Possible cause for pain/numbness near kidney? (pt. on way to ER)

In My Humble Opinion
21

Oh. So the buildup of toxins due to not being able to urinate (or not as well as one is supposed to) wouldn’t affect the kidneys eventually? Obviously I don’t know what I’m talking about.

Poor Matthew was due to get the MRI at about 1am (90 minutes ago), but he is in such friggin’ agony that he can’t lie on his back for the MRI, so they have to knock him out. He’s actually crying out from pain.

Why can’t pain management work on this? It’s horrible. Could a herniated disk (that’s what the doctors are expecting, acc. to my sister) really cause this much sudden-onset and lingering agony?

Edited because I realized I forgot to thank you for replying with the info, USCDiver. Just because I’m anxious and upset doesn’t mean I should forget that you’re helping.

22

There’s absolutely no reason he should be in pain. Is your sister raising holy heck with the pain management team? Has she spoken to the charge nurse? There are social workers and/or patient advocates in every hospital-if she’s not getting anywhere managing his pain, she should try talking to them.

This really pisses me off. :mad: Poor guy.

23

Thanks Helena330. I know, it’s infuriating. My sister’s a social worker who daily works with seniors to help them navigate the government benefit system to make sure they understand and obtain the benefits they’re entitled to. I can’t imagine she’s not fighting for Matthew as best she can (without getting tossed out of the hospital!). I just zipped her an email asking if she’s been in touch with the hospital’s patient advocate or ombudsman.

By around 3:30am they again put off this damn MRI for later. I don’t know why. My sister finally had to leave and get some sleep; I only hope Matthew was able to get some rest. He is an incredibly stoic man in his daily life, the type who doesn’t go to doctors seeking drugs for minor aches and pains (or really anything–he normally just fights through whatever ailment he has). But last night he told my sister he’d rather die than continue with this suffering. It’s fucking heartbreaking.

I understand hospitals must give patients the least amount of pain meds they can, and then work upwards. But this is ridiculous. Three days now and they still can’t find something other than Ativan to put him to sleep? If the same medication (Dilaudid) hasn’t worked thus far, why are they continuing with it?! Try something else already! :frowning:

24

When I went to the ER with a kidney stone, I had no idea what was wrong. After a few tests a nurse came into the room and said ‘it’s a kidney stone, here’s your morphine’. I think it’s pretty standard to get a kidney stone PT on pain killers as soon as they know what’s going on.

25

Good grief! I’m just now reading this and I am so so sorry! And you are correct, that going to the hospital on a holiday weekend is the absolute PITS!

I don’t have anything helpful except to say that I am pulling for you and praying for you and will be watching this thread for good news–and very soon, I hope.

26

Thank you so much, ThelmaLou! Yes, Matthew really had crappy timing on this one! :slight_smile: In fact (and this is also relevant to Helene330’s excellent suggestion), I found out my sister did try to get in touch with the patient advocate… and because of the holiday they’re not around! I don’t know if s/he’s gone for the whole weekend or what, but oy. (I mean… New York/Columbia Presbyterian, one of the top five hospitals in the country as it loves to trumpet, only has one patient advocate working in this massive establishment? Yeesh!)

There was actually some good news just an hour ago. My sister, who was on her way to the hospital, actually got a call from Matthew, who sounded a little better (but groggy, not surprisingly). She said just seeing his name/face on her phone was a shock and relief; she must’ve felt like crying. I know I did, hearing it.

He said the pain’s lessened somewhat. And then he asked her, “So what are you plans for the day?” :smiley: Which made her laugh, because, duh, they’re being with him. Of course she still has to push for them to do the MRI. Sadly she has no confidence that the nurses/whoever will take put any priority on this without her reminding them.

(Although she does understand it’s a holiday and, as ThelmaLou says, basically the worst time as far as both staffing and busyness. Hopefully none of the usual holiday injuries–drunk accidents, fireworks, whatever–have happened yet.)

Anyway, thank you all again for your wishes & support. Hopefully Matthew will soon be able to declare some independence from this horrible pain.

27

Day 3, I think, right? He needs the MRI. Holiday, schmoliday. Some other thoughts on how to get it. Call the hospital administration office. Next steps if your family does not start to receive adequate care, and make sure they know this, are Facebook, Twitter, and your local news.

Talk to the Dr, talk to the nurse, find out when the MRI is scheduled and hold them to it. Same deal on pain management. He does have a potentially life threatening issue (for all you know), the level of care is wholly unacceptable, and Twitter may have to be your family’s Best friend.

I once had the misfortune to be in the hospital for spinal surgery during the December holidays. I could not get out of bed. The entire nursing staff, minus one person who was answering the phone, went to a party. One of my lines clogged and I had an alarm sounding in my room for almost an hour. I finally called building security, who physically sent someone to the floor to find a nurse. Which is to say, I feel your pain. Keep on pushing. There’s NO EXCUSE.

28

Yes. You’re absolutely right, thank you! Good ideas about seeking more help. My sister’s talking to the doctor now to argue about this release idea.

Well, here’s the newest kick in the head (figuratively). They want to skip the MRI altogether and release him. One day of mild improvement and they want to kick him out! (He has insurance btw…)

The more I’m reading up, the more I do see that if a doc suspects a herniated disk vs. something more serious like cancer or spinal stenosis, an MRI might not be recommended (as per the APA guidelines). But so far he’s only been seen by an internal medical dude, not an orthopedist, and they should be ruling out nerve damage (which does require imaging of some kind).

But to talk about releasing him only a couple of hours after he finally starts feeling slightly less pain than “agonizing, wanting to die”? Give it a couple of days already! My sister is raising hell about that, she does not want him leaving until at least two days of non-agonizing pain, if not actual improvement.

Apparently they only just ruled out aortic/heart-related issues. Three days later! Jesus.

29

She might try the chaplain, too, even if they’re not religious. When my grandmother was in the hospital I was being her advocate as your sister is. My grandmother couldn’t hear and her English wasn’t very good. She’d fallen and hurt her knee so the focus was on that. Long story short, her shoulder hurt, too, and in desperation I asked the chaplain if he could get that through to her doctors whom I never saw and the nurses for some reason weren’t informing. He did and she finally got attention for it.

30

Oh that’s an interesting and helpful suggestion, Helena. Thank you for that! I’ve passed that along to my sis as well.

31

One time my H was in the hospital and needed an oxygen mask. He had the nasal breathing apparatus, but he was unconscious and breathing through his mouth. I couldn’t get the nurse to take me seriously, so I went to a pay phone (before cells) and called his primary doc (a nephrologist), who came over IMMEDIATELY and instantly had him moved to the ICU.

When you say “they” want to discharge him-- who is THEY? Who is responsible? (You don’t have to answer-- it’s just that these are the questions she needs to know.) She is in an extremely difficult position. But she has to press on and be aggressive, as the consequences of not doing so could be catastrophic.

One more thing: when I got my diagnosis of breast cancer back in February, the doc who gave me the bad news also gave me a good piece of advice. He said, “You have to take charge of your care. Don’t just take what the doctors tell you. Ask questions. Push back. You have to become a pain in the ass.” Yes, he actually said those words. He knew how it can be. As it is, I haven’t had to be a PITA, but your sis may need to be.

32

Lots of meds, including pain meds, have been hard to get over the past several years. :mad: This may account for why he’s had trouble getting effective pain relief - that they just plain old don’t have anything else.

33

Wow. Good for you, ThelmaLou; your husband had an excellent advocate (two of them!). My other sister has been suggesting that Kim (my middle sis/Matthew’s wife… sorry, I realize I haven’t named her in all this) contact Matthew’s PCP, too. I think that’s an avenue that she’ll explore. Of course, the holiday weekend again makes this difficult…

I agree, and she’s staunch enough to do this. It’s not in her nature to advocate for herself, but for others, she goes from a lamb to a tiger.

AFIAIK, Kim’s only spoken to the doctor twice during his 3 days there. I believe it’s the nurse assigned to him who insisted that he’d probably be released tomorrow. Kim demanded to speak to the doctor (the internal medicine woman) but she has proven elusive and too busy thus far. Kim’s standing her ground against Matthew leaving tomorrow–short of Matthew making some massive miraculous improvement.

Right now he’s sleeping again. I do find it a bit encouraging that the dosage he’s on today seems to have more effect. Unfortunately I don’t know what they were giving him yesterday, but this a.m. it was 8mg of Dilaudid, which seems to have helped significantly. He started feeling more and more pain again this afternoon, probably around… 4? And they gave him 4mg this time. He’s sleeping now. Again that seems, from what little I know (not much), to be encouraging? That a lower dose is effective?

Kim will probably go home earlier tonight if he’s still sleeping by 7. She needs to rest up for tomorrow–she’s said it’ll probably be a rough day if she’s gonna have to fight the staff!

First, congratulations on ending your radiation earlier this week! I just saw that. I’m really really happy for you, and all my best wishes go out to you for continued strength and healing. :slight_smile: You sound like a damn brave and feisty person.

And you’re right about Kim needing to be a PITA. I’m sad to say that the first night, when Kim was giving the nurses hell about not giving Matthew enough pain meds, I told her to try to be as polite as possible to the nurses. I regret that now.

That is… I’m not saying now that one should be an asshat to them–honestly, 99% of my interactions in hospitals (for heart attack symptoms that turned out to be stupid panic attacks) have been completely positive, and it’s almost entirely due to the excellent nursing care I got. Of course, those were at NY Cornell-Weill Hospital, which while technically connected to/the same hospital as NY Columbia-Presbyterian, sure seems WAAY more user-friendly.

But it’s clear the squeaky wheel gets the grease when something as potentially dangerous is concerned and people are just not giving you the care you need.

Thanks again, ThelmaLou. Your input is truly appreciated!

34

It’s a holiday weekend in July…Matthew might not have a very seasoned doctor at the helm. This could be why he’s not getting very effective pain relief.

35

But someone will be taking his calls for him. Do urge one of the sisters to do more than “explore that avenue”-- MAKE THE CALL and bring the PCP’s office up to date. They still have to get through Sunday at the hospital. We women are conditioned not to “bother” people, not to make a nuisance of ourselves. This is a time when making some noise is called for.

Dealing with his pain is one thing. But the pain is happening for a reason. And it’s the reason that needs to be found.

Thanks.

That wasn’t bad advice. You can be polite and still be firm. (Personally, I haven’t mastered that…but theoretically it’s possible.)

My bold. Please don’t call your panic attacks stupid. I have suffered from them all my life, and have gone to the ER on three separate occasions thinking I was having a heart attack. Don’t name-call yourself. Speak kindly. Panic attacks are a physical reaction that the mind interprets as life-threatening. There’s nothing stupid about them.

Unfortunately, that’s the bottom line. The consequences of a miscalculation could be very bad indeed.

You’re very kind. I’m going to be anxious for you until I hear some good news.

36

Get her to ask for stool softeners, too. Dilaudid’s pretty constipating.

37

Thanks, both of you. Good idea about the stool softener, Helena330. The way they’re pushing fluids through him (to clear the kidneys) I hope that won’t be a problem, but I’ll mention it.

And thanks for the tough (but thoughtful) words, ThelmaLou. To get me out of the way, yes, I know I’m harsh on myself. It’s hard to think about wasting the ER folks’ time when there are people like Matthew who are in terrible pain. My ER visits have lessened significantly since I’ve learned more control mechanisms, so that’s a plus.

So Kim came over and we had dinner together; poor thing was practically falling asleep mid-bite. Matthew called while she was here and he sounded a bit stronger (admittedly he does have a resounding voice even over a cell phone!). He was in more pain after the 4mg dose, so it wasn’t quite enough to do a full job, but it was not nearly as bad as it was the day before. (I was about to say “yesterday” but just realized it’s after midnight now!) And honestly I’m aware that full pain relief isn’t always possible. “Less pain” is sometimes all you can hope for. Right now, crossed fingers, “less pain” is what we’ve got.

I got more info that showed me just how infuriating and fucked up this hospital is. Sorry for the upcoming vent but I need to unload my verbal outrage.

First, some info. Columbia Presbyterian is (unbeknownst to me) divided into two campuses forty blocks apart. The MRI that (I thought) Matthew almost had the other night? I misunderstood and he did have one–or at least they started the procedure, but he was in too much pain on his back to continue. Okay, understandable. But the thing that kills me is that because of the holidays, apparently the more distant uptown campus didn’t have anyone doing MRIs.

So poor Matthew, already in terrible pain, had to be transferred by ambulance to the other campus, 40 blocks plus potholes and NYC traffic.

What. The. Hell. This is a major, major institution, seriously big, and they can’t find someone to work a fucking MRI machine at one of its branches (or whatever you call it)?

They gave him an Ativan during the procedure rather than sedate him. At one point Kim was waiting outside and she heard the MRI tech calling Matthew’s name several times, as if he was nonresponsive. Kim was in such a panic she started banging on the door to be let in. Of course it was just that Matthew had finally fallen asleep due to the Ativan. Then he woke up and the pains started and he couldn’t finish the images. The tech said that tomorrow they would try again and would sedate him; that’s done all the time, she said.

Flash forward to today, back at the original hospital campus. Kim asked the nurse when they’d continue the MRIs. “Well, we can’t do that, since he couldn’t stay still.” Kim: “I thought you would sedate him.” Nurse: “No, we don’t do that except for life-threatening cases.” Kim: "The MRI Tech said you do that all the time." Nurse: (silence.)

At that point, the nurse told her that “His attending doctor would like to see him released tomorrow.” (By which she meant today, Sunday.) Reminder: This doctor is an internal medicine doc, not a neurologist or an orthopedist or whatever.

Kim was disconcerted and said, “How can she make that judgment when he’s still in very bad pain and she doesn’t know what’s causing it?” Kim asked to speak with the attending doctor personally. After some phone tag with the nurse getting in touch w/the doc, the nurse then said flatly: “The doctor now says Matthew will be released tomorrow.”

I mean, what is that b.s.? Spite?! Kim said, “Just like that?! Can we please get a second opinion from an orthopedist?” Nurse: “I don’t think that’s possible.” Kim: “Excuse me? I’m his wife and I want a second opinion.” Nurse: “You’ll have to talk to the patient advocate. She’s back on Monday.” :rolleyes:

So yes, Kim is calling everyone/anyone she knows who holds some sway: Matthew’s PCP (who I think is affiliated with Cornell/Weill, which might be useful–maybe they can transfer him out of this shithole masquerading as a hospital); Matthew’s brother’s neurologist, who is affiliated with Columbia Pres.; the rabbi, the priest, the hospital administration ombudsman… and I guess anyone else who sounds like the beginning of a joke about people going into a bar.

To finish out this litany of bullshit:

  • The nurses and nurses’ assistants haven’t offered him any heat or cold compresses or any non-medical pain relief/soothing since the first night (the warmth does make him feel better, so Kim’s had to ask for it);

  • they never ask how he’s feeling or tell him what tests are being done;

  • they’re affronted when Kim asks “how much of a dose are you giving him?” re: his pain meds (one nurse actually said “why do you need to know?”); and on and on.

Basically they act as if a patient/spouse have no right to know what’s happening.

Sooooo yeah. Kim is doing her best and will have a fight ahead of her tomorrow (well, today). If nothing else I hope they can get transferred to a hospital staffed by people who actually give a rat’s ass about their patients, even those who have the nerve (pun!) to get injured two days before a holiday weekend.

Most important is that KNOCK HUGE PIECES OF WOOD, Matthew was feeling somewhat stronger tonight, and even walked to the bathroom (wobbly thanks to the meds, but he was able to stand and, y’know, do what was necessary!). And it was so, so good to hear his voice over Kim’s phone. :slight_smile: Hopefully tomorrow will be at least as good. But I hope he’s able to get seen by an orthopedist or someone who can make a properly considered decision.

Whew. Sorry for the diatribe. I just can’t get over how bad the care has been–it’s nothing I would expect from such a highly ranked hospital. It seems systemic, too. If it was just a few nurses during holiday off-hours who were overworked, I’d get it, but it seems everyone there has a craptastic attitude (except the nice MRI tech down at the other campus).

Thanks again for your suggestions, they will be acted upon. And also, of course, for your good wishes and support. You guys are great.

38

BTW, for context re: the ambulance ride to the MRI: in NYC, 22 blocks = roughly 1 mile. So the 40-block ride means nearly 2 miles, in traffic, with a man whose back/leg/sciatic nerve/whatever is so painful that he was literally screaming. All because the 4th ranked hospital in the U.S. couldn’t get someone to run an MRI machine at one of its two campuses.

39

Don’t apologize for the diatribe. Also, when you go to the ER, you’re not wasting anyone’s time. They’re GLAD when it turns out you’re not having a heart attack.

Can your sis move him to a different hospital? Has she called the PCP’s office yet and raised hell. The doctor is probably a hospitalist, so he works for the hospital (not that there’s anything wrong with that).

40

Sweet jumping Jesus on a pogo stick, choie. I thought this kind of utterly ridiculous bullshit only happened in Irish health care (where the doctors don’t care if you sue because the government will pay).

Two suggestions:

Get your sister to make it very clear to the doctors and nurses that she’s documenting everything. She can carry a notebook and write down stuff during conversations, or record them with her phone.

When my mother-in-law was in hospital, the hospital was dragging their feet on something - I can’t remember if it was pain relief or what, but it was something very basic and essential that they hadn’t bothered to do for two days because it was a weekend and nobody felt like it. My husband finally rang up the ward and said, politely and very firmly, ‘My mother needs X. She has needed it for two days now. I’m coming in to visit her. I’ll be there in forty minutes. I’m ringing to let you know that, if X has not been done, I WILL make a scene. Is that all clear?’ She rang him ten minutes later to tell him that X was sorted.