How bad is this going to hurt?
August 18, 2010 2:15 PM   Subscribe

Kidney stone filter: What am I really in for? Give it to me straight.

So Sunday night, after intense pain and going to the ER, I find out I have a kidney stone. It's 4mm and it's currently stuck in my ureter. The pain of it moving from my kidney to the ureter hurt pretty damn bad, but not the worst pain I've ever felt. I've had period cramps worse than that. Everyone keeps telling me that the real pain begins when you try to pass it through your urethra. Also everyone I've talked to that has had one, has had ones the size of "a grain of sand." Mine is 4mm and significantly bigger than that so I would like to hear from people who've had ones that size. I have a good stock of Percocet but is that going to be enough? Will I have to go back to the ER because of the pain? Is there really anything else I can do to help ease the pain when the time comes?

I saw a urologist the day after the ER visit and I have another visit with him on Monday. Hopefully it will have passed by then but we'll see. I can feel that sucker inside of me, but it doesn't really hurt that bad since it hasn't really gone anywhere yet. I have named him Reginald Rosencrantz.
posted by MaryDellamorte to Health & Fitness (30 answers total) 2 users marked this as a favorite
Oh God.....Bless your heart, and your kidneys...

I've had several, big ones, (not in a few years, knock wood). To me the worst part was from the kidneys to the bladder, pure, screaming agony...I've never felt the bladder to outside part, I've caught several (sorry, TMI) but I was always recovering from the first part of the journey...... I've always been told that for girls, the trip to the bladder is the worst and for boys, the trip to the outside is the worst. YMMV, keep the percocet handy...

Good Luck!!
posted by pearlybob at 2:24 PM on August 18, 2010

I visited to the ER for intense pain once and found out I had a smallish kidney stone (2 mm?) that had entered my ureter and was traveling. I ended up back in the ER with pain much, much worse and was dosed up with Dilaudid until I didn't know what planet I was on or what species I was. I passed it shortly after.

People have different pain tolerances, though, and hopefully you're able to pass yours without any more hospital visits.

p.s. During my other kidney stone experiences, I tried to drink a big glass of water every hour to help pass it.
posted by rachaelfaith at 2:26 PM on August 18, 2010

Oh I forgot to mention that my urologist told me to drinks lots of water and lemonade (which I have been doing) and he prescribed me Flomax which he said might help open up the tubes a little bit.
posted by MaryDellamorte at 2:28 PM on August 18, 2010

For me, the worst part was while it was in the ureter. The way it was explained to me is that the real problem with pain comes from when it blocks the flow from the kidneys to the bladder, causing the kidney to swell.

YMMV, but if you can get past that part, you should be past the worst of the pain. You have my deepest sympathies. Good luck!
posted by Lafe at 2:36 PM on August 18, 2010

Now I think there are some other treatments for kidney stones. I have heard about sonic waves being used to break them up, but I don't know anything other than that. Someone may know more about this or your doctor will definitely know more about it.

I have never felt a "10" on the pain scale before I had my second and third kidney stones (together). Percocets may or may not be enough depending on the pain. For me, they were not. I also felt weird in that general area for a week or so afterward, fyi.
posted by TheBones at 2:39 PM on August 18, 2010

Also, you may want to rename him to Captain Reginald Rosencrantz as he's gonna be driving your boat until he escapes.
posted by TheBones at 2:44 PM on August 18, 2010 [2 favorites]

I get them fairly often. The first one was the worst because I didn't know what to expect + fear/dread. The most painful part for me is from the kidney to the bladder but once it hits my bladder I don't feel a thing (for guys, the last mile is apparently much worse). I wouldn't know if passed one if it wasn't for the little strainer thingy the doctor gave me.
posted by jamaro at 2:45 PM on August 18, 2010

Flomax and Vicodin (aka Norco) are your friends. The first will keep you up at night frequently, but it keeps things going.... the latter will comfort you when things get rough.

The fear of dying is the worst part... now that you know its not fatal, but just annoying as heck, it should help a lot.

I've been told they are worse than childbirth, but you may luck out. At least you have good meds. 8)

Good luck, and welcome to the club.
posted by MikeWarot at 2:56 PM on August 18, 2010

First one (about 8 years ago) was horrible - 10 on the pain scale, and I rarely complain about pain. It didn't pass, and I don't remember the size. I had to have surgery, which really sucked.

Second time, about 2 months ago. The initial pain was horrible again. I think the doctor said it was 6mm, which seems fairly large. I had only a couple of moments of pain after the ER visit that were manageable with percocet/vicodin (I also got Flomax+heavy duty ibuprofen), and I'll be damned if it passed unnoticed to me. So I guess the painkiller worked, or the ER part of the ordeal was the worst.
posted by O9scar at 3:09 PM on August 18, 2010

It's such a crap shoot. You may be in agonizing pain. You may show up to your appt. and find out you passed it without noticing. I've had several over the years. One that was 4x5 got stuck in my ureter, and I had to have the ureteroscopy surgery to pull it out. (That was after dealing with it for a month, not unbearable pain, but not pleasant to have to keep dealing with it.)

I think the lithotripsy sound wave thing isn't used in women when the stone is low, like yours is. My doc's explanation had to do with it being too close to the lady parts.
posted by BlahLaLa at 3:34 PM on August 18, 2010

Been there, done that.
I had a 5mm stone that showed up on the CT scan; except that they saw the small end it was actually 7mm.
After the initial ER visit, they wanted me to 'wait and see' it it would come out on its own. After a month, it didn't. The Dr. had to go in to get it. (Yes, go in that way.) Pretty heavy pain after that visit.
During the procedure they placed a stent which remained for a couple weeks; it was uncomfortable. Removal of the stent was an office visit. The discomfort there was more from worrying that the pain would be bad.

A year later, another stone, treated with lithotripsy. That was under sedation, not bad, blew the stone to dust!

Keep on the water and lemonade. They think that the acid in the lemon juice helps dissolve the stones; jury is still out on that one. Doctor told me that each person makes stones for different reasons. Some because they drink too much milk, others because they don't drink enough milk. Bottom line was: don't believe anyone who tries to tell you the reason without analyzing the contents of the stone you form. The universal treatment: drink plenty of liquids.

I've never had percocet, but vicodin (norco) is your friend.
The Flomax will help also.
posted by Drasher at 3:37 PM on August 18, 2010

You are a lucky duck if it's not bothering you too badly. I've had two stones and each time the trip from the kidney to the bladder was the worst *worst* pain I have experienced (outside of childbirth - except following that you get more than a chunk of mineral). As other posters have said, it is a different experience for everyone though so don't freak out waiting and worrying.

To answer the "what to do" question: keep your painkillers handy and don't be afraid to ask for more or more potent pills. They always seem to start you on vicodin/percoset, but this last time I asked for oxycodone right out of the gate and got a script right away. They do NOT mess around with this stuff. Also know that if it gets unbearable you can always go back to the ER and get some sweet sweet intravenous dilaudid and complete oblivion for at least a few hours.

Good luck.
posted by lilnublet at 3:46 PM on August 18, 2010

I had one about your size (I think it was 5mm). I did the whole thing without anything stronger than Aleve for a variety of reasons. It took close to a month to pass as it pulled off the road and out of the way on its trip to my bladder a few times, but there were really only 3 episodes of absolute, out-of-my-head agony. Each of them lasted between 12-24 hours. I'm sure drugs would have helped.

Once it got to my bladder, there wasn't a lot of pain. I ended up passing it an hour before I was to head into the doctors office to get it removed. The actual passing didn't hurt much at all compared to the trip down, though it did tear stuff up on the way out.

It's no fun at all, but it won't kill you. Thinking that I was going to die before I was diagnosed was hands down the worst part of the experience.
posted by bluejayway at 3:55 PM on August 18, 2010

Percocet is oxycodone. I think my biggest fear is the stone not passing and then having to go through what Drasher went through. Gives me the heebie jeebies.
posted by MaryDellamorte at 3:58 PM on August 18, 2010

I had kidney stones a couple times in a cluster, the first time the pain lasted for a week. It was like monstrously bad cramps the whole time - a stabbing pain in the lower back. I was terrified about the "moving through the urethra" part because everyone said that was the worst, but honestly, when it passed I didn't feel a thing.

Maybe it was because I was already on a bunch of pain meds, maybe the water and lemonade worked some magic, I don't know, but the only way I even knew it passed was because there was some blood, and the pain was suddenly gone afterward.
posted by ella wren at 4:04 PM on August 18, 2010

I had two smallish stones many years ago. Passing the first one was comparable to pulling a large pinecone through my dick. Passing the second one was extremely painful. Haven't had any recurrences, and I drink red wine vinegar every other day or so to prevent any recurrences.
posted by motown missile at 4:22 PM on August 18, 2010

My one experience with a kidney stone was actually pretty meh. I had a lot of pain as it moved out of the kidney, but once it was free, it was no where near as bad as people kept telling me it would be.

I felt at first like I had pulled a muscle in my back very badly, then felt it moving lower. I went to my student clinic, got a prescription for some pain meds, and went home.

I took an oxycodone, lay down, went to sleep, and drank a bottle of water every time I woke up. I also drank some olive oil and vinegar mixture which seemed to help, about half way through things. The stone was fairly decent sized (big enough I found it in the toilet, but not very thick) but again, the worst of the pain was over within 6 hours. I slept through most of the last 8 or so.

Of course, I have a form of neuralgia, and THAT hurts by far more than any of the kidney stone thing did, so my experience may not be typical.
posted by strixus at 4:24 PM on August 18, 2010

Just an aside: Percoset *is* oxycodone - with Tylenol. If you're taking a lot of it then you'll want to get switched to oxycodone because too much Tylenol is bad news for your liver. that's I guess the point I was trying to make.
posted by lilnublet at 4:37 PM on August 18, 2010

Something I haven't seen mentioned yet is take lots nurofen. I can't remember the exact mechanism of action in renal stone pain but nsaid's are far and away the analgesic of choice for your condition. That plus the flomax which may help to push the stone out (studies are fairly inconclusive but it can't hurt).

If the pain gets really bad don't be scared about going to an ER. Kidney stone pain will get you to the front of the line in all but the busiest days (and at mine we'll bend the rules and give IV morphine in the waiting room if we're full).
posted by Silentgoldfish at 4:54 PM on August 18, 2010

I had what turned out to be a kidney stone. First noticed it on the train home. Was in so much pain I actually asked my seatmate (who I knew) if he had a pocket knife on him as I was getting prepared to do an emergency appendectomy on myself. I thought I had a burst appendix. Wish I did (almost). The pain was all that day and the next few. Never felt is actually pass!!

The point I am writing about is the Percocet. They work. But, they work when they are taken either before the pain or in the very beginning. Not as much when you are lying there freaking out curled up doubled over making promises to god that you will never drink again if the pain just goes away. So, you need to be willing to either anticipate it or pop one as soon as the first sign of trouble. The problem being, you might take one and not need it and then you are just drooling on yourself which may or may not actually be a problem for you. No one noticed the difference for me.
posted by JohnnyGunn at 4:55 PM on August 18, 2010

I've had kidney stones 3 times, the first when I was twelve. Since kidney stones are rare for twelve year olds, they thought I had appendicitis and I was on my way to the OR when the pain miraculously disappeared. They had put in a catheter to do an ultrasound and it dislodged the stone.

The worst part for me (and what always landed me in the ER) was vomiting so much from the pain that I became dehydrated. As soon as I got to the ER and hooked up to an IV, hydrated and on painkillers, it was a lot better.

On time I ended up with a kidney infection because of the stones, and had a 104 fever on top of the pain. Now I drink about 2 gallons of water throughout the course of the day and keep some serious painkillers on hand incase I get that familiar feeling in my back.
posted by elvissa at 5:10 PM on August 18, 2010

If you're taking a lot of it then you'll want to get switched to oxycodone because too much Tylenol is bad news for your liver.

So, you need to be willing to either anticipate it or pop one as soon as the first sign of trouble.

Yeah, the ER doc, the urologist and the pharmacist all emphasized to me not to take more than 8 pills of Percocet a day because the max intake for acetaminophen is 4 grams in a 24 hour period. Each pill of Percocet contains 325mg. I was only taking a good amount of it back when I first got out of the ER. Two pills every four hours. It make me a zombie but then I cut back and I only pop one if I think it's about to get bad which has only been 3 times. But it never got bad. I still have a lot of pills and I can always get more on Monday when I see the urologist again. Hopefully it will be a non issue by then. I like water, but damn if I ain't getting sick and tired of drinking it.
posted by MaryDellamorte at 5:17 PM on August 18, 2010

I had the first one of my life in January. When it passed out of my kidney, I was fairly sure I was going to die. Well, that I wanted to die. Fortunately, I realized that it was a kidney stone. Anyhow, wife's driving me to the hospital, I'm hollering my head off, and then I got there, they gave me an if of something lovely, and it was all good. I was on some kind of serious painkiller (Percocet, I think, like you), but it made me feel all confused, so I stopped taking that after a couple of days.

It took a few days to pass it. When I did, it wasn't at all painful. More satisfying than anything else. It was 3mm, jagged, like a meteorite or something. I'd been thinking that "passing a stone" meant to actually expel it from your body, but when people refer to that, it turns out they're talking about moving it out of the kidney. That's the painful part for most folks.

At 4mm, I'll bet the worst is over for you.
posted by waldo at 7:00 PM on August 18, 2010

OP, see if they can give you Vicoprofen - hydrocodone and ibuprofen. It gives you the NSAID + the narcotic and you don't have to worry about your liver as much (though there are still risks to NSAIDs). A few doctors have told me that the combo of ibuprofen and hydrocodone is more effective than the acetaminophen and hydrocodone combo.
posted by bedhead at 7:30 PM on August 18, 2010

I had my first one last year (year before?). Oddly enough, I felt the pain backwards - from my vaginal area around to my back/kidney (neither my family doc or urologist knew what to make of that). I had Vicodin and didn't feel it when it passed. I've had a couple smaller ones since then and they've been tolerable with just OTC pain meds.
posted by deborah at 11:29 PM on August 18, 2010

Urethra: big, wide tube for (comparatively) high pressure flow to outside. Ureter: narrow little tube for trickle to bladder. The latter is much the more painful place for a stone.

Such is my experience, and my first stone was 6 mm in its longest dimension, shaped roughly like a stegosaurus. Actually passing it from the bladder didn't hurt at all.

Good luck with yours; I hope it will be easy.
posted by wjm at 4:09 AM on August 19, 2010

Just relating my experience... I've had back problems for a while. But one night a few years ago, I was woken up with a pain bad enough to send me to the ER. They took a scan (CAT? PET?), and said I had kidney stones. One on each side, the right one (where the pain was) was 2mm, the left 1mm. The pain was close to the worst I've felt (but I'm a wuss), and I got dilaudin (sp?) in an IV which turned the pain off like a switch.

Got refered to a urologist, and got lithotripsy on the bigger stone. Apparently, it was in a position where this would work. In some cases they can't lithotripsy it, the stone just bounces around. A few days later, I got an ultrasound on the remaining one, and it might have gotten bigger (the ultrasound has less resolution than the scan they did), but they said it should pass on its own in a few days. So I filtered my pee for a few weeks, but never saw/felt anything. And since then, I never felt anything pass. But I'm a guy, and as someone said further up, the plumbing is different.

And my thoughts on pain killers in preperation for passing the stone... As I understand, when it passes, it will be a quick thing. So unless you stay medicated the whole time, it's probably not worth it.

Good luck! I think the worst is behind you.
posted by ObscureReferenceMan at 8:33 AM on August 19, 2010

Here's my horror story, and I'll comfort you by assuring you that yours won't be like this:

I had a monster stone get hard-stuck just outside my kidney -- not a candidate for the sonic blast because of location, nothing else would move or dissolve it. I was referred to a specialist doing a "new" procedure which was the only option left besides surgery: a laser gun would be inserted upward (yes, through there) and used to blast the stone into powder.

The waitlist for the procedure was over a month, so I endured the stuck stone for six weeks... without painkillers (between allergies and life, I couldn't take anything strong enough to help). I've had other stones (and in fact my gall bladder ruptured from filling up with them), but none of that pain is even comparable to the impacted stone's. I spent basically every moment I didn't have to actually do things in the fetal position, and got my sanity questioned openly by the three nurses I met who had suffered the same issue and claimed it was far worse than childbirth pain had been.

While the wall of pain was gone as soon as the procedure was over, between the stone and the roto-rootering it was a long time before anything returned to anything resembling normal -- long enough that my doctors were "very concerned." So, if anyone suggests such a procedure to me again, I intend to opt for surgery or death instead.

Moral of this story: please, please, please take your painkillers.
posted by Pufferish at 8:56 AM on August 19, 2010

Funny timing--I've just been informed that I'm harboring a rider myself (Guildenstern? 1.5 cm! JEEZ). I've been having symptoms for a year. Ugh! I almost went to an ER a year ago but I had more pressing medical matters on my mind, and then by the time I went to my (now ex-)doctor, she blew the diagnosis. :| My new one is on the ball, though. Waiting for the next step at this point.
posted by wintersweet at 11:38 AM on August 19, 2010

I'm surprised to hear that so many people were told to wait it out for several weeks. I had a stone about 6 years ago that got stuck in my ureter and by the time my doctor figured out what it was (I thought the pain was from muscle spasms) they told me I needed surgery ASAP because the blockage was causing my kidneys to swell up (with pee, I guess?).

The surgery was easy (i.e. no incision) and the recovery was much less painful than the movement of the stone. The only thing that really sucked was the stent removal. They put it in while you're under general anesthesia, but take it out while you're totally alert. The process of retrieving something through your peehole while you lie on a table with your legs in stirrups is uncomfortable to say the least.

My stone was a lot smaller than yours, but it was by far the worst pain I've ever experienced. I guess it just varies from person to person. I'm not sure about it's effects on the liver, but I found that Toradol did wonders for the pain and didn't make me feel groggy or sleepy like the fistfulls of Percocet that the urologist prescribed.
posted by Mrs.Spiffy at 1:32 PM on August 19, 2010

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