By Pete Williams
Some women describe the pain of kidney stones as worse than childbirth. If that’s the case, I have an even greater appreciation for the labor process.
I rang in the New Year with the worst pain of my life. Shrieking, cursing, I-want-my-mommy pain that made my appendectomy pain from a decade ago feel like a mild tummy ache.
More than 500,000 people annually visit the ER with kidney stones and this year I became one of the first.
Sitting in the ER begging for pain relief, I literally screamed for my mother, a nurse who had died 20 years ago to the day (at 51). Mom was a health nut, and even though I won’t die of ovarian cancer, I’ve always followed her lead when it comes to diet and exercise.
Kidney stone? I don’t drink coffee, soda, or tea. I drink only water, except for a sprinkle of skim milk on my oatmeal and an occasional glass of wine. I’m a triathlete, the co-author of fitness books and a guy who catches grief from my Sunday morning cycling group for ordering egg whites and dry wheat toast. I rarely eat red meat, consume little dairy, and get accused by friends and family of taking my nutrition way too seriously.
There were warning signs. A week before Christmas, I felt flank pain for several nights in a row. Friends who have endured stones told me to drink more water and lemonade. I did and figured I passed the sucker. After all, more than 80 percent of stones pass on their own.
Instead, a CT scan revealed a stone nearly 1cm in diameter, too big to pass. Because my right kidney was swollen and inflamed, a urologist put me under and installed a stent, a straw-like device that goes from the bladder to the kidney, stretching the ureter in the hopes of letting the stone pass, or at least allowing me to take a leak relatively (relatively) pain free.
For the next 10 days, I lived with a stent. The doctor laid out the two popular ways to deal with big kidney stones. The first is non-invasive. Shock waves are used to break up the stone and hopefully you pass the pieces. My stone was too big for that.
That left ureteroscopy. With the patient under anesthesia, the urologist sticks a long, narrow device through the urethra, bladder, and ureter and takes aim at the stone. He lasers that bad boy and the pieces go flying. (The video is pretty cool.) Some remnants he’s able to extract with the laser but the rest, mostly dust, you pass easily.
At least that’s the theory. I woke up four hours later and struggled to take a leak. A nurse pulled out a device from the Bones McCoy collection and scanned my bladder – 500 ccs. Not good. The urologist said that if I wanted to go home, he’d need to install a catheter.
My wife had gone to pick up the kids from school and I pondered my options with Dad, who in a weird way had appreciated the distraction 10 days earlier of not having to think of the 20th anniversary of my mom’s passing.
I nodded at Dad and stood, my backside exposed. Dad handed over the plastic “urinal” bottle. Now I had always thought the term “pissing razor blades” was an exaggeration. It’s not. I screamed and cursed as 400 ccs of crimson filled the bottle.
An hour later, I headed home, again with a stent inside me. This time, the stent hung out of me via what looked like high-test fishing line. The idea was that I’d return to the doctor in a week and he’d yank the stent right out, assuming the X-rays were clear.
The string was knotted in two places and tied underneath me. I didn’t consider this engineering until I woke up screaming in the middle of the night, no doubt after an enjoyable dream. I had raised the mast, forcing the string and the knot to move until it couldn’t go any further.
For the next week, I cleansed myself of impure thoughts and wondered why we don’t rig stents to sex offenders. This strategy didn’t work at night, however, and I never slept more than 90 minutes at a clip.
My doctor was off on Monday, Martin Luther King Day, but agreed to let me see one of his partners in the interest of getting the stent out a day early.
As I approached the medical building – Day 17 since the ER visit – I looked forward to ending the ordeal. Free at last, indeed.
I looked terrible as I posed for another X-ray, which I took upstairs to the urologist. At some point, I stopped shaving and assumed a uniform of sweat pants and ball caps. The nurses eyed me suspiciously, but my pinch-hit urologist had a puzzled expression on his face as he looked at the X-ray.
“Is something wrong?” I asked.
He checked the date on the X-ray, which still showed the stone. “Maybe they re-printed the one taken before the procedure,” he said.
My eyes widened as he called radiology, which confirmed the worst. The X-ray was accurate.
I’m not proud of what happened next. Seventeen days of pain, frustration, sleep deprivation, and fighting off arousal boiled to the surface and I went HBO, dropping more per-minute f-bombs than Rex Ryan and Bruce Boudreau. I’m pretty sure I used the phrase “miss the target?”
To get me out of the office, the doctor sent me back to radiology for another X-ray, which was not needed and not taken. But that bought enough time for my actual doctor to arrive. His surprise appearance disarmed me and he quickly talked me down.
We compared X-rays. The stone was smaller, but still there. It likely was two smaller particles, each 3-4 mm. He could pull the stent and hope I passed them.
“Or you could be back in the ER tonight cursing my name,” he said.
Another ureteroscopy, which would have to wait three days since I had been off antibiotics for several days. This time, no lasering was needed. The doctor simply grabbed the particles with the scope. When I woke from my third anesthesia of the month, I was thrilled to not feel – or see – a stent. Best of all, some preemptive medication kept me from passing razor blades again.
The doctor recommended I stay the night as a precaution and, naturally, I shared a room with a poor old guy who screamed all night. So I continued my month-long process of making up 2010 reading. (Thanks to Bill Madden, Dirk Hayhurst, Tim Dorsey, and Maureen McCormick for getting me through the month!)
I also read No More Kidney Stones, the definitive book on preventing reoccurrence. About 50 percent of kidney stone sufferers have another one within five years.
By now, I was ready to give up any food to avoid a sequel. It’s not that easy since just about everything is linked to kidney stones, including many foods that appear in any healthy diet. In fact, much of my diet is on the bad list.
I had not worked out in three weeks, dropping seven pounds, but felt flabby and bloated.
As I left the hospital on Friday – Day 21 – I felt relieved but confused.
What could I eat now?