Screening Pee & Spinning X-Rays - March 17-25, 2008
I unpacked my new screening device in the airport parking lot. It's like an old collapsible cup - a series of concentric plastic hoops that expand out into a cup-shape, in medical white, with a very fine screen at the bottom. It also had a nice cover and a compartment for storing any stones found. Fit easily in my pocket. Inside the Salt Lake City Airport there are a couple of men's rooms that are not heavily trafficked, and NO, I won't tell you where they are. Sharing intimate details of my anatomy and biological functions is one thing, but useful information like restrooms you can use is quite another! I made my way through security and found the one nearest my gate. Empty, as I had hoped. I grabbed the screen, expanded the cup, pulled up to a urinal, and let fly. It was certainly awkward, and the screen tended to disperse the splash in unpredictable ways, but no harm done. Once finished I inspected the screen to find - nothing. But now I have a pee dampened screen in one hand, my junk in another hand, and how to proceed next without a third hand was not obvious. I ended up setting the cup on top of the urinal to finish my business. Then I quickly rinsed the cup in the sink and took a paper towel to clean the urinal top. Clearly this approach would need modification. Carefully dried the cup and collapsed it, then stuck it back in my pocket. Off to Tucson!
Over the next several days at hotel and office I found an approach for screening that worked pretty well. Using a toilet stall, unwind some TP and place it (3-layers, folded) on a flat surface, often the top of the TP dispenser. Take out the dry cup and place it on the TP. Stand OVER the toilet (not just in front). Pee straight down through the cup into the center of the toilet. When complete, set the wet cup on the TP, finish business, inspect for stones, and then proceed to the sink for rinsing. Dry carefully (so as not to damage the screen) with a paper towel and return to pocket. Given some practice, all of this can be done quickly and discreetly. All week I screened and found NOTHING.
When the weekend came I had a dull ache in the lower abdomen, just above the groin, where the bladder is. This grew to become quite painful by Saturday night, but only once for a few seconds could it have been described as intense enough to be thought of as kidney/bladder stone pain. By Sunday night it was pretty much gone. Still screening pee and finding NOTHING.
Monday afternoon I headed to St. Mark's Hospital for my CT. I had learned from my previous doctor that locations convenient for me were inconvenient for the medical people, and not following the norms would likely result in delays and mishandling of information. So with my own best interests at heart I changed my behavior to make their system work better. St. Mark's, formerly an Episcopal hospital, is now part of Columbia/HCA out of Nashville, and it is a very efficiently run business. The radiology admissions department had called me the week before to take most of the routine information, and the doctor's office has provided most of the necessary forms to fill out in advance. When I showed up, I had to sign a couple of things, fork over ID and benefits card, and wait maybe 10 minutes.
The X-ray tech came and escorted me to the changing room. No pants, shoes, socks. Underwear and shirt OK. You get gown and booties. No problem. I opted to remove my long sleeve dress shirt to make starting the IV possible. It's been 31 years since I've seen a hospital gown, and longer since I've worn one. Progress is a wonderful thing. Apparently the "ass in the wind" style with closure in the middle of the back has been replaced by a half-wraparound style that overlaps in the back and closes on the side. Brilliant! A few minutes later the tech returned to escort me to the CT chamber. I was pleased to see they had the latest ones, donut-shaped, rather than the old, claustrophobic "Star Trek Tubes." I needn't have worried as this procedure was done feet first.
So here's my confession. During college my summer job for 3 years was as a Nurse's Assistant (now called CNA) working graveyard shifts at Deaconess Hospital (now known as Forest Park Hospital) in St. Louis, Missouri. I was trained to do, and DID do, many unspeakable things to other people without blinking or losing a day's sleep. I think I was pretty good at it, as I got few complaints, and the nurses loved having me on their shifts. Unfortunately the entire universe changes when the subject is ME, and I have been known to faint when being poked to get a blood sample. Irony at its worst. So I have learned to caution anyone who is starting an IV on me that I might faint, and that I am a "hard stick." So even if the vein looks good, it will roll over and hide from a needle. The upside is that I would make a horrible drug addict.
The technician got the IV started without incident, and she let me know that she did not like me putting all that pressure on her. Sorry, but apparently it worked! The IV was hooked to a ginormous robotic arm with two HUGE syringes. One was saline and the other an iodine solution that provides X-ray contrast. The tech walked me through the process. I would lie on my back on a table, the machine would pump me up with saline, then I would slide in and the machine would give me breathing instructions. Then they would do some shots with a trace of iodine, which would make me feel warm and funny. Then I would wait 20 minutes, and they would repeat the whole deal while pumping me full of iodine, making me very warm indeed. The whole thing went exactly as described, and I could actually taste the metallic flavor of iodine and feel it warmly flow into my body. I handled it well, and the warm feeling was not at all uncomfortable. Some don't, and you will see shyster lawyers advertising everywhere looking for victims to sue deep pockets. This process is also known as IVP, or intravenous pyelogram. I tend to think of it as the world's slowest and most expensive carnival ride.
If you don't know, CT stands for Computerized Tomography, which is a technique to use X-rays taken at several focus levels by spinning the camera around you - hence the donut shape. These films may be examined like normal films, and they may also be used to generate a computerized 3-dimensional image of your organs (for additional cost). My doctor was happy with the films, and I was instructed to collect them today and bring them along the following Monday. This system puts the information in the hands of the person most interested in getting it to the right place, so it's a good one!
So I went home and spread out my X-ray films on the kitchen table. There was one full-sized one and hundreds of others at 20 per page. I set them in time order, and tried to look for stuff. I could identify the spine, hip bones, kidneys, liver, and bladder, but detail was just whooshes and blobs and swirls to me. Nothing that looked like stones. Kathryn (my wife) had pretty much the same impression. So we had data, but it was a mystery to us.
Tuesday morning I got up at 5AM to head for a 6AM prayer breakfast meeting with my friend Frank, his son Benjamin, and any others who might show up. Did the pee through the screen routine, and suddenly there was SOMETHING. Tiny, smaller than grains of fine sand, colored dark red - 2 grains and a speck. I grabbed an Exacto knife and carefully guided them into the storage container. Eureka, we have stones! I crushed the smallest one to make sure it was solid, and it was - hard as glass. I must admit my smugness level was getting pretty high. During the balance of the week I collected some lighter colored (and less dense) stuff - 2 or 3 tiny ones, and some stuff that was very light, like dandruff. All carefully collected dried, and stored. We'll see what Dr. Hopkins has to say about THIS!
Frank, Benjamin, and I had a great breakfast, and I told them the short version of the story with the found stones as a great punchline. We prayed for my health and several other things and went our separate ways.
Posted by Steve Kelley