Monday, March 27, 2017

Spring . . .

Lots of brand new baby lambs at my friend, Michelle's, farm!!  Yay!!

And this morning - in the early dark - when I went outside to place my Fed-Ex package on the porch for pick-up, it was a symphony of birdsong.  I stood for a bit, out there in my pajamas, and just listened.

Spring is here . . .

When you have about 40 minutes, enjoy this, from my favorite composer, in its original score and original purpose.  Appalachian Spring was written as chamber music for a Martha Graham ballet.  She's the one who named the piece, not Copland.  Here's a good article about it if you're interested.  Can't even tell you how much I love that Martha Graham was 50 when she choreographed and originally danced the Bride.  I love it even more, that - in the version below - filmed for telly in 1958, she was 64.  Yup . . .

Part 1



Part 2



Part 3


Part 4


Have a beautiful day  :-)

Sunday, March 26, 2017

The Sunday Wrap Up . . .

I mentioned the follow up testing I was having this week pertaining to The Kidney Stone Incident., and my friend, Ely, asked me this: "Is this amount of follow-up for stones the norm, or are these just preventative measures because the Drs aren’t sure why you got the stones in the first place??"

I've wondered about that myself, and the answer is that I don't know for sure.  Another friend who has had two stones told me that they were doing 99% more testing on me than she had had (she lives in another state), so there's that.

But I do know that there is a tremendous difference between the first urologist I had (who did my surgery) and the one I have now in terms of interest in my case/wanting to help me avoid another stone.  In addition, I have an excellent primary care physician - he's been on top of this since it started.  As well, I live/work in one of the largest cities in the country with some of the best doctors and hospitals in the world.  Having lived a lot of other places, I can say with certainty that the standard of care here is exceptionally high.

So - these are the tests the new urologist requested since I started with him:
  1. Urinalysis:  I had to pee in a cup there in the office for them to make sure there was no bacteria in my urine.  There wasn't.   
  2. Blood Draw:  My understanding is that the initial blood work I had when I met with the new urologist's physician's assistant a couple of weeks ago was necessary to rule out certain physical causes.  I didn't have any of them.  Yay!  It did show that I was just under the range for hemoglobin, and I was advised to follow up with my primary care doc - which I did.  Nothing to worry about unless it doesn't correct itself by the next time I have a blood draw.
  3. A Follow up Ultrasound: I had this on Thursday.  The first urologist had requested that I have one of these before I saw him again in 6 weeks, so I think this is common.  He never explained it to me however, just told me to get one . . . if you know me at all, you know that didn't go over well with me.  There is good reason for this test - it's to make sure there are no other stones hiding in my kidneys (I don't think there are - no one mentioned any in the ER or hospital), and also to be sure that there was no residual swelling or scarring in my kidney/ureter from the stone.  The one I had on Thursday was far more extensive than the ultrasound I had in the hospital prior to surgery, and the tech spent a lot more time on my left kidney (where the stone was) and looked at it in many more ways than she did the right.  This gave me pause at the time, but I know she can't say anything or she could lose her job, so I didn't question her.
  4. Two, back-to-back 24-hour Urine Collections:  This is the last test, and I've been doing it all weekend. To do this, you have to collect your pee.  All of it.  For two, 24-hour periods.  That means you can't pee anywhere but at home.  If you miss capturing your pee, the test is ruined and you have to start over again.  It's kind of a pain, but it's not difficult.  You just have to follow the instructions they send you with the kit.  I'll be FedEx-ing my samples back to the lab tomorrow morning.  The first urologist mentioned it to me, but he didn't explain or tell me anything about how important is it, so I declined to do it.  The new urologist's PA explained it extremely well, and my own research made it clear to me how important of a test it is.
In fact, this last test is probably the most important one of all.  This is the test that should tell the urologist what caused my stone to form in the first place so he can tell me how I can hopefully avoid having a recurrence.  Unfortunately, once you've had one stone, you are at a much higher risk of having another.  So - four tests.  Is that a lot?  Again, I don't know.  I don't think so, though.  And are they preventive?  No - I think they fall into the diagnostic category.

There are also some additional circumstances that may (or may not) be contributing to the level of testing and care that I've received.  Again, I don't know if these things have any bearing on what's going on or not - but:
  • I couldn't pass the stone on my own even though it was of a size that 60% of the population, in theory, should be able to pass on their own.  Because I couldn't pass it, I had to have surgery to break it up and extract it.
  • I have a family history of kidney disease.  My father died at the age of 33 from kidney disease.  No one except me seems very concerned about this, but I tell every doctor, so maybe they are keeping that in mind.
  • I am extremely motivated to never, ever experience that pain again.  Seriously. Motivated.  I will do whatever they tell me I have to do to avoid another stone.
That's the update from here.  I've nearly finished working on my taxes (yes, I'm about a week behind in pretty much everything), and one load of laundry is done.  Time to get another load of clothes going, and I'm going to block my Hale-Bopp Shawl.

I'm in another 80s mood . . . Back to Germany days . . . bizarre video, he's a terrible lip-syncer (worst than Rod Stewart, and that's saying something  :-), but a super amazing tune.


Monday, March 20, 2017

Hurry Up and Wait . . .

I have been feeling very much at loose ends.  I remain very tired and have low energy since The Kidney Stone Incident.  I feel like it's taken on its own identity and is a proper noun now.  :-D

I saw the physician's assistant at my new urologist's office last week.  She was able to start the ball rolling on the battery of tests I have to have.  That means that I still don't know anything.

They have requested all the imaging and records from the ER, hospitals, and the previous urologist.  I guess that can take some time to get.  In the mean time, I had to pee in a cup, and they took blood for more blood work.  On tap for this week, is another ultrasound of my kidneys and bladder, and a 48-hour urine collection.  That will be my exciting weekend activity  ;-D  Seriously, I'm staying at home because you have to get it all or the test will not be accurate.  Apparently this test is one of the most important for them to be able to tell me what, if anything I might need to adjust to avoid another stone.

Interestingly enough - I was advised to stop drinking all the extra water and to eat how I have normally been eating.  This makes me nervous, but apparently they have to see where I am now to know what, if any, changes might need to be made going forward.  They didn't seem too concerned that I might be forming another stone in the meantime, so I'm doing my best not to worry about it.  I'll see the actual doctor in early April, and then I should know more.

There's a chance that this was a one-off and I might not need to change anything.  I know I keep saying this - I've been saying it for weeks and just said it above, but I'll know more after I see the doctor.  :-D  Through the online portal I was able to see the results of the blood work they did, and apparently I'm a bit anemic.  I suppose that could account for my tiredness, although they did take a ton of blood out of me in the ER and hospital.

In other news of the day - my Run the Year page keeps disappearing.  I think it's something to do with  the HTML for the ticker I've been using.  I think I'm going to have to discontinue that if I want the page to show up again.  Bummer.  I liked the ticker.  In any case, I'm currently behind and haven't had enough energy to get on the bike and rack up some miles.  I will need to do this soon.

I finally finished the Hale-Bopp shawl, which was a mystery knit-along on Ravelry.  I'm not sure that I care for it - but it's done except for blocking.  Photos soon!  And yesterday I picked up a sock for the first time since the Year of Stash Sock group on Ravelry folded.  I was seriously "socked out."  :-D  This is a plain vanilla sock that I started back in November.  That was the month when things went pear-shaped here in the US so it's not really a surprise to me that I haven't looked at a sock in all this time.  I'd like to finish this one, though, mostly just to be done with it.  The yarn has great qualities, but it really is not comfortable to knit with.  I had just finished the cuff and was just in to the leg of the second sock when I set these down.  Time to finish.  :-)

Yesterday I drove over to Valparaiso, Indiana for a craft fair that was billed as "Shipshewana on the Road."  I love Shipshewana - it's Amish country in Indiana and I've been there multiple times.  It's peaceful and pretty and the food is good and the shopping is great - beautiful hand-made things.  I always enjoy the time I spend there, so I thought it would be big fun to drive about an hour east and check out this fair.

What a huge disappointment  :-(   It was mostly commercial vendors with things like tube socks, t-shirts, sweat shirts, junk, makeup overstocks, hot tubs, and more junk.  I picked up a couple of things from the one or two vendors who had interesting/unique stuff, and there were a couple of food vendors in the hall who had Amish food and/or breads without preservatives, etc.  Of course, being Sunday, there were no Amish people in sight.  I'm really sorry I paid four bucks to get in and I certainly won't go again.  It was like going to Swap-O-Rama, where it's mostly permanent vendors, not flea market individual/interesting vendors.

At least it was a nice day for a drive  :-)  And, I was listening to the Oldies radio station and I heard some great music I hadn't heard in forever.  Here's an oldie - not one of the ones I heard yesterday, but one of my favorites . . .




Sunday, March 12, 2017

The Sunday Wrap Up

I did go back to work this week - and I was pretty wiped out every evening.  I missed Tai Chi (you know I was tired if I missed Tai Chi).  I'm still going to bed early most nights and sleeping right through.  I also saw my primary care doc this week and that made everything so much easier. 

I am extremely grateful for the insurance I have, and that I have a wonderful doctor.  He has a private medical practice - sometimes called a concierge practice.  He didn't when I first saw him, but he's been my doctor for at least a decade and he's the best doctor I've ever had.  I gladly pay his fee every year to continue to have him as my doctor.

He agreed with me that the urologist I had for the surgery was not a good fit for me, and he's set me up with another urologist in the same medical system.  I'll see the new guy on the 24th and then I'll have more concrete information on everything. 

I did receive the results of the composition of my stone - it was a calcium stone - two different types:  80% Calcium Oxalate Dihydrate, and 20% Calcium Phosphate.  What this means for me going forward isn't clear yet.  I'll know more after I see the urologist.  I do know, however, that he and my primary care doc will likely send me to a dietitian to be able to work on crafting a plan for whatever and however I need to eat going forward.  In the meantime, I'm just to keep on drinking more water. 

The research I've done on my own seems to suggest that it's not a matter of cutting out a bunch of foods - many of which are healthy choices - but rather a matter of eating foods in certain combinations so that molecules combine in the stomach rather than them getting to the kidneys where crystals can be formed that then form into stones.  As mentioned before, my guess is that my last bad habit (salt) might be instrumental going forward.  Something to consider, however, is that as far as I can tell, most of the research has been done on men, not women.  Of course I will have a lot of questions for the "Stone Man," as my primary care doc calls him.  It will be interesting, I'm sure, and, in any case, I will do what he tells me because I never want to have another stone.  Seriously - I think I said this before, but if they told me that I had to learn to stand on my head and do it every day for the rest of my life.  I'd do it.  That's how bad the pain was . . .
 
It's been a quiet weekend for me - yesterday I ran some errands - took a bag of stuff to the Second Chance Shop, and went to the local framer, who announced on FB that he was retiring after 40 years.  I figured I'd better get the stuff in that I had let sit.  Three etchings of Heidelberg, purchased when I lived there a million years ago (I'm having them redone together), and an original piece by Inuit artist, George Ahgupuk that my father bought back in the 1950s.

A little 80s flashback this afternoon.  I saw Any Trouble on tour with Joan Armatrading back in my Germany days.  This is one of those bands where you have to wonder why they never broke massively large.  They were so great.  They don't really exist as a band any more, although they've reformed a number of times.  Their lead singer, Clive Gregson is still making some great music. 

This has always been one of my favorites - from their third album, Any Trouble.

Enjoy  :-)

 

Sunday, March 5, 2017

The Sunday Wrap-Up

Every day I am improving.  Mostly I'm tired and my back is sore off and on.  I am also somewhat lightheaded off and on. Not sure what's up with that, but usually after I eat, that goes away.  I have an update email in my primary care doc so he's aware.  I am drinking what seems to me to be a stupid amount of water and peeing like a racehorse, but it's what is supposed to keep my kidneys happy. 

Although I don't have any results back on the stone composition, I've already cut down on my salt intake, just in case.  I always called salt my last bad habit . . .  ;-)

I'm now behind in my miles for Run (Walk) the Year, but I know I can catch back up on my bike.

Today it's warmer out and the sun is putting in occasional appearances.  I took a walk part way around the retention pond  About a mile.  I had to return home due to intestinal distress.  This is something that I've had pretty constantly since Wednesday, and I have an email in to my PCP to ask about it because they told me I would most likely be stopped up from the pain meds.

I'm not.

I also seem to be very light-headed/dizzy multiple times a day.  I'll wait to hear what the doc has to say.  These things concern me because of my commute into the city.  I'd like to go back to work tomorrow, but if these continue, I'm not sure it's advisable.

TMI?  Sorry.

I've been doing a lot of research.  That's not necessarily a good thing because there are so many different schools of thought out there and it's hard to know who and what to believe.  It's my hope that my doc will send me to a dietician again who will work with me on getting a handle on everything.  So many things to think about!

But for now, I'm going to make myself some lunch and and watch a Netflix movie  :-)


Friday, March 3, 2017

4mm

I had every intention of catching up here sooner.

I have a good excuse. 

Let me start by saying that I'm OK :-)   And then let me say that I do not recommend kidney stones in any possible way.

I hadn't felt quite well since last Thursday.  On Saturday, the pain started.  Bad pain.  I messaged Linda the Chicken Lady to ask her what it felt like when she would have an attack of diverticulitis.  But it wasn't that.  I lay down for awhile and the pain stopped.  On Sunday I went to a book study at church, and then to the store, and over to the dojo where they were having a vendor market - which was great!  But I left early because it felt like the pain was coming back . . .

It was - and it came back even worse this time.  After a discussion with my primary care doc, I drove myself to the ER with a possible kidney stone.  Level of pain at that time was 7 or 8.  Once I got to the hospital, the pain subsided and I felt like I was wasting everyone's time and my money - but the CT Scan showed a 4mm kidney stone.

This is apparently right on the edge, size-wise.  At 5mm they probably would have admitted me because 5mm is usually too big to pass.  But they sent me home with pain meds and and antibiotic because a 4mm stone should, in theory, pass on its own.  I had some anti-nausea med left over from my shoulder surgery last summer, so I was armed with everything I needed.

I stayed home from work on Monday. Unfortunately my arsenal of drugs were not effective because I was not able to keep anything down.  Who knew that a kidney stone makes you barf.  I couldn't keep the pain meds down and my pain was getting worse and worse.  One of my cousins, S, was on her way over to me because she was going to pick something up for me.  I told her I thought she was going to have to take me back to the ER.

S did drive me back to the ER (second night in a row) on Monday evening and I was - literally - screaming and attempting to throw up (which wasn't really possible since I hadn't been able to keep anything down). I was soaked in sweat and my BP was 187/85 (my normal BP is 110/70).  I have never felt such pain in my life, and I think I was only sicker one time in my life - back in Germany days.

It took them 45 minutes to free up a bed in the ER for me.  In the mean time, they took me out of the waiting room (I'm sure I was scaring everyone) into another interior waiting room where I continued to scream.  It was off the pain chart pain.  Once they got me a bed, I was dosed with another anti-nausea med, and a super strong anti-inflammatory called Toradol.  That worked for awhile and at least I wasn't screaming any longer.  S stayed with me until two of my other cousins, ME and R, came.

The pain returned and it was too soon for another dose of Toradol, so they decided to try morphine.  Apparently I am likely allergic to morphine because I developed a bright rash all over my face.  I'm already allergic to codeine and tramadol, so this wasn't much of a surprise to me.

It became clear that the ER was not going to send me home a second time, so I encouraged ME and R to go home. Rather than admit me where I was, I was transferred to the larger hospital campus of my local hospital around midnight on Monday night because they thought I might have to have surgery, which they couldn't do where I was.

Another rough night, this time in the hospital.  Almost no sleep.  Then, all day Tuesday they tried everything they could to help me pass the stone. Another cousin, K, sat with me all day on Tuesday and conferred with another cousin who is a nurse (her sister, M who is not local, and yes I really do have all these cousins). This was helpful. I really needed K and I was so glad she was there.  The Toradol was no longer working well, and I was apprehensive about trying the morphine again, so they gave me Dilaudid.  It was terrifying and I didn't like how it made me feel, K looked at the nurses and said, "she didn't like the high back in the 70s either."  which is pretty hilarious since I never did anything like that back in the 70s  :-D  Another nurse came in and told me that I could ride out the high or that they could give me Narcan to reverse the effect but then my pain would come back.  I looked at her said, "I'll calm myself down."   It took the pain away.  I made K sit next to me and hold my hand.  That's how bad the drug made me feel. 

Next was a bolus of liquids into me, and then a dose of lasix to make me pee out all the fluid I could in case I could pass it at the last minute.  That didn't work - and it turned out to be quite painful with the fluid pressure on my left kidney and bladder.  I was so dosed with Dilaudid that I couldn't understand how I was feeling any pain again.  The lasix didn't work either.  So, on Tuesday afternoon I had a surgical procedure with a laser that broke up the stone, and then they suctioned out all the bits and put a stent in to help me heal and allow the kidney to drain better after surgery.  They decided to keep me another night in the hospital just in case. 

ME joined K and was there after the surgery, and she picked me up on Wednesday when I got to come home.  You'd think I would have lost weight not being able to eat anything for 2+ days.  Nope.  You'd think I would have stayed the same, though, right?  Nope. I gained like 6 pounds. Seriously, can't a girl get a break?!?  The urologist told me it was all the IV fluids I was given.

Another cousin, J, took me yesterday to my follow up appointment with the urologist where they removed the stent. Later last night, the pain and vomiting came back.  It was controlled this time by the Norco they sent me home with from the ER.  I'm certainly peeing a whole lot, and today I'm not in any pain.  Cross your fingers.

I have to see my primary care doc next week, and then I have another follow up appointment in six weeks with the urologist.  I have to get another renal ultrasound before then.

They should have the results of the stone composition next week - that will help me know what to do/what to avoid/what to eat/what not to eat, etc. going forward. The biggest thing seems to be to drink more water.  According to the urologist, we're supposed to pee out 2-3 liters a day.  ===:-O

I always thought I was a good water drinker - but apparently I have more work to do in that area.

You guys, this has seriously been the No-Fun Plan.  On the positive side, I'm pretty sure that I've met my insurance deductible and blown by my out-of-pocket max for the year again. 

I'm not 100% yet and I'm off the rest of this week. I should be back at work on Monday.

I know that many people all over were keeping me in their thoughts and prayers.  I so appreciate that and I know it helped.  And I continue to be grateful that I have such wonderful family. 

We Are Family indeed.

Sunday, February 19, 2017

Catching My Breath . . .


I'm still here.

There are things to share.

I need just a little more time . . .

. . .  to catch my breath.