The Stoning

The human body is a mysterious thing. One minute it can be lying comfortably in bed without a care in the world. The next, it can be mimicking the feeling of a knife in the back, causing its owner to stagger into a bathroom, clutch a towel rack like a boxer on the ropes, and debate whether to die quietly or cry out to others.

But what exactly should I yell?

“I’ve been stabbed – please come quickly!” (That wasn’t really accurate, and the request for assistance felt halfhearted.)

“Someone help me – it’s an emergency!” (Using the universal someone allows everyone to tune out, and one man’s true emergency is another man’s search for toilet paper.)

“Help – I’m in pain!” (This is a plea that lacks context, inviting a range of off-target responses from “Can I get you some antacids?” to “Here’s my therapist’s card – she’s easy to talk to and very affordable.”)

By the time I finished debating what to yell the pain had subsided. So I took some aspirin, continued on with my morning, and chalked it all up to a strained back muscle.

Bad diagnosis, Dr. Alan.  

On average each year, kidney stones are responsible for more than 600,000 emergency rooms visits in the U.S. Two nights after my mysterious back pain first surfaced, I became part of that stone cold stat.

“You have a 7 millimeter kidney stone in your right ureter,” the ER doctor confirmed.

“Is that considered big?” I asked, not sure if I should picture a poppy seed or pop corn.

“Anything below 5 millimeters usually passes on its own,” he explained. “Above 5 millimeters and it’s less predictable.”

He had that right. After those first few hours in the ER, I was hospitalized for three days; put on IV fluids, morphine and nausea meds; released from the hospital with new pain meds; given home care instructions to flush the stone out naturally; and endured four days of excruciating discomfort and nausea as the pain would ramp up before the next doses of meds could be taken. And still, the stone loitered stubbornly in my ureter making my life a living hell.

Finally, a week after my trip to the emergency room, my urologist scheduled me to undergo shockwave lithotripsy, a procedure where you’re hooked up to a machine that generates high intensity sound waves to shatter the stone into smaller pieces inside your urinary tract. Sound like fun? Not unless you consider your body a video game battleground where the one who bags the biggest rock collection wins.

“How’d it go?” I asked back in the foggy ambiance of the recovery area. “Did the shockwaves work?”

“The stone wouldn’t shatter that way, but I nailed it,” the urologist reported with the cocky air of a video game scoring champ.

“You used a nail?” I probed uncomprehendingly, still dopey from the anesthesia.

“I put in a catheter and attacked it arthroscopically,” he clarified.  “After I pushed it back into your kidney, it fragmented into a pile of powder and gravel.”

“Clutch move,” I murmured. “Sorry I slept through it.”  

My post-procedure homework assignment was to carefully strain my urine for a week so I could bring in my game-winning gravel for analysis. I don’t mean to brag, but after handing over a sample for the lab tests I had enough left over to start my own line of kidney stone jewelry and collectibles.

The brochure the doctor gives you says that once you’ve had one kidney stone there’s about a 60 to 70% chance you’ll have another. The good news is that you can greatly lower the odds of recurrence by taking certain preventative steps. Having been through one stoning and lived to tell about it, I’m in.

Reduce animal proteins? Done deal.

Cut down on sodium? No sweat.

Watch my oxalate intake? A-okay.    

Drink enough water each day to fill the killer whale tank at Miami Seaquarium? Gulp ... I’m working on it.

Hey, if it will dilute my urine enough to keep crystals from gradually building into a rock-like mass that can send me back to kidney stone purgatory, I’m all for it.

Which reminds me. I need to find a bathroom. Wait, who am I kidding? With this kind of fluid intake, I need to find every bathroom.