Sticks and Stones and the Kitchen Sink

As you may have heard, I recently had surgery to remove a fairly large kidney stone that has been an unending source of fun, happiness, and sunshine and rainbows. (I hope the sarcasm is just dripping.) Many of my friends, after hearing of my complications, scolded me for not updating them on my health status. But, here's the thing: IT WASN'T SUPPOSED TO BE A BIG DEAL. I've had kidney stones before, and, as statistics show, the probability that I'll get them again is high. This was, however, my first time that surgery was required to get them out. (Previous episodes simply involved much wailing and gnashing of teeth as I poised over the commode...P.S. I apologize in advance for anything you don't want to know, but hey, I'm trying to be discreet, and you are, after all, still reading, aren't you?) This was also not my first experience with Navy Medicine—Aaron was, after all, born at NMCSD (Naval Medical Center, San Diego) one balmy eve following the birth of Christ back in 2006—but after this experience, I certainly hope it will be one of the last.

My kidney stone originally reared its ugly head on June 12-13. On the evening of the 12th, I woke up in excruciating pain around midnight. Having had stones previously, I know right off the bat what it was. After I threw up for the third time, I had to enlist the help of my superwonderfulawesomeamazing friend, Lois, for help. While she stayed at the house while Aaron slept, I made my way to the ER down the road from us. That experience wasn't anything out of the norm, and, though it took awhile to get in and out of there, I walked out with pain meds and instructions to call my PCM.

Now, a sidenote about how military health care works. We have TriCare Prime, which means that we can go to our PCM (Primary Care Manager) as much as we want, and it's always covered; but, in order to see a specialist, any type of specialist, we have to be referred by our PCM. Even if I were to find a specialist on my own who accepts TriCare, TriCare will not pay for their services unless a referral comes through the PCM. Hoops, yes, but, more importantly, FREE.

But here's where things get slightly tricky. I went to see my PCM 2 days after my visit to the ER. TriCare did not approve my referral until 7 days later. Furthermore, they did not notify me that they had approved it until 6 days after THAT. Most unfortunately (for me), however, was the fact that my referral was picked up by an MTF (Military Treatment Facility—i.e., a Navy Hospital). The particular MTF to which I was referred was aboard Camp Pendleton, 30 miles and close to an hour away from my house. However, as TriCare operates on a "straight-line mileage" system, (basically, draw a straight line from my house to the MTF, and if it's within a certain radius, boom, it's done.), ultimately cutting both the actual time and distance in half. Whatever. I had kidney stones, I was in pain (albeit not constant), it had already been over 2 weeks since my diagnosis and I needed to see someone, STAT.

And, so, my tumultous relationship with NMCCP (Naval Medical Center, Camp Pendleton) began.

*Ring, ring*
Corpsman: Thank you for calling Naval Medical Center, Urology, this is Corpsman Whateverhisnamewas, how may I help you, sir or ma'am?
Bree: Hi, I have a referral from TriCare. I was diagnosed with kidney stones about 2 weeks ago, and would like your earliest available appointment.
Corpsman: [...][...][...][...]
Bree: Hello?
Corpsman: Yes, ma'am, I'm looking for you now. How about next Wednesday, the 8th at 0820?
Bree: No, I said I needed your FIRST available appointment.
Corpsman: Yes, ma'am, that is the first one we have available.
Bree: Today is June 29th. That's over a week away, and I've been in pain for 2 weeks. Not to mention, I won't be able to make that date since my husband will be coming home from Iraq that day.
Corpsman: [...] One moment, ma'am. [...][...][...][...][...][...][...][...][...] (at this point, we're probably on the phone for about 15 minutes.) OK, ma'am, I just spoke with the doctor, and he can stay after hours for you on Monday, the 6th.
Bree: That's still a week away.
Corpsman: Yes ma'am, but it's the first available appointment.
Bree: Well, in that case, can you put me through to someone who can release my authorization referral to a civilian provider who can see me in a more expeditious fashion?
Corpsman: No, ma'am, since NMCCP has space available, we are unable to release your authorization.
Bree: You mean to tell me that your clinic is claiming to have "space available" and you can't see me for 7 DAYS?!
Corpsman: Yes, ma'am.

At this point, I called shenanigans. I threw temper tantrums at (admittedly undeserving) underlings, I called supposedly higher-ranking powers-that-be, I even tried crying, and none of it worked. By the time I had finished, the "first available" appointment was no longer available. Of course. I FINALLY got in to see a urologist on July 13. ONE MONTH after my diagnosis. After an extensive (and by "extensive," I obviously mean "the doctor spoke so fast I had trouble keeping up, and by the time I left his office, my head was still trying to comprehend the first 7 words he spit out at me") interview, I left the office with a pre-op date, and an appointment for same-day surgery should the stone not pass on its own as well as a prescription for, as the doctor told me in his own words (the three I actually managed to understand) "medicine for prostates."

Um, excuse me, doctor, did you happen to notice that I'M NOT A MAN? I mean, sometimes my fingers swell when it's hot, but the long hair and the high heels didn't give it away? I DON'T HAVE A PROSTATE.

Oh, and maybe I should mention that all of this was arranged without any type of scan. No, no, Doc trusted me. If I was still having pain, then it was probably still in there. Drink a lot of water, try to pass it, and, for God's sake, woman, take your prostate medicine!

2 weeks and 1 day later, I head back to NMCCP for my pre-op exam. In those two weeks and one day, I had had some pain, an occassional flare up, and I assumed that the stone was still there. So, again, the Doc TOOK MY WORD FOR IT. Surgery was set for the next day.

Scans? Who needs 'em? Why bother verifying that the thing you plan to retrieve by STICKING A HOSE UP MY LADY PARTS is, actually, in fact, there in the first place? Semantics.

Wednesday, July 29--Same day surgery. All goes well. I check in, they put me under, wheel me in, take it out, and bam. I'm done. Prove to us that you can, in fact, pee, and you're good to go.

Thursday, July 30--Since I'm on some pretty heavy pain medication, I spend the day sleeping and watching movies.

Friday, July 31--Back to work. Things feel slightly weird, since, after all, I will continue on with a stent in my ureter for 3 more days to ensure everything heals all nice-like. I sit at a desk and read with my red pen poised, and it's not like I do any heavy lifting or anything, so this should be fine. And it is, until it isn't. Once I stand up to retrieve something I printed off, I come to realize that my pants are wet. I take that back. My pants are SOAKING wet. Now, I can't really remember the last time I wet my pants, so this is a little shocking to me. After telling my boss that I have to go home, because I literally just pissed myself, I call the urology clinic on the way home.

*Ring, ring*
Corpsman: Thank you for calling Naval Medical Center, Urology, this is Corpsman Whateverhisnamewas, how may I help you, sir or ma'am?
Bree: Yeah, hi, this is Bree Brown, and I was in your clinic on Wednesday for same-day surgery. I seem to be having some, uh, complications? May I speak with a doctor, please?
Corpsman: Unfortunately, there are no doctors available to speak with you ma'am. You see, we're holding a free prostate screening today, so they're all occupied with that. Is there anything I can help you with?
Bree: (after mentally correcting Corpsman's grammar) Um, well, I'm having some side effects that no one ever mentioned, so I'm a little concerned that something's wrong, and I'd really like to speak with a doctor.
Corpsman: Well, unfortunately, they're unable to speak with you.
Bree: Well, can you go grab one of them? I had SURGERY in your clinic TWO DAYS AGO, and I, apparently, no longer have control over my bladder. I. Need. To. Speak. With. A. Doctor.
Corpsman: Ma'am, I'd like to help, but I suggest that you go to the ER if you think you're having complications.

At which point, the humiliation of having peed myself in public, and the mounting frustration with Navy Medicine get to me, and I say, "Great. Thanks. Good-bye," and go home to change my pants.

But, no, the story doesn't end there. And, if you're squeamish, or don't like reading about anatomy, stop reading now, and know that I'm all better now. :)

So, for those of you who decided to stick it out, when I got home and went to the bathroom, I realized that the stent was no longer attached by a string, as it should have been, but rather, hanging half out of...well, you know. Since things have now obviously gone wrong, I pull it the rest of the way out (um, OUCH, to say the least) and I call the clinic determined to find out just what. The. Eff. Is. Going. On.

**ring ring
Incompetent Civilian Bitch: Urology.
Bree: Hi, this is Brianne Brown. I had surgery in your clinic on Wednesday, and I'm having complications. I need to speak with a doctor now.
ICB: [...][...][...] *sigh* Mrs. Brown, you were told that we were giving free prostate exams today, and you know there aren't any doctors available to speak with you.
Bree: I understand that, but I'm actually a patient of yours, one who had SURGERY in your clinic from which I am having what I believe to be serious complications; don't I rank slightly higher than someone who walks in off the street and who may or may not be sick? What would you like me to do?!
ICB: Go to the ER.
Bree: Oh, yeah, great, thanks.

And just as I was about to ask her another question, I heard a click, and realized the ICB had just hung up on me. At which point, I burst into tears, from both frustration and an ever-sharpening pain in my back. Ian, at this point most likely fed up with me, throws me in the truck, slaps his bluetooth in his ear, and simultaneously drives me to the ER while pulling rank to "bludgeon someone into submission" (his words, not mine). Although his attempts at bludgeonment were, ultimately, lost on the ICB, I still thought it was pretty sexy.

So, we get to the ER after a minor (and brief) struggle as to which ER we should go. He suggested the ER at NMCCP, and I said, no effing way you are...aaaaaaaaaaaahhhhhhhhhh, ooooooooooooo, ohhhhhhhhhhhh, god, it hurrrrrrrrrrrrrrrrts...out of your freaking mind if you think...aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaahhhhhhhhhhhhhhhh, make it stop!!!!!!!!!!!...think I'll be stepping foot in that mother effing...OHHHHHHMYYYYYGODDDDDDDDD, OOOOOOOOWWWWWWWW...hospital again. (Or, you know, something along those lines.)

So we get to the ER, where I am now crying solely from the pain. They want me to pee in a cup, and I can't, since apparently, it all came out IN MY PANTS. In public. At my job. FML. (I won't be spelling out that acronym for you, but if you know what it means, then you know what it means. If you don't, I apologize.) They FINALLY wheel me in to a room, where I change and they start the IV of pain medication. Dilaudid. It's amazing. As soon as it hit my bloodstream, my shoulders went numb, and I was all, like, "Kidney stones?! What kidney stones? This is niiiiiiice. Oooooooooooohhh, shiny lights..."

Eventually, Ian had to leave me to attend to the needs of and procure arrangements for our son, happily oblivious to what he would later refer to as "Mommy's owie." While he was gone, the doctor came in to tell me that, after looking at my scans, I had a kidney stone. And I was all like, well, that's funny, since I just had one taken out, and I HAVEN'T HAD A SCAN YET. (This hasn't been confirmed, but my suspicion is that he was looking at the one and only scan ever taken for this kidney stone, the same one that originally started this whole mess.) And he was all like, "Oh, well we should have you get one." And I'm all like, "YA THINK?!"

Well, they finally wheeled me off for said scan, and apparently, the doc was pyschic: the scans STILL showed a kidney stone. What to do, what to do? Eh, screw it; just send her home with a prescription for some anti-nausea meds to add to her ever-expanding home pharmacy.

I felt like making a tshirt that said, "I spent 6 hours in the ER, and all I got was this lousy Zofran."

Saturday and Sunday were spent muffling my screams of pain and sobbing into my pillow.

Monday Ian took the morning off work and together, we set off for NMCCP to crack skulls. I was originally scheduled to head back there anyway, to have my stent removed, but thought I would take the opportunity to rain my wrath down upon the Urology clinic. Since I didn't have an appointment, I had to wait. And as Ian and I honed our skillz on iPhone Jeopardy, I grew increasingly enraged.

Unfortunately, I didn't really have a chance to rain said wrath, because what the doc said (and I made him speak slowly this time) mostly made sense. Since the stone I had removed was so large, and in such a weird spot in the ureter, they had to blast it into pieces to take them out. During the surgery, it seemed, one of the pieces decided to be all sneaky and wily and head out to go hang out at the bar in the kidney, so the docs didn't see it, and therefore, didn't get it out. When the stent fell out (apparently, not uncommon in women, since the stent doesn't have as far to travel in men, and men don't accidentally tug on the the string when they wipe themselves after they pee) the ureter was raw and irritated from the surgery, and, as Left Behind Stone started to make its way out, it was coming through rather, uh, rugged conditions, if you will. Hence the pillow screaming.

Doc sent me home with, gasp, shock, more pills, including the prostate one again, but also the pill form of the shoulder-numbing IV drio I had had in the ER on Friday.

So that brings us to now. I haven't had any pillow screaming episodes since, and I was able to return to work on Thursday. (Slightly inconvenient for my very patient and understanding boss, since I'll be leaving again for a week beginning Thursday on a planned vacation...oh, well.) I don't know if the stone ever passed, or is passed out in the Kidney Bar, and I still have a pharmacy's worth of pills at my beck and call. I'll soon be googling the street value of Dilaudid. Make me an offer, people.

The moral of the story: Navy Medicine sucks, and while free, it certainly seems that you get what you pay for. Also, Murphy's Law applies; whatever can go wrong will.