What a difference a quarter makes

Tom Mackey, TMMBA Student

This post is mostly personal, and medical related; I’m posting in hopes that some of the lessons learned and pain experienced may spare someone else down the line. No TMMBA content — You have been warned.

After my annual physical in September, I started experiencing increased shortness of breath, momentary dizziness, momentary chest pains, irritability, and extreme fatigue. By the time Quarter Four was underway, I was getting worse, and I also started to experience rather severe back pains. My physician called me back into the office and told me my blood pressure was going up and she wanted to put me on a mild med to bring it down. She also told me to get more sleep. Between the worries over my health, and a conscious decision to limit my stress and anxiety level, I pulled back some on my studies and tried to get more sleep. By late November, my blood pressure had started to come down to just a little over optimum.

I was told to track my BP daily if possible, and since we have one of those BP measuring stations in my building, I could do that. Of course, I could not resist keeping track of my BP in a spread sheet, and then running stat pad on the results and creating a plot of Systolic, Diastolic, and Pulse along with date and time. That confirmed to my physician that I was a Class-A Nerd! But it also showed that the med and lifestyle changes were working.

While shuffling Halloween, Thanksgiving, and Christmas decorations down from and back into the garage attic, my back ache got progressively worse. I was starting to wonder if this was it and I would be reduced to hiring someone to do the work for me. Then about two weeks before Christmas I woke up one Saturday and could not bear to even sit on the bed. I could not stand, could not walk for sure. I had to crawl on my hands and knees to the toilet, and finally a full 30 minutes after I awoke I could finally stand and sort of shuffle around. The next day was much better — just a bad back ache mostly on my right side.

The Sunday before Christmas I woke and sat straight up in bed, with incredible pain. It felt like someone had stuck a spear in me. It was in my lower right abdomen. Marilyn looked up symptoms on the internet and there was a possibility that it was acute appendicitis. Another possibility was a kidney stone, but I did not seen to have the kind of pain over my kidney that seemed indicated. Now I warned you there would be medical content. After a bout of diarrhea I felt much better. By lunch I felt well enough to eat, so I did. Immediately the pain returned, worse than before, and radiating all the way through me, still centered in my lower right abdomen. It was well below freezing outside, and after trying and failing to install tire chains (I had been sold the wrong size, but that’s another story), we headed out into eight to ten inches of snow to get to the hospital. The pain was so intense that I came close to blacking out several times. Once there, the triage nurse told me that it was probably not a burst appendix, but was probably a kidney stone. I said that of the two, a kidney stone was probably less serious, and she agreed, but said the appendix would be less painful After five hours, chucking my lunch, three morphine drips, and a cat-scan which verified a 3mm stone two thirds of the way towards my bladder, they sent me home with a prescription of “Good Drugs” ™ and a filter funnel to catch the stone.

I think I paced a mile in the house that night, as anything else was too uncomfortable and the pacing seemed to make the pain more bearable. The drugs, by the way, when you have “Real Pain”, don’t really do that much. The ER doc said every six hours, but the effects were wearing off in three and I was hanging on until four. He also said to drink extra fluids to “flush it out”. My doctor was out on Monday so it was not until Tuesday that I could talk to her. She called her Urologist and then called me back with more bad news. It turns out that once a stone is moving, drinking more fluids just increases the pressure behind it, causing the duct to balloon, and thus causing even more pain. She sent in a prescription that would relax the ducts and I ceased fluid intake as much as possible.

Christmas Eve morning I awoke drenched in sweat but to no pain. I figured that the stone had passed into my bladder as I mercifully slept through the final burst of pain. Sure enough, the little bugger was captured in the funnel filter — a little black BB was all I was able to show for my efforts. The next day was the best Christmas I ever had: pain free!!!

So where are the lessons learned? Interestingly enough, my Blood Pressure is now within the “good” range. My back ache has also disappeared. I put all the Christmas stuff back into the attic without any problem. Turns out that pain can increase your BP, as well as stress, lack of sleep, and diet. Also, in further reading, “flank” pain like I had is an indicator of kidney stone issues. I suspect strongly that the Saturday I could not move was the day the stone started it’s journey and the back pain was the result of its movements through and out of the kidney. If passing a kidney stone, reducing, not increasing, fluid input may be best. And in the case of the type of stone I had, which is most typical (calcium oxalate monohydrate), drinking more water and some minor diet modifications (the same in many respects that help lower blood pressure) will help prevent future stones.

Finally, I hope that this nasty week-long cold that I just shook is the last of the medical challenges I face for some time to come. This getting old stuff really bites