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Pain Relief - 6/1/2012 11:37:07 AM   
LafayetteLady


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I have been suffering from kidney stones since around September of last year.  It has gone on this long for a variety of reasons, but I'm finally on a path of having the situation resolved.

Anyway, after spending Wednesday in the ER due to yet another attack, it was discovered that there are 3 large stones (8mm, 9mm, and 1cm) causing a blockage.  The urologist (who I really didn't like anyway) wanted to put a stent in, however, the clinic where I had gone for treatment that would completely resolve the issue told me that if I had something like that done somewhere else, they would no longer be able to treat me.  So I had to refuse and discharge against medical advice, although they encouraged me to come back any time I felt I needed to.

Anyway, while there, as is the pretty standard protocol (at least with me), they injected 1mg of Dilaudid.  The problem is that because this has been ongoing for some time, I've developed a tolerance to the Dilaudid and it really doesn't work anymore.

So here's my question....who knows which pain killers might be more effective?  I have an appointment with the clinic next Friday, but I will no doubt not be able to wait that long before another trip to the ER.  The ER at the hospital where the clinic is is nearly an hour away, so there really isn't an ambulance that will take me there, although I'm hoping I will be able to get my local ER to transfer me.
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RE: Pain Relief - 6/1/2012 11:52:08 AM   
JstAnotherSub


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Morphine is a wonderful pain killer. It saved me during a gall bladder attack and an ovarian cyst that ruptured.

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RE: Pain Relief - 6/1/2012 12:12:59 PM   
LafayetteLady


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Thanks, but dilaudid is actually 6-8 times stronger than morphine.

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RE: Pain Relief - 6/1/2012 12:24:17 PM   
JstAnotherSub


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I have had both, and morphine did me a lot better. Maybe ask to try it? Or something different? You may just need something different to get results again.

Good luck. Pain sucks! At least that kind-lol.

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RE: Pain Relief - 6/1/2012 12:26:40 PM   
LafayetteLady


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That's a good point.  My tolerance is to the dilaudid, so morphine might offer some relief.

And yes, this kind of pain sucks.  Big time.  And it has just gotten progressively worse as time goes on.

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RE: Pain Relief - 6/1/2012 12:38:32 PM   
LafayetteLady


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Oh I forgot to message that because I am allergic to codeine, the stupid computer kicks back most of the narcotic pain killers and being incompatible with my allergy.

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RE: Pain Relief - 6/1/2012 3:56:17 PM   
kitkat105


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Is your kidney function being impaired by these blockages? Those are big, big stones. If you were at my hospital they would stent & lithotripsy (blast) them. Even then, you'd be peeing gravel for days.

I think while at home it would be worthwhile taking regular, 6 hourly tylenol (think 6am, 12nooon, 6pm, 12midnight). If you don't have any clotting issues, stomach ulcers or asthma, advil/motrin every 8 hours (8am, 4pm, midnight).

I don't see why they couldn't give you 2mg dilaudid. There is also the option of fentanyl (narcotic but not opiod based) injections. We sometimes give our urology patients indocid suppositories (antiinflammatories in suppository form) and they work quite well.

I hope you can get this sorted soon.


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RE: Pain Relief - 6/1/2012 5:06:24 PM   
LafayetteLady


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They wanted to put the stent in, but the lithotripsy is not done at the hospital, it would require finding a urologist and follow up.  Because my insurance wouldn't cover that, I have charity care at a teaching hospital that has a clinic.  They won't continue to treat me if I had the stent put in, so they wouldn't do the lithotripsy, which incidently isn't covered by their charity care either.  Quite a mess.

They didn't mention anything about kidney function, although there is hemonephrosis.  Since I did have kidney failure last year, I've been vigilant about watching for symptoms, none so far, thank God. 

I do not take tylenol and advil only when positively necessary.  Neither could even begin to touch this pain.

And yes, I am aware they are huge stones.  I knew about the one before I went in.  The two larger ones weren't there in March.

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RE: Pain Relief - 6/1/2012 6:54:36 PM   
kalikshama


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No advice, just


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RE: Pain Relief - 6/2/2012 12:58:46 AM   
LafayetteLady


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Hee, hee, thanks.  I actually have one of those, who does exactly that.  Both cats know I'm sick and they are following me all over the house.






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RE: Pain Relief - 6/2/2012 1:34:37 AM   
kitkat105


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<sigh> I'm so sorry you're having to deal with a complicated health system when you're already unwell & in pain. It's just not fair.

It may not be a bad idea to take tylenol & advil regularly... at least thats some form of simple analgesia in your system.

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RE: Pain Relief - 6/2/2012 1:57:27 AM   
LafayetteLady


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Thanks, but because of other health issues, they really just aren't a good idea.  At the moment, not doing anything (in the physical sense) seems to be keeping it to a dull ache.  It's when I decide something needs to be done, like the dishes or cooking dinner that the pain flairs up.  So I just let the dishes sit, lol.

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RE: Pain Relief - 6/2/2012 6:18:43 AM   
areallivehuman


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Can't really help with the painkillers, and I know first hand the pain from stones blocking flow. While you are waiting , you could try this: Mix 1 ounce (shot glass) of lemon juice with 1 ounce of extra virgin olive oil. Shake together well, drink, twice a day, for 10 days.

My mother just went through a 6 week stone episode, 2.5 cm, had to go in and physically break the stone up. The urologist did say that lemon or lime juice was good for softening the stones.

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RE: Pain Relief - 6/2/2012 9:22:27 AM   
LafayetteLady


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The citric acid in lemon juice can sometimes help to cause the stones to break up.  Been there, done that.  Although never with olive oil, and quite frankly that sounds pretty gross.  There is no need to use the olive oil, lemon juice in water, or just the lemon juice alone will work just the same.

Your mother's stone was beyond huge.  I do wonder why they waited six weeks to do anything.

As for my situation, in March, there was several small and one large (8mmx5mm) stone.  Come May and another CT scan and there are two others that have grown to large proportions.  That is really one of my main concerns, that two stones have grown so quickly in so short a time.

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RE: Pain Relief - 6/2/2012 4:44:21 PM   
lizi


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I react badly to painkillers, all of them. Had dilaudid for the first time in the hospital and they pretty much kept me there until it passed from my system because it did weird things in my system. Morphine was the only thing that worked decently for me and I could tolerate it. It's true what you're saying about morphine being less strong, but if you've built up a tolerance for dilaudid then even taking something less strong like morphine for a while can help, and then when your body's lost the tolerance to Dilaudid perhaps you can go back on it? I admit the morphine never took the pain away, it was still there but not as sharp. Hope things work out for you, sorry it's been so awful

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RE: Pain Relief - 6/2/2012 7:52:19 PM   
LafayetteLady


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Thanks Lizi,

The good news is that I finally heard back from the Pastor at my church, and he is making arrangements to get me to the ER at the hospital where the clinic is tomorrow, so hopefully this will be resolved very soon.

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RE: Pain Relief - 6/5/2012 4:24:26 PM   
angelikaJ


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quote:

ORIGINAL: LafayetteLady


Anyway, while there, as is the pretty standard protocol (at least with me), they injected 1mg of Dilaudid.  The problem is that because this has been ongoing for some time, I've developed a tolerance to the Dilaudid and it really doesn't work anymore.



I was in the ER and had an emergency hospital admit yesterday due to a gallbladder issue.
They gave me 2 mgs morphine, then 3 then 4.
After the last dose of morphine they gave me 2 mgs of Dilaudid.
It made me higher than a kite in less than 2 minutes.

So, I am not sure why they couldn't just go up on the dosage.

I hope you had good luck with the other ER and a good outcome there.



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RE: Pain Relief - 6/5/2012 7:13:49 PM   
LafayetteLady


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Actually, Sunday I never heard from anyone from the church to take me.  Talk about being pretty pissed off, lol. 

Anyway, about 3 in the afternoon, I started getting some serious nausea, vomiting, and chills.  I knew I had to take another shot with the local ER.  So I went there, and after dealing with yet another jerk of an ER doctor, the decision was made that I would be admitted to have the pain and nausea dealt with.

Then I got an extremely pleasant surprise.  This time when they called the on call urologist, instead of the complete asshole that I threw out of the room a few days before, the on call urologist was the doctor from the group that had handled all my other kidney stone issues prior to the change in my insurance!  He and his partner are probably two of the best physicians it has been my good fortune to have been treated by.

He came to see me the following morning, and even though he told me that I needed a stent put in (the same thing the asshole said), he answered all my questions about it (which the asshole refused to do).  I explained to him the situation with the other clinic, and his response was that if he had to call them personally to get that situation resolved, he would, and if not, he would treat me, and we would work something out for his costs.  He flatly stated, his only concern was making me better, and that my symptoms were accelerating and kidney damange was imminent if he didn't put the stent in right away.

At that moment, knowing that I was going to get top notch treatment from him (he is actually highly respected in the area as well), my anxiety went from a 20 to a 10 almost instantly.  We talked about how the dilaudid was not really working, and he said that because the situation had gotten so bad, that we needed to play "catch up" (not exactly what he said, but amounts to what he said) and changed the dosing of the dilaudid to 2mg, every two hours, and the surgery was scheduled for that evening.

So I spent the rest of the day getting the dilaudid every two hours along with a very small (.5) dose of Xanax to keep my anxiety controlled.  Needless to say, but the time they actually got me to the OR, I was no longer in so much pain (I don't think, lol), and was pretty well ensconced in happy land, lol.  In the ER, as is my habit I asked the anesthesiologist what he would be giving me.  When he told me propophol, I laughed and said, "oh, Michael Jackson drugs!"  Had to explain that one to him a couple times before he got it.  Also he gave me Fentanyl.  This was around 7pm.  I woke up at about 10:30 and I was still loopy beyond loopy, but had ZERO pain.  I went for a little walk around the floor (mainly to beg the nurses to feed me, since I hadn't eaten since 8am), and it was so nice to not have that pain.

Granted, by morning, I had pain again, because I don't do well with stents (had one twice before), but the pain is different.  Doc gave me a small script for oxycodone, which he said I really shouldn't need (but feel safer knowing it is there), and pyridium to ease the cramping and get me through to Friday when I have an appointment at the clinic.

So at this time, things are better painwise, then they have been since September of last year when this whole thing started.  The urologist and I had a long talk where he told me everything I need to insist on from the clinic and to keep them from doing a "treat and street" half ass job.  I know that lithotrypsy in my situation is NOT the right treatment, I know that it could likely take more than one surgery to remove the stones and what tests to ask them to do so we really know what is causing the stones and so can better prevent them.  Knowing that if the clinic fails miserably, I can still call on him for help is more comforting than imaginable.

Anyway, thanks everyone for your help, good wishes and suggestions.  Until the stent is out, I get to have that horrible UTI feeling, but the pyridium will control that pretty well.  But there is finally a light at the end of the tunnel to this whole kidney stone nightmare, thank God.

Oh, and luckily I don't have an addictive personality, so I was ok with them stopping the dilaudid this morning.  But I must admit, having a whole day being that out of it with no pain was very nice, and apparently, I'm quite funny when stoned out of my mind because when I'm talking to people, I drift off taking little trips in my head, then snap out of it and continue the conversation, but talk about my little head trip until I realize I'm talking about the wrong thing, lol.

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RE: Pain Relief - 6/8/2012 4:45:35 AM   
kalikshama


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Glad you found a good doctor! I had a similar experience with a doctor with better bedside manners being able to talk me into a procedure that a asshole could not.

All I know about kidney stones is that they are very, very painful - did/will the stent help you pass some? What happens at your appt Friday?

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RE: Pain Relief - 6/8/2012 6:26:25 AM   
kitkat105


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I'm so relieved you were able to get the stent put in and even better that it was by a urologist you have a rapport with.

So, are you still going to have the lithotripsy? Because surely even stented, you won't pass these stones.

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