Thursday, May 4, 2017

Aftershocks

This is the follow up to my "Easter" post. That will give this some context.

I suppose we all thought once you're sent home from the hospital, all's over, you're well. OK, well, perhaps a lot of us really knew better, but there is a dollop of relief in the fact of the discharge. Just not the end of the story. In fact, barely the beginning. I think that's been the biggest surprise in this whole thing. I started by thinking kidney stone = a few hours of "discomfort". Boy, did I have a lot to learn!

The stent was causing problems. My bladder was spasming, the infection just starting to get knocked down so everything was still extra sensitive, meaning I registered every spasm as a flash of sharp pain. And with everything a bit swollen, the end of the stent was poking the wrong things if I sat straight up in a chair. (What are those wrong things, you ask? Whatever it touched!) So I was stuck on percoset for a few days, which diminished but didn't clear the pain. I could definitely tell the individual spasms now that the background pain was controlled.

While an improvement, it came with side effects, forgotten about in the year since my knee surgeries. It slows the intestines. That's one of the reasons everyone in the hospital inquires about their function. Since I went in empty, was denied food until after surgery, and had no appetite for a couple days afterwards, I wasn't upset about lack of production. Nor were the staff, listening to all the gurgling and rumbling. Something was happening. Back in the olden days, I'd not have been released until they had visible evidence, meaning they would have kept me in for nearly a week.

Glad I didn't have to wait.

Dry mouth came back with a vengeance. It was bad enough the day of surgery when I wasn't allowed anything by mouth. I still fail to comprehend that one can have enough fluids in the system to produce copious amounts of urine but none of that water makes its way to the salivary glands. The first morning waking in my own bed, my mouth was so dry I couldn't talk or swallow until after a sip of water. Unfortunately that persisted for days. I even needed to have water between bites of food, or it would get stuck in the back of my throat, as I found out the hard way.  I couldn't breathe momentarily! Between that and the snafu with not getting anything through the mask jammed down on my face for surgery, I had the makings for the beginning of a new phobia!

I took that as an incentive to get off the percoset ASAP. (Turns out I was wrong about the cause, but...)

Fortunately, my pain levels were decreasing as the spasms were backing off. I figured the infection was getting knocked down. All the pain wasn't gone, but what was left was tolerable. It simply told me now I had to pee.

Every hour.

Day or night.

Screw sleep!

Off percoset a couple days, I somehow had this silly idea in the back of my head that my appetite would come back, when the reality was I could be quite satisfied with three tiny meals a day. Hunger never struck. No cravings. Just eat because I needed to, and let the persisting dry mouth drive hydration.

Now I thought the tap water down here was terrible the first year. Lemons and filters please!! After that, it was just... water. No flavor. Not till a day or so past being home. Every time water hit my mouth, I got a chemical taste on my tongue. OK, plenty of bottled water in stock, time to start using that. Same reaction! It was me, not the water. (Turns out whatever is going on also ruins the flavor of chocolate!) Maybe something in my other meds? I came home with 3, after all, percoset, an antibiotic, and something to treat the regional bladder pain. I'd never heard of the last two, my only concern was that the antibiotic NOT be Cipro, as it makes my heart rhythm regulator do just the opposite. This one came in two-tone green capsules, and as the days wore on, started stinking more strongly every time I took the cap off the bottle. Sulphur! Ick. I can't help wonder if having that in my system is flavoring my food and water. If so, just put up with it till they're gone, and hope my system rights itself.

Tuesday, 8 days post surgery, was doctors' visits day. Morning for the urologist, afternoon for my Primary for a generic after-hospital check. Both of them are the same building, but I couldn't arrange back-to-back appointments. At least it's a very short drive back and forth from home.

My primary basically just said hi and charged me for the visit. After all, the hospital did all kinds of tests, so what did he need to follow up on? Plus, "my" urologist (Never thought I'd have reason to use that term) was following up. So again, nothing for him to do. Makes me wonder just why the hospital sends you back to your primary after discharge.

The urologist visit was only a little less perfunctory. How was I doing, those were all normal side effects, go get an x-ray to see if the stone has moved, and schedule both lithotripsy and his follow up visit to remove the stent. Here's a packet of information, yada yada. Oh, and a free sample of meds for the bladder spasms that should be without the dry mouth symptoms.

Wait, what? That's what was causing the dry mouth?

Meanwhile I decided, if a bit late, to go online and do some more research on the new meds I was taking, or finishing, as the case may be. Turns out that yes, the sulpha was ruining my taste buds. A couple days after finishing with those, I could again drink a sip of water without recoiling from the chemical slap. It was indeed the anti-spasming drug (not a localized pain med as had been explained to me) which caused the dry mouth. I switched over to the freebee but after the first day with no improvement to dry mouth, and finding that it also caused that symptom (but only in 5% of users!) I just quit altogether. With the percoset, pain levels were way down and the spasms were noticeable but tolerable. Way more so than the dry mouth.

Lithotripsy was scheduled for the following Friday, out-patient surgery at a different hospital over in Sun City West. Now the barrage of phone calls started. I was given a time, to be changed later, of course. Why would I expect anything different? I was given directions on where to park and which entrance to use. On the day of, it only took circling the parking lot about 5 times to find any spot at all. ("Oh yeah, we're really busy here Friday mornings, which is why we tell you to park over there instead.") Yeah, right. My meds history was gone over, letting me know which I could take and what needed stopping when. And NPO after midnight, so no cheating by taking more than one tiny sip to swallow those 5 pills! Also no gum, cough drop, or rinse to ease this newest case of dry mouth either!

The funniest was their insistence that I take an antibacterial shower that morning before coming in. Dial soap was suggested. Now, I know enough to appreciate how ubiquitous bacteria are. Also how soap and water actually multiply rather than cut their numbers on your skin. And what's the point when your towel is not germ free, nor your clothes, nor the chair or car seat you sit in, not the dogs who say "Hi" before you leave, nor...? You get the picture.

Besides, lithotripsy is noninvasive surgery. No skin gets broken in the process. It the germ wasn't already there, it won't get added to the system. So why all the fuss?

After getting checked in, getting a new pink-stuff scrub by a nurse who insists there is a point to the home shower, a new show-your-booty gown, and given a final chance to pee (non sterile toilet), it's a ride down the hall to x-ray (also not sterile) for a final look at where the stone currently resides. Yep, there's a light shadow there. Steve is allowed in my cubicle. Oh, fyi, he's not sterile either. A few more items fussed over, and it's wheel away time.

There are two major improvements over the previous surgery. OK, maybe three. First, though I still have to transfer myself from my gurney to the operating table, at least this time the table coverings offer traction so I can actually do it. Second, my memory stops there. No fighting to breathe, nothing. Must have been a pretty good shot they gave me. Third, did I remember to mention the two big bruises on my belly that I came back from the first surgery with? I mean, it's not that they hurt or anything. I had to see them in my home mirror to even know they were there. But no new ones this time.

I don't even remember waking up. Let me just assure you that I did. Must have been a really good shot! The only discomfort was needing badly to pee. I was given a cup that fit into the toilet and a paper and mesh strainer to capture any and all stone bits coming through, plus a container with a lid to put them in. I used them twice before being sent home, and before even hitting the parking lot, I needed to again so much that we went straight home. No lunch, no stopping for prescriptions, nothing. Ahhhh!

That first bit of detectable stone is almost exciting. I know,weird, huh? But it's proof positive that something happened. Even then, it's more of a hint of lint showing up in the paper cone than an actual piece of anything. Less than dust. Silt is about right. A grey shadow slowly grows, until finally! On day two or three there's an actual something in the bottom of the pee cup, something to follow as you pour through the strainer, something to capture, something to prove it really worked.

Of course, all that paraphernalia is logistically impossible to drag around with you. Can you imagine, hauling the big cup and the paper cone with a slowly rising yellow ring working its way up the paper along to a public restroom? And forget about visiting a friend's house! Even if you could get past the disgust and embarrassment, how would you collect the bits for transfer to the container, then clean up after all the mess? At home, the container sits on a few layers of folded TP on the side of the sink, drying out until everything can be scraped out with the rounded end of a nail clipper or something.

Steve and I agreed that our planned restaurant meal would be postponed until the collecting was done. I did manage to hit my pharmacy for my new prescriptions that first evening, finally getting the capacity to wait over an hour between bathroom trips. I only filled two of them, though. The third was another anti-spasming dry mouth drug. Not only was I not spasming, I figured even if I started, the cure was worse than the problem. I still had percoset if it got annoying.

I'm not sure if all the bits have passed. When my urologist told me he blew the stone to smithereens, he wasn't kidding. Most of what collected was silt, and I'm convinced some of that made it through the screen. Still, I dutifully scraped and transferred, noting the occasional dog hair or mine. When a visible piece of something was produced, by the time it dried, it often was about a fifth of its "wet" size, and frequently stuck onto the mesh. It all doesn't seem to add up to a 5mm anything. And nothing has shown up the last few days.

I decided to become a bit more active, since things were going so well. The yard needed pooper scooping again, a couple bushes needed water, and an old sun-rotted hose needed collecting and tossing. Nothing much. But apparently the rhythmic motions resulted in the stent irritating the bladder again, and the spasms are back. Nothing big, but there.

Tomorrow, however, should be my last visit with the urologist, where the stent is removed. He says it's just a quick procedure, no painkillers needed, just reaching a tool in, hooking onto the stent, and pulling it out.

I hope he's right.

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