A Very Kidney Stone Christmas

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It has been a strange month.  For nearly 10 days, these were the thoughts that constantly passed through my head:

“Please, for the love of god, the next time I go pee, please let me piss out this f*cking kidney stone.”

That’s right.  I had a damn kidney stone.  Ken had one nearly two years ago as well, so at least I had very sympathetic company in the house.

Not Feeling Well

On Monday December 9, I wasn’t feeling well.  I was going pee very frequently and I thought I might have a urinary tract infection or something.  I figured I’d wait until Tuesday to go to my regular doctor, but late Monday evening my side started to hurt a little bit.  Knowing that side pain can be a sign of a kidney infection, I decided to hurry up and go to a local urgent care facility that was open until 10PM.  They diagnosed me with a urinary tract infection (UTI) as I suspected, but they said that my kidneys were fine.  If I had a kidney infection, I would have “jumped off the table” when the doctor pressed on my kidney.  No jumping off table = no kidney infection.

They sent me on my way with an prescription for antibiotics and a prescription for an over-the-counter medication that “numbs” the bladder and makes things like frequency urges better.

I went home, had some dinner, took my medications, and got ready for bed.  My left side still hurt a little bit, but I just figured it was all in my head and I was being a hypochondriac.  When I woke up on Tuesday, my side felt fine.  I didn’t have to go to work on Tuesday because it was a snow day here in DC and I was just lounging around the house.  Ken was working from home so he wouldn’t have to drive in the snow.

By Tuesday early afternoon, my side started to hurt a little bit again.  When Ken and I sit on the couch together, we frequently hold hands.  Ken noted how cold and clammy my hands felt, which he said was really unusual because I’m usually so warm.  By 3:00PM, my side was really hurting, especially every time I took a deep breath.  I was also feeling these random stabbing pains in the middle left side of my back.

I tried to calm myself down, “You just went to the doctor last night.  It’s just a UTI.  Give it a few days for the antibiotics to kick in.”  I was having chills and feeling nauseous, and thought I might have a fever.  I took my temperature.  98.4.  No fever.  You’re fine.  I took my temperature like every five minutes.  I was thinking to myself, “If I get a fever, I can just pass this off as the flu.  Nausea, chills, bad aches and pains.  You just need a fever and it will all equal a basic flu.  I never had “wished” myself to have a fever before.

I kept laying down in bed, trying to find a comfortable position, thinking if I could just take a nap, I’d wake up feeling better.  It hurt no matter which way I was laying down.  So I moved to the couch.  Then to my desk chair.  Then back to bed, then back to the couch.

By 4:30, my left side and back felt like it might explode.  It was like a professional MMA fighter was kicking me in the side and back constantly. I couldn’t even breathe without a stabbing pain in my left side.

I started to think about something that happened eight years ago.  I had had a random middle-of-the-back ache for nearly five days in 2005.  I woke up on a Saturday with the back ache.  By Thursday night I was vomiting with pain.  There was finally something that made me say to myself, “This is not a normal run-of-the-mill ache or pain.  This is weird.”  When I went to the Emergency Room that night in 2005, I learned that I had gallstones so numerous and large that it was causing a gallbladder infection and I would need to have surgery to have my gallbladder removed.  I was wheeled into surgery about 12 hours later.

So, I finally had that same realization about my side.  This was not some normal ache or pain that could be explained away by flu or a pulled muscle.  Something was weird.  And for me, weird = emergency room.  Better safe than sorry.

A Trip to the Emergency Room

I told Ken I was going to the Emergency Room.  I was convinced I had a kidney infection, even though I’ve never had one before and had no medical basis to assume I had one.  Ken joked, “Sounds like kidney stones to me!”  But I didn’t even really consider kidney stones.  When Ken had kidney stones, he was in the ER within like 20 minutes of experiencing the pain, so his was a very sudden onset of pain compared to my more gradual onset.  He also didn’t have any nausea, chills, or urination frequency like I was having.

I told Ken that I could drive myself to the ER since he was still doing some work from home.  Plus, I just figured the ER doctors would send me home within a few minutes saying that it was just a bad urinary tract infection or something.  Within a few minutes at the ER, the nurses and doctors were already telling me that I had every sign of a kidney stone and they would order a CT scan to confirm.  In the meantime, they started me in IV morphine and saline fluids.

I called Ken and said, “They think I have kidney stones.”  Ken said, “Kidney stones!  Welcome to my world!”  I told him that since I was getting morphine, I wouldn’t be able to drive home or anything.  He arrived at the ER a few minutes later.  (Luckily our nearest ER is less than a mile from our house!)

Doctors had ordered a pregnancy test out of an abundance of caution, and when a nurse came in and said, “You’re pregnancy test was negative, I can take you for your CT scan now,” Ken looked confused.  I looked at him and said, “Congrats, we’re not pregnant!” and quickly explained they have to do pregnancy tests to make sure it’s not something other than kidney stones.  When the doctor had asked me earlier if there was any chance I was pregnant, I told him that it would be very unlikely.  He said, “Well, I just have to check because there’s always one woman a day who doesn’t know!”

Although it had been about 30 minutes since getting the morphine, my side was still hurting (albeit less than when I first arrived in the ER). I had my CT scan, which was short and easy, and went back to my room in the ER to wait for the results.

 

My IV setup for morphine, saline fluids, Zofran (an anti nausea), and IV antibiotics

 

When the doctor came in with the results, he said that there was every sign of a kidney stone … except an actual stone.  My kidney was enlarged, my renal pelvis (which I didn’t even know was a thing) was dilated, and so was my ureter.  But no stone actually showed up on the CT scan.  He explained that A) I could have just passed the stone since getting to the ER, or B) the stone just didn’t show up on the scan because the scan only takes various “cross sections” and it might have missed it.

The doctor ordered some IV antibiotics in case the urine backed up in the kidney was in fact starting a kidney infection.  The IV antibiotics ran for 30 minutes.  Ken had called a friend of his that lives nearby.  Since we now had two cars parked at the ER, we had to get them both home.  So Ken drove my car home while I was getting my IV antibiotics, and his friend met him at our house and then drove him back to the hospital.  That way we just had Ken’s car at the hospital.

Relief

At some point while Ken was gone, I started to feel like a million bucks.  I was convinced that I had, in fact, passed the stone and that is why it didn’t show up on the CT scan.  My hands were warm for the first time all day.  So were my feet.  I no longer had pain.

I hit the nurse’s call button because I had to go to the bathroom and I was still hooked up to the IV.  A nurse disconnected it and I walked to the bathroom.

This next paragraph is going to venture into the way-too-much-information zone.

I peed SO MUCH.  For the first time in days, my bladder felt completely empty.  It was such a relief.  The previous few days, every time I would urinate, there would be very little urine, and within minutes I would feel like I had to go again.  So my empty bladder, coupled with the complete absence of pain (and probably also coupled with the morphine), I felt like I was on CLOUD NINE.  I felt like a million bucks.  Like I could leap tall buildings.  I was all smiles.

Ken came back, and it wasn’t very long afterwards that the doctor and nurses came in with my discharge instructions.  I was to follow up with a urologist ASAP.  They were prescribing me an antibiotic, different from the antibiotic I was prescribed the night before at the Urgent Care facility.  I was also prescribed pain medication and an anti-nausea medication.

After I was discharged, we went to Target to get my prescriptions filled.  D’oh, pharmacy was closed.  So we went to the local supermarket pharmacy, which was open until 9:00.  While I was waiting for my prescriptions, I literally felt like skipping down the aisles.  I just felt SO much better than I had a few hours earlier.  I was also starving, so after we filled my prescriptions, we went to the local pizza place in the same shopping center as the supermarket.  When I got home, I scarfed down my two slices of pizza.

Then I laid down on the sofa, and was feeling so relaxed that I knew I would fall asleep.  I went up to bed and that was the end of my crazy day.

Pain, pain, and more pain

Although I was feeling fine, I called off sick from work on Wednesday, and I guess it’s a good thing I did, because by Wednesday afternoon, my pain was back with a vengeance.  I guess I hadn’t passed the stone after all.  I asked Ken if he could leave work an hour early because I was terrified to be in so much pain at home by myself.  By the time he got home, the pain had mostly subsided.  Earlier in the day, I had called the urologist that the ER recommended.  They couldn’t fit me in for an appointment until the following Thursday, eight days from then!

Then the pain came back, I think worst of all, on Thursday evening.  I was literally crying with pain.  The pain pills they have prescribed for me (Hydrocodone), did not seem to be helping at all.  Luckily the pain subsided within 2 hours.

I spent Friday and Saturday mostly pain free.  Just a little discomfort.  I thought I had finally passed the stones.  Nope.

On Sunday I was in pain again, and the pain was not subsiding as quickly as it had on Wednesday and Thursday.  Also, I was having weird urination-related symptoms.  My urine was like very bubbly or foamy or something.  I re-read my discharge instructions from the ER and it said to come back if my symptoms changed or worsened.  After spending most of day in pain, I decided to take another trip back to the ER on Sunday evening.

They did more bloodwork (all normal), and a urinalysis (all normal too).  They did not seem concerned about the foamy urine.  One nurse explained that it could be a sign of the stone breaking into several pieces and the urine was developing bubbles as it “crashed” over the stones.

They gave me more IV morphine, a prescription for a stronger pain medication, and a prescription for Flomax, which they said would help “relax” my ureter in an attempt to allow the stone to pass more freely.  They also managed to get me an appointment with the urologist for the next day (instead of waiting until Thursday, which was the earliest appointment I had been able to make)

Once again, by the time I left the ER, I was feeling like a million bucks.  We went to (yet another) different pharmacy because apparently most pharmacies are closed at 6PM on a Sunday.  While waiting for it to be filled, we walked to Chipotle and grabbed some takeout.

Time to pee out these things out

On Sunday night around 11PM, I finally “caught” what looked like a stone in my urine strainer.  It was significantly smaller than Ken’s stone from two years earlier though.  But, I was happy!  The stone was gone.

Monday morning I went to the Urologist.  Not only was I the only woman in the very full waiting room, I was the only person under the age of 50. I guess 32 year old women don’t normally have occasion to visit a urologist.

The urologist said there were trace amounts of blood in my urine (something new compared to my  urinalysis at my ER visits), and he said that would be consistent with passing a stone the night before.  He told me to come back in a month for a sonogram, which would confirm that my left kidney was back to normal size, since the CT scan from the ER showed my kidney was enlarged.  Since there was no stone that actually showed up on my CT scan, I asked him something just for the sake of my sanity.  I said, “Is there anything else other than a kidney stone that could cause these symptoms like the dilated ureter and renal pelvis and enlarged kidney?”  He said no.  He said that occasionally people are born with a congenital defect that might cause those issues, but it certainly would’ve presented itself by my age.  He said that a kidney stone is the only explanation.  So that was a big relief.  I just get those random thoughts sometimes like, “what if it really is something rare or more serious than kidney stones.”

Monday was spent pain free, and I finally went back into the office on Tuesday.  I was at an important meeting on Tuesday afternoon, and I could feel the pain starting to come back.  I kept fidgeting and I was sitting in an insanely squeaky chair.  At the end of the meeting, I apologized, explaining embarrassedly my situation.  An older gentleman said, “Oh my god, I do not know how you didn’t get up to leave!  I had kidney stones 20 years ago and I still get phantom pains because of how bad it was.”  So, I had sympathetic company.  I went home straight after the meeting.

I was feeling very down in the dumps after I got home.  The new pain medication was helping more than the previous one, but I was still uncomfortable.  I was worried I was going to have to live with this pain indefinitely.  That it would ruin my Christmas.  I was feeling so resentful.  My Christmas season last year was a terrible one due to the death of my mother and serious injury of my father in a car accident in early December.  I just wanted to enjoy the Christmas season this year, and kidney stones were making that impossible.  I felt like a bratty little kid.  I had so much to be thankful for.  Excellent medical care, a non-life threatening diagnosis, and an easily treatable condition.  But I was still just so pissed off.  The pain made it impossible to do anything.

On Wednesday the 18th in the morning, now 8 days past my first ER visit, I caught two more tiny stones in my strainer.   And luckily, since then, I have been completely pain free.  I guess they’re finally all gone!

So, in addition to my gallstones of 2005, I can now check off kidney stones from the list of terribly painful conditions that humans can experience.  I’ll wear that like a badge of honor!