THAT caused all my pain?
Posted by WhiteCoat on October 21, 2008
For all of you that have had kidney stones,you know how painful they can be.
I haven’t had the pleasure, but have heard them described as “trying to pee out a golf ball,” “being stabbed in the back with a broadsword,” and “someone ripping my guts out through my hooter.”
We had someone that passed a kidney stone in the ED and caught it in one of the strainers. Below is what it looked like. Afterwards the patient asked me the same question in the title of the post “THAT caused all my pain?” Yup. And you’re lucky it wasn’t bigger.
Your chances of getting rid of a stone quickly is often related to the size of the stone. Stones less than 4 mm usually pass on their own without much difficulty. For stones between 4 and 6 mm, spontaneous passage is a coin toss. Almost all stones more than 6 mm have to be retrieved.
The biggest stone I have seen (on CT scan) is 10 mm (a little less than half an inch). This one pales in comparison at “only” 3 mm. Still caused the patient a world of hurt.
I won’t repeat all the fine work that someone put up over at Wikipedia, so if you want to read more about kidney stones and see a picture of a bigger stone that looks like a piece of cereal, head over there. The article also gives some tips on how to keep stones from forming.
One more thing for the docs – I have found that in the residency program where I work, most of the docs still don’t know about “Medical Expulsive Therapy.” Giving alpha blockers and nifedipine will help prevent ureteral spasms while administering steroids in theory decreases the inflammation in the ureter. Both decrease the time it takes a stone to pass and increase the likelihood of spontaneous stone passage. This Canadian study showed that stones of up to 7 mm would pass after patients received Flomax.
Read more about MET here and here.
HyperAl said
I unfortunately had that pleasure in 2003 but, contrary to the description above, I would say the pain was intense and sharp, however, tolerable. So I would give it an 8/10 on the pain scale. Don’t you love it when patients, sitting comfortably on the examining table smiling at you, would rate their pain at 10/10. I wanted sometime to slap them hard and then tell them that’s a 5.
I drove myself to the ED and 30mg of Toradol and 15-30min later, 90% of the pain was gone. I later(2days) passed a 4+mm stone. Maybe I was lucky or I just have a higher pain tolerance than some. I definitely don’t want to experience that again though.
SeaSpray said
Your Wikipedia link doesn’t work WC. Fixed it – thanks
My pain both times was a 10 and I am restraining myself from adding a plus anything to that number.
The pain trumps my labor stories and that was with relentless back labor and contractions…for hours.
You could always tell the kidney stone patients walking into the ED.. diaphoretic, hunched over and gripping their side… moaning and barely able to talk.
So when it happened to me at 4am… within 3 seconds of getting out of bed and standing up… I immediately hunched over, gripped my side and said kidney s-t-o-n-e… it was 6mm and stuck.
And ED staff at our hospital always hustles to get a kidney stone patient into bed.
It amazes me how things soooo small can hurt so much, stones, teeth, and even hangnails. Tiny little thing but no one wants to wiggle them back and forth.
NurseExec said
I took Topamax for a few years (it sucked, I’m glad I don’t take it anymore). The worst part about it was the kidney stones. I drank GALLONS of water, and still had stones on three separate occasions. Owwwww.
LindaR said
I had a kidney stone a few years back, too. NOT fun! I would have loved to let the doc hospitalize me and keep me drugged until the damn stone passed, but I had 2 young teenagers who couldn’t drive and a husband who was out of town for several days on business. Oh, they could’ve ridden the school bus into town, but what about groceries if I’d been laid up for several days??? We have NO family closer than 700 miles away, and at that time didn’t have any friends close enough to conscript into temporary parental duties. So the doc shot me full of just enough pain meds to bring the pain down to a quasi-tolerable level, wrote me a ’script for something to keep me somewhat functional, and I made my way home. The front desk folks said they would’ve sworn that when I came in, I *wouldn’t* have been going home that day. Apparently “gray” isn’t a skin color they like to see. lol
I think I’d rather give birth through my nose than have to pass another kidney stone!!
Pat Brown, RN said
I had natural childbirth with a 10+lb kid, and a kidney stone. The latter was worse by a significant margin! That was one syringe fulla narcs that I was VERY glad to see!
SeaSpray said
I’ll just add that while the narcotics must’ve helped me (morphine/dilauded)I was still writhing in pain… while vomiting. My only relief the first time was getting put under in the OR.
The 2nd time… after hours of pain and vomiting and headache… managed to drift off to sleep once up in my room and I woke up without pain in the morning. The nurse told me she didn’t want to wake me for pain meds.
I still ended up in OR with 3 stuck little stones that most people would pass.
I have never had the pleasure of passing a stone. Is that worse than stuck in the ureter? I can’t even imagine it!!!
geena said
I didn’t measure the one I had (CT said it was 4mm) but I do remember that it was very spiky. This guy’s looks relatively smooth the lucky bastard!
When I had my son, I was curious to find out if having a kidney stone was really worse than labor. Labor won, hands down. Maybe it was the pitocin.
marcia (2) said
I haven’t had the uh… privilege of comparing childbirth to passing a kidney stone, but if it’s worse than Pitocin with contractions every 2-3 minutes for almost 24 hours, count me out.
DH had kidney stones earlier this year, and thought he’d just strained a back muscle. Imagine his surprise when they discovered three 7-8 mm spiky (struvite?) stones in his kidney and ureter. I don’t know why he wasn’t in more pain, or how he survived the weeks leading up to surgery on Advil alone.
I’ll never say men are too wimpy for labor again.
SeaSpray said
I was on the pit too but not 24 hours. The combined labor back/contractions was so bad that just before they decided to go C-section, I hyperventilated. My kidney stone was worse because with labor…the medication helped me somewhat.. the kidney stone pain came through the meds. And no vomiting in labor but yes with stone.
And while AWFUL pain with labor… you know your getting a baby for your efforts. I do remember thinking that the clock had stopped toward the end in labor and I felt like I was in an eternity of pain. I couldn’t even think with the stone and it never occurred to me to look at the time. Neither is a day at the beach.
Marcia – your husband had a spiky stone for weeks and he only took Advil? What.. an entire bottle every 4-6 hours???
He’s a superman in my opinion and must be one stoic guy.
HyperAl said
Now, I really feel lucky my pain wasn’t that severe.
marcia (2) said
He’s not usually so much of a stoic, Seaspray. He also got a tooth abscess in a molar about a month or so ago, and you’d have thought he’d been shot from the way in the three days leading up to oral surgery. I had to hide the Vicodin and dole it out on a schedule, for fear he’d get addicted. And that darned molar was the only thing he talked about for a week (well, okay, also football and politics, but he’d have to be on his deathbed to ignore those topics).
A couple of times, I’ve seen him roll around on the floor moaning after stubbing his toe on a piece of furniture. And hot bath water, forget it! lol
For some reason, he just didn’t seem to have the pain most people seem to have under similar circumstances. It sounds like yours was particularly bad.
Yeah, I can see your point about anticipating the baby in a completely different way than you would the passage of a stone. I don’t suppose you took the stone home with you?
SeaSpray said
Marcia…maybe he just isn’t as sensitive in that area as most people.
I think that doc did offer me the stone when I came in for a follow up. I have this fuzzy recollection that he grabbed it off the shelf behind him and I adamantly said No thank you! I wish I had taken it but I wanted distance at that time. That 1st experience was the most painful thing in my entire life.
Haha! Then he yanked the stent out in his office (that was horrible pain but fast)and then offered me the stent in his hand and asked me if I wanted to hold it. I said NO!!! I was actually mad at him at that moment.
I will put this here because maybe it will help someone reading this in the future. Also… I am an admitted wimpette with pain.
Prior to the stent removal procedure… I asked this doc if I needed to take a Percocet for the removal. He said no…it’s no big deal. I decided to look it up on the internet.
Some people said…no big deal. But one person said “For the love of God… take Vikodin, take Percocet..Take something!”
That’s all I needed to read.
I took one Percocet. Tears instantly streamed down my face when he removed it and I cried out. I never did that in my life with pain, not even labor or kidney stones. So I was mad at him for not preparing me. My God! What if I didn’t take anything?
And that set me up to be terrified of having them removed in the office. I have a different doc now and with his permission… I took 3 Percocets and I still felt the pain but nothing like the 1st and second times with the 1st doctor.
He was a nice doctor. We just had different ideas about pain thresholds.
I think I might know of the worst pain if it was a long time. When the dentist hits a nerve in your tooth while working. Major zap!