3240 Ok. I'm weird.

Thursday, May 5, 2011

Violence is the last refuge of the incompetent.
-- Isaac Asimov --

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Appointment with the urologist today. Last week I had the blood test, x-rays, and CT scan. Also a urine something-or-other, but the doctor hasn't got the report from that yet, so I assume it was a culture. I expected to get some good news, like that we can break up the stones and then remove the stent.

I didn't get good news, or bad news, but certainly unexpected and very annoying news.

Remember how I said CT and MRI scans are slices, and small things can be missed because they might fall between slices?

The CT scan (and the x-rays, too, which I don't understand) from the White Plains hospital a month ago missed something important.

A normal arrangement looks like this:
Inside the middle of the kidney there's a hollow urine collection area. The urine produced by the kidney collects there and then flows through the ureter to the bladder. At White Plains they told me that I had a large stone blocking the ureter at the top, and a smaller stone blocking the same ureter at the bottom. They removed the bottom stone, and put in a stent (a long hollow tube that goes up through the ureter with one curl at the upper end in the kidney collection hollow, and another curl at the bottom in the bladder) to bypass the larger stone and allow urine to pass and drain. The larger stone could be handled later, after the infection was under control, and then the stent could be removed.

Last Thursday's scans and x-rays say something different.

Look at the kidney on the left side of this sketch:

Two ureters. Turns out I have two ureters on and two separate collection areas in my left kidney. This is not rare, something like 15% of the population has it. Apparently mine is slightly different from the sketch, in that the two ureters must join just above the bladder, and the smaller stone that was removed was therefore blocking both ureters. When that stone was removed, it allowed ONE of the two collection areas to drain. The other was still blocked by the larger stone at the top.

Here comes the annoying part.

They put the stent into the collection area that DOESN'T have a stone. They didn't realize I had a double kidney. The stone is still blocking the OTHER (hitherto unknown) collection area. Translation - the stent isn't doing a damn thing! It's totally useless! I still have the blockage. We don't know why I don't have any pain, and that must be what the x-ray technician noticed last Thursday, and why he asked if I was in pain.

So the urologist wants another CT scan, this one with contrast dye, so he knows exactly what he's got there. But I can't have the contrast dye without first ensuring that my kidney function is good. (They told me in White Plains that my kidney function was good, but that was then, this is now, with another month of blockage.) So I had to have another blood test today, and then call on Tuesday to find out if we can schedule the CT scan.

This time I was very clear with the phlebotomist that my arms were absolutely off limits unless it could be proven to me that the blood absolutely could not come from my hand. This time they listened to me. It took three tries, and I now have a huge purple knot on the back of my right hand, but it was still easier and much less painful.

So, this isn't finished yet. And I don't know when I'll get back to the old house.

This is ridiculous.
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