© Springer International Publishing Switzerland 2015David A. Schulsinger (ed.)Kidney Stone Disease10.1007/978-3-319-12105-5_31
31. Special Stone Stories
Department of Urology, Stony Brook Medicine, Stony Brook, NY, USA
David A. Schulsinger
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Over my 16 years of practicing Urology, I have encountered, managed and treated many stone patients, each with their own unique stone experience. In this chapter, I share with you some of these special stone scenarios.
How I missed my son’s wedding!
I would like to share my story about my stone that has taught me more than 1 lesson in life. I have always been a procrastinator. Never did I think that this personal trait would impact my ability to make it on the big day.
I had a stone that was small, but too large to pass. My urologist told me that it needed to be treated with surgical intervention. Like many things in life, I took it under advisement, but was not quick to act on it. I had many things on my mind including my son’s wedding. There was much to do and prepare for the big day. Unfortunately, I was working on other things at the expense of my own health.
On the weekend of my son’s wedding, I had a severe colic attack, unfortunately, with fever and chills. The emergency treatment for this stone was NOT the same for the elective procedure. The elective procedure was to have a lithotripsy procedure without a stent. The emergency procedure was to have a tube in my back, called a nephrostomy tube, followed by a second procedure to remove the stone. The time between these procedures were spent in the hospital receiving IV antibiotics. This, unfortunately, included the day of my son’s wedding. On that day, I participated in the wedding from my hospital bed listening to the ceremony service from my phone. The flowers in my room did not match the arrangement of flowers at the wedding.
I learned a very valuable lesson that day. I may be a procrastinator, but I will never be late again.
How stones may fly!
I was 73 years old when I visited Germany. Looking back, I should have “listened” to my body’s symptoms of flank pain, recurrent infections, occasional nausea and vomiting.
My flight to Germany was uneventful. There, I began to experience fever, tiredness and fatigue. By the time I got to my hotel room, I was in septic shock. That was the last memory of my trip. I was told that I was sent by ambulance to the local hospital where I was placed on a respirator, IV fluids, IV antibiotics and medication to maintain my blood pressure.
After several days, I was more stable. I was then airlifted from Germany back to the States. I remained on a respirator for almost 1 month before I could breathe on my own. After additional antibiotics, Dr. S then treated me for my stones. In retrospect, it was hard for me to believe that my kidney stone cut my trip short, let alone almost cutting my life short. My stone, however, racked up some frequent flyer miles!
Stones and My best golf game!
My most satisfying round of golf came from a kidney stone. While on a golf trip with my three best friends, I awoke to the pain of a kidney stone in the middle of the night. I was taken to the ER and diagnosed with an obstructing kidney stone. Surgery was scheduled the next morning. I was discharged on Sunday and just made it to my tee time. The pain still emanating from my flank was enough of a distraction to help me shoot one of my best rounds of golf ever. Normally my head is full of a dozen swing thoughts while driving the ball, however, this day it was different. There was no swing thought in my head, I was only focused on my pain. I swung the clubs with no thought at all, I just “let it fly” as they say. When I play today, I still try and remember that day. I tell myself to clear my head and let it fly. If all else fails, I could always pray to the golf gods for another kidney stone!
Choosing the right treatment!
I am a 51-year old male with a well-established history of stones. I also own a lithotripsy company that treats these stones. As a lithotripsy machine owner, I move machines to places where patients need to be treated for stones. As a stone patient, my stones move to remind me that they can cause pain. Over the years, I have passed many stones, both smaller and large. Recently, however, I passed a stone that was too great in size to pass. I knew that this stone required treatment by surgical intervention. The question to me was “by what method?” I know that there are interventions that are more invasive than ESWL, however, I was trying to avoid this procedure. Nonetheless, I treated myself with one of my machines. After multiple minimally invasive procedures, multiple trips to the ER, pain medication and lost work time, I knew the best treatment option for me was a more invasive procedure. As a lithotripsy company owner, you need to respect that at certain times you are a patient too. I am not only the stone club president, but I am a patient too!
Stones and pregnancy should not be used in the same sentence.
It was a surprise and a joy to find out that we were pregnant with our first at age 43. It was also a surprise but not so joyous when I needed a nephrostomy tube at 3½ months into the pregnancy. To be honest, I have dealt with kidney stones for many years prior to pregnancy, and while most were very uncomfortable, they were actually manageable. However, there were some situations that entailed curling up into a ball on the floor of the bathroom and praying to g-d to take the demon out of me, throwing up in the emergency room and taking Vicodin for a couple of weeks until it passed. Thank g-d for pain meds! Being pregnant with kidney stones is a whole different ball game. The option of a tube inserted into your back, snaked down into your kidney draining into a bag filled with urine attached to your thigh, sounds better than pain. My Louis Vuittone bag is hanging over my right shoulder while my lemonade colored “satchel” is filling up on my left thigh; very fashionable! From what I understand, kidney stones and pregnancy are not uncommon. They are still studying this phenomenon, but if you have them already and plan on getting pregnant, fasten your seat belt and get ready for the ride! Normally a nephrostomy tube needs changing about every 6–8 weeks, but in my case it was every 2 weeks and I had 10 of them to date. Lucky me!! While I have no intention of sounding frightened, one tube change was one too many!
With all said and done, I still am fortunate to have had a child at 43, survived the pain of stones through pregnancy, dealt with the litany of tears from tube changes and have grown to appreciate the benefits and limitations of pain medication; I now only look forward to the giggles and days and nights filled with numerous diaper changes ahead. Life is full of surprises, from the pain of changing tubes to the baby cries and reminders of lactating boobs!
My first stone at 4 years old and why I became a nurse!
I am a frequent stone maker, having made stones since the age of 4. As a child, I made almost 1 stone every year. By the age of 14, I had 14 stones. The first time I was treated for a stone, I was very nervous.
Over the years, I became very comfortable with my procedure and my physician.
Entering college, I thought about what I wanted to be when I grew up. Instinctively, I decided on nursing and chose a career to help others the same way that they helped me.
The forgotten stent!
Five years ago I had a stent placed for an obstructing 5 mm stone in my ureter. The pain was relentless and stone was unforgiving. I was told to follow up with my urologist so that I could plan the next and final part of my procedure. After the stent was placed, I felt 100 %. Because my stone was no longer bothering me, I figured I would not bother with it. Unlike cardiac stents that are permanent, urinary tracts are not. I was later told they should be removed in a year or less.
Needless to say, 5 years later I began to experience pain, bleeding and recurrent infections, a follow up X-ray revealed that I had a 3 cm stone in my bladder attached to my stent, a 4.2 cm stone attached o my stent in the kidney. The stent was calcified in the ureter and the 5 mm stone in the ureter was now 7 mm. I need to have one procedure to remove the stone in my bladder, another procedure to remove the stone in my kidney and a third procedure to remove the stent. In retrospect, it was very clear to me that three procedures is not better than 1. I will not forget about my stent next time.