PEDIATRIX - a perfect fit
What every 19-year-old young man wants for his birthday is a nice kidney stone. I know, right?
We knew something was wrong when Ethan first went to the bathroom and it looked like red kool-aid in the toilet. In my profession we call that a "clue." The only problem, and the one that kept stumping the doctors, was that he didn't express any pain. The closest he came to expressing any kind of pain was to say, "I have a cramp." He would then go lay on a heating pad and the cramp would subside. That was it! No fussing, no wincing, nothing outward that he was suffering pain of any real intensity.
His Doctor examined him, thought it might be kidney stones, but without the pain, he was as perplexed as we were. Over the next few days the "cramp" he complained about came and went, and came and went, a few times. Again he never fussed about pain, and the kool-aid color of his urine even subsided slightly.
Eventually we were left with instruction that if any of the symptoms got worse that we were to call immediately. Well, it didn't take much more than two hours.
Ethan was walking up the stairs, getting ready to turn down the hall to his bedroom, when I saw the first real sign of pain. He noticeably winced!
We called the Doctor and he directed us to go to the nearest hospital. We headed down to the closest hospital, and within minutes, Ethan was being taken back to a room - luckily we live near a recently opened hospital that doesn't get much traffic and were the only people in the ER.
The ER Doctor performed a quick examination and asked the million dollar question:
On a scale from zero to ten how bad is your pain?
Uh, a four.
Seriously, in the midst of being in an ER examination room, after peeing what appears to be blood, and most likely kidney stones, this kids is inclined to quote the Little Rascals movie at the Doctor.
Finally they brought in sign with a series of faces which ranged from a smile to a severe grimace. Asking him which face he felt like, he said, "Four."
Seriously? A four, again. Hmmm, maybe this kid has a high tolerance for pain, or it really isn't that bad.
A CT Scan was ordered and within 20 minutes of the scan the ER Doctor returned to advise us that Ethan was the proud parent of a 5 mm kidney stone.
* 5 MM *
Note to self, this kid has a super high tolerance for pain! 5 mm is the size of the pink eraser from a No. 2 pencil! Passing a 5 mm kidney stone would be like trying to fit a racquetball in your mouth! It could be done, but YIKES!!!
Besides the fact he was trying to birth a Volkswagen Beetle through a fire hose, the ER Doctor indicated that the stone was lodged in the Ureter just past the Renal Pelvis (the junction where the Calyces join together forming the Ureter). The removal of the stone would require surgery.
Within 40 minutes, our trip to the ER turned into this:
And 20 minutes later to this:
Ethan was transferred from our hospital to a sister-hospital just down the road. We arrived and were immediately taken to a room, where arrangements were made to help the discomfort and surgery was schedule.
While waiting, word got out, and a few close friends came to visit.
When Ethan was advised he was having surgery, his anxiety level rose, and he began firing off twenty-questions:
Are you going to use a knife?
Are you going to use a sword?
Am I going to have a scar?
Are you going to cut me with scissors?
Eventually the nurse, understanding that she was dealing with some special needs, and tried to gently explain the procedure in more descriptive terms. It didn't take long for Ethan to grasp the significance of what she was telling him:
No, we won't be using a knife. In fact we won't cut you at all. The Doctor is going to take a small tube and insert it into your penis...Ethan's eyes got real big and then he shuddered. He clearly understood!
By morning, when the Ureteroscopy was scheduled Ethan seemed in great spirits. In Pre-Op he got quite the kick out of wearing the hair net...
Surgery was successful. The stone was too big to remove, so the surgeon broke it up, left the fragments in place, and placed a stent within the ureter to aid in passing the fragments. Needless to say this left him a little worn out, but luckily his BFF was there to cuddle with him.
During the night Ethan passed the stone fragments with the help of the stent, and even coined a new phrase for that sensation when you are peeing, the stone blocks the urethra, then suddenly gives way and exits, allowing the stream of urine to continue. He calls them: "Pee Farts!" And yes, he attests that they still hurt, regardless of the stent!
By the next morning Ethan was feeling better.
JC May, a friend of Mo's, heard about Ethan, and not wanting his birthday to go unrecognized brought over a full-size Costco birthday cake! Chocolate of course! Ethan was ecstatic and eagerly ate two, or three, pieces.
He was released and sent home.
After a week of having the stent in, it was time to have it removed. Ethan was given some "relaxing medicine" before we headed over to the urologist's office for the removal procedure.
What should have been a two minute procedure never happened. They had booked us for the wrong day! We went home, waited it out over the weekend and by the next Monday we were back at the urologist where the stent was removed.
Throughout the ordeal I marveled at how kind the medical staff was, and how quick they were to recognize his special needs, and change their tactics to address his medical needs at his level.
The other day I ran Ethan over to the pediatrician, and while observing Ethan on the exam table, I had a chance to think. We've been going to the same pediatrician for the past nineteen + years. Since day one, Ethan has seen Dr. Harold Magalnick MD, FAAP. He was always kind and attentive to Ethan. I remember how Dr. Magalnick would sit on the exam table with Ethan, when he was about three, and while talking to us, nonchalantly check Ethan's ears, nose, etc. His examinations were thorough, but always relaxed, and fit perfectly with Ethan's autistic ticks, nuances, and tendencies. Over the years Dr. Magalnick has attended IEPs, assisted us in reviewing service plans, and was our advocate in the guardianship hearings.
Shortly after the kidney stone experience I broached the subject of Ethan getting older, and if it was time to make a change to a family practice doctor. Dr. Magalnick, smiled, and gently remind me that age was not really a factor, and his office was well equipped for Ethan, and though he is nineteen he was still a perfect fit at PEDIATRIX.
A Perfect Fit?
I know, right?