Renal calculi pain

  1. I have had kidney stones 3x before. Once, I was actaully hospitalized. Tonight, I am beginning to feel the all-too familar flank pain of those awful episodes. I'm uninsured (just started a new job and don't qualify yet) and can't afford an ER bill. If I can make it through tonight, I'll go to a walk in clinic tommorow. In the meantime, what can I do for pain? It's not yet reached the writihing, unable to sit still kind of pain that I know it escalates to, and I wonder if it will. What are the chances that it will pass overnight without the pain becoming unbearable? Is there anything I can take OTC to help? Someone suggested I take as many as four ibuprofin. Is this a safe dosage? Also, I'm getting nausea. Oh, I HATE HATE HATE being sick and in pain! (whiney, I know) but someone has to know something I can do to get by. Please help. Would a heating pad alleviate the pain? On a scale of 1-10, I'm at about a six right now. Thanks for any suggestions.

    Caroline
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  2. 9 Comments

  3. by   NRSKarenRN
    So sorry your going thru this. Husbands 90th stone causing some flank discomfort tonight too.

    Fill the bathtub as high as you can with hot water, as hot as you can stand. Soak for at least 20 mins, add more hot water as it cools. This helps to ease the spaticityof the ureter, relax and allow stone to move a little.

    If nauseated, wait til it passes to take ibuprofin:IB 4 tabs of over the counter 200mg dose=800mg , ok to take no more than 3 x a day.

    ...toradol helpful or Percocet ( husband always takes at ONSET of acute pain, keeps RX at hand). If nausaeted + takes PO med, husband always vomits.

    After spasms subsides, your wiped out but need to push water.

    Too much vomiting, get dehydrated---go to ER request IV Toradol + hydration.

    Good luck. Let us know outcome.

    Get your stones analyzed so you'll know what type. ? change in diet. Husband needs diurtic to keep kidney flushed along with allopurinol: down from a stone q 6 weeks a few yrs ago to every 6 months...hasn't been lithotripsied since 97, passed them all.
    Last edit by NRSKarenRN on Oct 28, '01
  4. by   janine3&5
    Caroline,
    Yes, the 4 ibuprofen (200 mg ea) is a safe dose. You can even take the ibuprofen along with some tylenol at the same time for really bad pain. DRINK lots and lots of water! Hope you'll feel better soon!
  5. by   CarolineRn
    Karen and Janine, Thanks so much for your advice! I have refreshed the main page about 10x to see if anyone responded.

    I am going to try the bath and 4 motrin. If I can just get to sleep, I should be ok.

    If it gets worse or doesn't get better by tomorrow, I'll get to a walk in clinic, and let you know how it went. In the past, my stones have typically been accompanied by either a kidney infection or a urinary tract infection. I haven't spiked a fever, so this one may be different. Hopefully, it's just a small stone and will pass with no further complications.

    Thanks again for the suggestions, and your support. Sometimes, just the validation from someone else that the pain is real helps alot.

    Caroline
  6. by   P_RN
    Do you have a primary doctor who might be willing to call in something for the pain?

    One more thought, when I ruptured my disk I too thought it was a stone.....had several many years ago. All the above helped.

    They are NO fun at all. I've heard guys say that it's like pushing a bowling ball through a soda straw. *I* would wager they're at least as painful as a 9# baby!!

    P
  7. by   prmenrs
    As much as you are able, push fluids but not just water or you'll get water intoxication. And you can take the 800mg dose of Motrin/Ibuprofen 3x in 24 hrs.

    I'm REALLY sorry you are going thru this!! Hope you feel better soon.
  8. by   CarolineRn
    P_RN, you're right. The pain is almost as bad as pushing out a nine pounder, all right. Actually, the pain feels just like contractions. When my husband had a stone a few years ago, I had already had one and told him that it would be the closest he'd ever get to understanding labor pain.

    prmenrs, Thanks for the heads up on the fluids. When I think fluids, I think H20, and I never realized that one could get water intoxication! Good excuse for me to get a mountian dew, anyway.

    I went to a walk in clinic today, and the Doc ordered an immediate shot of toradol, I think 60 mg IM. It helped to bring the pain from a nine to about a four, but I still felt it. He prescribed cipro (250 mg) and vicoprofen (7.5 mg/200 mg.) I took one and it helped with the pain some, but not great relief. I think the only way I can get relief is to sleep, and they definately helped with that, so they're working.

    Unfortunately, they also are making me nauseated. I ate with them, like the pharmacist suggested, but hydrocodone always makes me sick. I haven't puked, thank God, but I don't feel 100%.

    The doc said I could miss school, but didn't say for how long, and I'm wondering if I should try to go to class tomorrow. The vicoprofen doesn't make me feel high or anything, just a little sleepy.

    Thanks for the support, guys~
    Caroline
  9. by   hoolahan
    I had my first and hopefully my last kidney stone in July. So, I feel your pain. IV Hydration and IV Toradol gave me almost instant relief. But I tossed my cookies repeatedly, YUK! Don't have anything more to offer except, think about adding cranberry juice to your regular routine, just in case , for overall bladder health. I actually passed and retrieved my stones, ugly little devils, several days after the fact. Never did find out what they were made of!

    I hope you feel better soon.
  10. by   doj
    Having been there and done that more times than I like to think about myself and 3 times with my husband looks like everyone has offered you all the good advice I might have. The shower is my best friend when I am going through it as it helps to relieve the pain, also I've found if I can lay on the side with the stone and put pressure against it, like lay on a pillow or something under that side it sure helps. (It's a counter pressure thing we OB Nurses have) I went through the stone analysis and 24 hr urine workup and finally am on HCTZ daily to help flush the urine through so the stones don't form. Has helped but still have them, just not as frequently, thank goodness. I am never anywhere without my Percocet..........just in case! Just got my husband through his 3rd one. This time he had a JERK for a urologist and ended up doing the lithrotripsy, (which didn't work) and finally did a ureteroscopy and took the stone out. As soon as the urologist found out I was an RN he turned from a JERK into a total nice guy........what a A _ _! Didn't fool me and made me even madder. Anyway, husband will be doing a 24 hr urine soon to see what it shows and what he can do. I'd rather have a stone myself 20 times than go through it once with him. Hope you are doing better. You can do school, but shouldn't be driving if on the pain med. Being active is good as it will help the stone move if it's going to. Be sure to catch and have the stone analyzed if you can to find out what it is made of so you can see if there is something you can do.
  11. by   CarolineRn
    Quick Update:

    It's been three days since I first felt this hideous pain and I have yet to pass a stone! I missed clinicals today, which I did NOT want to have to do. In my program, we are allowed to miss Two clinicals, and our lab time counts as a clinical. Well, in my school, you had better NEVER be late for lab, because the door is locked at 0800, and if you are one minute late, you have a clinical absence! I happened to be three minutes late a few weeks ago and so I have two clinical absences now. This really, really bugged me at first, even though I completely understand the instructors' expectations of punctuality. Nursing is, after all a profession, and professionals should always be punctual. So, I screwed myself outta that one.

    Anyway, I was so nauseated after taking the vicoprofen for the pain that I felt I had to call off clinicals today. I'm sure anyone reading this has experienced the kind of nausea I'm talking about... The kind where you don't actually throw up, but your jaws get tight and your mouth waters and you KNOW *it* could happen at any minute. My clinical instructor is so very understanding, and I am told most are not that way, so I am lucky. I am really going to miss her when (if) I make it to second semester. She's so good and knowledgable, I've considered applying at the hospital she works at just because I know she has a lot that she could teach me, and you can tell she enjoys it. (teaching)

    Still, I have now maxed my absences.

    This means that if I am sick as a dog with the flu or anything, I still have to go to clinicals. The day I spent in the walk in clinic, there were about 20 coughing, sneezing, and otherwise infectious breathing bodies in too close proxiimity to me for comfort. To add an extra measure of paranoia, both of my sons are experiencing flu-like symptoms. I can practicially SMELL sickness in the air!!

    At any rate, I cannot miss another clincal, and I suspect my classmates hate me now, because I suddenly look so irresponsible. I know, I've given advice to others not to care about what ppl think, but that IS easier said than done. I really like my clinical group, and hate to feel like I'm not a team player, which is how I feel for not going to clinical today.

    Thanks again to all of you for your support, and a HUGE thank you to the people who provide the allnurses board. This place is the best!

    Love,
    Caroline

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