Showing posts with label doctor. Show all posts
Showing posts with label doctor. Show all posts

Wednesday, June 15, 2011

3284 Maelstrom

Wednesday, June 15, 2011

There is negative perfectionism and positive perfectionism.
Negative perfectionism is based on a fear of inadequacy.
Positive perfectionism strives for mastery.
-- Silk --

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In the past few days I have experience a maelstrom of emotions, ranging from anger, sadness, discouragement, fear, and disillusionment to joy, happiness, hope, and excitement, and everything in between, sometimes in quick succession and sometimes all at the same time.

Early Monday afternoon I met with the urologist. I had looked up the ESWL procedure scheduled for this Friday, and I had a bunch of questions and concerns, and when the office help said I wouldn't see him before the actual procedure, I had asked for an appointment to talk with him.

When I was shown into his office on Monday and took the seat in front of his desk, before I had a chance to speak he looked at me angrily and said, "You went to the internet! You can't believe anything you read on the internet! It just causes trouble!" or something like that, it may not have been his exact words, but that was the gist of it, and he was VERY angry.

I responded something to the effect that I went to the internet for questions, and have now come to him for the answers. Doesn't matter, I guess. It's obvious he doesn't like questions either. He's Egyptian, I think, has a heavy accent, and I got the distinct impression he doesn't like challenges to his authority. He asked what kind of questions.

So, I sorta blinked twice, and said, "Well, the most important one I guess, is that I have fragile capillaries. Could that be a problem?" His face turned purple, and he said, "Yes. I will not do the procedure. Do you have any other questions?" Well, that response pretty much eliminated the rest. I asked if it was possible that the fragility was only maybe in my skin, not the internal organs, and asked if there was any kind of test, and he said no, no, no, and reiterated that he would not do the procedure. Period. End of discussion.

I asked what next, then? He said we'd take the stent out and then "play it by ear". Those were his exact words. I was dismissed.

I was stunned. On the way out, I stopped at the desk to get the appointment for the stent removal, and was told that the first opening was June 30th.

I pretty much crashed then. June 30th is two and a half weeks away! This useless stent HURTS! It's hurting more every day. And there's no reason for its existence, let alone to be tearing up my insides!

I wanted to cry. I wanted to kill somebody. After all this, there's been no headway. There's been nothing but deterioration since April 2, when they removed a stone blocking the distal end of a ureter, and put the stent in the wrong place.

Driving home, I wanted to cry, but I was too angry to cry.

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You know, I got the distinct impression that it was not so much that I had questions at all, but that I said the words "fragile capillaries". One of the questions always asked is whether you have a bleeding problem or if you are taking a blood thinner. I always answer that I don't have a bleeding problem, I clot well and quickly and I heal quickly (in fact I have phenomenal healing ability), BUT that I do have fragile capillaries. I ALWAYS state that. And if it's not an interview, if it's the checkmark list, I always check "no" on bleeding problems, but then write in "I have fragile capillaries". So it was in my folder right there on his desk. It shouldn't have been a surprise.

(In fact, I suspect it's related to the blowout problem with my veins when anyone attempts to draw blood or set an IV. I just have thin walls, I guess.)

Now , here's the part that angered me more than anything else, more than his attitude, more than having to endure unnecessary pain for another two weeks, more than having no other avenue to resolve this -
I had the distinct impression that if I had not specifically asked, if I had not mentioned it to the nurse and she wrote it down as a concern when I made the appointment and if it had not been overheard by his office staff, no one would ever have asked, he would have gone ahead and done the procedure, and it's entirely possible that I could have started bleeding in and around the kidney, which is a life-threatening emergency. If I lived, I could have lost that kidney. If I had never mentioned it to him, he would have gone ahead and taken that chance!

By my actually bringing it up, he's now open to malpractice if anything went wrong.


And THAT's what made him angry!

That's not a conclusion I came to later. I had that impression right there in his office. Instantly.

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So, I have a double kidney with stones in the lower collection chamber, one of which is blocking the lower ureter, no stones in the upper collection chamber, but a stent in that upper chamber that is tearing up my bladder and doing absolutely nothing else since it's in the wrong chamber, and possibly tearing up the kidney, too, who knows, and I've had only one day in the past month or so that I haven't bled. My stomach is sticking out like I'm seven months pregnant, and it's incredibly tender, there's a nyt-load of edema going on, and since there's all that edema, but the doctor's scale says I've lot four pounds in the last month, I've probably lost a lot more than four.

There's a lump just in front of the urethral opening "down there" which I suspect is the stent poking the bottom of the bladder. It hurts. It hurts when I sit. It hurts when I walk. Imagine a fork shoved up in there, and then the tines are bent every which way, and the handle is hanging out. Now sit, and walk, and bend over. That's what it feels like. It HURTS!

I tell the doctor it hurts. I tell the nurses it hurts. Everybody just shrugs. I don't think they believe me. I tell them I'm bleeding constantly, and we're not talking pink lemonade, we're talking BLOOD! But nobody asks for a urine sample. I think they think I'm exaggerating.

In the meantime, I haven't been able to do anything physical, I haven't been to the old house in months and if I don't get out of there soon I will lose the buyer who's interested, my back and stomach are losing tone, which is dangerous because I need those muscles to keep my spine aligned, and nobody seems to care. Like two and a half more weeks don't matter. And I still have half a double kidney full of stones and blocked. That can't be good....?

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So, that was my status on Monday afternoon.

Late Monday afternoon, I got a call from the urologist's office. They had a cancellation Tuesday morning. Could I come in then to get the stent out?

Uh, yeah.

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So, Tuesday morning. Yesterday. Stent removal. Office procedure.

On Monday, during the unpleasant office conversation, I had pointed out that we still didn't know how the ureters from the left kidney were arranged - whether both ureters emptied into the bladder, or whether they joined into one before reaching the bladder, and that it was important to know that because if they joined, the stent itself could be blocking the lower ureter. I asked if it was possible to actually LOOK into the bladder with a scope, and then we'd know if there was one or two.

Apparently he hadn't thought of that. And you know sumthin'? I think that had a lot to do with the "cancellation". I think I piqued his curiosity.

When I arrived the nurse asked for a urine sample. (The first one in this office.) I filled the little cup with blood. The nurse's eyebrows shot up, but she didn't say anything.

The procedure involved a topical anesthetic swabbed around the urethra, and then a scope was inserted. With men, they use a flexible scope, but with women they use a rigid one (according to the internet - HE didn't say a single word to ME!). There's also a lot of saline pumped in to clear it out and expand things smoothly. The nurse stood next to me and told me what was going on.

The urologist cranked that damn scope all around like he was digging a hole. Then he grabbed the end of the stent and pulled it out. That surprised me. The stent has curls at either end that are supposed to keep it in place, one end in the kidney and one end in the bladder. When it's put in, a guide wire is used to keep the curls straightened out. I had assumed a guide wire would be used to straighten out the kidney end for withdrawal, but if there was any wire used yesterday, I wasn't aware of it. There were a few slight pinches, and a short feeling of heavy pressure, and then it was done.

I think the nurse asked him if he saw a second ureter on the left, and he muttered something about too much edema, so I guess that didn't pan out. I wonder if he'll ever say anything to me about it.

I put my panties back on, and the nurse told me that there would be blood for a few days, that's normal, and some pain and stinging on urination. They gave me a prescription for an antibiotic (Cipro) and a pain killer (Phenazopyridine). Six weeks from now, we need a 24-hour urine collection to find out my urine's chemical composition, and then we'll "play it by ear".

As I was walking across the parking lot, I suddenly realized I was walking without pain. The pain had crept up so slowly, and increased so subtly over the past two months that I hadn't realized how really bad it was until it was gone. Also gone was the pain I'd had in the right lower back, that I'd ascribed to my spine, because it was lessened by changing position. (Now I'm wondering if the stent had been pressing against my spine and had thrown it out of alignment.)

I threw my arms up in the air and shouted, "I'm walking! I can WALK!" I startled a few people.

Since then, I haven't seen a single drop of blood, not from the instant the stent was pulled and I was allowed to empty the saline load. It's a clear pale yellow, like evening sunshine. There was a little stinging when I piddled yesterday, but that's gone. I haven't even opened the pain pills' bottle. (And after reading the info sheet on it, I don't think I'd have ever taken it even if I did have pain. That crap can do some really nasty stuff!)

Of course, I wonder. Is all this pretty urine coming from the right kidney, and the left isn't working? Was all that blood coming not from the bladder, but from the left kidney, and now without the stent it's just building up in the kidney and not coming out? Is there any way I can know?

But I can walk without pain. I can sit without pain. For now, I'm happy.

Later, I'll think about the stones, and the blockage, still there. But not now.
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Friday, May 20, 2011

3257 Frustration

Friday, May 20, 2011

PMS - the time just before a woman's menstrual period when she acts like a man.

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It's now 4 pm. When I called the urologist's office yesterday afternoon, the receptionist said that he was back, but had not yet looked at my reports. He'd call me when he did. He hasn't called yet. I'm getting angry.

Yeah, I know many of the people sitting in his waiting room have bladder cancer, end-stage kidney failure, prostate cancer, things more serious than my miserable stones. BUT! It's serious and important to me!

I can't go anywhere, like up to the old house, because the stent keeps the valve between the kidney and the bladder open, so the kidney keeps dumping into the bladder and causes urinary urgency. When I get the first slight hint that I have to go, I have to go immediately! Like within five seconds. It's exactly ten steps from the computer to the downstairs bathroom, and when I'm wearing the jeans with the side buttons and zipper, I almost don't make it. So if I know I'm going to be away from a bathroom, I can't drink anything. The drive north is too far. I can't get repeatedly that dehydrated while I have the stones.

I'm worried that the useless stent is rubbing and messing up my bladder.

I'm worried that the blocked collection chamber is damaging my left kidney. The kidney is almost unique in the body in that it's the only organ that can't heal. Any damage is permanent, does not get better, ever. In fact, any damage gets worse over time. It's like the kidney is made of dominoes.

I want this fixed NOW!

I'd change doctors, except that being a new patient, I know it will take at least two weeks, probably more, to get an appointment with another.

I am extremely frustrated.

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I heard on TV yesterday that they're seeing an increase in skin cancer on the fingers, a very unusual place, and have pretty much identified it as due to nail polish dryers that use UV light. (I have to wonder about that. Why UV? Wouldn't infra red light be the logical choice for drying nail polish?)

Anyway, today on TV Dr. Oz was pushing teeth whitening systems using UV light. You stick the darn light in your mouth! Ok. How long before they start seeing an increase in mouth cancers? And how long will it take them to figure out why?
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Thursday, May 19, 2011

3255 Thoughts on stones and emotional reactions.

Thursday, May 19, 2011

"The more I study religions the more I am convinced that man never worshiped anything but himself."
-- Sir Richard Francis Burton --

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Don't know that I agree with the green quote above, but it is interesting, especially coming from such an accomplished and experienced man. Worth thinking about, anyway.

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The hospital folks told me that the doctor would have the results of last Friday's tests on Monday, and I was anxious to find out what happens next. I called the doctor's office, and surprise, he's "out of the office until Thursday". Great. "The reports are on his desk, and he'll look at them Thursday."

So I'll wait until mid-afternoon today, and if he hasn't called by then, I'll call him.

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On the trembling Friday, after the IV trauma: There was another instance of the same kind of trembling, two years ago, at about this time of year. I received an email that I thought was from a close friend. Turns out it was a fake id made to look like it came from the friend. I never did find out who sent it, but perhaps they knew me well enough to know that I probably wouldn't open an email, and absolutely wouldn't follow a link in an email, unless I knew and trusted the sender.

Anyway, I opened it, followed the link in it, and got a huge emotional shock. It was so bad I couldn't stop shaking for almost an hour. My head shook so badly my eyes couldn't focus. Arms and hands couldn't grip. Legs couldn't support me. I think I have an idea of what the later stages of Parkinson's might feel like. It scared me because I couldn't control it, and I was afraid something had broken in my nervous system and maybe it would never stop, that maybe I'd had some kind of stroke. Or something. At least fear of what was happening to my body took my mind off the message I'd just received and gave me time to absorb it.

That's what happened to me after the IV trauma Friday. The same kind of trembling. So I think maybe the nurse was correct, that it wasn't the contrast, or the cold in the room, but an emotional reaction. The trembling two years ago had the same effect on my body, too, in that it completely wiped me out. It took me a few days to physically recover then, too.

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I had vowed two weeks ago that phlebotomists would henceforth listen to me, that they would try my hand before the arm, or I would walk out. I have since discovered that all along I had been using the wrong words - that talking mainly about the pain, the fire, the branding iron, doesn't work. That just gets "Oh, you won't feel this", especially from those who think they're experts, followed by the pain, the fire, the branding iron, and "Oh, you must have a lot of nerves there". Yeah, that's what I said.

What DOES work is the words "thin walls, collapse, blowout", all of which are also true. They actually listen to and think about that.

And now I have another vow. If I ever have to have anything involving both an IV and dehydration, I will go in and get the IV whatchmacallit installed THE DAY BEFORE!, when I can be fully hydrated. I'll have to talk to someone and find out if that's possible.

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I've been reading up on what causes kidney stones and how to prevent them. It depends on the composition of the stones, but for the most common types it seems like everything I eat is bad. Especially the diet the nutritionist put me on last year, that was working so well for me.

In my darker moments I want to blame the stones on the diet, but I don't really think that was the cause. I think it's that I've had an undiagnosed untreated kidney infection for at least the past year.

Oddly, people who live near large bodies of water and those who drink soft water are also more prone to kidney stones. No reason given, just apparently an observation, a statistical correlation. I have moved from high ground in the woods, a half mile from a river, with well water measuring 13 on a 0-15 scale of hardness, to low ground a half block from a saltwater bay, with city water so soft that I can't taste it and drying drops leave no mark. Hmmmm.

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I've got a new peeve.

I've been reading/hearing more and more often "one IN the same".

That makes no sense.

It's "one AND the same".

Another example of people not thinking about what they're saying.

Sheesh.

Tuesday, May 10, 2011

3245 Stray Stone?

Tuesday, May 10, 2011

We ought to keep the rich as rich as possible, because
nobody poor was ever able to afford to give anybody else a job.
-- Lewis Grizzard --

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You hear that green quote above all the time, mostly from rich people, and from poor people who have been duped. I'm not sure I agree with it. There is such a thing as being so rich that the only jobs you have to offer are menial minimal-income jobs. Petting and pampering. The rich folks that offer real living-wage jobs are those who still have to scramble to support their lifestyle.

If we make sure there ARE no poor, then everyone can buy stuff, and that's what keeps everyone employed.

Sheesh. I sound socialist, but that's not such a bad thing, actually.

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After Sunday's post I went for a walk with Daughter, Hercules, and Nugget. We walked down to the bay, then along the bay until we ran out of pavement, then across some beach (that monster stroller is not fun on sand), to a park (where Hercules and I freaked Daughter out by pretending to give Nugget her first trip down a slide), and then back along some streets. Altogether about 2 miles.

Walking was a bit uncomfortable, because I can feel the stent in the bladder, swinging like a bell clapper. And Saturday evening I had noticed a sort of firm lump under the skin between the clitoris and urethra. I wondered if the stent had moved and was poking. There was no pain, just a slight pressure, like when a tampon is too low. I'm 14 years past menopause, but I still remember that feeling.

Then I took a shower, and went over to the kids' house for dinner, steaks grilled by Hercules.

Something very scary happened in my shower. I piddled before I got in the shower, but I didn't look at it, you know? Sometimes (well, usually, actually), even though I always go before getting into the shower, as soon as the water hits me I piddle a little more.

It was red. Blood. Like Psycho. Swirling down the drain.

It was Sunday. My urologist wasn't in, and not on Monday, either. My first fear was that the stent had poked through the bladder wall, or rubbed a spot raw, or something. If I call anyone, they're going to tell me to go to the ER. But hey, not only is there no pain, but the slight nagging ache I'd had in my right lower back for the past week was gone suddenly! And the firm lump and feeling of pressure were gone, too.

So from then on, when I had to go, I piddled a bit in a glass so I could see what was happening. Later Sunday night there was a bit of pink, but not as much as earlier. Monday morning, it was brown at first, but got lighter and lighter as the day went on. By early evening it was the usual pale yellow.

I think I passed a stone. From the right. Where according to two CT scans and two x-rays, there were NO stones. Which is why I didn't connect the back ache to the right kidney. Ho hum. Par for the course.

Today, Tuesday, I was to call the doctor's office to find out how my kidney function blood test from last Thursday had turned out. It needed to be good in order to have the CT with contrast. I had to leave a message, and the receptionist called back a few hours later to say that it was fine, and I should go ahead and schedule the CT scan. I didn't mention Sunday's blood. I seem to be fine now, and I figure the CT scan should notice if anything's gone flooey. (Yeah, you'd think I'd have learned a lesson by now. They miss a LOT!) I will mention it next time I see him.

Anyway, today I ran a bunch of errands in the morning, then about noonish went with Daughter and Nugget for the two-week OB appointment, then to a wonderful fruit/vegetable/bakery store where we had late lunch/early dinner outside from the deli counter. We got home about 6 pm.

It was funny - Daughter went off the pain meds almost immediately after leaving the hospital, and she's been walking a few miles every day, and taking Nugget everywhere with her, including in the car. Today, the doctor gave her permission to go off the meds, drive, and walk. Snork! If he only knew....

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Ever notice that on CSI and Criminal Minds, whenever the crime involves torturing the victims, it's almost always women who get tortured?
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Thursday, April 21, 2011

3225 Local urologist visit

Thursday, April 21, 2011

The past belongs to those who control the present.
-- George Orwell --

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Good news: He says we can probably blast the stone to break it up, and the stent can be removed in his office with local anesthesia.

Middlin' news: He wants another urine culture, CT scan, blood panel, and abdominal x-ray, then I'll see him again in two weeks. (Two weeks?)

Middlin' to bad news: It might be a few weeks, perhaps three or four, before I get the stent out.

Horrendous news: No sex until the stent is out!

ACK!

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As I was leaving, the receptionist was giving me the scripts for the tests, and advice on where to have the tests done, and she asked if I had any questions. I said yes, uh, can I have sex with the stent in? She seemed startled, said she didn't know, and said she'd ask the nurse. She whispered to the nurse, who looked startled, and said she didn't know, but she'd ask the doctor.

The nurse came back and said, "In answer to your question, no", and at that moment the doctor came out to give some stuff to the receptionist. He was standing next to me at the counter when the nurse said no. He didn't look at me when I turned to him, but he was grinning. I said to him, "No?! This thing has got to come out pretty darn quick, then!", and hit him on the arm with my Readers' Digest.

He cracked up.

(I'm just a wee tad insulted that the nurses looked startled at my question.)
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