Saturday, July 6, 2019

Catching Up

While reading older blog posts, it dawned on me that it's been nearly a year since I posted anything here and that was just about my kidney stones. So, let me get anyone who might still be interested in what's going on with me up to date.

About the kidney stones...I saw an amazing doctor who informed me of all the things that had been going on. First off, the surgery that had resulted in my being hospitalized had been unsuccessful. The first surgeon had been unable to get the scope high enough in my ureter to retrieve the fragments. Turns out, I had something called a stricture, which is a narrowing of the ureter and this is why he had been unable to advance the scope far enough. He had simply put in a stent and handed me off to this other doctor. Strictures are a pretty common side effect of kidney stones. What actually happened to me has a name---it's called "steinstrasse" (German for "street of stones") and it's where broken stone fragments line up behind each other and block the ureter. This is why my pain was so bad. The ureters are delicate structures and always working to move anything in them out. Experts believe that the pain response from a blocked ureter is the most extreme pain response the body can tolerate. Things like child birth, gunshot wounds and traumatic injuries are bad to be sure, but they believe that because the ureters are so delicate, the pain response is more acute. 

This doctor showed me my CT and the KUB films that had been taken. My entire left kidney was white there were so many stones. All of them were too large to pass by themselves. He said "I can't get you on the schedule for surgery this week, but next Wednesday, you're having surgery." In his office, Wednesday was surgery day and as I was seeing him on a Monday, I had nine days to wait it out. He told me to call him for anything I might need, whether it was more pain meds or if my pain got worse. I asked him why hadn't the people in the ER given me anything when I was initially diagnosed and he said "Those people aren't urologists. They tell you that nothing is being blocked so you shouldn't have pain. They would just about rather die than give a patient pain meds." I told him how I had felt crazy because I was having both pain and nausea and I was told I shouldn't be having either. It effected my work. He told me to sit tight and he would take care of me. He was the only one who had taken my pain seriously. He told me to rest up for surgery and drink lots of water, which I was doing anyway. What else could I do? 

On Wednesday, the 27th of September, my amazing and awesome cousin again agreed to drive me to the hospital. An hour before I was scheduled, the hospital called me and said they had had to cancel my surgery for that day because the laser they intended to use wasn't going to be available that day. Apparently, because those lasers are so expensive, Peoria only has one and both hospitals share it. My cousin, who lives in Pekin, was almost to my apartment when I called her and told her that my surgery had had to be cancelled. She asked if I wanted to have some breakfast. Well, heck yeah, I was starving. So she took me out to breakfast. They rescheduled me for six AM the next morning. My cousin and I had a lovely breakfast at Cracker Barrel and looked over some Christmas ornaments. The next morning, she was there at 5:00. I was scared and I told her so. We prayed in the car before going in. I got registered and then they took me back to prep me. I was given a gown, slippers and a shower cap to put on. Then the nurse came in and started my IV. The anesthesiologist came in to talk to me as well and to ask me some questions, particularly about my heart stent. The doctor came in after that and told me that all systems were go and that I was going to be rid of these stones. He later told me he had removed 21 stones from me. Some had been in the upper pole and some were in the mid-pole. A few were still stuck in the ureter, despite the stent. And a couple were in the pelvis, the meaty part of the kidney. They were just all over the place. He seemed confident he had gotten all of them, but he stopped short of proclaiming me stone free.

 This is what he was up against--a big ball of stones and fragments all bundled together at the proximal end of my left ureter. Yes, that red stuff is blood. The big blue thing is the stent from my previous unsuccessful surgery.

I had the surgery on Thursday, by Saturday I was starting to feel close to normal. I did the grocery shopping and stopped in to tell my boss that I had had my surgery and was just waiting on a follow up visit to let me know when I would be cleared to return to work. I returned the following Tuesday. Because the stent was still in place and caused irritation, I was put on short shifts for a while. It felt so good to go to work and to feel normal and useful again. Of course, it couldn't last. 

The following Friday, I had the stent removed. Let me just tell you a bit about that procedure. For one thing, it's a good thing I'm not that modest. A nurse I was becoming fond of took me into the Procedure Room and told me to undress from the waste down. She left me alone while I did this. She gave me a sheet to put over myself. Then, when she returned, she had me lie down and open my legs "like a butterfly spreads its wings". She numbed my urethra with some Lidocaine (I assumed) and then we waited for the doctor to come in. Other than the topical, you get no anesthetic with this procedure. The doctor came in, gloved and gowned, and produced a cystoscope, a small flexible scope for looking in the bladder. My stent was something called a "JJ stent" or a "pigtail stent", which meant it had little curls at both ends to keep it in place (thought they have been known to shift or fall out completely). On the end that's in the bladder, there's a string attached to it which allows the doctor to grab the string and pull the stent out. I could watch the whole thing on a monitor right next to me. A lot of people on Youtube said that this procedure doesn't hurt. I want to know what they have been smoking. It hurt for sure. But it only lasted a few seconds. But a stinging or burning sensation followed the removal. It wasn't that bad. I went back to work and felt that this was all behind me now, except for a kidney function test he wanted me to have.

The following Monday, I made pot pies for dinner and went to bed early. I wasn't due in to work until 11:30, but I was tired. At 2:30 in the morning, I awoke in extreme pain. Once you have this kind of pain, you never forget it. Since it was the middle of the night, I opted to take an ambulance to the hospital. A CT scan confirmed a 5 mm stone at the UPJ (uretalpelvic junction). I was in tears. I had just had surgery less than three weeks previously. Surely, I could not have made a stone that large in such a short amount of time? They told me to see my surgeon for follow up and gave me papers to give to my boss. I was still in tears when I took the papers in to him. I apologized profusely for the inconvenience, but my boss said not to worry about it. Later that day, I saw my surgeon and he confirmed that he had more than likely missed a fragment. He told me the debris field where he had blasted all those stones had been pretty large and missing one is common. "You're having surgery tomorrow." He complimented me on my good attitude. "I'm determined to make lemonade" I told him. 

So the next morning, my wonderful friend and sister in Christ took me to have yet another surgery (my fourth). It was quick and straightforward. The fragment was easily spotted now that the debris field had cleared (meaning I had peed out the sand-sized remnants).

They gave me two cups of grape juice in the recovery room, which I quickly vomited. I had drunk them too fast, apparently but I was dying of thirst and it tasted so good. I went in on the following Wednesday and had the stent removed. I've been problem free since then. I drink mostly only water now, with the occasional soda. I'm working now on getting some of this excess weight off.

On the scene front, things are getting a bit interesting. I have had a couple of very enjoyable play dates, one of which was with a man I had been wanting to meet for years. This stems not only from our love of spanking, but our mutual enjoyment of rectal temperatures. I like getting them and he likes giving them. We had a very nice time. I also have a few other fairly local tops interested in meeting me. It strikes me strange that this happened as soon as I left the party scene. It could be a coincidence or maybe not. Whatever the case, I'm determined to once again make lemonade. Stay tuned.