kidney-stones

by

You blogs, you stones, you worse than senseless things!

Hello and good morning.

It’s Thursday, and here I am writing another blog post to prove that yesterday’s was not a fluke nor a false flag nor any other term beginning with “f” other than perhaps “fair play”.

By the way, I may have previously used the Shakespeare-based title above‒it’s just so easy to make, and I’ve always loved that line from Julius Caesar‒but I don’t care.  It’s too perfect for my current circumstances to miss the chance now.  I mean, blogs and stones?  Come on!

I’m on my way to the office, and speaking of stones, I am far from being over the process of having, let alone passing, my kidney stone.  I’m trying not to overuse my pain meds, largely because they tend to have diminishing returns, and I want them to work when I really need them.  Also, they are quite…well, constipating.  Now, it’s true that I didn’t eat all that much over the course of the early part of this week, and of what I did eat, much of it didn’t stay down.  Still, I went Sunday through Wednesday without doing anything but peeing.

I have been doing a lot of that of course, deliberately.  It is not pleasant.  The pain is not like it was Saturday night, Sunday, and Monday, but it still doesn’t let me forget.  And, of course, we’re moving office this week, and that adds extra hecticity*.  

I don’t know how much you all would want to hear (that I haven’t already said) about what went on in the hospital.  I did talk about it a great deal yesterday.  I suppose I’ll play it by ear and just bring up things that occur to me as interesting.

I have not yet made my follow-up appointments, but I need to try to do so today, if I can.  Even writing about it makes me feel very tense and anxious.  I know there’s no good reason for feeling anxiety and resistance toward such things, but at least now I know something of the cause:  It has to do with ASD, with possibly some pathological demand avoidance, but also just with associated, fairly severe, social anxiety.

But I have to try, and I want to try.  I’ve been rather impressed by the hospital and its associated staff and attending physicians and their network and such, and I would like to get myself plugged into their system if I am able to do so.

They seem quite generous and caring as a tendency and policy.  They do everything from providing free meds for when you go home to getting you a Lyft if you don’t have a ride.  I think that’s pretty nice.

It was oddly nostalgic, being in the hospital.  Well, I suppose it’s not so odd.  I spent much of my earlier adult life in and around hospitals, from med school to residency to medical practice, nineteen years in total.  I guess I miss it.  It was nice working with intelligent, disciplined, professional people at all levels and being able to relieve and even prevent suffering, all while getting a good amount of intellectual stimulation in the form of understanding and solving complex problems.

I don’t expect that I will ever do it again, though.  There are ways, I am sure, to fight to try to get my license back and so on, but it’s not the sort of process for which I have any avidity.  When civilization falls apart, as it appears to be about to do, I can perhaps find a time and reason to lend my skills to the survivors, if I am one of them, which seems unlikely.  Otherwise, I don’t feel a lot of enthusiasm for supporting the world as it is.  Humans have revealed themselves over and over‒by and large‒to be inadequate to tasks that require actual cooperation and consideration and compassion and humility.

It’s ironic that humility is so challenging for humans.  Given how profound their limitations and failings are (despite undeniable strengths, as well) you might imagine that humility would be easy.

But somehow, the default setting even of those who try to be humble is to characterize themselves as absolutely worthless‒which from a certain point of view is always true, but which misses the point of real humility.

Humility is not self-hatred or self-contempt or self-destruction (from which, to some, the only rescue is through some imaginary supernatural being); it is a recognition that one is and will always be limited, capable of error, and incapable of being perfectly objective about oneself and the nature of one’s existence.  With such self-knowledge, one will tend to be better able to make good choices about oneself and others.

Maybe I should try meditating again, to try to keep myself calm when possible.  It might help with my serious social anxiety.  It would probably also help me to get less upset over the idiocy of the current administration**.  And perhaps my mind would then be more useful overall.

Anyway, that’s enough for now.  I hope you all have a good day and try not to get too upset, yourselves.  The world is going to end soon, but that has always been the case‒it’s just a matter of time scales.  On other scales, even a single mayfly’s life is practically eternal.

TTFN

*I think I made that word up, but it seems too good not to use.

**It would be nice to administer a fair amount of current to the members of this US administration, though‒alternating current, with enough voltage and amperage to cause serious discomfort, but not enough to kill them…at least not quickly***.

***See?  Upset.

by

I am not Thorin, son of Thrain, son of Thror…

…nor am I King Under the Mountain.

Nevertheless I return.

I hope no one was too worried about me these last few days, though I have probably given you cause to worry.  Honestly, though, I was in a fairly dire situation.  On Saturday night/Sunday morning I woke up just after midnight with what started as right lower quadrant abdominal pain, which at first I thought was some “normal” GI cramping, maybe from something I ate that I shouldn’t have eaten.

As it rapidly worsened, I became more concerned.  I checked myself for fever (didn’t have one) and for abdominal tenderness, including rebound tenderness.  That wasn’t really there either.

If you are a medical professional, you might recognize that I was worrying about my appendix.  And though the location was right (lower quadrant, ha ha), there were some things missing.  Still, I was concerned, and the pain was worsening.

To make sure I wasn’t being reckless or silly, I bothered my poor sister with a phone call in the middle of the night (she was very kind about it).  She asked me a few questions, tried a little light-hearted banter to try to relax me (I was, regrettably, not amenable, and I fear I might’ve been rude).  The final thing she said was to point out that I have chronic, often severe, pain.  If this was much worse than that‒and it was‒then I needed to get it looked at.

She is wise, my sister.

I had to finish the call quickly and call 911 because the pain continued to increase.  There was no other credible option but an ambulance.  I don’t have a car, but even if I did, I was not capable of driving at all, let alone safely.  There was no one who could drive me, nor was I going to call an Uber or Lyft.  The delay in that, both at pre-pickup and at the hospital, would be intolerable.

As I tried to keep speaking with the 911 operator, I went outside, onto the back patio, where I eventually laid down on the concrete, confusing at least one cat to a level that would have made Monty Python proud.  I figured it would be easier to get to me there, outside.  The lying down part was because I didn’t want to sit or stand, and didn’t care about getting dirty.  I also didn’t have any shoes on.

Then it occurred to me that I didn’t want to awaken my housemates, who have dogs that would bark if people walked up beside the house with a stretcher, so I made my awkward way to the front of the house, to the sidewalk, where I sat down, first with my back to the gate post.  Then the first real right mid-back (or flank) pain added itself to the mix and I think I cursed as quietly as I could and slumped to my side, trying to ease the pressure.

The 911 operator told me the EMTs were just arriving, and she was right.  I thanked her and said goodbye (my Mom and Dad did not raise their children to be rude to those who legitimately and professionally help others in emergencies).

The EMTs were very professional, and they were the first to recognize what turned out to be the case, though the ER doc also took one look at me and ordered an immediate non-contrast abdomen and pelvis CT which revealed the specifics of what he and the EMTs had clearly recognized:  I had a kidney stone in my right ureter.

So, to bring an already drawn-out explanation to a provisional conclusion, that’s why I’ve not written a blog post either on Monday or Tuesday of this week.  I’ve been in a torture chamber of my own body’s making.

Still, there are some compensations.  One gets pretty thorough evaluations when in hospital.  I learned, for instance, that though my blood sugar was rather high at first, largely due extreme physical stress, it came down to just above normal.  A hemoglobin A1C that was added on showed that I was high normal/low abnormal, or pre-diabetic.  Diabetes does run in my family, and also, I’m sure I have chronically elevated levels of cortisol and related hormones in my body that make such things worse.

Of more mild interest was that I had lowish hemoglobin and hematocrit, and my blood concentrations of hemoglobin and RBCs were low.  In other words, I was borderline anemic.  This was a mild surprise until I thought about how much aspirin I take.  As part of taking that aspirin, I also take acid blockers to protect my stomach (and to combat GERD).  So, from two ends, that can explain a bit of anemia:  some low-level blood loss over time from aspirin’s antiplatelet effects and probably chronic gastritis, and somewhat decreased iron absorption, since the acid in one’s stomach facilitates that absorption.

I know this much in such detail because of a cool service the hospital offers, which is an app on which you can access your test results and (to some degree) other medical records.  It’s really quite nice, because too often, people have only vague ideas of what their tests mean, and they arrive when the occasion might already be fading in their minds.  That doesn’t happen to me, of course‒mine is the superior mind, like Khan, who was even more in his own way than I tend to be.

Ha ha.  I am of course exaggerating, and not just about Khan being more in his own way than I am.  This app’s data is great information to have.  They even give you little notification dings when new stuff is added.  It can be handy.

I’ll go more into what happened in the hospital at another time, but I will give a spoiler or two now:  I have not passed the stone, but I have a stent in my right ureter and I am on meds to try to help that to let the stone pass.  My pain is not completely gone, but there is only a bit of right flank ache and spasm sometimes when I use the bathroom*, and a fair amount of blood and irritation in the urethra from the stent placement.  That’s always fun.

Also, I kind of pushed to get out earlier than they really wanted me to leave, because I have to do payroll for the office today.  It would be possible for my coworker or my boss to do it, but when you’re doing something you don’t usually do, there are much more likely to be errors, and I don’t want people to be accidentally underpaid (or overpaid).

Even before I finished the first draft of this blog post, I already found two places where that would have happened had I not come back.  So, while I was probably somewhat foolish‒I’ll tell you later about another extremely foolish thing I considered doing when my pain first subsided a bit on Sunday‒I am also confirmed in my judgement.  And the needs of the many (ceteris paribus***) outweigh the needs of the few or the one.

One final thing, the most important of all things, before I go.  While I was in the hospital, my youngest, Ezra, having followed my little comments on Threads or Instagram, realized that I was in the hospital and why and contacted me and came to visit me in the hospital!  That’s right, for the first time in almost 13 years, I got to hug my child.  They also made plans to get together with me more regularly.  

So, let me address the notorious question:  Is a kidney stone the worst pain I’ve ever experienced?

Absolutely.  And I’ve been through open-heart surgery and fractured my right scapula and had back surgery and “failed back surgery syndrome”.  We ASDers, supposedly, do not like to exaggerate if we can avoid it, but there was at least one time, and I think several, when I was asked what my pain was on a scale of 1 to 10, and I said 10 with no hesitation.  Sometimes I only said 7 or 8.5 or 9 or 9.5.  I try to be as precise as feasible.  But there were 10s in there, and I normally treat 10s on such scales like massive objects trying to go the speed of light, or probabilities in the real world trying to get to 1.

Was it worth it to get to see my child again?  Well, I would be afraid to offer to experience it again with that outcome in mind, but I would be willing.  Yes, it was worth it.

I will speak more about this tomorrow.  Thank you for your patience and apologies for any anxiety you might have had on my behalf.

*Perhaps because I’m not using it for that for which it is intended, which is, obviously, to bathe**.

**That’s an attempted joke.

***In the real world, ceteris is almost never paribus.