Adventures in Pain

September 14th, 2008

This past week was very hectic to say the least. Keeping up with the kids' school assignments and projects, the house, taking care of grandma, and working full time is an adventure within itself. Early in the week, Jonathan, Dylan and I were asked to give sacrament meeting talks in church. Nicholas, Luke and Kyle were asked to give a talk, be the spotlight child, and read the scripture and give the prayer in Primary. It was a challenge, but we were all prepared to fulfill all that was being requested of us.

Early Sunday morning (shortly before 6 am) I awoke with pain in the right side of my back. Initially, I figured that I had been sleeping in a bad position, and attempted to roll over. The pain worsened and therefore, I assumed that I had pulled a muscle. Jonathan got the heat pack and Ibuprofen for me and I attempted to go back to sleep. 20 minutes later, I felt another spasm which was much more intense than the first. I immediately knew that "this was much more than a pulled muscle." The pain came in waves, and when it came, created so much pressure and cramping in my back it was difficult to even breathe. We attempted moving around and even getting into a warm tub, but to no avail. If anything our efforts seemed to worsen the pain. With my medical background, I knew I either had appendicitis, an ectopic pregnancy, a torsion of my ovary (which is when your ovary twists around kinking the fallopian tube), or a kidney stone. Any of these diagnoses would require medical intervention. Therefore, I had Jonathan call my mom to have her come.

By the time my mom arrived, I was in tears from the pain. My mom took me over to Flower Hospital ER (it's the closest hospital and would most likely have the least amount of waiting). Jonathan got the kids and Grandma ready and took them out to Nicole and Craige's, not sure if surgery might be indicated. Jonathan joined us in the ER as soon as he could get everything taken care of at home. (Needless to say, we wouldn't be making it to church after all).

As time continued...I consistently had an aching in my right flank, but then I would get these intermittent waves of pain that would cause me to just writhe in agony. I couldn't stay still. I would move into every position I could think of, without success. The pain was so intense that it would create this heat to pass through me...I would flush and begin to sweat...then the nausea would come causing me to dry heave...and then I would feel so much pressure in my bottom that I would swear I needed to use the bathroom (but never could) .

There was no question in the doctor's and nurse's mind that I certainly had "something" going on. We all leaned towards a kidney stone...especially because of my inability to be still when the pain would hit. They did insist on doing a pregnancy test...along with a battery of other blood work. We kept teasing if they came back and told me that I was pregnant that there was going to be "a lot of explaining to do."

As is typical in ER, there was a lot of waiting that went on. I have often joked that the phrase "we'll be right back" translates to at least 45 minutes of waiting and if they say "we'll be back in a few minutes" then you are looking at least an hour. By the time the nurse had checked me over, I had been registered, the doctor had come in to assess my symptoms and establish his plan of care, and the nurse returned to start an IV and give me Morphine for pain and Zofran for the nausea...I was beside myself in agony and begging for an epidural :) (Hey, it works for the girls in my field!)

The Morphine helped quite a bit. The pain went from a raging 10 to a 4-5. I could still feel the spasms, but they weren't as intense. They took me for a CT scan (my very first ever) and when I returned she gave me some Toradol, which helps with the pain, but is also known to help reduce the spasming. The combination of Morphine and Toradol made me completely pain free. Ahhh! Now, that was much better.

The CT scan showed Right Mild Hydronephrosis (hydronephrosis is a dilation of the kidney usually due to an obstruction of the free flow of the urine from the kidney), but there wasn't any evidence of a stone. They also took a urine sample. Once the urine sample results came back and they saw blood in the urine, it was confirmed that I had either passed a kidney stone or was in the process of passing a stone and it just wasn't visualized on the CT scan. They diagnosed me with Renal Colic which is the spasming and pain that results often times from passing a kidney stone, gave me a prescription for Vicodin and Toradol and sent me home.

I spent the rest of the day, feeling completely exhausted and "beaten up". I felt some pain, but struggled more with a whopping headache/migraine and nausea. Therefore, I slept for a good part of the day and was relieved when they called me off of my on call hours at work.

Once again, my compassion for patients with any kind of kidney pain has expanded exponentially. Unfortunately, kidney stones generally like to present themselves in the pregnant population. We get quite a few of these patients on our floor. My understanding of what they are experiencing has become much more personal now. OUCH!