No Kidney Stone Unturned

I have endured a hellish ordeal over the better part of a month. 

This ordeal began nearly four weeks ago on the morning of October 30th. It was a Monday morning, and I was preparing to start another week of work. 

Shortly after getting out the shower, I felt an intense pain on the left side of my back which would soon travel to my front left side. 

It was a kidney stone.

I am no stranger to kidney stones. Prior to this year, I have had three kidney stones - February 1998, September 2003 and July 2012. The first kidney stone occurred while I was living in Ottawa and other two occurred in Boston. 

But this kidney stone would prove to be a very different beast. 

After informing my manager that I would need to go to the emergency room, I managed to make my way to the T and took the Red Line to Massachusetts General Hospital (MGH). Given my previous experiences, I suspected that I would be filled with fluid, given some pain medication and would be released within a few hours and perhaps take a day or two off of work to rest and recuperate. The problem was the pain kept coming back and coming back and coming back. As a result, I was kept overnight for observation. 

Although both an ultrasound and a CAT scan revealed I had an 8 mm kidney stone, the team examining me thought this was a GI issue. Complicating matters was that I was irregular. Despite my irregularity and feeling a fair amount of pain, I was released from the hospital at about 5:30 p.m. on Halloween and was told there was no reason I couldn't go back to work tomorrow. I had a very strong feeling that I would soon be back to the ER.

Indeed, on the evening of November 1st, the pain was absolutely unbearable. I would return by cab for my second ER visit. This time around I was in the hospital for only three hours or so. Working on the premise that this was a GI issue, I was given some Magnesium Citrate which I was to take in concert with Miralax, Colcate and Senna. I would return home via the T at about 1 a.m. on November 2nd.

Things appeared to be looking up. The aforementioned cocktail helped with my regularity and my pain appeared to have subsided. At about 3 p.m. on November 2nd, I spoke with my landlady and was optimistic about returning to work the following day. An hour later, the pain had once again returned. My landlady seeing that I was in distress offered to drive me back to MGH for my third ER visit.

Still working on the premise this was a GI problem, I was prescribed Bentyl as well as some Lidocaine patches and another bottle of Magnesium Citrate. Once more I would return home at around 1 a.m. on the morning of November 3rd.

I would get another attack before dawn, but the Bentyl helped subside my pain. The rest of November 3rd would be uneventful. I was hopeful that I could rest for the weekend and resume work the following Monday. 

Alas, the relief would be short-lived. By the afternoon of November 4th, the pain was as bad as it had ever been. The Bentyl did not work this time around. Nor did the Lidocaine patches. I also noticed my pain would get aggravated after taking Tylenol. 

So I took yet another cab and along came my fourth ER visit. Unlike my three previous ER visits, the urology team was consulted. After taking yet another CAT scan, the urology team concluded it was in fact the kidney stone which was causing my aggravation and that it would likely require surgical intervention. But before making that determination, they decided to keep me for observation overnight once more. I ended up back in the same hospital room I had been in on October 30th and 31st, but this time in the other bed. 

There was a possibility that surgery would be done as soon as November 5th. However, this was determined not to be feasible. A lithotripsy, which is a procedure to blast out the kidney stone, would be undertaken on November 8th. But there were two catches. First, the procedure was to be done at MGH's day surgery center in Danvers which is about 25 miles north of Boston. Second, I would have to schedule the procedure myself as it was a Sunday, and their offices were closed. Until then, I would be discharged yet again on November 5th. 

So, on Monday morning (November 6th), I had to call the MGH Urology Department to schedule the procedure. I was flat out told that this could not happen without a consultation with a doctor in the Urology Department. Now I had scheduled such a consultation which would have been scheduled to take place on November 27th (tomorrow). However, I made it very clear that we were well beyond the consultation phase, that I had spoken extensively the members of the urology department who were present on the evening of November 4th and morning of November 5th and had already signed a surgical consent form. 

After pleading my case, I was of course proven correct. Surgery would proceed on the morning of November 8th at MGH Danvers by Dr. Dyer. But I had to be there at 6 a.m. This would mean I had would give to make my way to the North Shore on the evening of November 7th and seek overnight accommodations. I called upon my friend Don Hammontree and he and his wife agreed to let me stay at their home in nearby Salem overnight to facilitate this procedure. I have promised them dinner at the restaurant of their choice once I am fully recovered. 

Don drove me to MGH Danvers at the appointed hour on the morning of November 8th. I was seen almost immediately as the procedure itself was scheduled for 7:30 a.m. The nurses felt badly for me when they saw my arms. They were beaten and bruised. I should mention that I am what they call "a hard stick". Drawing blood from me is not an easy task. On top of that, I am queasy as you can imagine. But they were very understanding and made things as comfortable as possible before meeting with Dr. Dyer.

I wish I could say things ended there. Unfortunately, Dr. Dyer could not get to the kidney stone. Thus, she had to put in a stent. I ought to mention that I was given the option of having a stent put as an intermediary measure before the lithotripsy, but I wanted to get it over with and done. The main reason I wanted to avoid the stent because it could be every bit as painful as the stone itself - at least where it concerned urination. Put bluntly, following the procedure, I felt like I was pissing razor blades. I also felt the full impact of the stent when it came time go to the bathroom. All of this was going to continue to happen the hard way.

A second procedure would need to be scheduled and it would be for November 21st - two days before Thanksgiving. This time around the procedure would take place at Newton-Wellesley Hospital. As with my first procedure at MGH Danvers, I would need someone to take me to and pick me up from the facility. Unfortunately, this was not feasible with anyone that I knew. However, I was given the option of contacting a medical transport service at the cost of $200. 

In the meantime, arrangements had been made for me to work from home beginning November 13th until the day before the second procedure. There were the inevitable problems of remotely connecting with my desktop at the office. But the bigger problem concerned my pay. Because I was out for an extended period, I could not claim my regular PTO. 

Instead, I had to apply for both short term disability through my employer as well as paid medical leave through the Massachusetts Department of Paid Family and Medical Leave. The process was complicated as my employer required Dr. Dyer to be very specific about my condition and as a result the letter which she wrote had to be revised on her end several times. As of this writing, this process has not been finalized as Massachusetts is awaiting a response from my employer and it might be some time before I receive any disability pay. 

I am happy to report the second procedure took place as scheduled on November 21st and the kidney stone was blasted. Because of these medical issues, I had to cancel my Thanksgiving plans to my visit Dad in New York. Fortunately, I was able to reschedule my bus ticket for Dad's 83rd birthday next April. I would instead use the Thanksgiving holiday to recuperate from the second surgery. My strength is coming back, and I shall be resuming working from home tomorrow (November 27th). On December 4th, a week from tomorrow, I plan to return to the office after more than a month away.

Naturally, I wish the duration of this illness had been shorter. To be precise, I wish the urology department had been brought aboard sooner. While I understand that there was a possibility there could be another explanation for my pain, the fact that urology was not brought into the picture sooner caused unnecessary delays and a lot of unnecessary pain.

Of course, even if the urology department had been brought into the picture earlier, I don't think it should have been left to me to schedule my first surgery. There ought to be someone on call in the event that patients seen in the ER during the course of the weekend should require surgery during the week in order to coordinate such matters. 

In these respects, I don't think I was well served. Mind you, however, MGH is considered among the best hospitals in the country. What would have happened had I been at a hospital of lesser quality? During my first ER visit, I overheard some of the nurses complain about South Shore Hospital in Weymouth. Last summer, I was having lunch with a friend whose wife has been rather ill. He took her to South Shore, waited 12 hours to be seen and when he tried to plead his wife's case, he was confronted be security and informed he was being kicked out of the hospital. Oh, his wife could stay. But he had to go. They would both leave.

Of course, hospitals are very unpleasant places. During the course of my four ER visits, I shared a waiting room with an Afghanistan military veteran who threatened to shoot people. However, he was well known by hospital staff and one of the guards quickly deescalated the situation. I also shared waiting room with a husband and wife whose relationship was strained because the husband was in constant pain and the wife couldn't deal with it. I also shared a waiting room with a drug addict who demanded syringes and his every other word was fuck. I also shared a waiting room with a young Muslim woman who was aggravating the nursing staff every five minutes as to when her doctor would be seeing her. Despite the nursing staff's best efforts, this particular patient was not amenable to reason.

Given my repeated visits, I did not want to be viewed as a problem. Despite my often-excruciating pain, I did not want to make anyone's job harder and did my best to maintain as pleasant a disposition as possible. For the most part, I succeeded. It also doesn't hurt to have a handlebar mustache as a source of amusement.

Although the worst of it is hopefully over (knock on wood and other solid substances), there will be a follow up ultrasound next month. While this might not result in complications, the hospital bill probably will notwithstanding my health insurance. I suppose I can be grateful all of this is occurring at the end of the year rather than the beginning of next year when my already high deductibles go even higher. Still, these are expenses I would have rather not incurred.

In any case, I can only hope that no kidney stone has been left unturned.