13 Oct Not For the Faint of Heart: My 4th Kidney Stone Surgery
Last week, Jill and I arose at 5:00 AM one morning for my fourth kidney stone surgery. The sun wouldn’t rise for another hour and a half. We get up this early only for a special occasion, usually a flea market or distant auction. Three extra-large stones had lodged themselves in my left kidney, which has troubled me intermittently for six years. (The largest was one centimeter in diameter.) Once again I was peeing blood and it’d be only a matter of time before one of those stones attempted its escape down my ureter. A large stone like that would never make it out. Once stuck in the ureter, the stone would bring me to my knees with pain so searing I’d start vomiting immediately, my body in shock.
I know, it makes no sense that so small an obstruction–not much larger than a grain of sand–could cause so much damage. It’s humbling really. Now, in my sixth decade I can only shake my head in wonder at how my expectations of a full and healthy life have changed. Never had I imagined that I would be a man in dire need of a good urologist. My last urologist seemed wholly unmotivated to find a solution to my body’s recurring insistence on manufacturing kidney stones. My new urologist says, “Once a stoner, always a stoner.” But I’ve been a “stoner” only since moving to the farm. So it’s got something to do with my life as a would-be farmer. Right?
I sweat a lot when I work outside. In the summer, I might change my sopping t-shirt three times in a day. By the day’s end, my jeans will be soaked too. Also I’ve eaten a lot of oxalate-rich foods. My stones are the oxalate variety. So I’ve cut out the worst of the offenders: spinach, beets, almonds, soy, raspberries, and potatoes. And I drink nothing but water. Problem is, none of us drinks as much water as we should. I’ll undergo a water test soon to check my hydration. It’s simple: you pee into a plastic container over the course of 24-48 hours to see how much your intake yields.
The missing link may be farm water, which is heavy with minerals and contaminants. Recently I replaced our simple household water filter with a super-duper reverse osmosis, triple-filtered system that takes up an impressive amount of space in our basement. I’m hoping this will do the trick.
As I drove to downtown Baltimore, the pre-rush traffic growing heavier and the sun still absent, I couldn’t help but consider how vulnerable Jill and I are. She’s my drive home, the one in the waiting room who will do whatever has to be done should things go wrong on the operating table. But she’s on opioids and dying of cancer. Still, she has reason to worry that I may die before her. I’m ten years older than she. I worry too, taking nothing for granted these days. The prospect of leaving Jill abruptly alone and stranded in her last few years keeps me awake in the early morning hours. I tell myself I can’t falter, I can’t fail. I’m determined to deliver her as much happiness as I can, which is why I’m working hard to complete the farm and bring her sheep, goats, and chickens for comfort in her final days. In fact, we just adopted two more cats for the house.
A few months ago, my middle brother had a stroke. He was in the car with his wife, two hours from home, and she was alarmed when, suddenly, he started slurring his words, drool leaking from his lips. They knew immediately what was happening but my brother insisted she drive him to the famous hospital at home. He’s since had surgery to open up both carotid arteries. And he says he’s okay now. After that, I rushed to my cardiologist to have myself checked out. Though my cholesterol is higher than it should be, apparently I’m not going to host a heart attack any time soon.
But who knows? Stokes have taken down everybody on my mother’s side of the family.
As it turned out, my surgery was in the same hospital and the same wing as Jill’s reconstructive surgery ten years ago after her mastectomy. To her considerable credit, this did not freak her out. She’s that tough.
The last thing I heard before I went under was a nurse saying, “He’s got such big hands!” In my increasingly groggy state, this sounded to me like a compliment. When I awoke, another nurse entered my curtained recovery bay and said, “Is it all there?” I was staring at my penis.
I said, “I do believe I survived.”
“That string is for the stent.” She smiled. “The doctor will explain.”
My penis–which I prefer to call my “peep”–had been through some serious trauma, as the doctor had to insert both a camera and a laser scope up my urethra, through my bladder, then up my ureter to get into my kidney, then seek and destroy the offending stones. He got all three. That’s a good surgeon.
Kidney stone surgery is always followed by the insertion of a stent, a long tube (about 8”) inserted into the ureter to keep it open and ensure that the fragmented stones can evacuate. The last stent I’d had was a monster-thick tube that never let me forget its irritating, slow-aching presence. It was so intrusive, I could hardly bend over without losing my breath. But the new stent is considerably thinner, making its presence subtle. And get this: it’s attached to a long thread that exits my urethra so that, after one week, I can pull it out myself. That’s right, a DIY stent.
After the surgeon debriefed me, they put me on heavy antibiotics, gave me a prescription for some oxies, then sent me home, Jill holding my hand as we made our way slowly back to the car. Once you’re off the operating table, you’re pretty much good to go. That is, barring some outlandish anomaly, you’re going to survive. Although I anticipated plenty of blood in my urine and a couple of days of painful pee, I was wholly unprepared for what happened next. As I attempted to empty my screaming bladder, I felt immense pressure from my left kidney, as if the blood were being vacuumed out of it, the kidney threatening to collapse into itself. This was very much like kidney stone pain, so severe I immediately broke into a cold sweat, my body racked with tremors and my gorge rising, readying me to vomit. I all but passed out until, finally, the pee came in a feeble, bloody trickle.
This was on top of the excruciating tickle of an overwhelmingly urgent need to urinate. That agonizing tickle (five times what you may have experienced in your worst I’ve-really-got-to-go! episode) has pursued me for three days and counting. But don’t forget, I’ve got a stent in there–and a string hanging out of my peep. Fortunately, the kidney pain has diminished day by day. I mean, think of it: there was a film crew in there poking around for an hour just last week. My kidney has cause to complain.
Jill and I have committed to getting our paperwork together–living wills, power of attorney, etc. Soon, very soon. Nature is making clear that we can’t procrastinate, no matter how much we’re reluctant to face the final facts of our situation.
As for the string hanging out of my peep. Its end is taped to the stalk of my penis, so it’s out of the way. Urine, don’t forget, is sterile, so there’s no worry about infection. By the time you read this, I will have pulled out the stent and, wonder or wonders, survived yet another bout of kidney stones.
If you can help with Jill’s medical expenses, here’s a link: