Shooting lazors up yer peehole

[drwex]

No, seriously. This is an update on my undesired passenger so ...

Got to see the urologist this week to talk about the (non)progress of my kidney stone. We looked at the CT together and that's a big mofo. Actually 7.3 mm. The urologist was pretty blunt - at that size the chances of it passing naturally are 5% or less.

He was surprised that the pain from a stone of this size is being managed with simple Advil. I don't think I'm any kind of hero nor do I have a pain tolerance especially different from other people like me. I've had to use the narcotic twice so far. The biggest change for me has been taking medication proactively; I'm used to taking meds reactively, when my back or arthritis flare. Here I'm using the drugs to stay ahead of the pain and it's working pretty well so far. The urologist warned me against doing workout-like things ("no going to the gym" was his exact phrase) but otherwise no limits.

So that brings us to medical intervention. The recommended intervention these days is to thread an instrument up the urethra and sample the stone, then use lasers to pulverize it, to grains about the size of beach sand, that are then flushed out naturally. A stent is placed to stabilize and help the ureter heal, then removed later in a second procedure.

It's day surgery, and the risks are said to be low. Based on the analysis of the removed stone sample, there may be follow-up action ranging from diet changes to a few months of medication.



If this doesn't make you cringe and want to cross your legs then YKIOK but YKINMK.

Comments

[corylea]

Well, it's never a good day when you're told you need surgery, but at least this sounds like relatively minor surgery. And you do want to find a way to manage this other than constant Advil; I gave myself an ulcer by taking Advil for too long, and you don't want that. either.

So I hope you "get" to have surgery soon, and I hope your recovery is swift and uncomplicated.

[drwex]

Yeah, I'm aware that long-term Advil isn't sustainable. I have some strategies to manage that, so far so good.

Surgery is just annoying because the guy I saw is only in the OR on Tuesdays and their schedule doesn't mesh well with mine. I've asked the clinic to see if there's another surgeon with better availability.

[gingicat]

Well, I hope you don't have to stay awake for the procedure. I imagine it's even less fun for a guy.

[drwex]

Yeah I'm planning on checking out as best I can. Me and anaesthesia have a ... funny relationship, though.

[gingicat]

Oral conscious sedation for my hysterectomy was FASCINATING in that I really didn’t remember anything. I kinda wish I’d gotten them to record it.

[c1]

Narcotics actually aren't the drug of choice: using NSAIDS, as you are, is, actually the drug regimen of choice. In the field, we typically use Toradol, which is just the Mjolnir equivalent of Advil, if OTC Advil were an average sized ball-pein hammer. And then we flush the sucker out with about one or two liters of saline. A benzodiazepine to take the remaining edge off and help the patient sleep through the process is the only other "pain relief" that we offer. As you're finding out, sometimes the saline doesn't do much, but speaking from experience, Toradol is a true wonder drug.

Narcotics, as it turns out, aren't really a very effective pain reliever for most pain, and especially kidney stones. Thank Purdue Pharma for leading us down that shithole.

My one bit of advice is that no matter how beat up you feel, and how short your rope, do your best to be nice to the nurses. They work long hours, so to those who make their day go by faster, they'll be quicker with analgesia and other creature comforts.

[drwex]

Toradol was bloody amazing. I'm sad that it's so bad for one's liver and not available in pill form.

I (and my brother) have found that narcotics provide a significant level of pain relief.

And I'm always nice to the nurses. I had fun cracking wise with the ER nurse that night.

[c1]

I'll have to get back to you about Toradol. However, as a means of comparison...

I can give Zofran OTD -- an "Orally Disintegrating Tablet" by mouth. It has few side effects that are significant pre-hospitally. My partner (a paramedic) is licensed to give the same drug, same concentration, intravenously. The difference? IV, one can experience "Long QT syndrome", where the Q-T interval on an EKG is lengthened. (This is the difference between the time when your ventricles contract, and when they're ready to receive stimulus again. Because it concerns your ticker, it's appropriately deemed serious.) So I wouldn't be surprised that there's a side effect to Toradol that limits its OTC administration. Because yeah, having passed two stones myself, Toradol is fucking amazing.

[flexagon]

No going to the gym... until the thing is gone, or what?? I would flip if given that advice. :-(

Like sands through the hourglass, so are the stones of our kidneys.

[drwex]

While carrying a known stone or while having the stent inside, sustained strenuous activity can cause perforation of the "requires serious surgery to fix" type.

[tpau]

since last we talked i have now had a scope stuck up a similar orifice for the observing of things with a camera. that was not so much a fun thing at all. and i didnt even get lasers!!

[drwex]

Eep! I hope you got anesthetic at least.

[gale_storm]

Yip yip yipe! About 10 years ago, I had my own stones drilled out or dissolved or what the hell was done. They weren't naturally faceted, and I didn't save one for wearing as a pendant.

But, yeah, easily manageable pain, over the next day or so, all that. Hope it goes well and rapidly and smoothly!