Oh, The Pain!

Some of you may have noticed that I have not been active for the last two months, or so. Well, here’s the story.

I was getting behind on a book that I’m working on, so I decided to get back to prioritizing that, having only a couple of chapters remaining to be written. Several weeks ago, I woke up on a Sunday morning and went into the bathroom. Though I had no other signs or symptoms at the time, what I urinated had the color of iced tea; not a good thing! Later that day, what looked like iced tea in the morning, looked like port wine! It was the very definition of frank, hematuria.

Of course, it was a Sunday and I had nowhere to go to get an echographic exam, but I did call a friend who was able to see me on Tuesday. Since I had no pain, I figured that that would be okay, so I set the appointment. In the meantime, I decided to hydrate as much as I could and to consult with my brother Gary. Gary is an Internist in Arizona and, though I have diagnosed many patients with kidney stones, I have never treated any. He, on the other hand, has treated so many I couldn’t possibly count them.

I made the mistake of talking to him on speaker phone with my wife present. After describing the signs, and answering a few of his questions, he told me to get either an MRI or a CAT scan with contrast as soon as possible for a suspected Renal Cell Carcinoma. My brother doesn’t mix words; he said to think of the worst-case scenario and go from there. When my wife heard this, she freaked out! What she heard was, “You’ve got cancer!”

Now, I’ve never been a “reactive” person; I usually keep my cool under most circumstances, but knowing my family history, Gary’s suggestion planted a little seed in my mind. I said nothing to my wife, but had to explain to her what “worst-case scenario” means in medical jargon and that I was more than likely just passing a kidney stone.

Monday came and I was feeling only a slight pressure in my left flank. It wasn’t bad enough to keep me home, so I went to work, as usual. That evening, after dinner, I started to feel some twinges of pain, but nothing really of concern. This, however, was only a heralding of things to come.

At 3:00 A.M. on Tuesday, I was awakened by a pain so strong, that it gave me the urge to vomit. I had to get to the bathroom as soon as I could, but I was doubled-over by the lancinating jabs of what seemed to be a hot knife sticking me in the abdomen. I was totally unprepared for this and had no analgesics or any strong anti-inflammatories available to ease my suffering on hand. I had to suffer through this torture until later that morning, when I could get to the local Emergency Room.

We arrived at the local Emergency Room at about 8:30. By this time, the pain was so strong that I wanted someone to put me out of my misery with a small dose of therapeutic lead – a good 45 caliber bullet through my right temple would have sufficed. I was finally referred upstairs to the sixth floor to the urologist at about 12:30 for an echography study. This study confirmed the hydronephrosis but could not localize the blockage of the ureter.

The urologist suggested a CAT scan with contrast, which could not be performed in the hospital because they were out of contrast media; the WHOLE hospital was out of contrast media! I was offered some morphine for the pain, but opted for an injection of Toradol, instead; I had the suspicion that I would be taking these injections for some time and didn’t want to become a morphine addict waiting to clear my urinary tract of obstructions. I was dismissed to do the CAT scan privately.

When I arrived home, my wife went off to the pharmacist and I called a radiologist friend who informed me that he could not perform the CAT scan until the next Tuesday, because the technicians only came in once a week for this kind of study and they had already left the center.

Over the next seven days, I injected myself with Toradol at least once every twelve hours, unable to sleep nights and having completely lost my appetite. I became so physically weak that my wife had to assist me in my movements. My three dachshunds sat vigil over me for hours when I was finally able to close my eyes.

The day finally came for the CAT scan and it confirmed everything I thought it would. When I returned home from the radiologist’s office, I called the urologist to set an appointment – Thursday morning at 11:00 a.m.. When Thursday finally arrived, I went to the bathroom and urinated out what seemed like a reddish-brown sludge and, instantaneously, all of my pain and pressure vanished. I was free! Two hours later, I was with the urologist and the echo showed a normal kidney and “jet” into the bladder from the previously obstructed ureter.

I was fully prepared for a short, hospital stay and the surgical procedure to eliminate the stone and stent the ureter, but was saved from this by the normal, but painful, course of nature. In the end, however, I lost 14 kilograms of body weight, my appetite was reduced to about half, my gluteal areas looked like pin cushions and my wife had to go out and buy me another seven pairs of pants because I had gone down three waist sizes.

I also missed over 450 telephone calls from patients, which I now had to call back and justify my late response by recounting the horrible episode I had just lived through. In any case, I have to say that they were all understanding and we had to reschedule a whole lot of visits.

Oh no; not again!

Two weeks had passed from that great relief when, again, on a Sunday morning, I urinated blood. This time, I called the urologist straight away and he told me to come directly to the hospital the next morning at 10:00 a.m. for another echo study.

Though I had no pain yet, the echo showed another obstruction. He told me to continue the treatment he had given me before and to hydrate as much as possible and to see how things progress. I was back on the merry-go-round and when the pain hit that evening, it was with a vengeance. Once again, I was buckled over. Once again, I was shooting Toradol. Once again, I had no appetite and was losing weight, sleep and what was left of my mental faculties. This continued until Thursday morning at about 3:30. I hobbled my way into the bathroom with the urge to go, but couldn’t. As I sat there rocking back and forth in pain, I looked up at the box of syringes and vials of Toradol on the medicine cabinet and rolled my eyes at the prospect of another injection.

Then, I had a flash of a memory from when I was a kid.

I remembered a conversation I had had with a Lenni Lenape elder about the value of the medicine man in easing suffering. I had to be about eight or nine at the time of this discussion, but it came back to me as if it had happened the day before. I left the Toradol and the syringes in the bathroom and prepared a hot water bottle.

I then got my cell phone and looked up “Native American Healing Chants” on Youtube. There, I found a 35-minute-long chant by a Sioux Medicine Man in the Lahota language and tried to find as comfortable a position as possible to listen in the darkened room.

Now, I don’t know whether it was causal or casual, but within 20 minutes of listening to that chant, I felt a warm sensation running down from my left kidney into my lower abdomen and the pain and pressure dissipated as though a dam had broken. I stood up and had complete relief. When I went into the bathroom at 4:00 a.m., I streamed out bloody urine and brownish bits of concretia; the stone had broken apart and was expelled. I stood there slack-jawed, exhausted and dumb-struck.

After a few moments of reflection, I went back to bed and slept like a baby for the first time in days. Later that morning, I awoke and went to the bathroom and my urine was clearing up nicely. I gave silent thanks to the Sioux Medicine Man and Our Father and Great Spirit who gave us the Winds and the Tatanka.

I think it is a good thing the doctors become patients every once in a while; it is humbling and a necessary lesson in humanity. As for my experience, I can tell you of the anatomy and physiology of the urinary tract. I can tell you how kidney stones are formed and what they’re made of. What I cannot tell you is how a Lahota Sioux chant seems to have busted up a kidney stone in an Italian from South Philly living in Southern Italy.

I am grateful, anyway!