The Pinnacle of Pain

Introduction

It was about one year ago tonight when I discovered what maximum pain really  means.  It was Good Friday night in 2013 at about 1 am, and I was getting ready for bed and taking a natural break.  Suddenly and without warning, Mike Tyson, in the prime of his boxing career, entered my bathroom and hit me with a straight right jab in the base of my left rib cage.  This powerful blow simply took my breath away.  Not only did this phantom punch take my breath away, it caused my diaphragm to begin acting spasmodically, making it impossible for me to breath normally.  

I gasped for breath and looked at my side to see if I had been shot. There was no blood but there was plenty of pain.  I slid my feet down the hallway like a 90 year-old man and awoke my wife Toni. I told her that I wasn’t sure what happened but something had gone wrong inside my body. I didn’t feel like it was a heart-attack or anything immediately life-threatening but that I was in some serious pain. She managed to fall back asleep while I took the journey of a lifetime.

 


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The pain started in the middle of my rib cage and over the next few hours, I could tell that the pain was moving vertically down my body.  Periodically I’d wake my wife in search of some sympathy, but there wasn’t much to handed out in the middle of the night. She eventually blurted out that she thought I was having a kidney stone.  A kidney stone, I asked? What the hell is a kidney stone?

For the next five hours, I tried my best to be a hard-guy, like Stallone in Rocky or Rambo.  I wanted my wife to see how tough I was, how I could handle the pain.   I did laps around my kitchen, doing a little jig as I moved, breathing as though I was in labor.  I tried hitting the ground in the fetal position, taking a cold bath, taking a hot bath, performing deep meditation, and trying any other pain relieving mechanism that I could think of, including taking two ibuprofen tablets.

About every hour, I was introduced to a new kind of vomiting that is world-class.  This type of vomiting hits with the suddenness of an earthquake.   The intensity is above an 8 on the Richter scale.  Your body heaves with such intensity that you are sure your organs are going to come flying out of your throat. I was convinced that EVERYTHING is going to leave my body,  each time that happened.  Your blood pressure hits an all-time high and you are sure your lights will be turned out momentarily.  After each of these episodes, I hopped like a bunny rabbit trying my best to help gravity speed the passage of that stone down my ureter.  Drink water, drink more water, is the best advice I could find.  All the water did was reload my stomach for another round of “how fast does this vomit leave your body this time?”.

While all this was going on, I was thinking about my past bouts with pain.  I remembered the lung illness I had in Norway that lasted about a week and a half that kept me in a state of delirium for a few days in a row.  I remembered the near removal of my fingers on the table saw, followed the next day by a case of mis-diagnosed double pneumonia that kept me bed-ridden for nine days.  The cases of flu from seventh grade and college (coupled with shingles), that hit me so hard that my biological clock went astray for a few days.  I remembered the molar abscess that I had that forced me to cry like a baby while crumpled down in the floorboard of my car while I begged my wife to get me to the doctor.  At the time, I explained that after having pain level 10 for seven days in a row, I was ready for suicide because the pain was right next to my brain and I couldn’t escape the hell I was in.   I erroneously believed that this was the worst pain possible.  I remembered the concussion I received when the drunk guy that blind-sided me and smashed his beer bottle on my face (this caused two-years of tooth nerve damage). I also remembered the muscle tears from power lifting. All of these extreme pain episodes came back to me with great clarity during that night.  None of these episodes of pain, even remotely, compared to what I was experiencing during this night of torture.

Also during this night, my brain took me to a deep dark place. Sometime in my past, I learned the word vivisection.  Once I learned this word, I had nightmares of what this must be like to be the subject of a vivisection.  According to Wikipedia,

Vivisection (from Latin vivus, meaning “alive”, and sectio, meaning “cutting”) is defined as surgery conducted for experimental purposes on a living organism, typically animals with a central nervous system, to view living internal structure. The term is sometimes more broadly defined as any experimentation on live animals (see animal testing).[1][2][3] The term is often used by organizations opposed to animal experimentation[4] but is rarely used by practicing scientists.[2][5] Human vivisection has been perpetrated as a form of torture.

During this night, I imagined that I was having a vivisection performed on me, from the inside-out.  My brain interpreted this pain as being caused by a tiny surgeon inside my ureter. He was was using multiple razor blades to vertically slice the inside of my ureter in an attempt to escape from that tube.  He was relentless.  Cut after cut, he proceeded to move down my ureter.  As I would later learn, the actual cutting implement he was using is known as a kidney stone, as shown in Figure 1. As you can see, there are plenty of blades to cut you with.  Believe me when I say this: the pain caused by the cutting action of the stone is world-class and inescapable.

Image

Figure 1 – A kidney stone in fine detail.

The Body’s Response to the Pain

When I finally relented, the sun was about to rise.  I wasn’t sure why I had to quit the battle, but the continuous loss of fluid from profuse sweating and vomiting left me with little resistance to fight the pain any further.  I’m not sure if it is possible to pass-out from pain but I’m pretty sure that I was close to finding out.  After my wife took me to the ER, the nurse took one look at me and said, “yep, you’ve got a kidney stone”.  I asked her how could she possibly know this.  She said, “you are doing the dance”.

The dance is the continuous movements that you do when you are experiencing this type of pain.  There is no relief to be found from the pain, but you involuntarily try to move any way you can to find some relief.  I must have looked like a total spaz, sweating profusely with sunken eyes that were screaming – please help!  Fortunately, the nurses know exactly what to do for you.  They give you a strong IV pain-killing shot and some anti-nausea medication.  That is the good news.  While you are temporarily feeling better, they throw you into a CT scanner to look for the little doctor and his razor blades inside your body.  Once they confirm the diagnoses, the doctor tells you: “Yep, you’ve got a kidney stone”.  I asked the doctor what caused the vomiting.  His one-word answer: “pain”.

At this point, you think you are now OK.  You are comfortable, lying in bed in a hospital, chatting with your supportive wife and trying to act like the hard-guy again. The bad news is, you are only on borrowed time.  At exactly 1 hour after the nurse gave me the IV pain shot, she opened the door and asked me if I was still OK. I said yes, “I’m fine”. As she turned to walk away, the hammer of pain slammed me back into reality with the same forcefulness as the initial Mike Tyson jab.  I quickly told her: “No, I’m not OK!” and she proceeded to disappear for 10 minutes before returning with another shot for me.  While she was gone, I did the dance some more while lying in the bed.  I pleaded with my wife for help.  I needed blankets, I needed medication, and I needed the nurse to get her ass back into the room with that shot.  I think she must have gathered the other nurses, went to the video feed from that room and giggled while I did the dance. She gave me 10 more minutes of torture just for the fun of it. When she returned, she said, “Hey I feel your pain. I have had both kidney stones and babies, and I’ll take having babies any day of the week!”.

After this bit of wisdom,  she left me with a bit of good advice.  She said, “You’ve got about 40 more minutes before the pain returns again.  Go to the pharmacy and get the medication.  Take it as fast as possible.  Keep it close to you for the next few days until the stone passes.” So I followed her advice and spent the next three days in a state of delirium.  The razors passed (see pic below) in about three days but the effects of this episode left me shaky for over two weeks.

passed stone

The primary kidney stone and its fragments that passed through me. Yikes.

Shortly afterwards, I had another bout with shingles that I’m fairly sure was caused by the hit my immune system took from the kidney stone.  Shortly after that, my immune system lost a battle it had been fighting with an infection below one of my teeth that has lead me down a whole other path of pain, and an entirely different story for a future blog post.

Why Did This Happen?

In retrospect, I think I now understand what caused me to have a calcium oxalate kidney stone.  The problem started a few years before the stone and it started in a place that you wouldn’t think could lead to a kidney stone.

I had a molar that started giving me some trouble by being sensitive to hot and cold.  The tooth eventually had to have a root canal performed on it. Prior to the root canal being performed, I was treated with antibiotics to kill the infection that had set-up in the tooth.  However, I was given the wrong type of antibiotics, twice, and then thrice, including a really painful shot of something in my ass that cause me to hop around like a jack rabbit!  Finally, a secretary at another dentist’s office told me: “Hey, they have been giving your gram-positive antibiotics, what you need is a gram-negative antibiotic! (or vice versa)”.  A secretary figured that out!  Once I returned to my dentist with this information, he said to me: “Are you sure you want to take this medication?  This is a five-day supply of the strongest antibiotic known to man”.  After seven days of pain level 10, I said, “Sure doc, give it to me”.

Well, he gave it to me alright.  By day three, my stomach hurt so bad that it was impossible to eat.  By day four, I was calculating which would be easier: 1. Taking the fourth pill, or 2. Jumping off the hotel I was staying at in Florida.  I chose number 3, which was neither.  I didn’t take the pill on day 4 or 5 (which I know is a big no-no when it comes to antibiotics) and I didn’t jump off the building,  but unfortunately the damage was already done.  My GI-tract bacterial population was wiped out for a long time to come.

For the next three of four years, I experienced a new type of fun.  It is called “esophagitis”.  The definition of this is shown below.

Esoph

I got to experience daily volcanoes of acid blowing up into my throat.  This was a great time.  Every night, I experienced a rude awakening by an acid volcano erupting into my throat, which sent me running to the bathroom to find some medication that might help. I tried things that stopped the production of stomach acid, and although those helped, the problem remained.  I didn’t like this option anyway since I’m pretty sure we need stomach acid to digest our food.  So I turned to the next best thing: Tums. Tums were my daily companion through these years.  Extra strength tums were great.  Mint flavored, fruit flavored, extra strength calcium!  I figured that the more calcium I consumed, the stronger my bones would be. I didn’t anticipate any side-effect of consuming Tums. Wrong, wrong, wrong.

What do you think your body does when it has too much calcium?  It will stock pile it in your kidneys, slowly building a future present it will return to you when it is ready.  After years of eating a bunch of Tums, my body returned the favor by eliminating the excess calcium in the form of a calcium oxalate kidney stone.  That is how my stone formed, at least it is my best estimate of the sequence of events. It also happens that I live in the “kidney stone belt” of America, where people consume a lot of green vegetables (these contain oxalates) and drink sweet teas (more oxalates), which contributes to the problem of kidney stone formation.

Will This Happen Again?

For anyone that experiences a kidney stone, there is an increased likelihood of re-occurrence.  For me, I’ve gone one year without any new stones emerging, but I know the probability is high for another episode for this reason.

When the CT scan was completed on me, a “spot” was seen on my liver.  I was sent for additional diagnoses, which involved an ultrasound of my liver.  The good news was that the liver spot was a non-issue, but the girl who did the ultrasound gave me the bad news that sounded like thunder in my head.  She said, “I just went and reviewed your CT scan from the night of your kidney stone.  I saw both of your kidney stones.”  I said, “Stones?”.  She said “Yes, I saw the one in your ureter and the one still sitting in your kidney”.  I said, “Why didn’t someone already tell me this?”.  She said, “I don’t know”.  Below is a picture of the bright-white calcium-based kidney stone in my kidney that is waiting to make its grand entrance.

Stone in the kidney

When this stone decides to make its appearance, at least I’ll be ready to start the pain killers before waiting 5+ hours to do so.

Now I know that I will likely have another visit from the internal vivisection doctor, but now I’ll be better prepared to handle the situation.  In the days prior to the Tyson punch, I had noticed the feeling of having to urinate frequently but not much flow was produced.  I subsequently learned that this is a clear warning sign of an impending kidney stone.

The Rest and Best Part of the Story

A few months before the kidney stone hit, I had discovered Rich Roll and his plant-based eating message.  My wife and I became plant-based eaters and I immediately stopped having any digestive problems.  The acid volcanoes were a distant memory and my inability to swallow food was gone.  Before the diet switch, I had this thing happen (as part of the esophagitis) where the food I was attempting to swallow would get caught in my throat.  I could not get it to move one way or another.  The food was clogged in my esophagus.   Tears would form in my eyes as I bent over trying to keep my composure, trying not to gag and to keep breathing.  It wasn’t easy.  After many of these episodes, I’d get a lingering case of hiccups.  Throughout these years, I didn’t enjoy eating that much and I learned about which foods were more likely to send me into this food traffic jam.  Now that my diet has changed, these issues are gone.  For this improvement I am thankful, and I am seriously a big fan of the Rich Roll podcast series that has helped me to better understand nutrition and its impact on our lives.

One thought on “The Pinnacle of Pain

  1. Pingback: Vikings, Throwing Axes, and Trips to La-La Land | 3danim8's Blog

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