ESWL ... a third time

ESWL - Extracorporeal Shock Wave Lithotripsy...a big name for a procedure using shockwave treatment to blast kidney stones to fragmented pieces to be passed out. Long story short - I had 1 laser treatment and 2 ESWL so far for my kidney stones.

This time, I must document the procedure so that I don't forget. Hope this will help relieve the anxiety of first-timers of ESWL too. This is my 3rd ESWL after Dr Ong found a small stone ... again...in my right kidney, on my last visit on 2 Jan 2014. What a start to a new year! He recommended another ESWL - considered as a follow-up so that I need not pay so much (about $400 vs $800 if I start it as a new treatment - note this is after govt subsidy and covered by Medisave). Also told him the Polyclinic doc had said my creatinine level was high so he ordered a blood test at the next visit. Nurse Lin Hsiaoyan was very kind and said that I should tell the nurse on my next visit to do the blood test after they put on the "plug", so that I would not need to be skewered twice.

That's the plug

So here I am today and did exactly what Nurse Lin recommended (she was on leave unfortunately). The duty nurse also injected some saline - she was pretty good as I didn't feel much pain at the point of the plug. Just a note - had to go on low-residue diet the day before (24h) meaning no meat, no vegetables and no fruits. Then at 8pm, take 2 laxative tablets to clear my stools during the night - that didn't happen until the next morning. Normal breakfast on day of ESWL but no coffee or tea .And a painkiller at 10am which I almost forgot to take..

After changing into my lovely KTPH nightie which made me look so pretty, I went into the ESWL room and met the same doctor I saw the last time, I think he's a Filipino from his accent - nice friendly doc. Made to lie on the bed with the big hole at the side.

Pretty me in my nightie -
yes, yes, laugh all you like!! I still look pretty...

The bed with the hole.
The blue knob is where the "rubber band" is located.
The lower back (kidney) rests on that knob.

The clinical assistant (or whatever they're called) applied some gel on the region of my right kidney - man, that was really cold in an already cold room. Had to shift my position several times so as to get the machine to point its shockwaves at the right spot. I had forgotten that the doc will inject me with a painkiller that would send me into a listless conscious slumber. He did it through the plug and I didn't even feel a thing. A warm sensation swept over - like blood rushing to my head, at which point, I started feeling groggy and had to close my eyes. Couldn't sleep too. Now we're gonna to start, they tell me. And so it starts. 

Like in the previous sessions, it's like a big rubber band pulled and released again and again at the kidney area. One shot per second, I counted. 1000 ... snap ... 2000 ... snap ... like an ant's bite, they told me at my first session last year. This sensation I can bear, not much of a problem. It's the shockwaves that can be unbearable at times and today, I had some pretty painful spasms when they increased the strength of the shockwaves intermittently ... at least that's what I think they did ... because the kidney really ached, a dull but powerful ache where I needed deep breaths to control the pain. Strange, didn't felt that bad the last 2 times. After an hour which seemed more like eternity, they said it was successful and my stone had been blasted to smithereens ... actually it looked more like powder on the screen. I estimated I was "bitten" between 3,000 to 3,600 times at one "bite" per second in that hour. By then, the groggy feeling had sort of dissipated ... well. about 80%. Still, I was able to get up on my feet.

It was while they were cleaning up the gel that they found some abrasion on my skin. Never happened before in the last 2 ESWL so I assumed it must have been that the "rubber band" tension was set too high. No wonder it ached so much this time round. Oh well, so long as the stupid stone was cleared, there was no cause to be upset. Such things happen and it's not easy for the staff to tell whether one's skin was "thick" or "thin". Looks like I don't have thick skin!! I don't really blame them but I'm pretty sure some other asshole Singaporean will write a letter of complaint. The asst told me it's just a small abrasion but the plaster felt pretty big. It was when I took it off later that I realized it wasn't that small an abrasion. Ouch, stings when bathing! Was allowed a peek at the screen before I left the room - well, the before and after x-rays showed that the damned stone was gone.

Rested in another room while they monitored me for an hour or so. The same SOP, take blood pressure at regular intervals, drink water and when all was ok, I could only be discharged if I am able to pee. As usual, there was blood in the urine but other than that, all was ok. No pain, unlike the laser treatment when peeing was agony for a few days. That one was bad. Hospital policy was that I must be accompanied when I'm discharged and Joyce took the afternoon off to get me home. Thank you, dear wife. And it's back to KTPH in another month's time for a check. 

Talking about KTPH, fondly known to some as Kill The Patient Hospital, I really don't know what's all the fuss about. I like it very much, compared to all the other hospitals in SG. The land-scaping, the scenery, the service, the staff have all been wonderful. I think we are really fussy here in Singapore. I don't want to delve into an endless debate on the standard of healthcare in SG, but we Singaporeans are really fortunate and should complain less. Doctors and nurses are humans too and we need to understand that and empathize with them.