Wednesday, April 01, 2015

The Stones on that Guy

I (probably) had a kidney stone on Sunday. You want to know what was the worst thing about that?

The agonizing pain.

There were other bad things about the experience too, and periodically I'd reflect on them and reflexively start think "you know what's even worse than the pain...." And then I'd stop and realize that, no, the pain is the worst part.

Anyway, as I said, I probably had a kidney stone on Sunday. I say probably because they never actually saw a stone, and it has not to my knowledge passed in my urine. Also, kidney stone pain usually moves from your back around your abdomen down to your genitalia, but I didn't notice any movement (it felt concentrated on the right side of my stomach). They diagnosed it based on the location of the pain (which was certainly in the path of a kidney stone), and the fact that I went from zero to "I need to go to the ER" pain in about 5 minutes, which is classic kidney stone. Also, there's apparently another stone currently sitting in my right kidney, which further implied that kidney stones were the cause. That stone might dissolve on its own, or it might drop and I'll go through the same thing all over again. No way to know for sure. Fingers crossed.

I woke up feeling normal Sunday morning -- maybe a slight stomach ache, but nothing different than normal indigestion. Jill announced she was going out to Starbucks, and as she left I jumped into the shower. All of the sudden, I feel this terrible pain in my right side. It rapidly got bad enough that I decided to get out the shower because I was genuinely afraid I might collapse and drown. I knew Jill was coming back soon, but I called her anyway and begged her to come home right away.

My first guess on what was wrong was actually appendicitis. I called my insurer's nurse hotline who squished that pretty quick -- it was too high on my side. But it wasn't getting better, and I was getting worse. Jill and I called an Uber and we directed him to the ER in Berkeley.

The Uber driver was somewhat less urgent than I would have liked. Jill hadn't put in the destination, and he would not even start driving until she plugged the hospital's address into the app. From my vantage point, he also seemed to be in no hurry, even though I was in pretty obvious agony in the backseat. I was still on the phone with the nurse hotline, who helpfully informed me that the Berkeley hospital was outside of my network. She suggested we go to Richmond(!) or Oakland instead. Fortunately, the Oakland hospital was only 15 minutes away. I could tough that out. Barely.

The ER intake line in Oakland was three patients deep, managed by an intake nurse who as best as I could tell was staring at his computer screen doing absolutely nothing. He was eventually replaced by another nurse who finally got the line moving. Patient #1 apparently had "excruciating" knee pain (which she described absolutely calmly and with no indication she was even mildly put out). Patient #2 was equally matter-of-fact in telling the nurse that he thought he had a stroke last night and could no longer feel half of his face; also he was having trouble breathing (that was more impressive). He immediately got taken in. Then we got to me, and the intake nurse also was pretty confident that I did not have appendicitis but that I probably had a kidney stone. We exchanged a sarcastic "hurray!" and she said she'd try to get me in as soon as possible.

This brings me to the first not-as-bad-as-pain problem with kidney stones -- they aren't really that serious. They're agonizing, but they're not going to kill you or anything. Which meant that, severe pain notwithstanding, I was actually pretty low priority on the queue. And that meant I sat in the waiting room for nearly two hours enduring steadily more excruciating pain. Well "sat" isn't quite accurate -- I paced for a long time in a futile attempt to "walk off" the pain, but eventually I couldn't even do that and splayed across several chairs with my eyes closed. I had not taken any painkillers, and I hadn't had anything to drink all day. This last part was actually more pressing in my mind, because as my condition deteriorated I began sweating, and eventually I was basically a human waterfall. Unfortunately, when I asked the nurse if I was allowed to have water, she told me no -- I might need surgery, and so I couldn't drink. By the end I was feeling like I might pass out, not from pain but from dehydration.

Kidney stones have been compared to childbirth in terms of how painful they are. I'm obviously in no position to evaluate the accuracy of that statement. Enough people have said it so that I assume it's true, but if that's the case I frankly have no idea how anyone has more than one child. The first can be chalked up to ignorance and bravado, but if you asked me "do you want to voluntarily feel like this again," I'd sacrifice a litter of puppies to avoid it. In terms of what it felt like to me, my best description was like doing and holding a crunch forever. You know that burning/tearing sensation you get when doing an ab exercise, and you try to "hold it" for as long as possible before releasing? Imagine the peak of that, except you can't release and its constant over two hours. I was asked to rate the pain on a 1-10 scale, with 10 being "worst imaginable". I gave it a 4 when I entered the ER and I later said it peaked at a 6. I may have been influenced by this comic, but basically my thought process was that being burned alive would be worse. More generally, on an instant-by-instant level the pain wasn't the worst I've experienced -- it hurts more to burn your finger on a hot stove, for instance. The problem was the duration -- burning your finger lasts a split-second, whereas this persisted for hours without relief.

But eventually, it stopped. In fact, it stopped about 10 minutes before I finally got called in to see a doctor, where I sheepishly informed the attending that I was feeling much better. They asked some questions, then gave me a tall glass of water (finally!) to facilitate a urine sample and scheduled a CT scan. This is where the diagnosis started to look like it might go off the rails a bit. My urine wasn't bloody at all, and the CT scan didn't seem to pick up a kidney stone. As noted, they eventually spotted one still in my kidney, but the one that had supposedly been the cause of all the misery 30 minutes ago was nowhere to be found. This is a bit worrisome to me. Nonetheless, I was instructed not to worry, given a prescription for 600 mg of ibuprofen (3x the strength of a Motrin!), and sent on my way.

I've been feeling mostly fine ever since -- a little wiped-out, perhaps, but in no physical pain. But I am now extraordinarily paranoid, and that's the second not-as-bad-as-pain problem with kidney stones. Even the slightest twinge in my stomach, the barest hit of indigestion, and my mind starts to panic -- it's all coming back. It hasn't, yet, but I'm terrified that it will. The discovery that I have a 3mm stone in my kidney right now is to my mind a ticking time bomb that I'm spending 90% of time willing to dissolve on its own (but how would I know?). It is very tiring to go through your day when every stomach burble sets off a mini-panic attack.

In any event, that's my kidney stone story. I honestly, honestly, hope you never go through it. And ladies, if you're thinking of having a child sans drugs -- take my advice and let them medicate you to hell and back. You do not want to feel what I felt unaided.

1 comment:

Barry Deutsch said...

Wow, that's awful! I'm really sorry you had to go through that.