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The Trouble with Stones: A Kidney Stone Battle

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Who can find comfort in a nurse telling you that childbirth won’t be as painful as the writhing agony of the present? While my husband tried to explain my medical history of kidney stones and pregnancy to the on-call doctor, I squirmed and rocked on the gurney, attempting to convince myself that it wasn’t all that bad. The tension and aching in my lower left flank would not let me believe anything but pain at the moment. Nausea had already consumed me and there was nothing left to give the wide pink bucket on the counter. My head was going to explode on top of everything else. Finally, relief came with a male nurse and a fabulous narcotic called Dilaudid, a morphine relative.

Laying in the ER with the Food Network displaying a delicious recipe for acorn squash, my husband, Jesse, and I watched the minutes tick by. This was my third visit to an emergency department with the onset of kidney stone pain; first pregnancy though. The last two times had been five years ago or more. I wracked my brain, and Jesse’s, for possible causes of my stones. Each episode (including some minor at-home occurrences), had never once produced a visible sample I could take to a lab for analysis. My stones have always dissolved before passage. On the other hand, I’d always been able to take a muscle relaxant for medication to ease the process. Twenty-four weeks pregnant meant no such drug and that also eliminated most procedures, including a CT scan that might locate the stones in the first place. All we could do was inject me with a narcotic for pain and try an ultrasound to see the little clusters that caused so much trouble.

The narcotic worked for a couple hours at a time, but the ultrasound showed nothing in my kidneys. The technician was nice enough to make a quick peek at the baby. She was as healthy as ever and seemingly unbothered by all the goings on with her mother. Many hours later, maybe about seven, they wanted to discharge me with a script and a follow-up appointment with a urologist. From past experience, kidney stone episodes had never lasted more than a couple days with some residual pain up to a week later. We left with little concern and I called in to work for the rest of the week. Two days later, it was like a freight train I never saw coming as the all-inclusive vacation-of-a-lifetime for stones hit my system like a New Year’s crowd in Rockefeller Center.

Back to the ER and back on an IV with more Dilaudid and little to no submission of the pain this time. I was in agony, tears, delusional at some points. Why isn’t this over yet?! They couldn’t see the stones or give me any effective medication to help them pass. All I got was narcotics and a worrisome cluster of my parents and Jesse standing around my bed. At some point, I had been transferred up to the prenatal floor. I remember getting a little sleep and moving to another room. I remember the pain getting so bad I was crying and rolling around and I couldn’t focus on who was there or what someone was asking me. I remember the obstetrician from that hospital coming in and telling me I was taking too much Dilaudid. I was taking too much? This was the guy signing off on the medication. It wasn’t like I had an all-you-can-eat tray of narcotics in front of me! Then he threatened that I’d stop breathing soon and started lecturing me about just dealing with the pain; that he’d had kidney stones too. I was too drop-mouthed to ask him if he’d been limited due to pregnancy at the time as well, but my husband intervened. Let’s just say I was quickly transferred to Beth Israel Deaconess where my OB practiced.

Now I was concerned, not panicked really, but concerned. What if the medication was damaging my baby? What if she became addicted? Could this harm her development? What took that doctor so long to notice one of his patients’ situations so that he felt he needed to talk to me like that? I remember the paramedics wrapping a few blankets over me for the cold November night, then a short ride into Boston, then I was in a Labor and Delivery room at the BI. Maybe I was delirious from the medication and pain, plus my head was swimming with questions, but the transfer couldn’t have been more night and day. Now, I’ve nothing bad to say about the nurses in the other facility, but the care at BI was so overwhelmingly comforting that my questions and stress melted away almost instantly.

They continued the same medication, explaining in better detail the ins and outs and side effects it might cause the baby. It was such a calming experience, answers before I could word questions, that I almost didn’t care what happened next. I’m not sure if the medication dosage changed or the stones slowed their party tempo, but soon I had more control of thoughts and could actually carry a normal conversation. I had another ultrasound and this time the tech thought she saw some stones in my left kidney. I was given options by their on-call urologist, who also explained that the pain could be enhanced by the baby’s position. I found that staying on my right side was more comfortable to sleep rather than the left. They kept me on an IV drip for fluids and monitored the baby once or twice a day, checking on her health as much as mine. Only a mother could understand the piece-of-mind that brings. Finally, the providers care about my baby almost as much as I do.

There was no pressure to leave the next few days as I stayed in the ante-partum hall. It was all a matter of my comfort according to my judgment, and I needed to stay hydrated and keep food down. I wasn’t a medical record number or a chart on the door. I was a person, a first-time pregnant girl with concerned family and, thank God, a healthy baby cooking. I saw the doctor once or twice a day and my daughter was monitored frequently (when they could get her to stop moving so much!), and they took blood every morning to stay on top of my kidney function and watch for infection. I got an update everyday as to the results and how they felt I was progressing. Jesse and I were so pleased with the care; it couldn’t have been better. Then there was life going on somewhere else without me.

Thanksgiving was supposed to be at our house (we lived with my parents). It wasn’t the usual crowd; big Italian family had split up a bit so it was just us and the in-laws. I couldn’t thank God enough for the love of my family … My mother-in-law brought a picnic lunch to the hospital to share with my parents, Jesse, and later joining us was his brother and his wife. Sweet potato pie, turkey cold-cuts, and everything in between lined the vent by the window. I didn’t care how I looked at this point, though Jesse had helped me shower that morning and I wore a fresh pair of cozy pants under the hospital gown. The nurse didn’t seem to mind either when she came to monitor the baby’s heart rate. I’d been doing so well. I never expected the sudden weakness that washed over me shortly into the visit.

My lids hung heavy, my body lethargic and achy, my mother sitting beside me all concerned. I felt every ounce of energy leave me like an undertow had sucked out my very breath. I could barely lift my head though I remember through it all my daughter was swishing around as unaffected as ever. At one point, as everything darkened, I recall thinking my God, is this it? Please save this baby! I’m not sure how long that frightful episode lasted, but shortly afterwards, when my energy returned and my vitals had been taken again and the baby had been checked out, the on-call doctor came in for a visit. Based on my almost complete recovery of senses and the low level of pain, she deducted that the stones had merely moved a significant amount. Sure felt like something bigger had been happening, but I liked her answer better! My blood pressure and temperature had been fine and my daughter, well, she never stopped dancing down in her little world.

The rest of the visit had gone great and my mother-in-law finished off our makeshift Thanksgiving with a healing prayer for me. It could have been the random lethargy, or the entire fact that my life had paused in the last week, frozen in time until these stones saw fit to release me from their bonds. Maybe it was the unselfish way that my family had been there for me unceasing and constantly vigilant. Maybe it was even the innocence that danced on untroubled by the world immediately beyond her own throughout the entire experience. God knows it must have been everything at once that overwhelmed me, but I have more than I could ever express to be thankful for.

Two days later, I was discharged with a list of medications, two of them just supplements, and instructions to follow-up with my OB and the urologist. They made the objective clear: healthy baby, comfortable mom. Once she was born I’d need to follow-up again with CT scan to check my kidneys. I still had pain, still wasn’t eating full meals, but I was able to stay hydrated and keep food down and manage the pain I had. I still couldn’t go back to work, not while on narcotics and not up to full energy levels yet. That’s okay, plenty to do at home from upcoming holidays and a little bundle making her debut two months after that.     

Jesse and I felt that parenthood crept up and hit us with more realism than even those first ultrasounds had produced. We still didn’t have a place of our own, but mom and dad’s downstairs was comfortable enough for now. I still wanted more financial stability to try to lessen the money woes. I hear there’s a bandwagon for that want. There is nothing in one’s life more delicate than one’s health, except the health of one’s child. We certainly grew closer in more ways than one during the entire experience. It may not be an exaggeration to say we’ve grown up a little as parents even. I know I’ve gotten a better check on what matters in life since then and I’m more grateful to God for the blessings I have. After all, reality checks are only a stone’s throw away.


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