09 Dec Ouch! Oooouch! or Romancing the Stone

Nurse… Nuurse… Nuuuurse…

Fellow ER Patient Moaning in Pain

It began as a pressure in my lower back. Instinctively, I knew what it was. I broke out in a cold sweat knowing that over the next few days I would feel what my father and my sister had both felt. Our shared genetic connection: I was about to pass a kidney stone.

I had dodged this bullet before. Three times I had passed a stone with no pain whatsoever. In fact, I didn’t even realize I was passing a stone until it unceremoniously plopped into the toilet. Such was my luck. But that was about to run out.

It was a dull pain that began about 10 am. Focusing on my work, I could ignore it for most of the day. But on the commute home I couldn’t shake it. As a diversion I looked around at my fellow commuters. How many were involved in their own pains? I was able to mask mine, but anticipated walking through my front door when I would finally be able to acknowledge it with a moan. That’s when it seized me.

The arrow marks the cause of my intense pain as it made its way towards my bladder.

I never realized a dull pain could be so intense it made you nauseous. My sister had a stone when she was eight months pregnant. “I’ll have a kid any day over this,” she had said back then. And, shortly thereafter, she did. I tried my version of Lamaze. That effort lasted less than a minute before my wife decided to call my doctor who told us to get to the emergency room immediately. Thinking I might get faster care Susie asked me if she should call an ambulance. “No, let’s just drive,” I said, trying to deny the severity that call would acknowledge.

Naïvely, I thought that seeing me in such agony, the hospital staff would immediately whisk me away to a gurney and medicated bliss. I was shocked at the frontline admins who looked at me with indifference when I grimaced, barely able to speak my name and address. It was 7:30 pm. And we waited two hours until my number was finally called. Once again, I thought, this is it. Finally.

I was led to an alcove with six draped compartments. “D2 is yours,” the triage nurse told me. And, as the newest member of this section, I immediately got to know my neighbors. From D5 came the constant sounds of a young man. “Nurse,” he’d moan. “Nuuurse.” But there was no nurse. Despite my pain, it was clear he was in worse shape than me. My wife went looking for a nurse –for him. Then, just to the right of me was Miss Chatty Cathy. She had come in with some respiratory malady but was well enough to carry on a conversation with my wife about her day. I silently begged Susie not to encourage her with any response. She was hard to ignore. Finally, there was the woman just to the left of me. Separated only by the curtain, I witnessed her vomiting into a wastebasket. It was enough to make you really sick.

Almost three hours after our arrival I was led away for my CAT Scan. Then we waited. And waited. You’d think the nurse would know by now that the curtains provided no sound barrier to her phone conversation: “I’ve been here over twelve hours. I asked Kevin to come down to relieve me but he’s got patients up there. I’m leaving.” And she did. For an hour and a half no staff checked up on us. D5 kept moaning; D3 kept talking; D1 kept vomiting; and Susie kept searching for someone to help us all.

Finally, Nurse Kevin arrived –our medicinal knight in shining blue scrubs. This was Kevin’s first job out of nursing school. And it showed. With no long term experience in the ways of the American health system, he was attentive and immediately set to alleviate D5’s pain. Kevin acknowledged it had been a particularly bad night for the ER (aren’t they all?). In the interim, our newest community member in D4 arrived. Another kidney stoner!

Kevin set me up with my favorite ER experience: a simple glucose IV. The doctor had outlined the steps they’d take when I had first arrived hours ago. Get some fluids in me and give me a painkiller and an anti-nausea drug. But it was that IV I was looking forward to the most. I’d had one on each of the few previous ER trips in my life. It felt like internal air conditioning. The other drugs were simply icing on the cake. They allowed me to really enjoy that IV. Pretty soon, I was feeling pretty good. And it was only four hours into my most recent emergency room experience.

The CAT scan showed my 5 mm stone was about 4/5 of the way through the ureter on its way to the bladder. A couple days and the stone would be gone. The doctor would give me a prescription for pain and soon I’d be out of there. But it wasn’t until an hour later Kevin brought me my parting gifts: my scripts, discharge papers, instructions, and hospital-issued screened funnel to catch that sucker when it finally passed. It was now 2:30 am.

The stoner in D4 was waiting for his CAT scan results; D5 had been given more pain meds and moved to the hospital proper; Chatty Cathy had left (luckily her father arrived to take her home as she had been lamenting about getting a taxi at that time of night); and the next door vomiting had ceased.

I wonder who’s in D2 right now. Is he in pain? If he’s really lucky, he’ll get Kevin to give him an IV. Oh, and maybe some pain meds.

• [ Kidney Stone, Health Care, Emergency Room ]