Magical Medical Tour: IN GRATITUBE
Act one: Signs and Symptoms
I was absorbing the beautiful light of a mid-May dusk when my right kidney decided to gift me with a nugget made of calcium oxalate (a chemical compound that forms needle-shaped crystals and is a major part of human kidney stones). I was grateful that the diameter of the tube (Right URETER) from my right kidney to my urinary bladder was larger than the diameter of the needle nugget slowly slashing through it(me). The “passage” was still painful enough to bring me to my knees while causing involuntary emesis (vomiting). The pain subsided in 24 hours on a regimen of anti-inflammatory medication, increased fluids, rest and meditation. But I didn’t realize this episode was a harbinger of things to come. Two months into the future, I will be viewing this kidney stone and more on a CAT (computerized axial tomography) scan.
In June, I was grateful for the second tube that carried water from my camel back to my mouth so that I could endure the 100+ degree temperatures at an elevation of around 6000 feet, climbing to Delicate Arch in Arches National Park Utah, where I became a fiancé to my fiancée .
Three days later, it was July and I was NOT grateful for the tube (The URETHRA) that traverses from my urinary bladder to the outside world. It refused to work on my behalf or request. My kidneys were producing urine and my bladder was storing it but my urethra closed off and would not allow me to relase or empty. As a doctor, I began to evaluate signs and symptoms on my quest for a clinical diagnosis. While I am in the mode of believing that everything happens for a reason, I also search for lessons. Of course it was the first day of the July fourth weekend and I did not want to go to the Emergency Department, at least not yet. Fortunately, having medical friends with benefits, I was able to call my friend, a surgical specialist (UROLOGIST), who agreed with my potential diagnosis. He gave me a few pills to take to assist me through the weekend. It was not a fun Fourth.
♬Dah, Dah, Dah, Daaah ♬. Beethoven was in my head as the Fifth arrived. I was happy to be seeing my Urologist. I wanted this problem to be finished. The first thing he said, when he observed my distended abdomen, was “you look like you are 28 weeks pregnant”. He confirmed with an ultrasound that I was not about to be a “fother” (not actually sure what I would have been called if pregnant). Two liters of trapped fluid (Urine) was the cause. Even with my eyes closed and still lying on my back, I could sense him reaching for the next tube (FOLEY CATHETER). This is a very long tube that was about to be inserted through my urethral opening (The MEATUS) all the way into my bladder, the goal being the release and relief of my false pregnancy. I had mixed emotions (not about the pregnancy). On the one hand, I did not want anything to enter my bladder from the outside world. On the other, I needed my bladder emptied to save my kidneys. I’m cool. I can handle an “in-out” catheterization. “Nope, it stays in for one week”, said the Urologist. “And you will be on medication.” I really did not want this because of potential side effects. What followed was a set of instructions: Here’s how you empty the bag. Here’s how you change the day bag for your evening bag. Here’s how you take the medication. In case you’re wondering, it is not easy to follow technical instructions while having a Foley Catheter inserted.
Act two: The Diagnosis
I drove to the Radiology facility and sat in the waiting room watching some very, very sick people dealing with assorted maladies, in many cases very gracefully. Trying to get up on to an x-ray table with a catheter and bag ensemble required a new set of skills. I was so appreciative of the scientists who invented a tube (CAT Scanner) that would use less radiation than a regular chest x-ray and help nail down my diagnoses of bilateral kidney stones and an enlarged prostate gland. The scan also showed that I did not have a malignancy(cancer). All other organs looked very good. Next, I went to the laboratory waiting room where I observed more courageous people. I was hoping the lab tectnician would find a willing vein with the first needle stick. The tight tourniquet exposed a plump tubular appearing vein. After the appropriate sterilization of the site, accompanied by the smell of alcohol in the air, he took the sharp needle and went for it. Relief came when all five tubes were filled with my blood and the needle was removed. The ensuing analysis would give information on the status of the rest of my body and offer parameters influencing my treatment plan.
I survived the week with my clumsy catheter, fearful at all times that I might accidentally catch the tube on something and rip it out of my body. The good news was that it did allow me to sleep a complete night without worrying and I never did catch it on anything.
The plan was for me to get up at 5:00 a.m., deflate the balloon holding the catheter in my bladder and carefully extract the very long tube. I succeeded in removing the catheter but my urethra was not in a benevolent mood. Five hours later, no liquid gold. I was unable to urinate.
Across his desk the urologist said, “Too late for medication; you need surgery, NOW!”. I was grateful to my very competent and knowledgeable friend for sending me to another specialist, who used a special surgical instrument that would be best for me.
I drove calmly across town from one doctor’s office to the next. I didn’t know if I would be in surgery in an hour or what was about to unfold. I had no idea at the time that the element, Boron (Atomic number 5 on the Periodic Table) would play such an important role in the upcoming treatment of my condition.
Can you say photoselective vaporization?
Stay tuned for Act three: A Nightmare Week
Magical Medical Tour:
[tags]Kidney, Urinary Bladder, catheter-urethra, clumsy-catheter-deflate, photoselective vaporization, Radiology-x-ray[/tags]