Christie Ruth
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Hurristone Sandy

11/15/2012

5 Comments

 
As an ER nurse I have cared for my fair share of kidney stone victims. The patient is an obvious one; typically male, overweight, enters the ER bent over in excruciating pain, gripping his back where the lowest rib meets the spinal cord, aka the “flank”. These are one type of patients that we rush to the back and start IVs on so we can promptly administer pain medication. It is a pain described as being, “one of the strongest pain sensations felt by humans (being worse than childbirth, broken bones, gunshot wounds, burns, or surgery)”—according to Wikipedia, who we all know is never wrong.

My kidney stone patients always ask me the same question; “How do you get a kidney stone?” They ask it in hopes of knowing what never to do to prevent from having to endure the pain ever again in their lives. I usually just give them a simple answer about not drinking enough water, or drinking too much soda (which apparently has nothing to do with it). Little did I know, I would come to know firsthand what they were going through and find myself wanting the same thing; to never have to endure the pain again.

The night started out harmless, we spent the evening up in Canada, enjoying the first of my 5 days off and trying to recover from a long stretch of work. A group of us got together at our friend Carley’s house where we made delicious sushi and had a great time getting to know each other a little better. 
After the party, Max and I were relaxing on the couch, talking to Max’s dad about life. Just as he was heading to bed, it hit; the most excruciating pain, just exactly at my right flank. I was bent over the sink, trying not to vomit and when the pain didn’t go away, Max started to panic. I kept telling him I didn’t want to go to the ER, especially in Canada where I had no idea if my insurance was valid. I knew something was wrong and I knew it felt exactly like a kidney stone, but I couldn’t accept that it could be happening to me. The pain finally subsided and I decided that the best thing to do was drive back down to Browning where I could be seen in the ER. We had to take the long way, seeing as it was past midnight and most of the border crossings were closed. The pain hit me one more time while in the car, and luckily it was the last. We passed the time by talking about what it could be and after I told Max all I knew about kidney stones, we decided that’s for sure what it was. I told him that it was probably the size of a little grain of sand, to which he named my little friend, “Hurristone Sandy”, after the storm that had just wreaked havoc in New York the week before.

We finally arrived at the ER and I walked in with Max at my side, feeling very awkward ringing the triage bell instead of going through the back door like the employees do. Luckily, Dr. Gianarelli was on, the best night shift doc we have. After blood work, urine tests, and ultimately 2 CT scans, they found what I was dreading, an 8x5mm stone lodged right there in my ureter (a big bigger than a grain of sand). If you know anything about stones, 5mm is the “limit” to a stone that will pass on its own. Needless to say, mine was going nowhere.

It felt so weird to be the patient. I felt so helpless and ignorant. And if I ever have to have IV contrast again, it will be too soon. It made my insides feel like they were on fire and then I thought I peed my pants…Max thought that was pretty funny.
It was about 5 in the morning and as I was feeling better by then and Max and I were absolutely exhausted, they sent us home with some pain meds just in case. The next morning I was given a referral to “the best urologist in Kalispell” who said she wouldn’t be able to see me for 4 days. I was so worried that things would get worse in the meantime, but luckily they didn’t. I felt like a ticking time-bomb, but I didn’t want to just sit around waiting for the pain, so we decided to go back up to Canada and be with family. We spent the next few days relaxing, cross-country skiing, making delicious food, and celebrating “Remembrance Day” as they call it in Canada, all the while thinking about Hurristone Sandy and when he would rear his ugly head. 
Three days later Max and I headed down to Kaslispell for my appointment with Dr. Mckerrow. She was a tall, petite, blond woman who informed me that she, too, had experienced the joys of kidney stones (how ironic for a urologist). The appointment went well and we had surgery all planned for the next day. I had originally thought it would be lithotripsy, where you lay naked in a tub and have ultrasonic waves sent at your stone to break it into passable pieces. Instead she decided cystoscopy would warrant a better outcome. This is a procedure done in the OR where they put you all the way under and the surgeon goes in with a scope and a “basket” to grab the stone and pull the whole thing out. 

On our way out we were sent to speak with the lady who would give us some very bad news. I know it’s impolite to talk about money, but this is the thing that caused me more pain than Hurristone Sandy ever could. Apparently Max and I were very mistaken about what my insurance would cover, even after reading through the whole booklet that rainy day in Glacier. She informed us that the surgery would cost me $5,000 after insurance, and my heart sunk. I was absolutely dumbfounded. We left the clinic in a bit of a daze and parked down by the river. I thought about cancelling the surgery and letting Sandy pass with excruciating pain, before making some phone calls and finding out that I had already accrued 5,000 dollars worth of charges just with my ER visits (after being very misinformed by my supervisor).  It wasn’t that I didn’t have the money, or couldn’t afford it, but I felt sick thinking about spending such a huge amount on something as silly as a kidney stone.  I thought of the places we could have traveled, the down payment on our first home, the computer I have been saving up for so I don’t have to restart it every 30 minutes when it overheats. I started to cry with frustration and then I realized a few things. First, it is amazing that I can afford a 5,000 dollar emergency without having to take out loans or wonder how I’m going to afford my rent. Second, I was so lucky that this all happened just a couple months after I got insurance, thereby saving me over 25,000 dollars. Lastly, I would be able to get rid of Hurristone Sandy for good, before having to endure his passage through the rest of my urinary tract.

So, disappointed but content, Max and I shared a delicious “last supper” of Mexican fattiness, and I took a long very bubbly bubble bath at the beautiful resort that would be our home for the next few days.

The day of the surgery went very smoothly. Max stayed by my side the whole time while they poked and prodded, but I was so lucky to have great nurses and doctors and had the upmost trust in them. I donned a hospital gown for the first time and was so excited to get my own pair of skidless slippers. Almost as excited as I was about getting those toasty warm blankets right from the warmer that I am always so sad to give up to my patients on cold winter days. 
It was a long wait before the surgery but we chatted with the nurses (who all had crushes on Max), while he took the liberty of being my personal photographer…just in case I was too out of it to remember the day. The only time I was nervous was in the OR, lying on the bed, feeling so vulnerable knowing I would have no idea what would go on for the next couple hours, and would wake up in pain. All I remember is coughing, uncontrollably, most likely when I was being extubated, and then I woke up in the PACU where I was in such a sleepy state that I could only open my eyes for a few seconds, and mumbled some words to the nurse about being in pain, to which she promptly gave me fentanyl-which knocked me out once again.

I have no idea how much time passed, but I finally returned to the original room and Max was there waiting for me, just reading and looking darling as ever. I spent the next couple hours in and out of sleep and pain.  Max schmoozed the nurses a little more and after I passed the pee test we were given permission to leave (but not after max pushed me around in the wheelchair a bit, poppin' wheelies). 
Last night was the first night in who knows how long that I slept without Hurristone Sandy. It was also a very painful one, tossing and turning all night long, but grateful to have some pain meds to help me out.

Today we toured the resort and at the end of our walk I was finally able to stand up straight again. I won’t go into the details of the pain or what I’m feeling but I can say that I am so grateful to be done with it all. Thank you to my loving friends and family who have been so thoughtful during these past couple of weeks and for all the prayers in my behalf…especially for something as silly as a tiny little stone called “Sandy”.

Oh, and whoever “Christy” is, is going to get a huge bill for this :)
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5 Comments
Lindsay Cox (your fantastic europe friend who you miss tons!)
11/15/2012 02:05:42 pm

Oh my goodness!! I'm sorry Christie! A few months ago I had to pass a kidney stone and I did describe it as more painful than my labor with Annie. I had to go to the ER as well and Jordan was freaking out because it was 4am and we didn't know what was wrong. Well we didn't even bother looking into my insurance we just went to the closest hospital...which ended up being out of my network...awesome ugh. After many tears and stressing about my hospital bills I just have to remind myself that money isn't as important as my family and friends. Dang kidney stone! you look great in all your photos though. I'm sorry about your surgery, hope you are doing well!!

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Christie Ruth link
11/17/2012 02:51:50 am

Lindsay! I am so sorry to hear you had to endure that as well! Only it sounds to me like you had an even more rotten experience. Oh, and you are certainly still my fantastic Europe friend whom I miss tons :) I think about you much more often than I actually connect with you and I love to look at your pictures of your sweet family. If you ever need a break, I'll take your baby for a few weeks. She is absolutely perfect.

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leslie
11/15/2012 10:39:33 pm

adam says just go back to canada where the bills wont find you:) im glad everything went well and love reading your blog!

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Christie Ruth link
11/17/2012 02:54:01 am

Ha ha, I thought about that...for about a second...before realizing that I'd be a fugitive and never be allowed back in the states :) It does sound kind of exciting though. I miss you like crazy!

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Chuck
11/18/2012 06:37:01 am

ooooohhh those warm blankets. I too have a hard time handing them over to the patients sometimes..or jump into the warmer and hide to warm up on those particularly cold days in the ED.
I am glad you had nice nurses and Max there with you. Reading this makes me reconsider how I handle (or overlook) all the small and seemingly insignificant parts of the patient experience--glad it turned out to be a happy ending. I love the photos and I will never stop saying this: I wish we were living closer.

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