Saturday, February 19, 2011

Living with kidney stones

As I wrote yesterday, the nephrologists seem no closer now than they were last autumn to guessing what I can do to avoid kidney stones, apart from not eating anything, and drinking one water tower of distilled water per day. Some of their remedies seem drastic in terms of their impact on my quality of life, but they're very casual about them, because everyone they see -- or at least every fat person -- probably already has hypertension, high cholesterol, diabetes, and leprosy (okay, maybe not that last one) anyway, so they should all be going on draconian diets for other reasons already. Why not throw in one more reason to avoid everything?

When I asked for the referral last year, I had no idea it would be six months and still not even feeling like we've started on it, nor that the possible solutions would be so grand and drastic. Ultimately, I feel like we're coming to a point where I have to ask a question the doctors all assume isn't even on the table: do I want to treat this at all?

If they'd said "we can prevent kidney stones, but it'll take a costly, invasive, risky surgery," they would take for granted that I'd be trying to decide, is it worth it? Maybe I should just live with it. The same for lots of other treatments for lots of conditions, particularly conditions that have virtually no risk or only intermittent or minor effects (like, for instance, toenail fungus, which doesn't really do anything to you, and the treatments for which can cause liver failure -- that's a no-brainer).

But as long as all they're saying is "make drastic changes in your diet" then the question seems to go off the table. Of course I'd want to give up everything so I can avoid a kidney stone. It's just a matter of which everythings they need to put on the list.

Well, that's not how I feel about it. Sure, those few hours in the hospital were awful. The second one was either the most intense pain I've ever felt, or the second-most (there was this one time I fell off my bike and... you probably don't want to hear the rest of this sentence, you'll be wincing for hours). But one night like that every few years is chump-change compared to the kind of medical issues I used to have to face, with things like diabetes, where you're not talking about discomfort, you're talking about disability and death. And kidney stones have a very, very tiny risk of ever being anything more than a few agonizing hours and a few uncomfortable days.

Maybe I'm being dumb, but I really think the idea of having to go back to measuring and counting every particle of food I eat, having to avoid almost everything that I enjoy, and then having my blood tested and wasting a day in a doctor's office every three months, is just not worth it to avoid that one day of pain. The cure is worse than the condition. I spent way too long having to live that way for much more serious reasons. I got a surgery (and if you think about it, that was deliberately inducing the same kind of pain and discomfort as passing a kidney stone) specifically to avoid the medical concerns (namely diabetes) that led to me having to live my life that way.

No, I'm not saying I want to be dissolute and throw caution to the wind, eat anything I damned well please, and give up exercise. (Okay, actually, I would like that, who wouldn't? But I'm not saying that that's what I'm proposing.) I'm just saying the balance I have between the things I do to take care of myself (the things I don't eat, the exercise I do even when I don't want to, etc.) and the things I do because I like them (like exploring interesting foods, or saving a few minutes a day with convenient foods sometimes), needs to be maintained. I'll go so far to avoid the pain of kidney stones, but if they want me to go five times that far, I'm inclined to go buy some more Pepsi and say to heck with them. I'll just budget a few days off each year or two for passing a kidney stone.

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