Kidney Stone Update

I had my 6 month check up with my urologist today. I can't help but feel that I failed. You may ask, how can you fail a check up with a doctor? I have no idea, but I feel I did.

Number 1 - According to a test I'm not producing enough urine. In other words I'm not intaking enough fluids to flush the kidneys. My doctor said the number 1 reason in the US for kidney stones = dehydration. And I'm the poster child for that model. Great. I've tried to up my fluid intake with always having water/lemonade with me at work and using straws. Unfortunately my type of work isn't the best situation to be drinking all the time. Not only the drinking, but visiting the can too. I'll try to work on it.

Number 2 - In the past my stones have never been seen on radiograph, only by cat scan (there were approximately 2 in the kidney last scan). This time? Yep, one of the stones is showing on the radiograph. It's either that or I have arthritis on my ribs. I wouldn't put it past my body about having another problem, but chances are I don't have arthritis in my ribs...yet. This isn't necessarily a bad thing that it's now seen on radiograph....but in my mind I think it is. My thinking....if it's visible on radiograph, it's larger than last time.

Number 3 - I'm currently on potassium citrate to inhibit the formation of stones. My citrates used to be really low, so we started supplementing. After 6 months of supplementing my citrates have risen. However, not enough. So now I'll be on 2 tablets 3 times a day. Not real fun. It's not a big deal, just a hassle to remember sometimes. In addition, more pills means more money.

So that's my visit in a nutshell. Time to kick it into gear with more hydration and more potassium citrate, then I get to do it all over again in 6 months.

Struggle

My kidney stones are still present, but I have an appointment with the doctor this week. I have continually fought the mental battle of running the past year or so and the kidney stone issue isn't helping one bit. I've taken time off (even before the stones), but that didn't help. I know what I need to do, get up and move, but when you're hurting it just doesn't happen. I've gained wait, feel unfit, and when I do run I'm not seeing those miraculous goals happening like they were when I was new to running. The concept of running was hard at the beginning, but the pounds melting off was a huge payoff (that's not happening now). Then I started to eat healthy and I felt like a machine. Of course I wasn't close to being a machine, but I felt the best I've ever have in my life. At the same time I was so obsessed with running and what was being put in my mouth that I felt like I was also becoming a robot. I started to back off a bit so I could become more human....unfortunately that backing off lead to slacking, which has lead me to where I am now. I feel like a broken record, because I know I've blogged about this multiple times, but I'm hoping at some point a lightbulb will go on and I'll find my motivation to get my ass moving regularly and find that happy medium. In the meantime our work schedules are back to the "school schedule," so hopefully that will help. I'm also thinking about signing up for this run. (virtually of course). It's an excellent cause and you can't help but love the mascot, eh? And as always, if you have a run you're working towards, even if not competitively, that helps you get out and moving

Wall

Last week I hit a wall. You know, one of those imaginary walls your mind and body slam into? I was tired, in pain, and just worn out bother physically and mentally. Thankfully I was able to take an afternoon off at work, get a massage, and just relax...or relax as much as I can relax. I also ceased running for the past week. Just trying to get everything back in line. At this point I'm still having the pain issues with the kidney stone, but my stress level has come down a few notches....for the time being. I will say, it's just over a month until we leave for Puerto Rico and boy are we ready. I don't want to get my hopes up but I am hoping for a relaxing vacation. Even still, having our vacation within reach gives me peace of mind. Just got to keep my eye on the prize.

Oxalate

When I had my first kidney stone back in March I was ready to do whatever I needed to do to prevent another stone formation. At the time the doctor told me to be patient. Although these problems tend to be genetic it could have been a freak occurrence. He said we'd address diet change if another stone formed.

So, that's where I am now. 4 months later with 2 more stones. Call me crazy, but I think it's time to address my diet....changing it to low in oxalate. Not surprisingly, looking at my daily intake I'm seriously high in oxalate. I have a pretty set diet....meaning I eat the same thing almost daily. (Yes, I don't adventure through foods like most people. I enjoy what I enjoy, but ultimately food isn't my thing and would be ecstatic if I could go through life without dealing with deciding what to eat and actually going through the motions of eating.....but that's another post for another time). I have milk with Ovaltine for breakfast - milk is low whereas Ovaltine is high in oxalate. Lunch usually is cheese and an apple - cheese is ok, apple is high, unless peeled. My snacks and dinner vary. If you have calcium oxalate issues you should avoid Vitamin C supplementation - I was taking a vitamin C supplementation daily. Soy is high in oxalate. My diet isn't loaded with soy, but it's present.

Gah! So yeah, I think it's time to make some adjustments. It's not going to call for me giving up being a vegetarian (according to my research), just making some changes. However, before I make further changes I thought it'd be a good idea to ask my doctor. I've put in a call to my doctor and am hoping to hear back soon. Wishful thinking? Dunno. I have yet to be offered an examination, so I also asked if I should come in for an exam. Maybe an exam is uncalled for, but basically I've been diagnosed with a stone through testing and have yet to hear from my actual doctor. It's not that I don't trust the nurses in his office. I just think it's easy to have things overlooked when the communication is going through multiple individuals....oftentimes not even the same individuals.

And it's not so much that I'm worried about having the stone. Yeah, it's painful, it's been 3 weeks, I'm worried that I'll need to have "surgery" at the beginning of the year AFTER my deductible resets, and I want it to pass, but at this point I want to be proactive in preventing future stone formation. Basically I'm looking for professional guidance and advice. As expected, I've ventured into the Internet to do my research and have compiled a ton of information. I consider myself a realistic person who can decipher fact vs. crap and come to a consensus, but once again, I'm looking for the reassurance that I'm doing the right thing.

For instance, everyone says, "drink cranberry juice." Sounds like an excellent idea. However, cranberries (or any berry for that matter) are high in oxalate. So if I'm trying to prevent calcium oxalate stones, but drinking cranberry juice that can encourage formation of stones, it defeats the purpose....right? Well, it depends on what you read.

Guess I'm in a conundrum. If anything, at least I've learned a few things from this experience. One thing, if you're not an advocate for yourself, no one will be, and you're screwed.

Drink, Drink, Drink

Last week I broke down and had a CT scan performed. My discomfort wasn't getting any better on the antibiotics and I figured it was time to take the next step. Yesterday I received the results. It looks like I have 2 more stones present. At this time they are a "passable size" per the doctor's office. As expected I was unable to get straight answers. Like, "How long should this go on before we need to intervene?" I was just told to continue with "lots and lots of fluids." Unfortunately this has been going on for almost 3 weeks now. The pain is still present and has not moved. I'm going to continue my fluids and if I have no further progress by next week I'll have to make another call. Something I never found out was the size of my last stone. Which leads me to my next question. I've now had 3 stones in 4 months. The doctor said that I shouldn't worry about my diet after the first stone because it could be a one time deal. Obviously that's not the case. I'd really like to address this issue but am unsure what to do at this time. This "problem" I have was inherited, however there our ways that I can encourage stone formation...or inhibit too. The only changes I've seen within the past year was my change to becoming a vegetarian and running. I've looked real deep at both of those changes and honestly don't think they have been that big of changes that should have caused these problems. True, I no longer eat meat, but I didn't eat much meat before. I was lucky to have meat once a day, if that, before. Soy can cause problems, but I don't really eat much soy. As for my running, I've actually decreased my running distance. So I dunno.

As for now I'll drink, drink, drink. David has already warned me that he's about to strap his Camelbak to my back. I'll pass on that. Bottoms up!

Pain And Nausea

Last Thursday I started to have abdominal pain and nausea. I thought to myself, "oh boy. here we go again. another stone." It wasn't the intense pain I had last time but it was the dull constant pain that had presented itself before the last stone. I started pounded down fluids to no avail. I have the ability to perform radiographs, so I did so on myself. I didn't see anything. Come Monday I still had pain and nausea. I made a call to my urologist and they sent an order for a KUB (kidney, ureter, bladder) radiograph....basically what I already did. Although I knew it would come up negative, I went through the actions. I promptly left work and had the radiograph performed. I was told my doctor would get back to me as soon as he saw the radiograph and that it was being sent to him immediately. I was patient. There was no call Monday. No call Tuesday. Wednesday comes and I make a call only to hear, "Oh, your doctor is out of the office for another week and a half." You're kidding, right? So I ask if someone else can look at the radiograph. They say, "sure" and they'll have someone call me. No call Wednesday. No call Thursday. I call Thursday afternoon, and am on hold for forever, then someone comes back to the line and says, "It's negative. They'd recommend a cat scan now." Once again, following their recommendation, I tell them I'm open to time and date, but would prefer morning if at all possible. They say they'll call me back. In the meantime I run a urinalysis on myself. Sure enough there's bacteria present. Not to mention my pH is sky high....could be because I'm a vegetarian. Wouldn't it be smart to start with a basic urinalysis before exposing myself to a cat scan's radiographs and cost? They call me back and leave a message saying a cat scan isn't available until the end of next week. Right. I give them a call this morning and basically say, "I'm not trying to tell you what to do, but I really don't know if a cat scan is the appropriate direction right now. Can't we start with a urinalysis?" I went on to explain that I have the ability and have done one myself and gave my results. I also stated that I have a culture and sensitivity running on it as well. They still stand by the thought that a cat scan should be run. But they can put it past the other doctor on MONDAY. So what they're telling me is, even if I have a cat scan (which can't be done until next week anyway) I'm still going to be sitting through the weekend with this abdominal pain and nausea. I've had pain/nausea for over a week and I have yet to talk to an actual doctor or even have an exam offered. In the meantime I believe I have a kidney infection that continues to fester. I have put in a call to my family doctor, but unfortunately I have a feeling this issue will not be addressed anytime soon. Frustration has set in.

Alive And Well

Thursday night to Friday morning was horrendous. I kept waking up in SEVERE pain with projectile vomiting. I couldn't hold anything down. And everytime I wretched my abdomen flaired up worse. It got to the point that I had absolutely nothing in my stomach. I don't think I have ever been that sick, and wretching that hard. It was horrible. Come 6am I thought I was going to die.

Upon David waking up we attempted to call the urologist. They said in order for them to see me I'd need a referral from my family doctor. Unfortunately there was answer at my doctor's office. At that point I knew I had to go back to the ER. Due to David's schedule, he dropped me off at the hospital. I was soon entered, started to receive fluids anti-emetics (anti-vomiting) and pain meds. Within moments of being seen my cell phone rang and the person left a message. It was the urologist calling to get me "right in." That's when everything turned into a whirlwind. The ER doctor came in saying that the urologist just called and they wanted to go into surgery at 3pm. Say what? Guess I wasn't going to pass this stone on my own. The usual thinking is, hydrate and give the stone time to pass. However, with my blockage, oftentimes the fluids totally bypass that kidney and choose to go to the other kidney, which doesn't help a thing. Of course I didn't fight the decision that they recommended, surgery. I was soon transferred to the surgery preop area and waited me turn for surgery.

Thankfully the surgery didn't require any incision. Basically, they place me under deep sedation (almost anesthesia, but not) and then insert a scope to investigate the problem. Upon visualizing the stone they remove it. If necessary, they use a laser to break it apart, then remove the fragments. In my case it was found that my left ureter was swollen shut and that's why the stone wasn't moving, so the surgery was definitely a good idea. We don't know if it was swollen due to the trauma or if it's my anatomy. Either way, he had to dilate the ureter and remove the stone. A stint was placed to keep everything "open and flowing." I went to recovery and by 8pm I was home resting. Here's a drawing the doctor made..... the ureters come down to the bladder, which then empties into the urethra. The box on the ureter is showing where the swelling was.

I feel MUCH better. I can't even describe how much better. The only discomfort I had yesterday evening was a bit of stinging pain upon urination. But hell, if they place something up there, you know you're going to get raw and inflammed, causing discomfort. That pain is waining and now the only discomfort I have is just a bit of abdominal pain (due to trauma) and the feeling have having to urinate more. But, I'll take this over Thursday night any day! All of this is normal and thankfully, with meds, I'm feeling more comfortable as time goes on. I'm alive and well. Thank you to everyone for their kind thoughts and energy. It was greatly appreciated. Although we're planning on laying low this weekend, we still plan to do a little celebrating for passing my boards. It's been an interesting week, that's for sure!

Stone

So, last night was eventful. I went to bed at my normal time, with the same pain I had all day. I woke up at 2am feeling fine, got up to do some business, then went back to bed. That's when the pain came back, again, with a vengeance. The most intense it's been. I must have been making enough noise because David rolled over to comfort me. Finally the intense pain subsided to the regular pain. I was able to get a few more hours of sleep, then 6am came and the whole thing started over again. I knew it was time to do something.

I laid there thinking, "do I wait to call the doctor? or go to the ER?" I figured, I'll have to wait longer for the doctor and he'll more than likely send me to the hospital anyway. So we got up and moving and headed to the ER. Once again, for those that know me, I absolutely hate going to the hospital. I don't have a problem with needles or pain, it's more the waiting and the cost that comes along with it. I don't even want to think about the cost.....That and what if something serious really isn't going on? I'd look like a total idiot going to the ER for gas.

We arrived and the ladies in reception looked at me, didn't say a word, and looked at me like I had 3 heads. I couldn't help but think, "Am I in the wrong place?" I was in the right place and thankfully got right in upon registering. Actually everything went quite smoothly. The nurse came and got me, I saw the doctor, he did an examination, they took blood, took urine (via catheter....yeah, that's a first and not fun). After a decent wait the results came back showing nothing....one of my greatest fears. You can't help but think, "a\Am I a hypochondriac?" But I reminded myself, I knew something was wrong. I wouldn't be here if there wasn't. Even though my urine came back fine they were concerned about kidney stones. (which is a good possibility since mom has a history) So it was on to a cat scan and xray. Another long wait, and then my results came back.

Yep, that's my diagnosis. A partially obstructing kidney stone. They can only figure that I've been dehydrated, then running while dehydrated, which has lead to the problem. I know I don't drink enough and David is CONSTANTLY on me saying, "You need to drink more!" The thing is, I already urinate a ton and often. Anytime I add more fluids to the mix I'm literally in the bathroom every second of the day and sometimes I don't even think I can make it on time!

I've had this pain on and off for a couple years....this has been the most intense experience. I've been seen by the doctor for it before, but when time came for diagnostics (at a later date due to their scheduling) my symptoms were gone, so I'd always cancel. I'm wondering how many stones I've passed in the past or if the present little booger has been around a lot longer.

So, that's the deal. My current treatment plan is pain medication, lots of oral fluids, and straining my urine to collect anything. Fun times. Then I'll follow up with the urologist. I can only imagine what my bill will be, even with having insurance. Thankfully we no longer have the HSA! But that's a worry for a different day. Onward to hydration....

Pain

I must admit defeat for my week's running plan. I know I had such a positive blog, yesterday, but there's absolutely no way I can make it to the gym today.

I woke up this morning with a lower left side abdominal pain. The first thing I thought was, "it's gas." I know, TMI, but whatever. But that proved not to be the case. The pain has persisted all day long. Thankfully HOT baths have helped and I've been able to lay in such a manner that allows me to sleep through the discomfort. Also, thankfully our appointment schedule was super light and I have available sick time to be able to stay home. If you know me, I don't take sick time off of work. As it stands I have approximately 40 hours of sick time earned/saved. I just don't like to take off....not to mention I've been quite healthy. (knock on wood)

I've hunkered down today in hopes of allowing the pain to go away and against my mother's wishes I did not go to the doctor. I have absolutely no idea what the pain could be emanating from, but I'm going to try to be patient. I was all excited when I woke up from a nap and the pain was entirely gone. That was until I moved to get up and it came back with a vengeance nearly doubling me over in pain. But, that's okay. I'm fine.

With that being said, I will not make it to the gym today. A defeat in my new plan? I guess so but I know when this girl's in too much pain to go to work, she's in too much pain to go to the gym.