent care that evening wasn’t great. The PA on duty asked me to identify where my kidneys were. After I was able to do so correctly, he chewed me out for not coming in sooner. “Are you trying to rupture a kidney?” he asked. I hadn’t even been aware that this was a thing I should be worried about.

You can bet I was worried now, though.

He injected me with a mild muscle relaxer and told me that if the no-flow problem hadn’t corrected itself overnight that I was to report to the Emergency Room.

At 7 AM the next day, I was among the first in line.

The Hospital House of Horrors

In one sense, I feel bad for the folks that work the local emergency room. They have to work insanely long shifts dealing with the dregs of humanity.

On the other hand, this can leave them with a certain, shall we say, “casual” approach to tending to legitimate patients like myself.

I will admit that reporting that I hadn’t urinated in three days got me through the initial triage stage pretty quickly. But, after being placed on a bed in the back…nothing happened. For hours. A nurse came by and told me that someone would be by shortly to administer some pain meds. This became a familiar refrain as a parade of nurses, nurse’s aides, and even a couple of EMTs all promised to produce medication to deal with the agonizing waves of pain that were now emanating from every point of my body south of my chest.

After several hours of this, I finally pounced (metaphorically) on the next nurse that happened by, and I asked for a catheter. This might have been the point where they started taking me seriously. Probably not too many requests for one of those in the average day.

For those that don’t know, a catheter involves taking a flexible hose, about half the size of a normal drinking straw, and inserting it into your body. Yup, right through the aperture that your urine normally flows through. I can feel you wincing from here. I can assure you, it feels even worse than you are thinking it does.

Unfortunately, even this drastic remedy provided no relief. I could tell the nurse was deeply suspicious when she got it implanted and almost nothing flowed out the other end. I could hear her thinking: “Have I just inherited one of those people who enjoy being in pain?” She promised me drugs (again) and then vanished.

A few more hours went by. During this time, I was now in pain both internally (from the kidney stones), and externally (from the catheter, which I remain convinced was a veterinary version designed to be put into livestock, and not designed for the human body.) Lor literally had to talk me out of removing the thing myself.

At last, someone showed up to haul me off to the Imaging department. They were going to MRI me to find out just what the heck was going on internally. I thought this would bring relief.

I was wrong. So very, very wrong.

Under The Microscope

I could tell that things weren’t going to go well when I got parked outside the door to Imaging. The person pushing my hospital bed was bitterly complaining to someone on the phone about what an asshole her boyfriend/spouse/SO was while we waited. When my turn came, she rolled me into the room, being sure to hit every single bump and corner in the hallway. Considering even breathing was painful at this point, this did nothing for my mental state.

But the coup de grace came as I was transferred from my bed to the MRI slab. Undoubtedly frustrated with all things male, my technician tried to “help” me move faster from bed to machine. In doing so, she managed to pinch the hose of my catheter between the rolling bed and the immobile MRI machine. She then yanked me across from one platform to the other.

I moved, the catheter hose did not.

By the time she sorted out what had occurred, I was literally lying on the MRI weeping in pain. She rolled the bed away, readjusted the hose, and walked out of the room, her vengeance upon the male half of the species accomplished. No apology was forthcoming.

By the time I got back to the emergency room, I was ready to just die and get it over with. I did finally get an assigned nurse, who also promised me drugs. She agreed to remove the catheter from my bruised and battered equipment, wincing when I told her the story about my experience in Imaging.

More hours passed.

Size Matters

That evening, a full 11 hours after I checked myself in, a Doctor appeared.

“Guess you’re not feeling too good, eh?” he asked jovially. I agreed that, indeed, I was not. “Well, there’s a reason! You’ve got a big ol’ kidney stone. 10 centimeters. We’re going to try to schedule you for emergency surgery tonight. In the meantime, I’ve approved you for all the pain meds you want. You must be miserable.”

With that, he left. I was so deliriously happy at the potential application of endless morphine that it took me several minutes before I processed what he had said.

…10 centimeters…?

I was pretty sure I was remembering my metric conversion correctly but wasn’t an inch equivalent to 2.5 centimeters?

Did I really have a kidney stone FOUR INCHES in diameter stuck in my piping somewhere?

I asked Lor for my phone. Puzzled, she handed it over to me. I called the only person who I knew would assist me.

“Dad,” I said when he answered the phone, “they’ve just told me I have a 10 cm kidney stone. If they tell me that they want me to PASS this thing, I need you to take me out behind the barn and shoot me.”

My father solemnly agreed to do so and added that he and my mother were on their way to the hospital now.

Metric Fractions

While my hospital room began filling with family members, I was visited by my nurse and a nurse’s aide. They were astonished by my doctor’s diagnosis. They rummaged around on the computer system and returned with a couple of pieces of news.

The good news: my doctor misspoke. The “stone” was 10 MILLIMETERS, not centimeters.

The bad news: 10 millimeters is still the size of a bullet for a good sized handgun. There was no way it was going to pass on its own. I would, indeed, have to have surgery.

More bad news: my doctor had sort of buried the lead while raving over the size of the kidney stone. Turns out I had STONES (multiple), not a single one. I had a 10mm one blocking the ureter on one side. Then, there was a 4mm stone actually stuck in the ureter on the other side.

No wonder I hadn’t been able to move any fluids for nearly three days.

Since I now had free access to all the drugs I wanted, I will admit that the rest of the evening is a bit of a blur for me. I was finally taken back for surgery about 11 PM. After admitting myself to the ER at 7 AM, mind you. Later on, in recovery, I was convinced that my Urologist said they had only removed one stone. Must’ve been the drugs, right?

Wrong. They really had only removed one of the two stones – the smaller one. I would have to set up an appointment to have the other one taken care of.

The Gift That Kept On Giving

In the meantime, they had left me with a special present…a device called a “stent”. This involves jamming latex tubing up through your ureters in order to keep them open and to assist in passing any smaller particulate that might be trying to come through.

It also leaves you with a (no shit) length of fishing line emerging from the same aperture your urine flows through. The end of the line is then taped around your gear, so you don’t “accidentally” remove it.

The problem? The tape had been applied inexpertly. I had what looked like half a roll of scotch tape wrapped around me half a dozen times, pinning the fishing line in place. Unfortunately, they had not given me enough slack in the line. Every time I shifted position, it yanked my equipment this way and that. I’ve heard of men being led around by their penises, but this was ridiculous.

I asked my long-suffering wife to fix this after we finally made it home. She took one look at the situation and went looking for scissors. After she calmed me down and reassured me that she was not preparing to amputate, she told me what had happened. Apparently, the surgical staff had not bothered, umm, “cleaning up” the area before they applied the rolls of tape. Consequently, I had bunches of pubic hair all gathered up in the rolls of tape along with the fishing line.

10 minutes and a trim later, I was finally no longer being yanked to and fro. I put myself back together, and we headed off to the pharmacy to get the supply of pain meds that would have to tide me over until my next surgery. Which had not even been scheduled yet, by the way.

You Can’t Haz No Drugs

Because the surgical gods were still not smiling upon me, there was another issue. A big one. The pharmacy would not fill my prescription.

It seems that the urologist who performed my emergency stone-ectomy, (OK, fine, it is referred to as a “lithotripsy.”) was NOT licensed in the state of New Mexico. He was a recent transplant from Arizona and had not completed his licensure requirements here.

The upshot of this was that they would not fill my prescription whatsoever. I was going to have to suffer in stoic silence through the next several weeks until my second lithotripsy.

I considered suffering in silence beautiful. For about 30 seconds. Then I busted out my medical marijuana card and had Lor drive me to the closest dispensary.

Thank God for medical marijuana is all I have to say. The same substance that assists me with seizure control was about to keep me from being in unending pain for the next three weeks. After trying (and failing) to keep straight faces after I told them the whole story, the budtenders at R. Greenleaf had mercy on me. They set me up with a vaporizer loaded with a strain designed for folks suffering from intractable pain and sent me home.

The Stone and The Stent

And there I sat, for the next three weeks. Completely baked, on my couch, craving Cheetos and Oreos. Every time I could feel the pain emanating from either my stone or my stent I would self-medicate again.

It is entirely possible that I smoked more weed in that three-week period than I had consumed in my entire adult life leading up to that point.

My doctors had informed me that I would get used to the stent in a day or so. My doctors lied. I never stopped being in pain from the installation of miles of latex tubing shoved into my urinary tract. When combined with the irregular pulses of pain from the over-large kidney stone, I was not sure I would make it to the procedure to have them both removed.

As it turns out, I only got to have one removed. The second lithotripsy went smoothly, but I was dismayed to discover that I would be leaving with the thrice-damned stent STILL INSTALLED.

Turns out I would have to wait another week before I could remove that horrible, horrible stent.

Before,  I removed, you ask? Oh, yes. After your recovery period, you are told to grab that nasty line emerging from your equipment and yank it out yourself.

I thought that the day could not come fast enough. When it finally arrived, I self-medicated, covered Lor’s massage table with old ruined sheets, and assumed the position. Lor, as fascinated as always with anything involving human physiology, offered to assist. I declined. She settled in to observe instead.

The Never-Ending Latex

Thus, my journey toward freedom from the stent began. I pulled. It hurt. I pulled some more. It hurt even more. I kept on yanking, tears streaming down my face. I went through my entire vocabulary of curse words and began inventing new ones. And still, the thing wouldn’t come out.

I had started to wonder if another error had been made. Did the surgical team leave behind a spool of fishing line inside my kidney? But, finally, a piece of latex tubing emerged. This, then, was the stent, apparently. I was maybe halfway there. I kept crying and pulling. The pile of fishing line and latex just kept growing.

Meanwhile, Lor was so fascinated by the process that she kept leaning closer and closer to watch this never-ending stream of plastic emerging from my body. When I finally reached the end of the procedure she was probably only a foot from where the extraction was taking place.

At last, with a final exhausting tug, I pulled the last of the 24 inches of stent out of my body. (No exaggeration – we measured it. See the photo above if you want proof.) As it emerged, however, a back wave of urine that had been clogging the pipes behind it emerged in a manner not unlike a fire hose.

I did mention that Lor was only about a foot away at this point, yes?

As I sat there panting from the effort, Lor stood there dripping and blinking. “I suppose I should have anticipated that,” she said, and she wandered off to the bathroom to clean up.

TL;DR (Too Long, Didn’t Read)

I had multiple kidney stones. It hurt. I cried. Multiple surgeries were performed. I got stoned. Lor got wet. The end.

But, seriously, if you take nothing else away from this, take this piece of wisdom:

STAY HYDRATED.

Catch you all tomorrow,

  • Jeremy

The Saga Of The Stones (Not a Story About Iceland)

After you go through bariatric surgery, you are warned about a few things. “Take your multivitamins” your nutritionist will tell you. “Otherwise you will suffer from malnutrition.”

“Make sure you exercise 150 minutes a week” you surgeon will prod you. “Lack of physical activity is the #1 leading cause of regain.”

And your whole medical team will tell you “Stay hydrated!” They will give you a long list of things that can go wrong if you don’t drink enough, including this one: “Lack of hydration can lead to kidney stones.”

Turns out your medical team actually knows a thing or two about this.

The Path Paved With Good Intentions

I had thought I was doing pretty well on the whole “hydration” thing. I drink about 40 ounces of (decaffeinated, sigh) coffee over a couple hours every morning. After that, I try to down another couple of 20-ounce bottles of water during the course of the day. 80 ounces of hydration a day, right?

Except…well, a few things have come up in the past few weeks. We’ve started a pretty intense new exercise routine at our gym called “BodyPump”. It involves high-rep (like 70+reps) low-weight exercises for the entire body. Though we only do it a couple of times a week, it is a major drain. And I can’t say that I leave the class feeling like I am fresh and hydrated. More like I am a squeezed-out dishrag, really.

And, then, we have our semi-annual visitor. Our nephew has come to stay with us for a few weeks, which throws our entire schedule into disarray. We spend all our time hanging around with him (we like him), and tend to ignore our regular routine. Between the new exercise program and our break in routine, my hydration habits have probably been less than optimal.

And down that path lies madness.

Eruption

It began one night late last week. At about 9 pm, I stood up to head to bed. Suddenly, I was aware of what felt like a cramp, deep in the right side of my abdomen. It felt as though someone had inserted a metal bar into me. No matter what I did to stretch, nothing worked to release the pressure.

Finally, I shrugged it off and went off to complete my nighttime routine, hoping the pain would simply go away on its own. However, during my ritual nightly visit to the bathroom, something unusual happened.

Nothing.

No matter how I strained and pushed, I could not pee no matter how hard I tried. I knew I needed to. I just couldn’t manage to get the job done, as it were.

Now, I am a man in his late 40s. I have been through some of the more…exotic…issues that accompany my aging physiology, including prostatitis. But this just didn’t feel the same. I finally gave up and went to complain to Lor. She immediately questioned my hydration for the day.

Now, as it turns out, my fluid intake for the day had consisted of…one cup of coffee. All day. No more. She suggested I down some fluids. I spent ten minutes taking in 20 ounces of water, hoping to get things moving.

Then all hell broke loose.

Suddenly, I was no longer suffering from a sore spot in my abdomen. Now, I suddenly felt as if someone had inserted a red-hot poker into my abdomen and shoved it all the way through my lower back.

The Night That Would Not End

Chatting later with others that have suffered from kidney stones, I was able to determine that this was a pretty normal set of symptoms. At the time, I was positive that no one had ever experienced pain on this level. From 11 PM till 1 AM, I kept up an ongoing argument with myself about whether or not I needed to go to the emergency room. I was quite certain that my appendix had burst, or something equally dire.

However, at around 1 in the morning, I was suddenly able to produce about an eyedropper’s amount of urine. Some of the painful internal burning subsided.

I immediately drank a little more, hoping to flush out whatever was causing this ailment.

The pain returned.

I kept this cycle up, also taking a shower four different times, hoping the heat would help with the muscular pressure. (It did, a bit.) Finally, at 4:30, my exhaustion overcame my pain and I fell asleep on the couch.

At 7:00 AM Lor came and woke me up, ready to take me to the urgent care center. I made one last attempt to go to the bathroom…

And succeeded, producing a bowl filled with an evil-looking orange fluid. I spent the next two days seated on the couch, trying not to move due to how sore I was.

Except, of course, during my frequent trips to the bathroom.

Hydrate Or Die

So, did all this occur due to a week’s worth of bad habits?

Almost certainly not. I have probably been failing in my hydration goals for weeks now. Certain people have suggested to me that downing 40 ounces of fluid first thing in the morning should probably not be counted toward my 80-ounce a day goal. It apparently needs to be spread out over the day, not all done at once.

If I wasn’t a believer in hydration before, by God, I am now. I may never leave the house without a Camelbak again, just to avoid another night like that.

My PSA for the day: Avoid Kidney Stones.

I tried it, and you won’t dig it.

Still Sore, Four Days Later,

Jeremy