Thursday, December 15, 2011

Getting stoned.

Working in a medical organisation it can be easy to forget what a big deal it often is for someone to suddenly find themselves classed as a patient. They can go from walking around happy and healthy then, BLAMMO!,  something untoward occurs and they're no longer in complete control of their lives.

The modern medical ethos is to involve the patient at every stage of their treatment if possible.

This is great.

Mostly.

There's always the "I don't want to go to that hospital because they do crap sandwiches and my 103 year-old great Aunt died there after a boob job, so take me to one fifty miles away" patient who perhaps doesn't get all the respect they deserve, however unprofessional that may be.

Usually though, we try to accommodate the patients wishes and, for them to make an informed decision, we like to keep them informed.

But everybody is different. We're all individuals. We're all unique*

So you might be surprised to learn that many people who end up in the purple-gloved clutches of the ambulance service don't want to know anything about what we're going to do to them. Or for them. Or with them. They have a "just get on with it, man." philosophy.

"I don't ask a plumber why he's wrenching that nut as long as he fixes the leak, and the same goes for you, Sunshine."

Fair enough.

When someone tells me that, I just obey their wishes and open the sterile packaging for the medical nut wrench.

In general, though, people do want to be involved. They want to know what's going on and why you're doing it, and above all they want to talk. It helps them retain a semblance of confidence and some aspect of control when entering a strange and often unfathomable new environment.

Putting yourself in the patients shoes, not literally as that is frowned upon and results in letters of complaint, is a useful mental exercise, but there's nothing like suddenly finding yourself on the other side of the professional fence to engender feelings of empathy in the future.

So I thought I would relate the story of my own hospital admission which happened about four years ago and what I learned from it.

It all started, as many tales of woe are wont to do, in the middle of the night, when I woke up with some discomfort in what is termed, in medical parlance, my tummy banana.

Bit weird, I thought to myself, and presumed it was simply the after effects of some strong Belgian lager I'd had earlier in the evening. I went to the toilet and noticed my wee was pink.

Stylish, I thought, trying not to worry too much, but I was more concerned about the ache in my lower abdomen having not reduced at all. In fact it was a bit worse now.

I got back into bed, but started tossing.

And then turning.

This disturbed the missus and our new bed-sharing baby, so I got up and went downstairs.

The pain spread round to my side and crept along my back, getting worse, until the ache became a sort of cold grip that made me gasp.

I tried unsuccessfully to go to the loo again, but did achieve a new pain. A completely unrequired pain that no man should ever have to endure. The tip of my penis hurt.

"Oh come ON!" I grunted to myself, as I wondered if I should try and rub it better. "I know something's wrong, so is really there any need for that?"

The pain in my side was now worse than the worst pain I'd ever had before, when I'd gone sub aqua diving with a cracked tooth some years ago. And then it got worse!

I looked in the mirror, surprised by how pale I was.My pulse crept up past 120. I retreated back to the toilet just in time to throw up magnificently, as if my body didn't know what to do so thought it would try that, see if it worked.

Staggering to the the living room, I couldn't sit, stand or lie without the pain coursing through me, although I did at the time remember thinking how bravely stoic I was being, keeping it to myself and staying quiet so I didn't disturb my wife and new baby upstairs.

Suddenly, Mrs The Jules appeared at the door.

"Why are you whimpering?" she asked, adding "So loudly?" to make a point. Then her eyes adjusted and she got a good glimpse of me.

"Bloody hell. What's the matter?" she made a face at my sweaty pallor and took my pulse, muttering "One thirty!" and rushing off to get some paracetamol and ibuprofen. She returned and I downed the tablets like sweeties.

"I think . . ." I grimaced, " . . . I've got . . ." I gurned, " . . . a ki . . . " I grunged, " . . .a  ki . . ." I garbled, " . . . . a ki . . ."

"A kidney stone?" Mrs The Jules finished impatiently. I nodded up at her, now bent double in a comical Notre Dame mutant campanologist pose. "Shall I call an ambulance?" she asked.

I wasn't sure a kidney stone was particularly appropriate for ambulance transfer, despite having treated many in my time. They are excruciating, but not particularly life threatening.  Also, the thought of one of my colleagues picking me up, giving me morphine and subsequently taking the piss out of me for the rest of my working life made me shudder, despite the pain. Instead, we lashed the baby into his bucket seat and made our own way to the Emergency Department.

The drive was appalling. Even my missus, who is a smooth driver, couldn't stop me clutching on to the hand hold, shaking like a dog doing it's business outside a nursery,

The pain got worse! How can it get worse, I wondered? There is no more pain to be had. Any more pain and I won't be able to think. I'll be like a . . . no simile came to mind. The pain had de-similefied me!

Of course, at the Emergency Department, there happened to be a number of ambulance personnel  who were most surprised to see one of their off duty colleagues scuttle out of a yellow Nissan Micra, bent double and sporting a dashing grey colour, and into the recpetion area to book in. A couple of them helpfully followed me in to point out how funny I looked, and would I like a poke in the ribs to see if it really did hurt, and also how funny I looked.

It was relatively quiet, and I got efficiently triaged, assessed and dosed up with morphine and diclofenac. I actually sighed with relief as the pain ebbed to a dull throb over the next half hour.

Then, three days in hospital on fluids and antibiotics, all waiting for the emergence of what I presumed to be some sort of spiky boulder as it made it's way down my lacerated ureter and into my bladder. Eventually, I went home and caught it in a tea strainer that my wife now refuses to use.

And all because of this:


Hang on, that doesn't show the true majesty of the thing. Try this one:

Three millimetres! Three enormous millimetres of calcium oxalate reduced me to a barely functioning quivering wreck, rather than my usual barely functioning non-quivering wreck.

Observe the wonders of nature!

So, anyway, what did I learn from the experience?

Well, despite the best care from attentive and decent staff, hospitals are boring. Really boring. For this reason, I always tell my patients to grab a book if they can. Hospitals are also noisy at night, so take ear plugs.They're disempowering, so take a positive mental attitude.

And they're full of sick people, so take a decent immune system.

Most of all, I was reminded how thin the line is between us and them. Between the practitioner and the patient. So thin, indeed, that often it fades into invisibility.


* " I'm not."

18 comments:

  1. You had me doubled up in pain just reading this post. arghhh...I kept thinking ' how come he hasn't called the ambulance at the first sight of pink pee?" then reminded myself its because your're a para-medic!

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  2. I knew there was something I liked about you. It’s the Sacred Fellowship of the Stone! Mere mortals haven’t a clue. I’ll never see The Gravel Farm in quite the same light again. Salut.

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  3. Joe P - True. I try and find a nice balance between being blase and being a hypochondriac.

    Jeaux - A fellow sufferer! My sympathies go out to you. It reall is an experience, innit?

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  4. Ugh, I have friends that went through this. Amazing something so tiny could be so painful. If it happens to me, I'm not worried about any pride - I'll call in the national guard if I have to!

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  5. Wheeeee! How much fun can one man have? Loads, apparently, as you make even a searing tale of gravel expulsion something worth chuckling over.

    I shall go about the rest of my life trying to avoid this...

    Pearl

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  6. I'm just stopping by different type of blogs and thought id say hello folks. So greetings from an Amish community in Pennsylvania, and wishing everyone a merry Christmas and a healthy and happy new year. Richard from Amish Stories

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  7. It's ginormous! By urethral standards. I assume.

    Hospital are stupendously boring, which, is why they should have a Monty Python Channel.*

    * "Always look on the bright side of stones . . ."

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  8. Why did your dick hurt if it wasn't actually in your dick?

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  9. Let me handle this, Jules...

    Once the demon seed announces its arrival, your whole urinary tract, to the tip of its nethermost outpost, responds with alarm. It’s probably some sort of enzyme release. Every tissue in its approaching path screams. Everything behind it applauds.

    The uninitiated contemplate its final exit with horror, but that’s a walk in the park, a hiccup. When it first leaves your kidney and begins clawing its way down your renal ureter, as delicate as a strand of vermicelli, the magnificence of this torture chamber lurking in your own body, is a revelation that can scarcely be described.

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  10. oh dear . . . there are no words. sympathetic thoughts but no words. . . maybe a smile at how well you have described this experience. In fact on reflection there is a word Trooper!!

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  11. Having had to pass two of these boulders in my time on the planet the only thing I would add to your comments is that it hurts way more than you indicated... Here in OZ the nurses tut-tut, remind you thats it's ONLY like childbirth and send you home with the advice to come back if it gets properly painful.

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  12. Wow, TWA - Damn right! I'm not messing about if I get another one either.

    Pearl - All of life is blog fodder, as you so eloquently understand!

    Amish Stories - Thank you and may I, through the wonders of technology, wish you the same.

    Nicole - That would be ace.*

    *And well spotted!

    GB - What Jeaux said below. I believe it's termed referred pain and is, like the same hole used for breathing and eating, just another way of demonstrating that we haven't been designed, but are a result of a series of evolutionary compromises.

    Cass - I am ever so ever so brave, aren't I?

    Tempo - There was a woman on my ward who said she would rather have all three of her children at the same time than another stone.

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  13. Good to hear it was just a temporary setback. I will imagine that you considered 'Another Piece for the Gravel Farm' as the title for this here post.

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  14. Eric - Ooh, that didn't even occur to me. If I made another few thousand I could have myself a new background picture.

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  15. Jules,
    I am a bit disappointed you did not think of your your OOH colleagues. Would have saved you the painful trip to hospital and the boring stay in hospital.
    Hang on to some diclofenac supp just in case of a recurrence!
    Jeevan

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  16. Jeevan - Ha, I do have a secret stash for just such emergencies. Good to see you last night. Have you any unexplainable mystery headache remedies?

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  17. That story was both horrifying, and utterly hilarious. I was crying by the time you caught IT in the tea strainer. I had my gallbladder yanked out, so I may have an inkling of the pain you felt.

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  18. karensomethingorother - I've heard gall bladder yanking is of a similar level of agony, so I reckon you can! And if you want a touch of TMI, when it came out it felt like someone had flicked the end of my todger with a too much gusto.

    Far too much gusto.

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