Tag Archives: Kidney

Coping with Distress

Today has already been what some might call distressing.

I spent my morning in the ER. Again. I thought, perhaps, it was a continuation of one of the two problems I’ve had within the past two weeks: either another kidney stone or another small-bowel obstruction. Fortunately (or unfortunately, depending on how one looks at it) it was neither of those things. Instead, it was a condition called inflammatory colitis – in other words, an infection inside or outside the small bowel causing inflammation, pain, nausea, etc. To me, the symptoms were very difficult to distinguish from the feel  caused by a kidney stone or a bowel obstruction. There was a slight variance in severity and location of the pain, and the level of physiological distress (I separate this from pain because for me, it is a separate issue) which is a term I have invented for that feeling of intense frustration and anxiety that occurs when one has a medical condition or illness (or even a psychiatric or psychosocial issue) that is continuing to reoccur or worsen despite your best efforts. It is that feeling inside your head that makes you crazy: you start to wonder if perhaps there is no cure, no treatment, no solution that will be effective for you. It starts to seem like no matter what you do, you will always have pain, always be depressed, always have difficulty meeting people or with the opposite sex, or perhaps that you will always be estranged from a friend or family member whom you love.

I may have invented the term “physiological distress”, but I’m betting I’m not the only one to have experienced it. Like pain, or anxiety, this type of distress defies external measurement. It is subjective. In fact, in my experience, it is so subjective as to be unpredictable even to one who has experienced it multiple times in multiple situations. For example, I have had abdominal pain and nausea more times than I can count in my short life. And yet, there is no predictability in the way each iteration of these symptoms will cause physiological distress. Last Thursday I was feeling possibly the worst pain and worst nausea out of the last two weeks. Yet I proceeded to drive myself to the hospital and wait in the ER and explain everything to the nurse who commented: “you seem incredibly calm for someone experiencing the symptoms you are experiencing”. And yet, when went to the ER this morning, I was so anxious and upset that I took the wrong freeway exit, then misspelled my name, then nearly missed the gurney as I tried to sit down. I could barely get the gown on, and for those who have ever put one of them on, they are about the simplest garment one could imagine: there are two holes for your arms in the upper portion of the gown. That is it. Sure, it has a place to tie in the back, but no one expects you to tie it yourself.

I guess this post is really about this idea that the frustration in dealing with chronic or reoccurring problems in my life can actually become a significant, separate issue that may not really coincide with the severity of the inciting incident.

That is really easy to demonstrate, given that today, I was not actively passing a kidney stone, nor had I passed one (at least to my knowledge) in the past several days. A kidney stone SHOULD produce a significantly higher level of distress than a simple inflammation of the intestinal tract. And yet, possibly because it seemed to be a reoccurrence of an incurable and unpredictable problem, today’s pain and nausea (most likely lower in severity than that of a few days ago) produced a much higher distress level.

I honestly don’t know what the application would be. Perhaps all of this just means I need some more psychiatric and psychological help. (that is probably a fact rather than a supposition, whether for this type of distress or for one of the other myriad of mental absurdities my brain and body put me through on a daily basis) Perhaps it just means I am spending more time than I should using my brain to watch my body and using my brain to watch itself – we typically call this “introspection” or something like that, but I find that term to be rather one dimensional as it primarily refers to using one’s brain to ruminate on past actions, behavior, thoughts, and responses rather than focusing one’s attention on what one is thinking NOW, or a combination of those things, or even what one is feeling emotionally and physically combined with what one is thinking at any given point in time.

Enough with the terminology.

My question to myself and to all of you, in light of the distress I was feeling this morning, is this: if and when you are feeling physiological distress, what methods are available to deal with it, and which ones are the most effective? Which ones are healthiest? Which ones support your personal wellness and lifestyle goals?

For example, one way many of use deal with our distress is to eat. Yet for many, that is a destructive way of dealing with distress, and might even wind up causing distress in the future. Another method for dealing with distress is recreational drug use. But if you don’t know from personal experience, then take a leaf out of my book: this is NOT the way to deal with your distress. It ultimately causes a significantly higher level of distress in all areas of life, rather than a single source of distress that may have triggered the drug use originally.

But there are healthy ways to deal with what distresses you. One thing I can almost always count on to alleviate my distress is to act. To DO something that addresses whatever is causing me to feel the way I do. So today, that action was to go to the hospital. Something that, even as frustrating and anxiety producing as it was, was actually less frustrating than sitting at home hurting and anxious.

I wish I could tell you that because I am aware of this dynamic in my life I always choose the healthy ways to combat my distress. In fact, it is probably the opposite: even though I am aware of this dynamic, I still often choose unhealthy coping methods.

I’d love to hear from you about your experiences. Have you felt “physiological distress”? If so, what does it feel like to you, personally? What methods, healthy or not, have you employed to cope? What works best, and what just doesn’t work at all?

Thank you for reading. I wish you a distress-free Sunday!

Peace to you,

-Nathan

A Rolling Stone Gathers No…?

Kidney stone with a maximum dimension of 5mm.

Kidney stone with a maximum dimension of 5mm. (Photo credit: Wikipedia)

***Disclaimer: This is an absurdly long post. Read at your own risk.***

This post is officially for yesterday. I’ll be posting again this evening for today. For once, however, I actually had a pretty good reason for not writing yesterday. What is that reason, you ask? It is the simple matter of me passing a kidney stone, without any pain killers. Yep, you read that correctly. About 24 hours ago I passed a kidney stone and it was, to say the least, quite uncomfortable.

I knew something was wrong yesterday morning. When I awoke from the couple of hours I was able to sleep, I felt like someone was squeezing my lower abdomen in a vice. The pain got so bad that I began to vomit, and was unable to keep liquids down, rendering the pills I took for the nausea totally useless as twice I tried to take them and twice the just came back up again along with whatever was left of my stomach contents at that point.

But I suspected another bowel obstruction, so fortunately I decided I needed to get things checked out at the hospital. By 1pm I was at Legacy Emmanuel Hospital. I would have gone back to Legacy Meridian Park, where I was seen for the previous obstructions, but when I called, the guy at the ER admitting desk told me that the wait was over four hours long! So since all records are shared between Legacy hospitals, it made sense for me to go to Emmanuel, where the wait was only about an hour long, and where they would have all the records, lab tests, and scans from my previous visits to Meridian Park. Had I gone to Providence (where I would rather have gone, despite the fact that it is further away from my house than either of the Legacy hospitals), they would have had to start from scratch and re-do all the x-rays, CT scans, blood, urine and stool tests that were done originally at Meridian Park. And of course my experience is that sometimes two different doctors will read the same scans or the result of a blood test in two completely different ways.

So it made sense for me to go to Emmanuel rather than Providence.

I made sure I was able to drive; I had nothing left in my stomach, so vomiting wouldn’t be a problem. I was in pain, yes, but although it wasn’t getting any better, it also wasn’t getting worse. I was exhausted, yes, but I certainly was in no danger of falling asleep – there was far too much going on inside my body for me to be able to rest.

Once there, the wait seemed interminable. All I wanted was to lie down – the only position that seemed even remotely comfortable was lying on my left side with my knees curled nearly up to my chest. And there was no place in the ER waiting room for me to lie down like that. Instead I was forced to sit in a chair, hunched over so that my back wasn’t pressed against the chair. Not very comfortable in and of itself, and less comfortable for someone who has (albeit unknowingly) passed a kidney stone just an hour or two earlier.

Fortunately, the wait wasn’t much longer than an hour. By 2:30pm I was back in a room, lying on my side. The nurse placed an IV and drew blood for labs. Finally the doctor came in. He was a kind, partially balding man, probably in his mid-forties. His name was Dr. Gillette, which of course made me wonder if he was possibly related to either the family whose manual razors I have often used for shaving, or to my sister’s junior high basketball coach.

He asked me the obligatory questions, listened intently, then did his standard physical exam. Nothing was out of the ordinary, except that I nearly screamed and simultaneously jumped off the gurney when he pressed on my lower abdomen. I told him that it felt sort of similar to the way I’d felt with the bowel obstruction, but not exactly the same. And then, he asked me to lean forward and pressed on my lower back. I felt nothing when he pressed on the left side, but when he pressed on the right, I nearly vomited it was so painful.

He ordered x-rays to see if the obstruction had reoccurred, and ordered a urine test. Fortunately, I had just enough liquid in my body to be able to pee right away. He also ordered a bunch of IV fluids and some nausea medication through the IV as well. We were very clear that any sort of narcotic pain relievers were not an option.

The x-rays came back completely normal. But when he came back he told me that the urine had a lot of blood in it, which usually indicates either an infection somewhere in the urinary tract, bladder, or kidneys, or else a kidney stone, which he thought most likely. He ordered a CT scan to confirm.

Laying on my back in the CT was excruciating. But one of the great things about CT’s is that they take less than ten minutes. Before long I was back in my room, waiting. I didn’t have long to wait, however, because the doctor came back in to tell me that I had definitively passed a stone sometime in the past 12 hours. The CT scan I had taken at Meridian Park just days earlier had shown two medium sized stones in the right kidney. The scan he had just take showed only one. In addition, the scan showed significant inflammation throughout the urinary tract as well, which solidly proved his suspicion that the stone no longer appearing in the kidney had decided to take a painful tour of my ureter before exiting my body.

It was a bit of a relief, really, knowing that the stone had passed and therefore the worst was over, however, it didn’t change the fact that I was still in a substantial amount of pain. And it was at this point that the line became a bit hazy, for the doctor, if not for me. It was at this point, having satisfied himself that I was really in pain and not just there to try and scam drugs, he asked me if I wanted him to treat the pain or not. I’m not sure why I had the self-control to turn him down at that point, but I did.

I asked him if there was anything else, non-narcotic, that he could use to treat the pain. He said, actually, there was. Unfortunately, the particular drug he wanted to use was in my medical records in the list of drugs to which I am allergic. But it had been listed as an allergy since 2009 when the doctors at Serenity Lane (the first inpatient alcohol and drug treatment center I attended) in Eugene gave me an intramuscular injection of it, which caused an enormous rash, made me short of breath, as well as causing lightheadedness, dizziness, and a whopper of a migraine.

When faced with those two choices, however, I decided that perhaps taking a chance might be a good idea in this situation. I told the doctor that although the medication (a powerful anti-inflammatory called Toradol, also known as Ketorolac) was listed as an allergy, I would rather chance an allergic reaction than either have zero relief from the pain or take narcotics, which, although they may have helped in the short run, will always make me miserable later. He agreed, and ordered the Toradol, but made sure the nurse stayed with me for 10 minutes or so after she administered the medication, to make sure I didn’t have a severe reaction to it.

Fortunately, I had no negative reaction at all this time. It just goes to show you how complex our bodies are, that once I had a major issue with a medication, and several years later I had no problems with it at all. My suspicion is that the batch of medication given to me back at Serenity Lane was either old, or possibly just bad. Plus, the route of administration was different. An intramuscular (or IM) injection involves the medication being injected into muscle (usually shoulder, buttocks or thigh) and absorbing into the bloodstream from that tissue. It takes longer to be effective, and can sometimes cause a range of side effects that are unassociated with intravenous (or IV) injection. So perhaps that was the major difference. Or perhaps my body’s tolerance to the drug had just changed over the last four years. Who knows, really? The important thing is that the medication worked. I finally felt some relief, and was able to drive myself home, with the doctors instructions being to make sure I kept myself hydrated (as dehydration is the main cause of kidney stones) and to rest and take ibuprofen for the pain.

I could tell that the doctor was surprised that I didn’t accept his offer of opiate pain medication and that I didn’t ask for any to take home with me. Now, 24 hours later, I’m quite glad that I declined. If I had not, I surely would have run out of whatever medication he gave me (if I have access to a bottle of opiate medication, it is typically gone as quickly as I am capable of ingesting it) and would most likely be facing several days of misery. For most people, taking narcotics even round the clock for a day or two would not produce withdrawal effects. But for someone whose brain is still out of whack from years of opiate addiction, it can only take a day (for some people even just a few doses) and the withdrawal symptoms kick in.

Instead, although I feel sore, the pain is easing, and I don’t have to fight through three days of nausea, muscle aches and cramps, fatigue, dizziness, anxiety, insomnia and depression.

Right now, I’m just sore and tired – I didn’t sleep very well last night, because of the pain. But that is altogether preferable than the alternative.

I apologize to anyone who has kept reading this far. I know this post is immensely long compared to my usual. But it was a story I needed to tell. Not for bragging rights, but to remind myself that yes, I can make it through pain without having to take narcotics, and that I am capable or refusing them, even when they are offered by a sincerely compassionate doctor.

It is the reality that comes with being an addict – sometimes you need to chalk up the wins to remind yourself that you may be powerless over your drug of choice once you have made the decision to put that drug into your system, but that you have the power to choose not to use that drug in the first place.

Thank you all for reading, it is days like today where I am reminded how powerful it is to share your experience with others, even you may not know the majority of those with whom you share.

Peace to you,

-Nathan