Renal colic - anyone experienced this?

[TheSnitch]

Christ, it hurts.

I have a partially obstructive stone lodged in the ureter which does not seem to want to come out of it's own accord, and I may need a stent. Would appreciate any information on whether that will hurt like a bd too, or is it the lesser of the two evils?

[mrsmadbadger]

Kidney stones can be very painful and if left can lead to further problems. Have you looked into having lithotripsy first? If this is an option, I'd take it. If not, having a GA, a ureteroscopy and insertion of a stent is a straight forward procedure. However it does mean having surgery again later to have the stent removed. It can all be done in Day surgery too.

HTH

[TheSnitch]

mrsmadbadger said:

Kidney stones can be very painful and if left can lead to further problems. Have you looked into having lithotripsy first? If this is an option, I'd take it. If not, having a GA, a ureteroscopy and insertion of a stent is a straight forward procedure. However it does mean having surgery again later to have the stent removed. It can all be done in Day surgery too.

HTH

Thanks very much for that. They seemed confident that I would be able to pass it, but repeated xrays have shown it hasn't shifted. Lithotripsy hasn't been mentioned yet. I'll ask about it.
Whatever they do can't hurt more than it already does. Even morphine was only partly and briefly effective, so I'll take any option at the moment

[mrsmadbadger]

TheSnitch said:

mrsmadbadger said:

Kidney stones can be very painful and if left can lead to further problems. Have you looked into having lithotripsy first? If this is an option, I'd take it. If not, having a GA, a ureteroscopy and insertion of a stent is a straight forward procedure. However it does mean having surgery again later to have the stent removed. It can all be done in Day surgery too.

HTH

Thanks very much for that. They seemed confident that I would be able to pass it, but repeated xrays have shown it hasn't shifted. Lithotripsy hasn't been mentioned yet. I'll ask about it.
Whatever they do can't hurt more than it already does. Even morphine was only partly and briefly effective, so I'll take any option at the moment

In my professional experience a combination of morphine and diclofenac(voltarol) is pretty good at shifting the pain. If that doesn't help then pethidine should. Only available in hospital though What meds are you taking? Have you been able to obtain oral morphine ( oromorph, Zomorph, oxycodone )? If you do have the above a combo of what has been suggested should help.

[TheSnitch]

mrsmadbadger said:

TheSnitch said:

mrsmadbadger said:

Kidney stones can be very painful and if left can lead to further problems. Have you looked into having lithotripsy first? If this is an option, I'd take it. If not, having a GA, a ureteroscopy and insertion of a stent is a straight forward procedure. However it does mean having surgery again later to have the stent removed. It can all be done in Day surgery too.

HTH

Thanks very much for that. They seemed confident that I would be able to pass it, but repeated xrays have shown it hasn't shifted. Lithotripsy hasn't been mentioned yet. I'll ask about it.
Whatever they do can't hurt more than it already does. Even morphine was only partly and briefly effective, so I'll take any option at the moment

In my professional experience a combination of morphine and diclofenac(voltarol) is pretty good at shifting the pain. If that doesn't help then pethidine should. Only available in hospital though What meds are you taking? Have you been able to obtain oral morphine ( oromorph, Zomorph, oxycodone )? If you do have the above a combo of what has been suggested should help.

Yes, managing pain at the moment with paracetamol, codeine phosphate, took oromorph as required. Can't tolerate NSAIDs unfortunately. Also taking Tamsulosin and an anti-emetic. Had IV morphine as an in-patient but obviously managing without now. Thanks for the advice, good of you.

[TheDiplomat]

TheSnitch said:

Yes, managing pain at the moment with paracetamol, codeine phosphate, took oromorph as required. Can't tolerate NSAIDs unfortunately. Also taking Tamsulosin and an anti-emetic. Had IV morphine as an in-patient but obviously managing without now. Thanks for the advice, good of you.

Usually you should be on paracetomol + NSAID + opioid (in that order).

What is it about NSAIDS you cannot tolerate? Have you asked for the newer COX II inhibitory NSAIDS which reduce bleeding in the stomach?

Otherwise, you should certainly replace codeine with oromorph. Codeine is an absolutely useless painkiller; it is essentially a constipator with pain relief as a (minor) side effect. Don't worry about addiction with oromorph too much: this is extremely rare, and pain blocks the reward pathway in the brain.

Have a look at the Oxford table here: http://www.medicine.ox.ac.uk/bandolier/booth/painp...

Bit out of date (2007) but as you can see, codeine is right at the bottom.

HTH.

[BruceBogtrotter]

TheDiplomat said:

Usually you should be on paracetomol + NSAID + opioid (in that order).

What is it about NSAIDS you cannot tolerate? Have you asked for the newer COX II inhibitory NSAIDS which reduce bleeding in the stomach?

Otherwise, you should certainly replace codeine with oromorph. Codeine is an absolutely useless painkiller; it is essentially a constipator with pain relief as a (minor) side effect. Don't worry about addiction with oromorph too much: this is extremely rare, and pain blocks the reward pathway in the brain.

Have a look at the Oxford table here: http://www.medicine.ox.ac.uk/bandolier/booth/painp...

Bit out of date (2007) but as you can see, codeine is right at the bottom.

HTH.

Sorry this is bull. Are you medical?

The best painkiller for renal colic is paracetamol + rectal diclofenac suppository (100mg) + opiate (tramadol OR codeine) PLUS Tamsulosin, if still not controlled then oral morphine OK. Thats what the evidence says anyway.

Bruce (Urologist)

[TheSnitch]

TheDiplomat said:

TheSnitch said:

Yes, managing pain at the moment with paracetamol, codeine phosphate, took oromorph as required. Can't tolerate NSAIDs unfortunately. Also taking Tamsulosin and an anti-emetic. Had IV morphine as an in-patient but obviously managing without now. Thanks for the advice, good of you.

Usually you should be on paracetomol + NSAID + opioid (in that order).

What is it about NSAIDS you cannot tolerate? Have you asked for the newer COX II inhibitory NSAIDS which reduce bleeding in the stomach?

Otherwise, you should certainly replace codeine with oromorph. Codeine is an absolutely useless painkiller; it is essentially a constipator with pain relief as a (minor) side effect. Don't worry about addiction with oromorph too much: this is extremely rare, and pain blocks the reward pathway in the brain.

Have a look at the Oxford table here: http://www.medicine.ox.ac.uk/bandolier/booth/painp...

Bit out of date (2007) but as you can see, codeine is right at the bottom.

HTH.

Actually, I find codeine works pretty well for me. I can't tolerate even a COX 2 selective NSAID, I have tried. Plus a number of them have been withdrawn from the market in recent years because of safety concerns. Cannot tolerate even when co-prescribed with a PPI so really not an option.

[TheSnitch]

BruceBogtrotter said:

TheDiplomat said:

Usually you should be on paracetomol + NSAID + opioid (in that order).

What is it about NSAIDS you cannot tolerate? Have you asked for the newer COX II inhibitory NSAIDS which reduce bleeding in the stomach?

Otherwise, you should certainly replace codeine with oromorph. Codeine is an absolutely useless painkiller; it is essentially a constipator with pain relief as a (minor) side effect. Don't worry about addiction with oromorph too much: this is extremely rare, and pain blocks the reward pathway in the brain.

Have a look at the Oxford table here: http://www.medicine.ox.ac.uk/bandolier/booth/painp...

Bit out of date (2007) but as you can see, codeine is right at the bottom.

HTH.

Sorry this is bull. Are you medical?

The best painkiller for renal colic is paracetamol + rectal diclofenac suppository (100mg) + opiate (tramadol OR codeine) PLUS Tamsulosin, if still not controlled then oral morphine OK. Thats what the evidence says anyway.

Bruce (Urologist)

Thanks Bruce. I was offered tramadol or codeine, I have taken codeine before and found it easier to tolerate, so opted for that. Much appreciate your advice.

Hard to believe such a little thing could cause so much pain, it's a novel experience

[BruceBogtrotter]

TheSnitch said:

Thanks Bruce. I was offered tramadol or codeine, I have taken codeine before and found it easier to tolerate, so opted for that. Much appreciate your advice.

Hard to believe such a little thing could cause so much pain, it's a novel experience

No worries. Supposed to be worse than childbirth!

[Autopilot]

I've had renal colic, it's really not very funny!

The first stone I had didn't cause any problems when it was in the kidney, but once it was on the move it was agony. As it worked it's way through i had all sorts of strange pains in random areas. I posted about this particular experience before so probably not a post you'd want to do a search on if you're squeamish. I can't even think about my penis and jabbing a set of tweezers in to yank a stone out without feeling queasy these days

Stone number 2 caused me no problems once it left the kidney, it just passed through and was completely painless. The only real pain I had was when I realised I had a stone. I woke up with what felt a bit like I'd slept awkwardly and hurt my back a bit. About 20 minutes later and I was completely floored and almost unable to move.

Do kidney stones show up easily on Xrays? The reason I ask is that after I had my first one, I was was given the all clear and told there were no more stones in there. A couple of weeks later it was evident that I did in fact have another stone. It couldn't have formed that quickly(?) so would only presume it was present when I had the xrays taken.