Kidney Stones

Here's a recent great thread for first person experience with it. http://absolutewrite.com/forums/showthread.php?t=134415&highlight=kidney

Does anyone know how long a doctor would consider 'a reasonable amount of time'? The story needs the kidney stone for about 36 hours (lol).

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In my case, the doctor took x-rays, determined the stone was too big to pass so the "wait and see" approach wouldn't work. Laser surgery was scheduled. After the surgery, I had to walk around with a catheda (that spelling is soooooo far off) inside of me. I don't know why.

I was uncomfortable for about two weeks, and felt like I had to pee 24/7.

However, another time when I passed a kidney stone I was fine right after.

What did the kidney say to the stone?







This too shall pass.

I passed one without ever seeing a doctor, and from the first twinge until it finally passed, I experienced the most intense pain and thirst imagineable. It took about three hours and I could feel it moving every miserable millimeter.

The second one, twenty years later, began as a dull ache in my stomach. I also experienced severe indigestion. I had no idea what it was, but after a few hours with nothing getting better, I went to the emergency room where the stone was diagnosed. I was prescribed strong pain killers and scheduled for the "jackhammer" treatment using ultrasonic waves to break up the stone. I needed painkillers around the clock, as the pain seemed to intensify as time went on.

A week later, I had the procedure and when I woke up, except for some bruising on my back, I felt completely normal. I passed small fragments of the pea-sized stone and a small amount of blood for several days.

I'm not sure if a family doc will prescribe painkiller to patients with kidney stones. In my case, when I went to see my doc for the arching pain, he didn't wait until I was finished groaning before he gave me a slip to check into the ER.

I stayed in ER for like 8 hours, had X-ray, CAD scan, and other exams taken. I believed I had taken painkillers while I was there. The doc told me the stones had passed, so I didn't need to stay for interventions. He prescribed me with painkillers before I was discharged. I still had a little bit of pain when I walked out to my car, but that was understandably from the inflammation, and it was nothing, not even comparable to a headache.

So, yes, I think kidney stone can be an incident where a person suddenly suffers a lot of pain that will come very fast and also be gone in a snap. Also, for those (characters) who detest doing annual/regular physical exams. This can be a plot device to force them into one (they will make you do one while you're there.)

A woman I once saw as a cancer patient (no, I'm not a doctor, I was a PA at the time), experienced a kidney stone while under radiation therapy for the cancer. She claimed the pain was worse than cancer and childbirth combined.

I've never had cancer or a calculus, thank God, but if it's worse than labor...um.

Have you considered a gallbladder attack? I've had that and that hurts like crazy, but I wouldn't put it on a par with giving birth. And that pain does come and go 'til they treat it.

It's one thing to get a kidney stone and know what's going on, it's a totally different story when you don't know. I got one a couple of years ago. I'm in a foreign country and don't speak the language, so going to an emergency room wasn't an option, especially since I had no idea where a hospital even was. I managed to get my girlfriend's answering machine and told her I would probably be dead soon and asked her to get a hold of my mother and take care of things. I really thought I was going to die.

She called my back a few minutes later and said I probably have a kidney stone cause her mother once had one.

Point is, they come from lack of water. That was one thing I learned when I first started writing. I'd spend hours typing away with no food or water or bathroom breaks--completely absorbed in my imaginary world.

I know better now.

Basically, the MC ends up in serious pain and starts throwing up on day 1 (early morning). His wife takes him to ER (late morning), the doctor diagnoses kidney stone(s), gives him painkiller and sends him home, telling him to rest and drink lots of water. Day 2, MC is still in some pain and his wife says she wishes there was something she could do to help him. At this point in the story, their religious beliefs are very different. She is a Christian, and he is religious, but shares very few of her beliefs. He gets angry with her, and says he bets she's been praying a lot, but obviously it isn't working, so maybe she'd better quit. This leads to a fairly nasty disagreement, but is the turning point in him beginning to soften toward her beliefs. The kidney stone attack ends about midafternoon on day 2.

Reading the medical stuff I found, I thought I could make the attack last for about 36hrs, only now I know that might be a little ridiculous. If he had two stones, he could have on the first day and one the second, for like 4 hrs each. Hmm, that makes more sense to me.

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If he's at the point of throwing up, then he's had pain for months. Nothing major, just pangs of pain that go away quickly (at least that's what happened in my case when I passed a stone). So if there's a way you can incorporate slight pain here and there throughout the book (again, nothing major. just discomfort), then the 36 hr. scenario can make sense.

I had gallbladder trouble for years before finally giving in and having surgery.

The pain would last for several hours and would only go away if I was given pain meds via injection. I'd vomit, couldn't eat, hurt intensely.

The pain was just below my sternum in my upper abdomen. It felt as though a hand in a white-hot metal glove had reached into me and was twisting my guts. The pressure of the twist never seemed to let up and just kept getting tighter and more painful every moment.

I prayed for death at times. The only hope was to become medicated enough to sleep off the worst of it. Once the pain was gone, it was like I'd never had it. Then, a few weeks or days later, I'd have another one.

Once I had it removed, I felt a million times better. The op report said I had multiple gallstones of various sizes that filled the gallbladder.

Um...if you're making one of your characters Christian, please avoid the stereotype. We don't just pray and avoid seeking competent medical care. Most of us do both.

That said: if your character-Christian belongs to one of those fringe groups, of course, anything goes. Most believers, however, cringe at the idea of forgoing medical care when it's necessary.

As far as gallbladder: yes, you can definitely have your character become nauseated. It got so that almost anything I ate made me sick to my stomach before I had my cholecystectomy.

I've taken care of thousands of kidney stone patients. The primary treatment is to let them pass. If it's 5mm or less most people can. However I've seen some people pass stones up to 15mm and others get completely obstructed from a 2mm stone. Depending upon the stone composition, some times they can be dissolved with medications. Some times they need surgical intervention such as ESWL (Extracorporeal Shock Wave Lithotripsy), Ureteroscopy and laser plus or minus Stone Basketing, Stenting, and rarely nowadays Open Surgery. There are also medications that help the ureters to dilate a little to assist in passing stones depending upon size and location and shape of the stone. As long as there is not a complete obstruction and there's no sign of infection and the pain is only intermittent and able to be controlled with oral meds of reasonable dosage, then it is safe to wait months even. In Europe that's what they do and they don't have any statistically significant higher risk of kidney failure. In America, if you have to take every third day off from work for 2 months you are likely to be fired. We do more surgical interventions here partly for social reasons.

If the person has to take so much medication that they can't function, or if the pain makes it so they can't drink water due to pain induced nausea (therefore they don't drink water and don't make the urine to push out the stone) or if there is a complete renal obstruction or any evidence of an infection, then intervention is warranted. In a complete obstruction (assuming you have another healthy kidney) you won't notice any drop in urine production and there is typically round the clock pain for about 3 days, and then it tapers off as that kidney shuts down. Once it has shut down it it will start to become functionally compromised and by 2 weeks there is the beginning of permanent damage. By 6 weeks that kidney may be unsalvageable. So the pain going away isn't necessarily a good thing. Also passing A stone doesn't necessarily mean that that kidney is unobstructed by THE stone that is giving them pain.

Having your character in constant pain for 36 hours is reasonable. Those people I'd usually put in the hospital on IV fluid and a pain pump with either demerol or morphine. Often a 23 hour stay on IV fluid is enough to get them to pass it.

I'll share my gallbladder story too, if it'll help.

I had three separate gallstone attacks before I went to the ER. Each time it started out as back pain, lower right side. Extremely acute pain, like I'd pulled something while trying to lift a heavy box. In fact, I thought that was what I had done. Then the pain moved from the back to the front, then vomiting would ensue. The first time I thought I'd thrown out my back, took some pain meds and went to bed, and felt fine the next day. The second one occurred about a month later. The third time, I woke up with the now-familiar back pain, and after a while said, "Okay, it's going to move around to my stomach now," and it did. Then I predicted I'd be throwing up soon, and I did. Then we went to the ER. While I was waiting at the ER the pain was so intense that I couldn't sit up or lie down comfortably; the only thing that worked was kind of curling up half-slumped down in a reclining chair.

Point is, the pain came and went. So it could be really intense and "please kill me now" for a few hours, and then it would be completely gone. By the time I was finally admitted to the hospital to go into surgery the next day, the pain was gone and I was annoyed that I couldn't go home.

I was having a hell of a problem witth kidney stone. I am also prone to infection. The pain is always at the lower abdomen and it was quite severe. I took some aurvedic treatment than it got ok .
padma

They can give Demerol, Dilaudid--any number of pain medications. If a patient is allergic to MSO4, they'll give something else. Phenergan with the med in an IM injection potentiates the narcotic and also may help with the nausea.

Some people do become nauseated from the pain medication: Demerol or MSO4. I don't remember if Dilauded has nausea as a side effect.

I recall being given one of the narcotics in the ER once for my gallbladder and telling my mother, "You know, I still hurt, but I don't care." That's what the drugs do--make you not really care about the pain and help you sleep it off.

LOL, mine they controlled with oral Vicodin. Nobody offered me a shot, but by heaven I would've taken it.

And your prayer/no prayer scene works for me. I may have over-reacted, but I get so tired of people saying, "Oh, they're Christians so they'll just pray 'cause they aren't smart enough to go to the ER." Stereotypes: pah.

I had this problem a few years ago. I ended up needing surgery the next day (laser and then a stent) as it was too big to pass. But, the pain was pretty bad, came and went, but was gradually getting worse throughout the day. Was on one side, mostly in the back. I'd hold my breath and force a smile. Ended up on the couch, curled up, not wanting to move. Face white as a sheet.
If you have any questions, I'll be happy to help.