RE: UPDATE RE: Light at the end of the tunnel (Full Version)

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kalikshama -> RE: UPDATE RE: Light at the end of the tunnel (7/5/2012 5:24:00 AM)

Sending best wishes...




LafayetteLady -> RE: UPDATE RE: Light at the end of the tunnel (7/5/2012 3:19:36 PM)

Thanks Kali (and everyone else who sent positive thoughts my way).

The stent came out today!  Kidney still feels a little painful, but I'm sure that's just because it has been through so much manipulation lately.  What it doesn't feel like is that there is a huge knife in my back, yippee!

We discussed my options today.  He realized that there was no way I could continue with the stent based on the last month which resulted in 8 visits to the ER.  After he took the stent out, it was time to get serious about options.  We talked about the shockwave therapy, and how it would likely be multiple treatments, and may not work at all.

Then I asked him about Percutaneous Nepfrostolithotomy.  For those unfamiliar, it is a more invasive procedure (although still considered minorly invasive), where a small incision is made in the back, a tube inserted and the stones are completely removed.  The doctor feels that in my case, with the anxiety and the rapid growth of the stones, that I'm a good candidate for this procedure.

What I like about it, is that while it involves an overnight stay, and a tube out of my back connected to a catheter bag on my leg, the stones will be completely gone.  Shock wave therapy can take multiple treatments, the pain of passing fragments for a couple of months and still may result in the need for the other procedure.

PCN is a one shot deal, the icky bag is there just for a short time, and I am back to my old self in a couple of weeks.

While I realize that many people prefer the least invasive route, I'm just one of those people who wants the quickest solution to the problem that will involve the least stress and pain.  So I have been told by my doctor that I had better not have any attacks in the next week, since he will be on vacation, lol, but I will get a call from his surgical coordinator to schedule the procedure.

For me, this is extremely good news, although I tend to grow stones so rapidly, who knows how long I will be able to be pain free, but at this point, even a couple of days without feeling like someone is stabbing me is a good thing.
Then I asked him about the more invasive procedure called











kiwisub12 -> RE: UPDATE RE: Light at the end of the tunnel (7/5/2012 7:20:32 PM)

You might ask your doc about drinking lemonade or crystal light lemonade. I work in a urology surgical center and my docs have been recommending a glass of lemonade a day.
There was a study presented in the British Journal of Urology that indicated that it decreases stone formation.

and as a previous poster stated - drink, drink , drink! We typically see more stones in summer because people don't increase fluid consumption with increased sweating......

and if there is anything you need to know about any of the surgeries - i do them every day, and may be able to help.




LafayetteLady -> RE: UPDATE RE: Light at the end of the tunnel (7/6/2012 7:24:34 AM)

kiwi,

I drink so much fluid, it's a wonder I don't float away, lol.  Really.  I do drink lemonade, although more usually water with lemon.  I was made aware of that study after my very first stone back in 2000.  I do the water with lemon because lemonade tends to be way too sweet for me.  Being diabetic, the sugar isn't all that great an idea either.  I did hear another interesting theory, although I haven't tried it.  Steamed watermelon (sounds horrible to me, lol).

It appears that I would be one of those people who doesn't respond to the lemonade terribly well.  The stones have been growing at a ridiculously rapid rate.  In March, there was one, in May, there were three, by mid June, there were eight.

To bring you up to date, and yes I welcome your advice, in fact you are the exact person besides my doctor best to answer my questions, the stone in my urethra (1cm) was removed this past Monday.  The stent that had been in place was removed because I am forming stones so quickly, within a month, that stent was causing more pain than the stones it was so corroded.  We do know the stones are calcium, which I guess is a plus.

Originally, we were going to go for the shockwave therapy.  While it is the least invasive, it is also the treatment that takes the longest, and wasn't guaranteed to work, possibly needing the PCN anyway.  My doctor agreed that I was likely a good candidate for the PCN, he just needs to confirm that with the radiologist, but sees no problem there.  Not thrilled about having a tube come out of my back, but my understanding is that it is a very short time (how long exactly?), and with PCN, in approximately two weeks, all stones will be completely gone, with no fragments traveling through the ureter, bladder and urethra causing more pain.  This to me, is the best option.  Only bad thing I can find with the procedure is the tube and catheter bag, but because it is coming from my back, I don't have to worry about it irritating my urethra.  I had bladder surgery in the past, and us bigger girls, that damn catheter just twists and turns and irritates the shit out of your urethra when you walk, lol.

I have already had the blood work done on my parathyroid to see if that may be the main cause of the problem, since I have a nodule on my thyroid and the thryoid has been checked but never the parathyroid.  Hopefully that will give us some answers.  I am due to do a 24 hour urine catch, but the urologist told me to wait until the stone issue is completely resolved (catch was ordered by the endocrinologist).

So at the moment, I am enjoying having almost no pain in my kidneys for the first time since September of last year, even though it is only going to last a couple of weeks before the next surgery.

So here are my questions:

1.  This tube that is going to come out of my back; how much care does it require and will I need help with that? 
2.  I'm kind of figuring showing with that is going to be off limits, will it be?

Obviously, the tube and catheter bag are my biggest concern, as help is a little limited.  My son has already been put on notice, but I do understand his reluctance about wanting to be helping with that part.  He's good with the helping me up, and doing stuff around the house, but the personal stuff?  Not so much.  This is not exactly the best time of year to have a urine bag strapped to my leg, but I guess for a few days, I can just avoid people, lol.

My doctor has given me an idea of what to expect, and I do trust him completely, but find that doctors tend to understate what to expect, lol.  So what am I really in for?  It won't change my mind and make me go back to shock wave treatment, but it will help me mentally prepare and let the doctor know how much valium/xanax he needs to prescribe for my anxiety attacks, ha ha.




LadyHibiscus -> RE: UPDATE RE: Light at the end of the tunnel (7/6/2012 8:57:46 AM)

I am really glad to hear that you are going the surgery route. I don't like to poison the well, but why put yourself through needless torture when you have such a severe issue?

Managing the bag will take some practice, but won't be that big a deal. You'll need some help due to the site, of course. No eyes in the back of your head~!

Best of luck with a fast recovery and good result!




LafayetteLady -> RE: UPDATE RE: Light at the end of the tunnel (7/6/2012 10:53:53 AM)

My view exactly.  Why go through months of treatment that still involves pain and aggravation when there is a way to do it that is quick and final.  And hopefully, by that time, the endocrinologist will have some kind of definitive diagnosis as to why they grow so rapidly and how to stop it by the time this is over.




kiwisub12 -> RE: UPDATE RE: Light at the end of the tunnel (7/6/2012 9:03:13 PM)

The tube going through your back into your kidney is usually put in the day before or the day of the surgery. The idea of the tube is to allow the surgeon to put a scope through the hole so he/she can laser the stone. Hopefully at the end of the procedure most if not all the stone will be gone.
After the surgery the tube is to allow the urine to drain from the kidney, since it is going to swell, and possibly occlude the ureter. You'll probably have a stent in as well, for a while.

Really you shouldn't have to do much with the bag other than empty it. It should have a dressing that he may or may not want you to change - and you would need help with that.

Don't completely put off the idea of lithotripsy - when it works , it really works well.





LafayetteLady -> RE: UPDATE RE: Light at the end of the tunnel (7/6/2012 10:03:24 PM)

Well, lithotripsy was done on the one in my ureter.  It isn't that I am discounting it, it is more that there are so many, it would take multiple treatments, and the doctor has advised me during that time, I would be suffering some "discomfort" (which for me is typically excruciating pain).  When we discussed the options, the PCN was the fastest and most guaranteed to get me stone free as quickly as possible with the least amount of pain for the shortest time.

Now if I could just learn to stop picking up my granddaughter, I might actually be able to go through a day or two without pain.  But I seem to be completely unable to stop myself from doing that.  We went to dinner tonight, and while waiting for a table, she ran off (she's 18 months) and I ran after her, picked her up and carried her back.  Then during dinner, since she was tired and cranky, I picked her up again, and took her for a little walk.  Now?  I'm paying the price, lol.  If she wasn't so damn cute....

I also had a nice chat with my son at dinner and told him that this really isn't an option for him to help, it is a necessity.  I reminded him the tube would be in my back, so he wouldn't need to be seeing mom's private parts, and I wouldn't even have him help empty the bag (although if he pisses me off, I might wait until he is asleep and empty it all over him, lol).  He is starting to get it.  I have a back up plan, but it's important to me that my son be the one there for me.




areallivehuman -> RE: UPDATE RE: Light at the end of the tunnel (7/7/2012 5:27:14 AM)

My mother recently had the nephrostomy / tube/bag procedure. it went relatively well. When they had finally figured out her problem, after 8 days in the hospital, they put the tube and bag in, and discharged her, until we could make arrangements at a larger hospital. The tube acts as a bypass, so if the stones are blocking the kidneys exit, the urine has some place to go. She had the bag in about two weeks total, while we waited for the appointment, met the new urologist, set up the date for the procedure. She could easily empty the bag herself. Usually needed to be done twice a day. There were some leakage issues when she slept that I never really figured out. I don't think the bag would keep you from every day activities, it's fairly small, and should be unnoticeable under a loose pair of pants. The stone breakup and removal was done through the tube, under general anesthesia, and the tube came out the next day, before she left the hospital.

I had the shock wave treatment on mine about 6 years ago. First a stent, after my visit to the emergency room. They could not remove the stone then, the urologist recommended the shock wave treatment. Shock wave treatment required either general anesthetic, or an epidural. I did not enjoy the general anesthetic when the stent was put in, so I chose the epidural, which involved Lidocaine injected into the spine. That went ok, after the momentary discomfort. However, I was one of the unlucky ones who suffer from bad reactions/side effects to the epidural. The stone (there was only one, 6mm), was broken up, never had another problem there. I did have pain in the kidney for over a year, just a dull ache during moderate exercise, nothing like the pain of a blocked ureter though.




LafayetteLady -> RE: UPDATE RE: Light at the end of the tunnel (7/7/2012 11:55:34 PM)

No offense, but what kind of backwoods hospital took 8 days to figure out your mother had kidney stones.  One simple CT scan gives that answer, and the radiologist is never taking 8 days to read it.  I won't be having a bag in for 2 weeks, and I won't be needing to find a more qualified hospital or urologist for the procedure, since I have great ones to start.  Hopefully, but the end of next week, I will have a date scheduled.

The bag does NOT act as a bypass should the stones be blocking the ureter, but rather is there so the kidney remains decompressed at all times.  Sorry, but whoever gave you your info, I'm terribly grateful they aren't my doctor, and if you are smart, you would never use them again.

As for the shock wave treatment, my stones are significantly larger than 6mm, and there are significantly more.  I personally made the decision to opt out of shockwave treatment because I don't have a small 6mm stone, but about eight large stones which would require multiple treatments, resulting in longer term pain and aggravation.  I don't do epidurals and my doctor (who is well respected and would NEVER put a patient through what the doctors did to your mother, which borders on malpractice) chose the treatment that is best for me. 

While I do appreciate you trying to be helpful, all you have done is point out to me how lucky I have to have qualified doctors taking care of me.




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