Kidney stone

[Guest guest]

Matt,

I can sympathize with you regarding the pain you expressed in your post. My husband had two of them, however it took 2 trips to the E.R. before we found out what it was. The first DR. told my husband (after that dreaded exam most every man hates) that he had prostatitis, sent him home with some Tylenol 3 and some antibiotics. The second DR. (mind you this was 3 days later) said he still had prostatitis but this time kidney infection.

Two days later he was on his knees, throwing up in-between bouts of crying. I swear to you it was the first and last time I'd ever seen the man cry in 12 years of marriage. I finally called our family physician and described what my husbands symptoms were. He told me to get him over to his office immediately, so once we got there, he did an IVP on him and sure enough there they were, two huge round stones, one in each ureter. He was given some more pain medication, sent home and the very next day had the lithotripsy procedure done with immediate relief after he passed the pulverized stones. I can not imagine how any man could live through that kind of pain. His symptoms were exactly the same as yours right down what felt to him like testicular torsion. Its awful that kidney stones hit when you least expect it but I guess they do. There does not seem to be any symptoms or warnings of any kind that would allow a person to head it off.

Glad you are feeling better. Hope you never get any more. Happy Holidays.

PPeaches.

[texasems-L] Kidney stone

Howdy all!

Learned something new yesterday (Christmas day) on duty. I learned what a kidney stone feels like first hand. I write this because I want to set to rest the following thoughts I have heard expressed/had myself:

1> The pain isn't so bad. WRONG. There is NO way to describe the pain. 10/10 doesn't come close. Read my story, you will come to undertand.

I was sitting in a chair relaxing after a one hour nap (we had a quiet x-mas) when I began feeling like I needed to have a BM. Then I realized my mouth was quite dry, so I went to get a drink. While getting the drink I decided I needed to get to the bathroom NOW. I got into the bathroom, got cold, sweaty, and nauseous. The pain was " cramp like " in my right flank midway between my ribs and pelvis. Needless to say I couldn't go to the bathroom. I got up, put my pants back on and walked into the ER. I stopped at the nurse's desk and asked Mr. Redman (the PA) " What does a kidney stone feel like " . The RN asked, " Are you okay? " I said, " No. " (this is what got me concerned, I was asked if I was okay).

At this point I was described as " pale, diaphoretic, agitated " . I was also nauseous. One of my co-workers helped me to the bathroom. It made me sick to my stomach to walk. In the bathroom I knelt on the floor trying to vomit and couldn't. After a couple of minutes (which felt like hours as the pain had become " knife like " at about 8/10, " coming in waves " ) I was helped out of the bathroom to a bed. I got undressed, which took one helper and 5 minutes. An IV was started. (took two attempts because I COULDN'T hold still. I was literally " writhing " in pain. The pain had become 10/10 at that point) I was given 30 mg Toradol IV. At this point I should note that 1 T-3 (Tylenol with Codeine) usually puts me to sleep for 8 hours.

No pain relief was experienced with the Toradol. After several more minutes of pain, I finally relented and let them give me Morphine. (I don't like taking medications, especially narcotics) They started at 2 mg Morpine IV. No pain relief.

2> Morphine will relieve pain. WRONG. It makes you feel like you are packed in cotton. The pain is still there, it just doesn't bother you as much. I was still unable to sit still. I just COULDN'T find a comfortable position.

3> Morphine gives you hot flashes. CORRECT. It felt like my heart was suddenly hot, then so was the rest of me. VERY strange feeling.

4> Morphine gives you a dry mouth. CORRECT. No way to describe how dry my mouth got.

After 1000 cc NS IV I was able to provide a urine sample, which was positive for blood (25. normal is 0-3). I was moved to a wheelchair. The pain had risen to a 10/10 with the Morphine not even " dulling " it anymore. I was given 4 mg Morphine IV. I got nauseous again and did a first for me. I requested medication. I asked for Phenergan. 12.5 mg Phenergan IV later the nausea was gone. (as a note, this nausea could have been due to pain or the Morphine, so be prepared for your patient to complain of this)I was moved to radiology for the IVP.

IVP apparently stands for " Intravenous Pain " . First thing you should all be aware of is that if the patient is allergic to Iodine getting the dye is a " Very Bad Thing " . The second thing you should be aware of is that the dye feels like someone is putting a hot poker into your arm (at least it did for me). The third thing you should be aware of is that it makes the kidney stone pain WORSE. My pain shot to a 12/10, " knife like " , radiating to my right testicle. The only way to describe the pain in my testicle is " like someone was squeezing quite hard, and twisting simultaneously " . (I will now pause for all of the men to say, " Ow " ) I was given another 4 mg Morphine IV. This again did nothing to help the pain.

During the final 2 x-ray's, the pain suddenly subsided. The kidney stone had moved from my ureter into my bladder (thank you god). The pain dropped to a " nagging " 2/10. Things improved from there. Before you can leave x-ray, you have to give them a urine sample, and they take a last x-ray (this is to make sure you are voiding the dye). The urine sample took awhile to provide. This is because I was having difficulty standing (10 mg Morphine on board, go figure). I also simply couldn't urinate. Moving from standing to laying on the x-ray table was also quite uncomfortable. Before the final x-ray, I was given 1 mg Morphine because I said, " Ow " when I laid down on the table. (a co-worker was in charge of the MS at this point, and was trying to keep me comfortable) My x-rays showed only that my ureter was " straight and dilated " . I apparently passed the stone between x-ray's.

I was returned to the ER, given a second 1000 cc NS IV bolus, prescribed Percocet, and sent home with a urine strainer.

5> After the stone passes the pain goes away. WRONG. The pain stops being " knife like " . I still hurt. The closest I can get to describing the pain is " like I have been hit in the kidneys a couple of times " . Moving around increases my pain. I have spent most of the day asleep (thank you percocet).

I am writing this because I have never felt pain such as this before. I thought if I shared this story with you it would allow you greater empathy for your patients. I hope it helps you to understand what a kidney stone is like.

Happy and Safe New Year all,

Webb

PS: If I offended anyone with this story, I apologize. But I truly felt this story to be EMS related as we deal with patients having kidney stones.

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