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    KLD kidney stone

    KLD, i'm mostly venting here. in '95 i had a kidney stone in rt kidney. my new urologist in northridge diagnosed it and he tried removing it with a laser. my kidney bled blocking his vision and there were problems with AD. he failed. next he tried the shock wave procedure which worked. both procedures and the stint in place after the laser released and allowed a free flow of infection so i was very sick. the stint was removed after the shock wave.

    in 2006 i began feeling ill after 11 years of very good health and my urologist again diagnosed another kidney stone in my rt kidney. in '07 after feeling ill constantly, i had the laser procedure. my AD was controlled, but i bled again blocking his vision. he failed. i was septic and anemic after the procedure. after antibiotic, transfusions and iron treatments, i was released. at home within 10 days i was septic, severely anemic and dehydrated. although i was very sick, i didn't go to u.c.l.a. which is very close because i wanted the same urologist and internist doctor. back at northridge hospital after treatment, we tried electroshock wave. it failed. i went home.

    it's now '08 and i have decided i must do something. the stone's over a centimeter in size. i'm feeling constantly ill again with bladder infection. i put off further kidney stone procedures because antibiotic treatment made me feel better until about a month ago. sulfa made me feel as bad as the infection so i stopped it after 6 days and cipro hasn't worked. my uro wants to try electroshock wave again but at westhills hospital in the valley. SO, due to my uro failing and sending me home last year still very sick, i'm thinking of trying u.c.l.a. to get the stone.

    what do you think KLD?

    thanks.
    Last edited by tippyx; 23 Nov 2008, 1:35 AM.

    #2
    The stone needs to be removed. If you want to change urologists to UCLA, I think that might be wise as it appears you may have lost confidence in the urologist you were seeing before. I hope you have a smoother course in getting it removed. Is this the same kidney each time?

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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      #3
      KLD, yes the stones form in the same kidney, the right one. besides getting the stone out due to chronic infection, i have to remove it before having my scoliosis surgery. this is the time in my life i do a 'one two' punch to correct the problems that are sidelining me from fully living.

      it's my theory that the stones form in my right kidney due to my scoliosis pushing my organs against that kidney. perhaps it doesn't drain fully, or perhaps my bladder refluxes to the right side.

      i'm hoping since u.c.l.a. is a larger facility besides getting the stone out, bladder and kidney dynamics tests can be done. i have had a suprapubic catheter since '95.

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        #4
        The kidney stones form because of infection and are made up of infections material so when they are dissolved, the infection is opened up. You need to be admitted to the hospital several days before and placed on IV antibiotics then so when the procedur eis done you have less chance of getting septic.

        CWO
        The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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          #5
          kidney stones form due to infection?

          I thought kidney stones formed from either dehydration and/or too much salt intake and if stones made from calcium, too much calcium intake. Is this not true?

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            #6
            this is quite astonishing. in january i went to ucla urology and saw dr. schulam, a kidney stone specialist. since i felt bad and was running a 99-100 degree fever at some point everyday, he took a urine and blood sample, and ordered a contrast dye CAT scan. i admitted i wasn't changing my suprapubic catheter as often as i should. he told me to definitely change it every 4 weeks.

            the results of my urine C&S showed infection. my blood test and CAT scan showed my kidneys were functioning normally. i have a 7.7 mm stone in my rt kidney. dr. schulam said that since my rt kidney was functioning normal and my temp only 99-100, he was NOT going to remove the stone. furthermore, the CAT scan showed that my suprapubic catheter showed crystallization even though it was only 3 weeks old.

            so, i'm changing my catheter every 3 weeks. i feel better. EVERYONE (my past urologist, my internist, professionals here) adamately insist i get the stone out. it releases infection. it may occlude my kidney. however, expecting to have had surgery scheduled to remove the stone at ucla, i was baffled when i was told 'no'.

            dr. schulam suggested having the mitrafanoff procedure and not doing anything until i get a fever of 101/102 and above. it was mentioned the stone is in a particular area of the kidney which has some relevancy.

            i have a ticking time bomb in my rt kidney.

            Comment


              #7
              Originally posted by tippyx View Post
              i have a ticking time bomb in my rt kidney.
              I completely hear you, because I am having a very similar problem! I have had 3 lithotripsies [shock-wave treatments] in the past for kidney stones: 2 on the right kidney and 1 on the left kidney. In August 2008 I was told that I once again had a stone in my right kidney (7mm) and that we should wait because I had other medical issues which needed to be resolved before we could address the kidney stone. So I waited. Had the necessary medical issues resolved and then returned to see the urologist. In February 2009 the CAT scan revealed that the stone was still present, but it was now 5mm. [They believe the difference in size is due to measuring error] I was told that the stone is small enough to pass on it's own and no further medical treatment was required. Just to report back in 1 year. I said that I was prone to AD and had been fighing recurrent urinary infections the last 2 years. Besides which, I have a continent urinary diversion and didn't forsee a stone of 5-7mm passing out of my catheter. My next appointment is August 2009.

              I am not happy.

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                #8
                bump for KLD/DR. WISE response please.

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                  #9
                  KLD kidney stone UPDATE advise plz

                  bump for advise

                  Comment


                    #10
                    Stones need to come out. They are a constant source of reinfection of your urine, as if they grow large enough will damage kidney tissue or even take out a whole kidney. I would recommend you see another urologist for a second opinion...and be sure it is someone who does a lot of SCI care.

                    (KLD)
                    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                    Comment


                      #11
                      I agree that stones should come out. The urologist that I am currently working with teaches at the medical school and does surgery at both the University hospital and the VA hospital. Ergo, he and all of his medical residents are exposed to SCI patients. He wants to wait despite what the literature states.

                      6. INDICATIONS FOR ACTIVE STONE REMOVAL
                      The size, site and shape of the stone at the initial presentation are factors that influence the decision to remove
                      the stone (Table 14). The likelihood of spontaneous passage must also be evaluated. Spontaneous stone
                      passage can be expected in up to 80% in patients with stones < 4 mm in diameter. For stones with a diameter
                      > 7 mm, the chance of spontaneous passage is very low (1-4).
                      The overall passage rate of ureteral stones is:
                      • Proximal ureteral stones: 25%.
                      • Mid-ureteral stones: 45%.
                      • Distal ureteral stones: 70%.
                      Stone removal is accordingly indicated for stones with a diameter exceeding 6-7 mm. Studies have
                      shown that asymptomatic stones in the kidney sooner or later give rise to clinical problems (5).
                      It should also be observed that small stones (< 6-7 mm) residing in a calix can cause considerable
                      pain or discomfort (6-12). Such stones should be removed with a technique that is as little invasive as possible.
                      A narrow caliceal neck may require dilatation.
                      Table 14: Indications for active stone removal
                      LE/GR Selected
                      references
                      Active stone removal should be considered when the stone diameter is 2A/B 1-5
                      > 7 mm because of a low rate of spontaneous passage
                      When adequate pain relief cannot be achieved 4/B
                      When stone obstruction is associated with infection* 4/B
                      When there is a risk of pyonephrosis or urosepsis* 4/B
                      In single kidneys with obstruction* 4/B
                      Bilateral obstruction* 4/B
                      * Diversion of urine with a PN catheter or bypassing the stone with a stent are minimal requirements in these
                      patients.
                      LE = level of evidence; GR = grade of recommendation
                      © European Association of Urology 2006
                      • In general, stones that are 4 mm in diameter or smaller will probably pass spontaneously, and stones that are larger than 8 mm are unlikely to pass without surgical intervention. With MET, stones 5-8 mm in size often pass, especially if located in the distal ureter. The larger the stone, the lower the possibility of spontaneous passage, although many other factors determine what happens with a particular stone.
                      • Guidelines are now available to assist the urologist in selecting surgical treatments. The 2005 American Urological Association staghorn calculus guidelines recommend percutaneous nephrostolithotomy as the cornerstone of management.12 In the ureteral stone guidelines produced by a joint effort of the American Urological Association and the European Association of Urology, ESWL and ureteroscopy are both recognized as first-line treatments for ureteral stones.13
                      Nephrolithiasis
                      J Stuart Wolf Jr, MD, FACS, David A Bloom Professor of Urology, Director of Division of Minimally Invasive Urology, Department of Urology, University of Michigan
                      Updated: Dec 10, 2008


                      Any other suggestions?

                      Comment


                        #12
                        tippy,
                        Another place to get an opinion from (which is pretty far from you, but really good) would be Pomona Valley Regional Hospital in Pomona (by the LA County Fairgrounds). They have a kidney stone center there and would be a good resource. I went there when I had pain in the right lower quadrant of my abdomen one time thinking I had appendicitis but CT scan showed that it was a kidney stone. After 5 back surgeries I have to say that might have been the worst pain (well....close to it)! Luckily the stone passed on its own a couple days later. I've had at least 3 stones, and I think there have been a couple more that passed without me knowing (I feel the symptoms but never see the stone pass).
                        Hope you are able to get this all resolved quickly.
                        Mandy
                        ~Mandy~
                        SCI as a result of spinal surgery
                        TiLite Aero Z!!!

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