Had Lithotripsy -havent passed stones!

I don't have a stent. Shouldn't something be happening?

Sometimes you need more than one lithotripsy to get it crushed enough, but they can usually see on the scan that it's breaking up. And yours was only 8mm...seems like it should be easy enough to break with one litho. Try to drink about 100oz of water throughout the day and take a bunch of long walks. I was told it can happen quickly or a week or two depending on the size of the debris. Also if it's in your left kidney, lay on your right side (and vice versa) to encourage it to leave your kidney.

Hi Luna Sea,

Very Interesting!!! You were told not to move around too much with a stent in, but to walk without one. I've had a stent in since the first surgery, and I was told to walk, walk, and walk some more, so that's what I've been doing, and when I walk a lot, I bleed, and when I told the doctor about the bleeding, he said, that's normal, and that I will bleed as long as I have a stent in.

Barb

Yes, that was what I was told at discharge, which confused me at the time. I thought it was all going to come out with the stent in (at the time, I thought the purpose of the stent was to make the stone passage easier). When I went back to urologist after lithotripsy, I had a baggie with a tiny bit of sand to show him and told him I was worried I hadn't passed it all. He said that was normal and once the stent came out, the bigger stuff would follow. But the nurses that didn't know I had a stent after the litho told me to walk as much as possible and the one that knew I had a stent told me not to until it was removed. Mixed messages for sure.

Today is day 6 and I still have not passed anything more than 4-5 super tiny tiny pieces of something. I'm worried! Don't know if I should go to the ER with hopes they'll do a CT scan, or wait. Is there a chance the fragments will still pass? My Dr. Is on vacation.

Here are patient instructions for after lithotripsy that I found that might help put your mind at ease. It essentially says that it could take 4 to 6 weeks to pass everything for some people. Unless you are in extreme pain, I wouldn't worry too much.

POST EXRTACORPOREAL SHOCKWAVE LITHOTRIPSY (ESWL)

The purpose of the ESWL procedure is to pulverize kidney stones into small sand-like particles that may be

passed spontaneously through the urinary tract. ESWL does not actually remove the kidney stones.

1. Patients may experience discomfort, soreness or pain at the treatment site. A prescription for pain-

relieving medication or extra strength acetaminophen will be recommended. Some patients may havediscomfort or pain as particles pass through the ureter. Redness or bruising can occur at the treatment

site from the shock waves.

2. An antibiotic may be prescribed for the treatment or prevention of a urinary tract infection. All

prescribed antibiotics should be finished.

3. Unless otherwise instructed by the urologist, patients should be able to resume all of their normal

activities within 24 to 48 hours.

4. A liberal intake of fluids and mild exercise may aid in the passage of particles. Water is best.

5. Straining urine post-procedure will enable stone fragment analysis through your urologist’s office.

Some patients will not pass particles immediately, but may do so four to six weeks after the procedure.

These particles may be very fine or similar to sand granules. Particles can be brown, tan, or black.

6. Additional ESWL treatment sessions may be required to adequately pulverize kidney stones. Large stones are more likely to require multiple treatment sessions, but even small stones may require more than one treatment.

7. The adequacy of stone pulverization will be determined from x-rays taken at the hospital prior to your first follow up visit at your urologist’s office. Occasionally numerous sand particles can obscure a larger stone fragment. A larger fragment may become apparent on x-rays taken several weeks after the

smaller particles have passed. Another ESWL treatment may be needed to complete the pulverization

of any larger fragments.

8. Supplemental procedure(s) may be required. These procedures may include a cystoscopy with

ureteral catheterizaton, stone manipulation, or basket extraction which may be done just prior to

lithotripsy. Ureteroscopy or placement of a percutaneous nephrostomy (a tube inserted into the kidney through the back) may be done at your own hospital.

9. Most patients will be stone-free three months after ESWL, but a few will still have sand-like particles in

their kidney. Some of these particles may continue to pass, but others may remain in the kidney. The long-term effects of these retained particles are not known.

10. Bleeding around the kidney has occurred in some patients. A blood transfusion may be needed after a

lithotripsy procedure; however, this is rarely required.

11. ESWL will not prevent the formation and growth of new kidney stones. Metabolic evaluation and

medical therapy may help prevent the formation of new stones.

Well, thanks to Luna's fine research, it sounds like it can take a while to pass all the particles. Try not to worry too much and keep drinking water. Waiting is difficult, but it's Christmas and you've got to live your life, as long as you're not in too much pain. They will come out when they are good and ready. Take care!

To Luna and Assassin:

Wow...thx Luna, for the great article. I was relieved to see that the stones can be sand like and just pass! Hoping that's what happens! I have zero pain. Just fear.😆

I'm really sorry to hear you are so upset. During the 2nd Lithotripsy on the 14th of Dec., the doctor was able to break up the 9mm stone. Then he put a stent in, which he took out on the 21st. I have not passed anything, as far as I know, so whether I will in the coming weeks, or whether I won't, I don't know. but as long as I'm not in any pain, I'm not going to worry about it. Personally, I think the doctor may have removed the pieces during one of the times he did a Cystoscopy. I had one on the 14th, and another one when he removed the stent on the 21st. Going to ask him if he did remove the pieces when I go back next month for an ultra-sound of both kidneys, to make sure there aren't any other problems. Take care. Try to relax and enjoy the Holidays.  

Thanks, Barb! I wish I was as positive and optimistic as you 3 are! Instead, I sit and worry about the "what ifs", which I know, logically, is pointless, but getting past it is easier said than done. An additional worry is whether or not to take the trip I've had planned. It was planned for January, but I'm afraid something will happen and I wouldn't want to be away from home if it does. This forum is grest...I love reading everybody's input. Sign me Scareddcat.

The stent removal is really not that big a deal, Barb. Don't stress out about it because it will go more smoothly if you are relaxed. They put some numbing cream down there and it really isn't much worse than a pap smear. There is a second or two of sharp discomfort and then it's done. Not my favorite experience, but it's the end of a miserable journey. Think of it that way. Once it's out, you can move on!

Hi Luna Sea,

Is there any bleeding after the stent is removed? I'm trying to stay calm, and I'm thinking about what you said - the end of a miserable journey. You sure are right about that. I'm glad this "journey" will soon be over, but I recently found out (CT showed) I have severe coronary artery calcification, and Cardiologist said after I'm finished with the Kidney Stone problem, then something has to be done about that. When I look back, not a long time, just a few years ago, I used to be really healthy. I would go to the doctor once a year for a check-up, and during the winter, I would usually get (1) bad cold, but I'd be over that in a week, and the rest of the year, I wouldn't even take a Tylenol. Then all of a sudden, I started falling apart. I'll tell you, "they lied" when they said these are the golden years!  

Barb

If I recall correctly, there might have been tiny spotting immediately afterward, but nothing that stands out in my memory. After everything else, this was minor. For me, having the stent inside was so much worse than removing it. I was kind of afraid at my appointment he was going to schedule another day to take it out. But when he asked me if I was ready, I yipped with joy to get it removed.

What does your cardiologist want to do? I know they can place stents for this as well to help widen the arteries.

I'm just starting to feel the decline. I will be 40 next year, which isn't the end by any stretch, but I definitely have more aches and pains. I suppose it just gets worse from this point.

Hi Luna,

At 39, you've got a long way to go. A lot of good years ahead of you. When I was that age, I still felt, and was still acting like a teenager, even though I had 2 teenagers of my own, and one in his 20's. I'm 74 now, and It wasn't until I was in my late 60's when I started falling apart, and that really bothers me, because my Mother's side of the family lived well into their 90's, and one of my Aunt's had a huge garden, on her property, which she took care of all by herself, up until a year before she died.

The only advice I can give you is, whatever you do now, whether it's exercising, or dancing, or playing golf, don't stop, because if you do, it's soooo hard to start up again. Thanks for the information about spotting after the stent is removed. I sure hope that's all I have.

I have an appt. with my Cardiologist at the end of Jan. to discuss me having a Cardiac Nuclear Dobutamine Stress Test. That's one of those "nasty" 4 hour tests that's done on an out-patient basis, in a hospital. They don't do those tests in an office. In fact, he does other stress tests in his office, but he won't do a stress test in his office on me, because of my COPD.

Depending on what the test shows, I don't know if he will put me on blood thinner, or if he will want me to have the artery cleaned out, or both. He said some people just want the artery cleaned out, and don't want a stent put in right away. Said they go back at another time, if the artery gets clogged again, and have a stent put in. I can understand not wanting a stent, but the way I look at it is, if I have to go through having the artery cleaned out, since they will already be in there, they might as well put a stent in, so I won't have to go back again.

Barb