Kidney Stones in 2013
Thirty years later, I came down with yet another kidney stone. Having experienced one back in ‘84 was enough for me to cringe at the possibilities. However nowadays we have more advanced medications like alpha blockers which can help facilitate passage of small stones. We used Toradol for pain, which is non narcotic. In the process of diagnostics, we used a CT scan, which are easier and quicker to perform and do not require IV contrast. CT scans also provide more information to help with the treatment process. Once the stone was found treatment was decided. We had some options. One of which was ESWL (Extra-corporeal Shock Wave Lithotripsy) which was not available back in 84. This procedure is non invasive.
However for my stone, a urethral stone extraction was done. Today’s instruments are more advanced and much smaller. This helped reduce pain and trauma during the procedure. This was carried out at an out patient facility. After the extraction was performed a stent was placed in. This was a more tolerable experience due to the softness and flexibility of today’s Stents. Additionally, the stent was removed in only 3 days.
All in all, treatment for kidney stones has advanced vastly. From medications to instrumentation we have great options to help you with this problem in an efficient and effective manner.
We recently took some time to actually talk to some of our Urologists.
As a practice, we all spend a lot of time together. Its that kind of family like relationship, where sometimes you cant stand your little brother, or get annoyed at your dad not letting you go out this or that night. Oh, the memories! After spending some time with our doctors, not interviewing them but just talking to them outside of their Doctor like environment we came to realize how much like you and me they are (yes behind the MD title there is a person too). They are people with the same concerns we have and then some. Namely, taking care of you as a patient and us as their employees.
In the last few months, we have talked to them for some time. While you may think its just urology, its amazing how passionate they are about the cases they are working on and about their trade. Urology, Medicine they’re trades too, also an art in some ways. These require attention and keeping tabs on new techniques and/or medications to treat you know who? You. They sometimes get together over coffee and discuss some of their patients with the other Doctor’s in the practice. They do so with the utmost concern and passion, which sometimes is very inspiring. We as administrative staff may not know the medical lingo the way they do, but its kinda funny to hear them talk about some technique or the other for a surgical case. They are excited about it, about the challenge that those surgical procedures entail and how they’re ready to help YOU beat what ails you. On occasion we’ve asked them how did it go with this patient and his kidney stones, or the other with their bladder tumor? How did it go with that urethral repair? Its great to see them happy with each successful case. As with every thing not all cases have a single treatment solution, but the doctors come back with more information to create the next step in treatment. No, not all cases are surgery. Some are office treatment courses, or studies that help them figure out problems.
On top of having the constant pressure of dealing with their day to day life, they are concerned about you their patient. Besides this, many of our Urologists also lecture at teaching hospitals. It had been our impression that their work day was mostly 9-5 when in the office and which ever surgery cases they had at the hospital. Well, its not just that. Many times they arrive at our office after teaching at the hospital, presenting some conference at 730am. When thinking about that, consider that some of the doctors in our practice come from Long Island or New Jersey!
Medicine is not all glamor. Understanding all they do puts everything into perspective. It takes a lot of sacrifice and dedication, that not many people are willing to make. After coming to this understanding about the doctors at our practice, we have new found respect for them. We may complain sometimes about a stressful day at the office, and that’s fine, but now when we do, we also remember that these doctors we’re working for, never leave the proverbial office because they’re always available in some form to take care of their/our patients.
To ALL Urologists in our practice, and doctors everywhere we have to say thanks for letting us assist in the privilege of caring for your patients!
We’ve received great feedback with our online appointment requests. Many of our existing patients have enjoyed the convenience. If you want to avoid the phone, or being on hold and don’t have an urgent appointment, request it online.
If you are a NEW PATIENT, take advantage of our ONLINE PATIENT REGISTRATION FORM. We need all your information in order to create your account and make your appointment. If you register online, after requesting your appointment, we’ll be able to check your insurance for participation, have your information in our system and even make your appointment and just send you a confirmatory email. It will also save you some time at the office, all you will need to do is review and sign the forms, no more filling them out.
This also benefits new patients whom want to update their information.
Save time, register online!
Kidney Stones in 1986
Having experienced kidney stones twice in the past 30 years (see A Kidney Stone, a patient’s perspective) has given me some good insights, which I share with our patients at the New York offices from time to time. There are many aspects involved with diagnosis and treatment of kidney stones. Fortunately, our diagnostic and treatment options have improved significantly. Over time the art and science in treating kidney stones has improved vastly. I say art since not all stones are treated in the same way.
When I suffered my first kidney stone attack in 1984 diagnostic and treatment options were limited. During that episode the pain was unforgettable. It was like nothing I had ever experienced. At the time the mainstay of pain management consisted of narcotics which carry significant side effects. Patients where prescribed Percocet and/or morphine which did dull the pain caused by kidney stones but carried side effects of nausea, dizziness and constipation. The diagnostic options at the time of my first attack consisted of plain x-ray and intravenous pyelography (IVP). IVPs are rarely done today. This type of x ray was time consuming and and required an injection of dye into the bloodstream to locate the stone. X-rays do however deliver significant radiation exposure.
In 1984, I was unable to pass my stone (3-4mm) which was located in my left ureter (tube which transports urine from the kidney to the bladder) and caused intense and constant pain. There was no form of medical therapy at that time. My treatment consisted of a surgical procedure called ureteroscopy and stone extraction. At that time the instruments were large and cumbersome. During this procedure, the doctor inserts the ureteroscope through the urethra, into the bladder and then into the affected ureter. There he uses the instrument to visualize and grasp the stone to remove it. In some cases, the doctor has to break the stone into smaller fragments and remove them one at a time. The smallest pieces are to pass normally during urination. I underwent this procedure which lasted 2-3 hours and I was kept in the hospital for 3 days. The pain from the procedure was severe. After the procedure an ureteral stent was inserted to keep the ureter open and allow urine to flow from the kidney into the bladder. The ureteral stent was kept in place for one week. It left me with significant sympthoms. After it was removed, I slowly returned to my normal day to day activities.
In hindsight, the progress we have made over the last 30 years in treating kidney stones is amazing . Im glad we at New York Urological in Manhattan have access to much advanced methods for treatment today. I’ll be discussing my most recent experience in my next post for comparison of all aspects; from diagnosis through treatment. We know how it feels and understand that prompt and efficient treatment are the key to a better experience.