Saturday, December 22, 2007

Stone Search 2007

Brent had his 2nd surgery today. They weren't exactly sure what they were going to do when they took him down to surgery. The consent form we signed gave them "permission to do procedure A, B, C or D".

They did try several things and we learned some things as well. The doctor discovered that Brent's urerter has a section where it narrows significantly. It's called a stricture - it's probably scar tissue from a previous stone. It gets so narrow that there's no way a stone like this could pass. They couldn't even move the scopes up to where they needed to because of this stricture.

One thing that comes up when people hear about kidney stones is they have to start sharing what they've had relatives experience or gone through themselves.

"I had a 6 mm stone for 3 months in 1998 and barely felt a thing..."

"My Aunt Edna's cousin had a stone and you wouldn't believe where it got stuck!"

"I'll tell you, I've never wished I could die except for the time I had that kidney stone"

(which, by the way, isn't helpful to tell someone agonizing in pain from a kidney stone at the moment).

The thing that you don't think about is whether it's physically possible for your body to rid itself of a stone of a certain size. And for Brent, all those people who kept telling him it was a "small stone" were only looking at half the picture.

Now we know. And, as GI Joe would say, "Knowing is half the battle".

They put a stint in to try to help expand the area where the stone can't pass. The part I don't get is how the stone is supposed to pass if you're filling up the area with this device, but what do I know.

The other strange physiology thing we learned today was that Brent's kidneys aren't laid out normally. You're supposed to have an area where the ureter meets the different sections of the kidney - where all the areas of the kidney flow into each other. They call this area the "renal pelvis". I prefer to think of it as the "kidney foyer". The business end of the stint is supposed to sit in this "foyer" and wait patiently for someone come calling and take it out. Brent doesn't have a renal pelvis/kidney foyer to speak of. (there's a comment in there somewhere about how even Brent's kidneys aren't very social....) The doctor was quite frustrated because it limited what they were able to do and where they could work. And since Brent's kidneys aren't welcoming enough to have a foyer, the doctors had to wrap the wire end of the stint down into one of the portions of his kidney. The doctor said, 'That might be why the stint hurts him so much." MIGHT be?? Fabulous.

As a note, it's not a good idea to have your mother-in-law only hear the portion of the doctor's post-op consult where he says "Brent doesn't have a pelvis". All sorts of things start to conjure up and she starts to wonder exactly what they were doing in that operating room!

At any rate, we're still in the hospital, and we're trying to keep the pain under control and the other issues that accompany a stint contained and we're trying to get Brent feeling better. He's staying the night again. We'll know more tomorrow how bad it's going to be. The stint was the kiss of death for Brent last time.

If only he'd had the foresight to build a foyer in his kidney....


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