kidney stone attack

ttf_timothy42b · Post by **ttf_timothy42b** » Mon Mar 20, 2017 8:50 am

I ended up in the local emergency room late Saturday night with a bad attack.

The last time I was in an emergency room for this was 2003; I may have passed a smaller stone or two in between.

This time they sent me home with the news it is small enough to pass (4mm) and a prescription for Oxywhatsit.

That stuff does take the edge off. It doesn't totally block the pain but makes it tolerable. I know it's a drug commonly abused, but I can't see why. I don't find anything at all pleasant about it.

I'm hoping this doesn't take as long to pass as the last one. Pain comes in waves, lasts a few hours then fades for a while. No fun.

ttf_robcat2075 · Post by **ttf_robcat2075** » Mon Mar 20, 2017 9:07 am

Ouch!

ttf_Geezerhorn · Post by **ttf_Geezerhorn** » Mon Mar 20, 2017 9:10 am

Quote from: timothy42b on Mar 20, 2017, 08:50AMI ended up in the local emergency room late Saturday night with a bad attack.

The last time I was in an emergency room for this was 2003; I may have passed a smaller stone or two in between.

This time they sent me home with the news it is small enough to pass (4mm) and a prescription for Oxywhatsit.

That stuff does take the edge off. It doesn't totally block the pain but makes it tolerable. I know it's a drug commonly abused, but I can't see why. I don't find anything at all pleasant about it.

I'm hoping this doesn't take as long to pass as the last one. Pain comes in waves, lasts a few hours then fades for a while. No fun.

I'm sorry to see this!

I had a mild addiction to whatty-what's-it. There isn't a "high" per se - although I could tell you how to get high from it but I won't. When used as directed, it can result in a physiological addiction. When I realized it, I threw the rest away and didn't look back. I won't take that or anything like that anymore. Period. BE CAREFUL!

It'll pass. I passed one at age forty - back when "blood letting" was still very much the rage.

Can you still practice your horn?

...Geezer

ttf_robcat2075 · Post by **ttf_robcat2075** » Mon Mar 20, 2017 9:21 am

Do they give you any advice on how to avoid more stones in the future?

ttf_BGuttman · Post by **ttf_BGuttman** » Mon Mar 20, 2017 9:25 am

My sympathies, Tim. I've never been afflicted with them, but the people I know who get them say it's worse than being stabbed in the back.

Maybe part of the reason I don't get stones is because I drink a lot of water. That's supposed to help keep the kidneys flushed.

When I was in the hospital for the broken ribs after my auto accident they offered me Oxycontin. I used it for three days and told them to just give me Ibuprofen. I'll use anything like aspirin, phenacetin, naproxin, or ibuprofen rather than an opioid.

ttf_Geezerhorn · Post by **ttf_Geezerhorn** » Mon Mar 20, 2017 9:46 am

Tim, consult with your physician and/or your health-care insurance company for alternatives to that. It's my understanding there are commonly-taken over-the-counter meds which can be taken together for an effective but non-addictive pain-killer.

...Geezer

ttf_timothy42b · Post by **ttf_timothy42b** » Mon Mar 20, 2017 11:47 am

Thanks for the concern. I'm on a low dose, and I'm stretching the intervals longer than the minimum. I think I'll be okay with the meds. It's the stone that's kicking my butt. If I didn't have the Oxy I'd be back in the ER for morphine. This thing hurts!

I have brief gaps in the pain. The pain is caused by the stone moving, so when it takes a break I get one too. It was long enough this morning to get my routine done, but right now no way.

ttf_BillO · Post by **ttf_BillO** » Mon Mar 20, 2017 12:09 pm

Quote from: timothy42b on Mar 20, 2017, 11:47AMThanks for the concern. I'm on a low dose, and I'm stretching the intervals longer than the minimum. I think I'll be okay with the meds. It's the stone that's kicking my butt. If I didn't have the Oxy I'd be back in the ER for morphine. This thing hurts!

I have brief gaps in the pain. The pain is caused by the stone moving, so when it takes a break I get one too. It was long enough this morning to get my routine done, but right now no way.
I used to get kidney stones all the time. The painful uric acid kind. Sometimes 3 or 4 times a year, along with just as painful bouts of gout. Now I'm on allopurinol and no more stones or gout.

I tried a ludicrous diet and drinking 4+ liters of water a day, but they didn't really help. Just had me gaining weight and pissing 24/7

I hate having to take it, but I hate the alternative even more.

ttf_gregs70 · Post by **ttf_gregs70** » Mon Mar 20, 2017 7:53 pm

Had them many times, but not in at least five years. One doc said have a beer before bedtime and I won't get woken up again in the middle of the night feeling like a knife was in my kidney. I asked for a prescription for a 12 pack, but for some reason he just laughed and laughed and laughed and...

ttf_robcat2075 · Post by **ttf_robcat2075** » Mon Mar 20, 2017 8:14 pm

Quote from: gregs70 on Mar 20, 2017, 07:53PMHad them many times, but not in at least five years. One doc said have a beer before bedtime and I won't get woken up again in the middle of the night feeling like a knife was in my kidney.

You still have to get up in the middle of the night, though.

ttf_Stewbones43 · Post by **ttf_Stewbones43** » Tue Mar 21, 2017 2:19 am

I seem to get an attack about every 10 years-first one was 1976 and had one just before Christmas.

I had a stone analysed one time and it turned out to be mostly calcium oxalate so I've cut out chalk and rhubarb leaves from my diet

. Then found out that it could be caused by a couple of essentials, chocolate and nuts

Getting older is a bummer.

Sympathy and good luck

Stewbones

ttf_harrison.t.reed · Post by **ttf_harrison.t.reed** » Tue Mar 21, 2017 5:10 am

Do you guys drink soda at all?

ttf_BillO · Post by **ttf_BillO** » Tue Mar 21, 2017 6:36 am

Quote from: harrison.t.reed on Mar 21, 2017, 05:10AMDo you guys drink soda at all?
Not me, I have never liked it. Why?

ttf_harrison.t.reed · Post by **ttf_harrison.t.reed** » Tue Mar 21, 2017 6:47 am

It's a

known cause of stones. Kidney stones are a symptom of a bigger problem, sometimes it's hydration and sometimes its diet or any number of things. Everyone I know who suffers from this problem drinks diet soda like crazy.

ttf_BillO · Post by **ttf_BillO** » Tue Mar 21, 2017 7:30 am

Ahh, ok. Yeah, calcium oxalate stones are caused by solubility issues with the urine. Soda can adversely effect the ability of the urine to keep minerals dissolved. The uric acid stones (my problem) can be caused by lack of fluids, just making the concentration of uric acid in the urine so high it crystallizes out. Another issue (mine) is the body's s ability to process purines.

Purines are an essential building block of DNA and are found in the nucleolus of all living cells. About the same amount is found in any given cell, no matter what it's size. So a diet high in organ meats, some fish, yeast, mushrooms and certain beans and vegetables (all with small compact cells) can exacerbate the problem.

Eggs are great. They have only one cell nucleus and are very, very low in purines yet high in protein.

Betcha that was more than you wanted to know? When you've had the problems I've had (first stared having gout at the age of 12) and been to as many doctors to get the problem diagnosed and treated, you inadvertently learn some stuff.

ttf_nhtrombone · Post by **ttf_nhtrombone** » Tue Mar 21, 2017 6:12 pm

I had one just about a year ago now. Played a big band gig that Friday night and woke up at 2am Saturday in excruciating pain. Drove myself to the ER and they put me on morphine. DIDN'T TOUCH IT! Then they hung a bag of todorol (?) which took the edge off. I was prescribed percocet but after 2 days of that, I switched myself to ibuprofen because I was NOT enjoying the binding side effect of the percocet. Mine was 1/4 the size of timothy42B's and after it passed, my body went into shock. I can't imagine a 4mm stone! Ouch! I still have 2 kicking around in my kidney that could stay there forever or just decide to move when they feel like it. I have a low citrate count so I'm on potassium citrate to help boost it. Have to go back to the doc soon and see how it's doing.

Interesting that soda was brought up. I drink a lot. However, I'm also not great about my sodium intake.

I've had female friends who have given birth and had kidney stones and have said the kidney stone pain was worse than childbirth!

ttf_gregs70 · Post by **ttf_gregs70** » Tue Mar 21, 2017 6:31 pm

Quote from: robcat2075 on Mar 20, 2017, 08:14PMYou still have to get up in the middle of the night, though.

True dat!

ttf_timothy42b · Post by **ttf_timothy42b** » Tue Mar 21, 2017 7:22 pm

I called my GP and told him the Oxy wasn't touching the pain; he prescribed Vicodin. Turns out they're roughly the same strength. Ah well. I see him tomorrow and will try to get a plan.

This morning the pain was so extreme I went to the ER again, thinking I might get some pain meds. Wrong! I was so bad when I got there I was unable to sit in a chair, I just lay on the ER floor panting and throwing up. A couple hours later they got me into an exam room, and by that time the pain was easing up. Funny thing, Saturday night at an essentially inner city hospital ER I was seen right away, same place Tuesday morning they put us in the hallway to wait, no exam rooms available.

The ER doc was pretty sharp, though, and I asked her if I could increase the dose of the pills since they weren't touching the pain. No, the narcotic part won't hurt me, but they put enough tylenol in them to fry my liver.

I drink soda but I'm not extreme, usually one can midmorning.

ttf_robcat2075 · Post by **ttf_robcat2075** » Tue Mar 21, 2017 8:11 pm

Whatever happened to that ultrasonic hydro gizmo that they were zapping kidney stones with a few years ago?

Is that not a thing anymore?

ttf_dershem · Post by **ttf_dershem** » Tue Mar 21, 2017 8:16 pm

I had one in August on the way to a gig! They gave my prescriptions for Tylenol 800 and oxycodone and floquil, and my shrink (who has had several) told me to drink lots of lemon juice, as the acid in it cancels the alkaline that creates the stones. It worked, and now I am MUCH more careful to stay hydrated. Didn't take the Oxy, as I had a bad reaction to that in 2014, but the tylenol made it survivable.
And I made it to the gig (zoned out on Dilaudid) and was able to play, but was glad I didn't have any solos or features.

ttf_timothy42b · Post by **ttf_timothy42b** » Wed Mar 22, 2017 6:24 am

Quote from: robcat2075 on Mar 21, 2017, 08:11PMWhatever happened to that ultrasonic hydro gizmo that they were zapping kidney stones with a few years ago?

Is that not a thing anymore?

Yes, lithotripsy. It's a standard treatment for a big stone. Conventional wisdom is stones smaller than 5.5 mm can be passed, larger ones require intervention.

Mine in 2003 was a big one, but the doctors said it was too far down for lithotripsy to work. It's no win with a big stone. Lithotripsy breaks it up into a number of razor sharp shards that hurt on the way out. Passing a big one hurts on the way out.

I really played bad warming up yesterday but tried to get through some maintenance. Today I was in mild pain and could pay more attention. The flank pain was causing "guarding" in my abdomen, which prevented a full breath, or even a partial relaxed breath. I did a little better by paying attention to that.

ttf_timothy42b · Post by **ttf_timothy42b** » Mon Mar 27, 2017 12:17 pm

I saw the specialist today. The stone is not moving and the longer it sits the more chance of damage, so I'm scheduled for lithotripsy Thursday.

Or, it could pass between now and then. But he doesn't think so.

ttf_BGuttman · Post by **ttf_BGuttman** » Mon Mar 27, 2017 12:29 pm

Good luck, Tim. Hope it all works out for the best.

ttf_eightyeightH · Post by **ttf_eightyeightH** » Mon Mar 27, 2017 2:46 pm

Opiates are hopeless for the pain of ureteric colic. NSAIDs are what works. Ketoprofen, diclofenac are the traditional ones ; naproxen probably works but takes a while to get going.

That's the UK advice.

https://cks.nice.org.uk/renal-or-ureteric-colic-acute#!scenario

ttf_timothy42b · Post by **ttf_timothy42b** » Fri Mar 31, 2017 7:25 am

I went in for my lithotripsy yesterday.

I'd been told it wasn't a big deal, you aren't totally out but they give you enough IV meds to keep you happy.

Turns out it's a little more invasive than that. There's the pre-op, no eating or drinking after midnight, the IV insertion (student nurse could NOT get it in that vein, and I have good ones; finally needed help from the instructor). The hospital is cold but the litho room is 50 F, seriously, and you have to crawl into this hammock sling thing with bars poking you and your neck cranked. Still, it's all survivable and much more pleasant than having the stones.

Except it didn't work. The stone had moved to where they couldn't focus on it, and they sent me home untreated. Kept my co-pay though. It's possible it passed, but I had pain this morning so probably not. I bought some good beer last night, hoping for some progress this weekend.

ttf_robcat2075 · Post by **ttf_robcat2075** » Fri Mar 31, 2017 8:05 am

That's disappointing! They should have zapped you sooner.

I have an indelicate question... how do you urinate if there is a large stone blocking your urinary passageway?

ttf_timothy42b · Post by **ttf_timothy42b** » Fri Mar 31, 2017 8:29 am

Quote from: robcat2075 on Mar 31, 2017, 08:05AMThat's disappointing! They should have zapped you sooner.

I have an indelicate question... how do you urinate if there is a large stone blocking your urinary passageway?

Here is the map of anatomy.

First, kidney. then, long thin twisty tube called ureter connects kidney to bladder. Then, urinary passageway connects bladder, to, well, delivery system.

My stone is in the ureter. It hasn't made it to the passageway. There are two ureters so even if one is completely blocked by a stone the other still flows liquid. But that's dangerous for the kidney that's backing up.

If the stone makes it to the bladder (now I'm going to tell you WAY more than you want to know) they can reach in with a claw and grab it. That is the preferred method, per my urologist.

ttf_robcat2075 · Post by **ttf_robcat2075** » Fri Mar 31, 2017 8:40 am

Someday there will be nanobots to do that stuff.

ttf_hassein · Post by **ttf_hassein** » Fri Mar 31, 2017 9:34 pm

Or, you could look into why stones form in the first place-Magnesium deficiency.

ttf_timothy42b · Post by **ttf_timothy42b** » Sat Apr 01, 2017 9:57 am

Quote from: hassein on Mar 31, 2017, 09:34PMOr, you could look into why stones form in the first place-Magnesium deficiency.

Good thought, but I eat a lot of nuts, it's my preferred snack.

Well, my preferred snack is chocolate, but I stay away from it most of the time.

There are four different kinds of kidney stones, and they all have different chemistries.

ttf_robcat2075 · Post by **ttf_robcat2075** » Mon Apr 03, 2017 2:23 pm

Quote from: timothy42b on Apr 01, 2017, 09:57AM

There are four different kinds of kidney stones, and they all have different chemistries.

Do you have to wait until one comes out to know which?

ttf_eightyeightH · Post by **ttf_eightyeightH** » Fri Apr 07, 2017 1:16 am

Quote from: robcat2075 on Apr 03, 2017, 02:23PMDo you have to wait until one comes out to know which?

If you want a definitive answer, yes. XR/CT/MRI can give a pretty good idea, but catching one and analysing it is better.

ttf_timothy42b · Post by **ttf_timothy42b** » Fri Apr 07, 2017 6:04 am

Quote from: eightyeightH on Apr 07, 2017, 01:16AMIf you want a definitive answer, yes. XR/CT/MRI can give a pretty good idea, but catching one and analysing it is better.

The specialist did an xray. He told me a uric acid stone will not show, you need CT for that, but calcium stones show on the xray.

He took one look and said calcium immediately. To him it was obvious. I'd looked at the xray and saw what I thought was the stone but it wasn't the same smudge he identified. <g>

ttf_BGuttman · Post by **ttf_BGuttman** » Fri Apr 07, 2017 6:44 am

Even a 4 mm stone is pretty small to see. Especially in a full torso X-ray. But with modern technology you get digital X-rays and they can zoom in the image.

If they still have it, the Smithsonian Museum of American History had an exhibit called "America's Attic" and one of the odds and ends shown was a collection of kidney stones. Most of them were pretty big; must have been extracted from cadavers. I couldn't imagine pissing something like that out.

ttf_BGuttman · Post by **ttf_BGuttman** » Fri Apr 07, 2017 6:44 am

Even a 4 mm stone is pretty small to see. Especially in a full torso X-ray. But with modern technology you get digital X-rays and they can zoom in the image.

If they still have it, the Smithsonian Museum of American History had an exhibit called "America's Attic" and one of the odds and ends shown was a collection of kidney stones. Most of them were pretty big; must have been extracted from cadavers. I couldn't imagine pissing something like that out.