Country Life The Retirees: May 2013

My Journey through Kidney Stone Land

A beautiful day in March 2012 I was having a wonderful time choosing new chickens for my chicken coop . Suddenly I felt something moving within my body, kind of like bad gas pains starting on the left side of my back at my waist line. I tried to ignore it but it continually got worse. It slowly moved around to the front of my abdomen. By the time I got to my vehicle I was in trouble…extreme agony. The pain traveled to my lower abdomen. I was grabbing at my stomach with both hands, digging into the skin and squeezing as hard as I could as I moaned and groaned loudly. My husband was driving and I was in the front passenger seat, bent over backwards with my head in the back seat. When we arrived at our house it took everything I had to walk into the house. I was bent over and kept falling to my knees in the driveway. I felt extreme pressure in my lower abdomen and was doubled over wondering if I was taking my last breath. And then the pain began to ebb. I had no idea what I had just experienced. I’m an RN and yet I was thinking everything except “kidney stone”. It was like an animal had just clawed its way through my body. The pain was gone and I had no further symptoms. It left as fast as it came, except for the soreness and bruising on my stomach from my vice like grip.

Fast forward a year later to March 2013. I began to have problems urinating. It wasn't anything I couldn't deal with. I had recently become a vegetarian and thought possibly the change in diet was irritating the lining of my bladder or maybe I had a urinary tract infection (UTI). I’m not prone to infections and don’t believe in 64 years I've ever had one, but in menopause I have learned that anything can happen to my body. I did everything I could to take care of my problem, drinking cranberry juice, taking large doses of granular Vitamin C by the spoonfuls. It was not improving. I was savvy enough to know that if it was a UTI that the Vitamin C should take care of it. I made an appointment with my general practitioner, saw the physician assistant who prescribed antibiotics and took a urine specimen. My first pee in the cup began my long journey to diagnoses and wellness. A week later the PA called to tell me I did not have an infection…which by now I had figured out on my own.

I spoke to a friend about my problems and she informed me that she strongly suspected a kidney stone because she had been through the same thing. She recognized my symptoms. I began to read about my symptoms on the internet (oh how I love technology). I knew what was wrong with me. I made an appointment with a urologist in San Antonio, Dr. Haverkorn, a woman. I wanted a woman because women listen to women and understand a woman’s body more than a man. I researched her qualifications and felt like I had chosen well. My appointment was at 9:40am on April 5, 2013. I arrived early and was greeted by a rude receptionist. She asked for my insurance card and driver’s license. I handed her my license telling her I did not have my insurance card. She informed me she had to have my insurance card. I told her I did not have it, that it was being mailed to me. She asked me if I had lost it. I ignored her and told her again it was being mailed to me. I also informed her that I had given her all my information several days earlier over the phone. She asked me if I had filled out the papers she mailed to me. I told her I did not receive the papers…..(3 weeks later I still have not received them) . She was clearly irritated and handed me a clip board with several forms to fill out. Even though I rarely go to doctors and for obvious reasons, I am fast at filling out their paper work, mainly because I take no meds, have had no history of medical conditions to speak of and stay as far away from doctors as I can. I did it in record time and gave them back to her. I would like to mention here that there are many doctors in our family and I mean them no disrespect. They are young and just starting out in their profession. I hope the blog of my journey will stay with them as they grow in their professions. The purpose of this blog is not to complain or criticize but to not remain silent. Silence will never change anything in this world and my goal here is to make a change no matter how small it may be. “One small voice for mankind.”

As I mentioned before I am an RN. I’m not a doctor but I paid attention in nursing school, especially to the part where I was taught to “listen” to my patient. To treat the patient, not the disease, in other words to take a holistic approach to their care.

Back to Dr. Haverkorn. My appointment as I said was at 9:40, I was already livid with the treatment I experienced from the receptionist. I should have listened to my intuition and walked out but I was in pain. Two hours later at 11:45 I was ushered into an examining room after having peed in my second cup. I’m getting good at that. I waited for 15 minutes before the doctor arrived. She apologized saying she was “on call” and had an emergency procedure. I was polite. I went through my complaints, told her I suspected a kidney stone. She did not hear me. It was after 12 noon, she was hungry and her staff had already gone to lunch. She did not examine me. She decided the lining of my bladder was irritated. I’m assuming she meant interstitial cystitis but she did not give me enough credit to even offer up that term. She gave me a list of foods to eliminate from my diet. Being a vegetarian it meant I would starve to death if I followed her list. She also gave me a prescription for a med that would numb the urinary tract and turn my pee purple. I had already been using a similar over the counter med AZO which turned my pee red but didn’t help much. I left her office feeling slighted and angry, asking myself why did I waste my money? I knew the list of foods was not my offender but I vowed to give it a try. Again my pee test was negative for bacteria or white blood cells. I went to the pharmacy to get the prescription and was informed it would cost over $100. I did not purchase it. I went home and read some more on the internet and began drinking more water and thinking.

Several days passed and I was getting more and more miserable, peeing 10 or 11 times in the middle of the night….unable to pee during the day. I knew something was blocking my ureter. I finally decided to make an appointment with an OB/GYN. My daughter suggested the clinic she uses. Female doctors. I figured since I had not had a gyno exam in over 15 years that maybe this was a good time to do it and possibly rule out any problem in that area. This was a good doctor…Dr. Karen Hasty, she listened to me. She did what a good doctor should do. She spoke with me in her office, listened, really actively listened to my problems then took me to the exam room and took a look. I was in great shape for an old lady who had delivered 5 full term babies. But she was stumped, what was causing my pressure and pain. I began to think “tumor”. She had an ultra sound done on the spot and discovered a large foreign object sitting on top of my bladder where the ureter enters the bladder. A stone and a large one, 2 inches in length. It looked like a stalactite hanging from a cave. She said I needed to see a urologist and I moaned. I told her about my experience with Dr. Haverkorn and she suggested I see a Dr. Hvlanka, Urologist/OB , he was was great, so sweet. Ok I didn't want to see a male doctor but I agreed with her recommendation. I heard her call him and tell him I had a 2 inch stone on top of my bladder. I was able to get an appointment with him on Monday, April 29 almost a week later.

I went home and read more on the internet…I was learning. I forced myself to drink a lot of fluids hoping to make a difference but judging by the ultrasound picture of my foreign object I didn’t think it would help much.

An hour and a half drive into San Antonio on Monday morning to see this “sweet, good doctor” was going to fix me. I’m an optimist sometimes. I filled out more forms, peed in another cup, had an xray , another ultrasound, a cystoscopy, and the doctor didn't find much. Bladder was clear but ultra sound revealed a blockage somewhere. I tried asking about the results but was treated like an idiot who was incapable of understanding. He ordered blood work and a CT scan with dye contrast. Blood was taken and I understood them to tell me to go to the waiting room and wait again. I waited 30 minutes. My dear husband went around the corner to the OB’s office to get the copy of my ultrasound exam from her because it showed the obvious foreign object which did not show up on the urologists ultrasound. I gave it to the receptionist and she wondered why I was still there. She told me I was finished for the day and should have checked out and made an appointment for the CT scan. If she had not seen me sitting in the waiting room again I would probably still be there. I saw the doctor standing at the counter inside the office and approached him to show him the results from the OB. He clearly was not interested. He was done with me for the day. I tried talking to him, I had many questions for him but he was not having it. I showed him the picture of the strange object in my abdomen and he dismissed it saying the ultra sound was not good, he could not use it….he needed the CT scan. I just wanted him to acknowledge it and make a suggestion as to what it might be. I suggested it was a large stone. He would not commit and became obviously irritated and walked away from me. I went to his nurses who were standing around waiting for something, probably lunch which was being delivered and smelled very good. I said I had questions. They were irritated, what was I still doing there? I asked if this could be caused by the well water I had been drinking for the last six years. They would not commit, said they couldn't tell me because they didn't know what my UFO was. I said, “Well suppose it is a calcium oxalate stone, would you suggest I drink soft water or bottled water.” They said, “We can’t tell you that, again because we don’t know what it is.” I was about to go through the ceiling at this point. I said, “What about the pain, I've got another week before I come back, what am I suppose to do, how about a med that might dissolve the stone. It says here in your pamphlet there are meds for that.” They said, “We don’t know what it’s made of so we can’t give you a med.” I said, “What if I drop down writhing on the floor screaming in pain, then what”. They said, “Go to emergency room”. I said, “And they will give me morphine”. They agreed. I turned around and left.

What the hell? If I had treated a patient like this during my years as working as a nurse I could not live with myself. I could not go home at night and sleep a peaceful sleep knowing that I had not done my best by my patients to ease their pain or address their concern. I was disgusted, livid and feeling a myriad of emotions I could not even express. This is why I don’t go to doctors if I can avoid it.

These are reviews of Dr. Hlavinka and his staff that I found on the internet:

“Knowing that my husband was obviously in pain and scared, the Dr. showed no sign of compassion or willingness to help him with his problem.”

“Staff will play on computer internet and ignore you. They will send you walking uncomfortably for no reason down long hallways. Urinary problems they just don't get...they enjoy watching a patient struggle and wait. They will spill urine on you. Doctor won't even be there. What's next? Don't waste your time there to stomach the incompetence.”

“Dr. Hlavinka and his staff are uncaring and RUDE. The communication from the office would go a long way to alleviating patient fears and distress. However, they don't care what you need or want. Losing test results and not returning phone calls is par for the course with this office. Then when we finally did get a call from the Dr. He was rude and unapologetic for himself and his staff. The patient is your client (customer) and you will not stay in business this way. Peoples lives are important!!!!”

“Dr. R. Snitzler referred me to you. I will not be coming. Over a two month period no one has answered the phone,I have called all day long from 8:00am on. No one calls to confirm appts.,when I arrived at your office I was accused of never being at home so they could cancel my appt. as you weren't coming in that day. I said I am home every day and have a message machine.The desk clerk checked and said your office did not have a phone number for me. Your staff is incompetent or lazy--they are rude, disinterested,and not suitable for the line of work they are in at present. It is your reputation. One good and well paid RN could run that office with efficiency and care for worried people with health problems.”

“Very unhappy with the care given by Dr. Hlavinka. He caused more problems than what I started with. It is hard to get an appointment and the staff are not friendly and caring like you would expect especially dealing with many older patients and patients with cancer.”

On May 1, 2013, I went for the IVP, Intravenous Pyelogram at San Antonio Urology, next door to the Uro’s office, all part of the same system. The technologist, Rene was a wonderful, compassionate human being. He’s at the top of my list as a human and believe me you gotta be pretty good to get to the top of that list! He was normal! He knew his business and was not so busy or so threatened by questions that he felt the need to be rude or defensive. This man sat me down with my husband present and began explaining to me everything he was about to do to me. He walked me through every step telling me what would happen and how it would feel. He assured me he had a crash cart nearby and knew how to use it in case I developed an allergy to the dye (such as anaphylactic shock). He told me how the machine worked and that it would be talking to me telling me when to hold my breath and when to breathe. At some point I asked a question about results and he assured me my doctor next door would inform me of the results. I assured him that I was not so sure I would be able to get any information from the doctor or his staff because they were incredibly rude. He was surprised and empathetic and told me that he was going to make up for that and walk me through this test imparting all the knowledge he could to me without actually diagnosing me because he was not allowed to do that! Fair enough. The test was a walk in the park and the machine was so fascinating. As I lay there I thought about the brains behind the making of this machine and I was in awe. I appreciate how extremely intelligent humans can be and how advanced we have become since days of the covered wagon and surgery without anesthesia. After the test was complete, maybe 15 minutes all total, this wonderful gentleman, Rene extended his hand and helped me from the table. He led me into the computer room and showed me the results and how the machine “dissected” my body. The last segment showed my unidentified object, the foreign invader lolling around at the entrance of my bladder….kind of stuck in the door between the ureter and the bladder.

My next task was to call the Uro’s office and ask the nurse what to expect next Tuesday when I see the Uro again. She informed me it would be a consultation to review the IVP CT Scan and decide how to get the invader out of my body.

I stopped at the local grocery store to purchase lemons. I figured lemons are acid and maybe drinking lots of lemon juice over the next few days I might be able to wear down the edges of the stone in order to help it pass through the door to my bladder.

Thursday morning May 2, I called the Uro’s office again to ask if they could prescribe a medicine to dilate the ureter and perhaps the juncture to the bladder. I spoke to a nurse named Patricia. She asked me how I knew about such a thing and what was the name of the med. I told her I did not know the name but knew there was such a thing. She then asked me how I knew about it and who told me about it. Why did she ask me such questions? What difference did it make. She was clearly being rude and trying to intimidate me. She informed me the doctor was not in and therefore she could do nothing for me. After my call ended with this little twit, I was verbally chastising myself for forgetting the name of the med so went to the computer and looked it up, “Flomax”, of course and she knew the name of it, she was one of the “bad guys”. Why do these people go into medical care? Why?

A week later I returned to the Uro for the results of my CT Scan. I waited in his waiting room for 2 hours before being ushered into an exam room. Apologies were offered for the long wait. The doc had been at the hospital. After about a 20 minute wait in the exam room, “his majesty” entered. Again we were into the lunch hour. Having had experience with this I knew he was hungry and this was going to be a rush conference. I could feel it, it was in the air, his need to escape. So he asks me how I have been feeling. I tell him the stone is gone, that I have been symptom free for five days. He agreed and said it was probably pushed out by the dye contrast from the IV during the CT Scan. I did not tell him that I had consumed massive amounts of granular Vitamin C, fresh lemon juice and hydrochloric acid since last seeing him. I knew I had dissolved it on my own. Thanks to my 20 year old son who is a geography/archaeology major. He told me that since we live on limestone rock which was once an ocean bed that my stone was most probably made of calcium and the best way to dissolve calcium is with acid. I had read many conflicting testimonials on the web regarding lemon juice cures. I decided to give it a try. Within a day of starting the lemon juice I began to notice a difference in my urine stream and the pressure and inflammation was obviously subsiding.

The Uro suggested I make another appointment in a couple of months for another CT Scan. I knew I would not. I asked him about well water and he suggested I do not drink it but instead drink bottled water. I asked him about the safety of vaginal estrogens and he babbled his speech about them being safe with no side effects that he was aware of with any of his patients. Of course I knew I would not be using them. I asked for samples which he gave me. I will be giving them to a friend of mine who swears by them. I came home and read more on the use of these hormones and decided it would be a cold day in hell before I injected such a thing into my body. I would rather age naturally instead of take my chance with breast cancer, endometrial cancer, uterine cancer, ovarian cancer, hair loss, dementia and weight gain. Next I caught a glimpse of his white coat as he flew out the door. Taking cue from him I did the same. I couldn’t wait to be out that door, into the bright sunshine and be done with that office forever. As I exited, I looked up at the sky and inhaled deeply, as I shouted, “Free at last”. Yes I felt free from the stone, free from the illness. I had regained my power which I felt being slowly stripped from me as I dealt with this illness and the incompetent medical people I had been surrounded by.

I called the Uro’s office a few days later to ask for my test results. A week later the bills began to arrive for the numerous testing I had subjected my body to. $$$$, it was adding up fast. I received the results of my tests and was absolutely flabbergasted at the Uro’s report. What a liar he is. I can’t even be nice and say that he embellished his report because that would be lying on my part. This man actually said he counseled me on the use of vaginal estrogens and to call his office for any questions about possible side effects or reactions and reminded me of the continuing need for breast cancer screening. On my mother’s ashes, those words never came from that man’s mouth. Also he did not address the fact that I might continue to make kidney stones and that it might be beneficial to me if I increased my acid intake my drinking lemon water. However I must give him credit for having a brochure regarding that in his office that I might or might not have picked up while waiting patiently for him. Perhaps that’s why we are called patients?

Patient beware is my advice if you are dealing with any type of illness which surely you will be as you age. Always ask for your reports. Read them thoroughly over and over. They are not easy to understand but you can always research the meaning of words or phrases you don’t understand. In my case, reading the report from my CT Scan I discovered that I do have other issues that were not addressed by this doctor. These issues may be just normal signs of aging or could possibly be the beginning of serious medical problems, however how would I know? The Uro was treating a kidney stone, not the patient. The ball is in my court again to find out what these issues are. I will have to take this report to an internist I suppose and spend a lot more money. I’m hoping my family doctor can interpret this for me. What I’m trying to emphasis here is that if I had not asked for the report and read it myself, all of this would have gone by the wayside and perhaps I would begin having symptoms and eventually after much repeat testing and scans an astute doctor would recognize a problem and begin treatment if it is not too late….or better yet it is just part of the aging process as the body begins to rot like a piece of fruit and I will live well into my old age, rotting slowly!

I had to write and publish this blog for the world to see. Maybe one doctor will listen and feel guilt. Maybe one doctor will change and listen to their patient, treat the whole person and not usher them in and out like cattle in a chute. A copy of this blog will go to all the doctors involved in treating my kidney. Perhaps they won’t even read it. But maybe one will and maybe that one will remember their teaching in medical school. Maybe just one.

A big thank you to Dr. Karen Hasty of Four Seasons OB/GYN for her “holistic” treatment and to Rene at San Antonio Urology for being such a gentleman and explaining each step of the CT Scan process and what I would experience.

Stay well and take care of your bodies and take the lead in your medical care.

Country Life The Retirees

Saturday, May 18, 2013

Country Life The Retirees: My Journey through KidneyStone LandA beautiful d...