October 09 '99
Volume 175
Stone Saga It Came To Stay
Cats are believed to have nine lives,
In all my kidney stone experiences, prior to the one that made September memorable, the stones came, caused me great discomfort until the morphine put me to sleep, then the stones exited my system, and life became good again. The September Stone was different in that it failed to exit of its own free will. It was also different by hospitalizing me twice with severe pain as opposed to my having to be hospitalized only once with each of the prior three stones. Approximately two weeks after the onset of the September stone, I spent a workday in great distress with pain in my right kidney that was induced by pressure of a partially blocked ureter. I took two prescription pain pills, four hours apart, and kept going until my work project was done. I had driven less than thirty minutes on my drive of 165 miles back to Greenville, when the pain went away. Approximately 30 hours later, as I prepared to go to bed, the pain returned, but lasted less than two hours. For more than six months I had awaited the last week of September, anticipating a fishing trip off Chandelier Island in the Gulf of Mexico. Eleven other men and I were to spend three nights aboard a large boat and fish for three days in the shallow waters near the Gulf Island. However, during much of September, the thought of being in the middle of the Gulf and having a kidney stone attack hovered over me like a dark, ominous cloud. My doctor in Pontotoc, a general practitioner, had recommended a sonogram, following my pain that lasted all day, and had scheduled the procedure for Thursday morning, 9/24, in Pontotoc. He had hoped to have the results sometime Thursday but did not receive them until early Friday morning. When I spoke to him, he indicated the test was inconclusive and referred me to an urologist in Tupelo who would see me that same morning. The urologist's office was located in the East Tower of the North Mississippi Medical Center in Tupelo. I arrived there around 10:00 a.m. and by 11:00 a.m. was being readied to see the physician. Routine paperwork took about half my waiting time before being taken to the lab area. I found the urologist, Dr. Jonathan Kalish, to be pleasant, and, more importantly, he had a sense of humor. My theory is that proctologists and urologists must have a strong sense of humor or else they couldn't handle the routine chores in their line of work. After filling him in on my kidney stone ordeals he began his examination. I will spare you the details of the unpleasantries of that experience. (Actually, I am sparing myself, for such remembrances tend to create strong rectal contractions.) I will note that health professionals seem overly preoccupied with the age of the patient. Not only did I have to write down my age and date of birth on a form for the receptionists at the urologist's office, but had to verbalize the same to her and was asked my age by at least a half-dozen others prior to my leaving the building. The urologist, upon discovering my age as 57, expressed surprise that I was not in my forties, though upon further reflection I decided it was a ploy to win my trust or at the least to expose my vanity. He was the first physician I have ever had, who, when about to examine me exclaimed, "You look like you are in pretty good shape!" (Most, mutter something about my needing to lose some weight.) To which I replied, "I do my own yard work," and mentally noted he had already determined that I had no history of disease, was a non-smoker, and did not consume alcohol. After viewing my most recent set of x-ray films from Pontotoc, noting the recent kidney pain I had experienced, and upon discovering my sensitivity to pressure on certain areas of the abdomen, my urologist concurred with my personal diagnosis that the stone was still inside me. It was then, I agreed to a plan to remove the stone the following Monday, the date I had once reserved for a fishing vacation. I was disappointed not to be able to fish with friends as planned, but comforted myself with the knowledge that a healthy kidney was far more important to my well-being than a vacation. Following the doctor's examination, I spent another half-hour with a different "form lady," who, then directed me to second floor of the tower where more forms and indoctrination from the folks at Pre Admission Testing awaited. The "pre admission" people were a different experience. First, I was directed to sign-in using a form that lay on a low table instead of being placed on a comfortably positioned desk. The low table prompted me to ask the receptionist in the Pre Admission Testing department if they had very many midgets come through. She chuckled and responded, "I've never had anybody ask me that before," and she shared my attempt to be humorous with a co-worker who also laughed. Later, as the receptionist was extracting from me much of the same information that I had supplied to the urology people, I complained that the office was as cold as the one that I had just left. She acknowledged the room was pretty chilly, but cheerily assured me the operating room would be much colder. Once the receptionist had completed her paperwork, she handed the forms to me and ushered me down the hall where the Pre Admission Testing team awaited. I was directed to have a seat inside one of the private rooms and told someone would be with me in a moment. If memory serves me well, there were five somebodies who had their turn with me. I had the feeling I was on some type of medical assembly line. One nurse shared with me concerning the anesthetizing procedure, another quizzed me on my medical history, another took my blood pressure and temperature, another drew blood and checked my pulse, and another nurse gave some final instructions and released me. Once the determination was made to proceed along the path to remove the kidney stone rather than to pursue a fishing adventure off the Gulf Coast, some of the stress I had been experiencing was relieved. However, the weekend was spent in a state of quiet unrest. I would be facing a medical procedure that required me to undergo general anesthesia. The urologist would be using the catheter method to first make certain a stone was in fact present in my ureter, and some procedure to extract the stone would follow. There are folks who want to know every detail as to "how and what" is going to be surgically done to them, prior to the procedure. I am not such a person. I prefer to know as little about the procedure as is necessary for me to have a general understanding of what is to be done. Some friends asked me if the urologist was going to shatter the stone using shock waves, while others asked about laser surgery, and still others wanted to know if the stone would be captured by the basket method. I did not ask prior to the surgery and chose not to ask after the surgery, but I presume the basket method was employed, since a catheter was used. Suffice it to say, the procedure was an Ureteroscopy and instruments were sent up the urethra, through the bladder, and into the ureter to extract the stone. I was unable to tell friends when I would be scheduled for surgery, until after 4:00 p.m. Sunday. Apparently, the surgery teams have adopted the procedure used by Circuit Courts in calling in jurors. Jurors have to call after 5:00 p.m. to find out if they are to be in court the next day. Surgery patients must call between 4:00 p.m. and 5:00 p.m. on Sunday to learn the time they are to arrive at the Short Stay Surgery desk on Monday. The kidney pain in my back returned late Saturday night but relented shortly after bedtime. The pain resurfaced once more about the time I arrived at Church Sunday morning and lasted for several hours. Rev. Paul Sims was subbing for our Interim Pastor, and I hope he did not interpret my facial expressions as disagreement with his sermon. Needless to say, I was glad to see Monday morning arrive, and, before I arrived at the medical center for my 7:30 a.m. appointment, I was hurting again. Somehow, I was not expecting to have to wait to be assigned a temporary room, but I should have known better. Yet, by 8:00 a.m., I was in a room with a cloth door, and there I lay shivering in a hospital gown beneath a sheet and spread as I awaited final preparations for surgery. I remember being setup with an IV, and, after Barbara alerted the staff to my painful condition, I received an injection in the IV that gave me considerable relief, but rendered my speech sluggish. Shortly before 9:00 a.m., I was rolled into the even colder surgical room. Fortunately, I was not awake long after being transferred to the cold surgical table. I remember a nurse spreading a warm (heated) blanket across my chest that my body greatly welcomed. Another nurse placed an oxygen mask over my nose and mouth and told be to inhale normally. She explained the gas was oxygen and about a minute later the same nurse stated she was starting the anesthesia and asked me to breathe deeply. I counted two deep breaths before my lights went out. I awoke in recovery as a nurse called my name again and again as she patted my hand. I felt frustrated because I could not swallow. My mouth was dry, and I asked for water, only to be told that water would be available back in my room. My right shoulder was extremely sore, and I could not understand why I could not move into a position that made it feel more comfortable. I remember sitting upright and looking at the other folks who were also recovering from an operation. They looked dead, and, while I was not certain I was alive, I knew I wasn't dead. Back in my room, I continued to feel only half awake as I was told that the surgery was successful, and I could then dress and go home. My body was saying, "Wait a minute¾I need to be awake before I leave. What about the light nourishment mentioned on the fact sheet I had been given on Friday? I didn't eat breakfast, you know." Barbara began to help me get dressed and relayed the Doctor's report about the stone. "Dr. Kalish said your stone had a hook on it, and that's what kept you from passing it normally," she stated, then grinned and said, "I'll bet it's a fishhook." I remember telling her that I did not think her remark was funny, and, at the time, it would not have been funny, even if I had thought of it. We were back in our Pontotoc home shortly after noon. I slept most of the afternoon. Somehow, I managed to sleep most of the night away, but routine sleep was interrupted by frequent trips to the bathroom. There is something about the presence of a stent in one's urinary tract that contributes to the higher frequency of bladder voids. With each trip, I found it more and more difficult to get out of bed. The soreness in my right shoulder had worsened, and I discovered that all muscles from my knees to my nose were sore. On Tuesday, the soreness was overwhelming, and I wondered what could have caused so much muscular discomfort. My right biceps muscle was bruised, but I presumed that to be caused by the automatic blood pressure cuff that I had been fitted with during surgery. By mid-morning, I was taking pain pills to alleviate the soreness. I would not discover until Wednesday morning, when I revisited the urologist, the cause of my soreness. When Dr. Kalish asked me how I was doing, I told him I was extremely sore over most of my body. "Nobody told you about your recovery?" he questioned with a smile. "No, what happened?" I asked. "You were an ideal patient in surgery, but during recovery they said you became a wild man. In fact, they told me you came up swinging, and they had to restrain you. You even bit your tube into. I've never had a patient do that." When I asked what tube, he referred to the one placed in my mouth and down my throat during surgery. "Yeah, they had to use a hemostat to fish out the rest of it," he stated. "That's an interesting choice of words," I thought, then reflected on my recovery, all the while picturing myself as an older version of the Incredible Hulk, who, when provoked, transformed from a mild-mannered individual into a raging, beast-like hulk. "So, are you about ready to get rid of your stent?" he asked, and I responded affirmatively. I am pleased to report that the anticipated pain was at the worst, mild. In fact, I would not describe it as painful. It was my younger brother, James, who had forewarned me to be prepared for a painful event. Since all of us have differing thresholds for pain, perhaps my threshold is higher than is his. But, that may be the "big brother" in me talking. Because prostate cancer has occurred in my family, I took the doctor's advice and had some blood drawn, while in the office, in order to be tested for the possibility of a cancerous condition. It will be a while before I hear from that test as well as the tests to determine the chemical composition of the pea-sized kidney stone that was removed. I now have enough needle marks in my arms to arouse suspicion of my being a "user." As of this writing, 9/30, I feel fine except for some residual soreness in my neck and abdominal muscles. For the family record, I believe this kidney stone puts me even with other family members for the most number of stone attacks. If that is not the case, I am certain I shall be corrected in the near future. In closing out the saga of my last stone, I will note that doctors still seem divided over what actually causes the formation of stones inside individuals. Twenty-five years ago, I was warned against consuming any dairy products, since the first stone was of calcium composition. Now, I have been told to avoid caffeine. A listing of dietary recommendations to reduce one's risk of kidney stones includes:
However, unless kidney stones begin to plague me more frequently than every 8 to 12 years, I think I will listen to my own counsel and eat those foods that I enjoy, at least in moderation.
Bodock Beau Too High Tech For Me Beau found the following humorous story, concerning our technical age, quite amusing. Beau sends thanks to Malcolm Lindsey for contributing it. A guy walks into a bar, sits down, and after a few minutes, he starts dialing numbers, like on a telephone, but on the back of his hand. He then flips his hand over and starts talking into his palm. The bartender comes over and tells him that the bar's in a very tough neighborhood and that he doesn't need any trouble from weirdoes in his bar. The guy says, "You don't understand. I'm very high-tech. I had a phone installed in my hand because I was tired of carrying around the cellular." "Prove it!" demands the bartender. So the guy dials up a number and holds his hand up to the bartender's ear. The bartender talks into the guy's hand and carries on a brief conversation. "That's incredible," says the bartender. "I never would have believed it!" "Yeah!" said the guy. "I can keep in touch with my broker, wife, you name it. By the way, where's the men's room?" The bartender directs him to the men's room. The guy goes in, and 5, 10, 15, 20 minutes go by, and he doesn't return. Fearing the worst, given the violence in the neighborhood, the bartender goes into the men's room and finds the guy spread-eagled against the wall, his pants down around his knees and a roll of toilet paper between his buttocks. "Oh my God!" said the bartender. "Did the locals rob you?" The guy casually turns around and says, "No, I'm okay. I'm just waiting for a fax." Click for October Issues of RRN Copyright © 1998-99 RRN Online. 
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but I have a hunch they don't have kidney stones. Otherwise, they'd
petition God for fewer lives. In most cases, people who experience a kidney
stone do not
die¾ they
just wish themselves dead.