Tuesday, May 24, 2011

3264 Moving forward, but slowly

Tuesday, May 24, 2011

“The deeper insanity becomes, the more consistent it becomes,
until it wraps around and looks like sanity.”
-- Silk, August 9, 2008 --


It was a beautiful day today, sunny and warm with a gentle breeze, the first nice day in the past week and a half. And I spent most of the best part of the day, from 10:30 am until almost 4 pm, in the doctor's office or the hospital.

I admit I was worried when the doctor, to all appearances, was in no hurry to look at my scans, and then once he did look at them he wanted to see me immediately. That's almost never a good sign.

Last night I ran through all the bad scenarios, what he could say, end-stage renal failure, kidney cancer, bladder cancer, etc. etc., and pretty much came to terms with it all.

When I got there, the nurse put me in an examining room, and then later the doctor stuck his head in the door and asked me to come to his office. You know, with the big desk, and the two chairs in front, and the box of tissues on the corner. Another bad sign.

That made his news a relief. The most recent scans do not confirm either the first set which implied one collection chamber and one ureter on the left, or the second scan which says two collection chambers and two ureters. This latest set says two collection chambers, with the stent in the upper, and the obstructing stone and a few smaller ones in the lower, but neither the x-ray (IVP) nor CT confirm a second ureter, because I've got really good kidney function apparently, and the upper chamber cleared the contrast solution so quickly that it never even reached the second chamber or ureter (which is blocked anyway, remember?). So we still don't know exactly what we've got in there. But at least it is pretty clear where the stone is.

So we're going to smash the stone(s).

Not this week, because of the holiday coming up, but probably the end of next week. The procedure is Extracorporeal Shock Wave Lithotripsy (ESWL), described here: http://www.healtheast.org/st-joes/programs-services/kidney-stone/treating-stones/shock-wave-lithotripsy-eswl.html.

I told him how the stent is now causing bleeding after physical activity, it's irritating the bladder, and how I can feel it poking and it is getting worse, to the point where the seat belt hurts, and the urinary urgency is getting worse, so will we be removing the stent at the same time? He said no, because we're not sure where and how the second chamber drains, and the worst case is only one ureter, and some piece of the smashed stone gets stuck in it, blocking the entire left kidney. So no, the stent stays until we know what's going on.

Crap. I can lessen the bleeding and poking and irritation by avoiding physical activity. No lifting, raking, mowing, walking far, dancing, driving long distances, etc. etc. etc., anything that makes the stent move. Crap crap crap. I want this damn thing OUT! NOW!

So when I got home I read up a bit on ESWL. Two possible negative consequences are damage to the pancreas leading to diabetes, and damage to the capillaries in the kidney, leading to renal failure. The pancreas thing is unlikely because we're working only on the left kidney. The capillary thing worries me a little. I have fragile capillaries. I'll have to tell him about that. However, my stone isn't very big, so it (I hope) won't require much to break it up, and it's localized, and my clotting abilities are ok, so maybe that will be ok.

[My theory of what's in there is different from his, I think. I do think there's a second ureter, which the larger stone is blocking, because there are also a few much smaller stones in that chamber which, if that chamber connects with the chamber with the stent, seems to me that I should have passed those stones by now through the stent. A few other details argue for the second ureter joining the first somewhere north of the bladder. So the stent could actually CAUSE the moving stones to get jammed at the joining point. But at least then the second ureter would show up on a contrast x-ray for the length that it's open, and the blockade could be eased by pulling the stent. So I'm not going to argue with him.]

I just want this DONE!

After I left his office I went to the hospital to pick up my personal copies of the scan and x-ray done elsewhere a few weeks ago, that they had asked for for comparison, and to get copies of the recent scan and x-rays with contrast. There were at least three misunderstandings. It was three and a half hours before they managed to get it all together. About every 40 minutes or so they'd bring out part of it, and I'd have to ask again for the rest. And then wait. (At one point they actually insisted that I had NOT had the CT scan.)

When I first arrived at the hospital, at about noonish, as I was putting the top up on Hal, I got a call from Piper. We had a lot to talk about, and about 20 minutes in I mentioned that I had a bone to pick with The Angel, and told Piper about the IRS and NYS letters. Piper said he was worried about The Angel. He's had some kind of serious medical problem for the past few weeks or months, and Piper had called him twice yesterday and again this morning, "...and he always returns my calls immediately", but he hadn't heard from him. Piper was afraid The Angel was in the hospital, and if so, it was bad because otherwise The Angel would have contacted him.

Piper said if he hadn't heard from The Angel by this evening, he'd call his parents. He'll let me know.

So. Onward. Fred's tire is still flat. Sigh.

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