Thursday, 8 October 2009

The munted kidney

Monday, 3.10pm. I lie on a wheeled hospital bed in the Emergency Observation Area at Christchurch Hospital, the same bed I've lain on since arriving at the hospital shortly after 9am, waiting to be taken up for a CT scan. To my left is Mrs Fool, a Murakami Haruki paperback in her hand. To my right is a male nurse clutching a diagram of my urinary tract which he's just sketched on a notepad.

"It won’t be confirmed until we get the results of the CT scan, but nine times out of ten we can tell from the patient's description whether or not it's a kidney stone. The level of pain is a good indicator. They say it's enough to make a grown man cry."

"That it is," I say. "That it is"

The nurse closes the notepad and gets up to leave.

"Actually, do you mind if I keep that diagram?" I ask. "I know suckers who're prepared to pay good money for that kind of thing."


Monday, 6.50am. I awake and immediately become aware of a pain in my lower right abdomen. Is it the groin? Nope, the pain is too high and I can move my leg about without any trouble. I lie still for a while, hoping it will go away, but it doesn't. Moving slowly, I roll out of bed and put on my slippers and dressing gown. I feel a bit unsteady on my feet and slightly nauseous. I make it to the toilet but on the way back decide I'm in no fit state to make breakfast let alone work, so decide to head straight back to bed. The pain worsens. One of the cats jumps on to the bed and snuggles up to my head, intent on getting under the blankets. I appreciate the show of affection but my mind is on other things. Actually, it's on one thing: the pain in my abdomen.

I can't lie still, so I get up and shuffle to the bathroom. I take a Nurofen. Something tells me one won't be enough, so I take another. I walk around, try sitting down, but the pain persists. By this time Mrs Fool is worried. She follows me back to the bedroom, where I crumple onto my knees next to the bed, bury my head in my hands and in the bedclothes and start to sob. It isn't so much the pain, but the despair.

I need help. I ring my GP. The earliest he can see me is 11.15am. It's still only 8.40am. I confirm the appointment, but soon realize I won't be able to wait that long. We decide to go to A&E. As Mrs Fool gets ready, I dress and gather together a few items in case I end up being admitted. I'm able to send a brief email to a client telling them I won't be able to work today. In the car on the way to the hospital the pain worsens, and I sit clutching the handgrip above the door with both hands, moaning.

Mrs Fool drops me off at the entrance to A&E and I check in at reception while she goes to find a car park. She soon returns and together we wait to be called through to be seen by a doctor. There are about a dozen other people in the waiting area. None of them looks as bad off as me. Couldn't I go in first? It's too painful to sit. I'm most comfortable leaning over with my hands on the back of a chair.

Eventually we're called through and I'm asked to lie down in a cubicle. A doctor comes in, and after listening to my account of the morning's events and prodding my stomach, she says she thinks I have a kidney stone. A CT scan will confirm this, but first I need to provide a urine sample. Having just been to the toilet an hour or so ago, I'm unable to comply. Meanwhile I've hooked up to an intravenous drip and given several glasses of water. I've already been given paracetamol and codeine for the pain, but I'm still shaking rather badly and so I'm given morphine. A blood sample is taken. Some time later I manage to produce a small urine sample and the presence of blood in the urine backs up the initial diagnosis.

It's passed midday. I'm booked in for a CT scan at 3.15pm and taken through to the Emergency Observation Area. By this stage the pain has subsided. Mrs Fool, who'd gone home to get some lunch, returns with my iPod and a book but I don’t feel like listening to music or reading. I lie and wait.


Monday, 3.15pm. An orderly arrives to wheel me upstairs for my CT scan. While I'm there, I also have an x-ray. I'm wheeled down again, but I end up back at the cubicle in A&E instead of in the Emergency Observation Area where Mrs Fool is waiting. We're soon reunited. Half an hour or so later a urologist comes to give me the results. I have a 3mm stone near the end of my ureter (the tube connecting the kidney to the bladder), "high grade obstruction" and developing urinoma (an accumulation of urine around the kidney). As the chances of kidney infection are quite high in people with this latter condition, I'm admitted overnight for observation.

In bed up in the ward, I have a bite to eat then listen to music and read until I feel tired enough to sleep. I go to brush my teeth using the disposable toothbrush Mrs Fool thoughtfully brought along with the book and iPod, but when I rip open the plastic wrapping I find not a toothbrush but a hairbrush. I show it to the nurses when I go to borrow a real toothbrush, and they all have a good laugh.

I manage to sleep well until around midnight, when the pain returns. I'm given some more paracetamol and codeine, and a drug called doxazosin to assist the passage of the stone through to my bladder. I sleep on and off until breakfast time. I eat the cornflakes and fruit, but leave the cold toast.

At around 8.30am the urologist returns (with half a dozen members of her "team") and after a quick examination declares that I'm infection-free and free to go. It takes another hour for the paperwork to be done. Mrs Fool meets me at the main entrance to the hospital at 10am, by which time I've picked up my prescription, including a three-month supply of doxazosin.


Thursday, 2.00pm. I'm feeling remarkably well. I'm in a bit of discomfort, but I have very little pain, and I'm back to work. I'm still taking some pain medication, but more as a precautionary measure. I haven't touched the codeine they gave me. According to the discharge summary that arrived in the mail yesterday, "there is an estimated 85-90% chance this small stone will be passed spontaneously". No one has actually explained to me what will happen if it doesn't pass "spontaneously", although this post from Russell Brown's blog offers a few hints. Oh, and feel free to send in bids for the drawing.


A secret admirer said...

I'll give you $50 for the drawing.

Anonymous said...

I'll give you 5 ngultrum for the stone.

Walking fool said...

So, how many yaks can I buy with 5 ngultrum?