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Sunday, June 30, 2024

The Saga of the Mysterious Abdominal Pain Continues (Part 2 - June 2024)

If you missed Part 1 of this Saga, you can go back and read it HERE

I took off the morning of June 3 so I could take Hubby to his Nephrology consult, and what an experience that was! Dr. L is this tiny little Asian woman, maybe in her 60s, probably 100lbs soaking wet. She listened to his symptoms and reviewed previous labs he completed. Before the appointment, Hubby submitted a urine sample and the results were the same (Proteinuria). His blood pressure is responding to the Amlodipine (prescribed last month by Dr. K); he’s now in the high 130s/90s range. She asked about his medical history, what meds he takes, normal stuff. Any time we’d say something she didn’t like, she’d crinkle up her face and then lightly lecture us (like, you don’t go for walks at all?!? Or Oh, you shouldn’t eat ham sandwiches, they’re full of salt and nitrates! Or You should never eat fast food ever again and switch to a vegan diet!!! Okay that last one was an over-exaggeration). Like, yeah, we get it. We know that we don’t eat healthily. But it didn’t feel like there was any empathy or caring to her admonishments; it came across more like nagging. She also seemed a bit rude and disdainful about the fact that his current General Practitioner was a virtual doctor; she called Dr. K a “Doc in a Box” in a dismissive little way (kind of a she’s not a real doctor because she can’t touch you remark). Neither of us were huge fans of her bedside manner (spoiler alert, she’s growing on us).

One interesting thing that she discovered, though… She went back and looked at all of the labs from when he was in the hospital for his appendix last year, and he had Proteinuria then! None of the doctors ever said anything! (My guess is that, since it wasn’t appendix-specific, they didn’t care at the time). So, he’s actually had this problem for much longer than just the past month or two… we only discovered it because of an unrelated pain issue. 

At the end of the visit, she put in orders for 13 different blood tests, plus a 24-hour urine collection, and recommended a possible change to his Blood Pressure meds (one that would have more benefits for his kidneys than what he’s currently taking). We picked up the Pee Jug and took it home with us – the plan is to start immediately, finish on Wednesday before his Colonoscopy Consult, then take the jug over to the lab afterward. 

Stress and worry came to a head later when we got home… Hubby started his 24-hour "pee clock" at 10:44am, which meant that his last pee would be around 10:44am the next day. Unfortunately, his GI (coloscopy) consult was at 11, and we had to leave the house by 10:15 to get there. I kept joking that he could pee before we left at 10:15, and bring it with us in case he had to pee again before 10:44, but he was adamant that he wasn’t going to leave the house until 10:44. No matter how I tried to explain that this was a stupid idea (in nicer terms, of course), he kept pushing back (he’s an obstinate SOB), accusing me of demanding he “pee on command” (which I wasn’t) and that he can’t do that (doesn’t matter, since I wasn’t asking him to). Finally, I just threw up my hands and said fuck it and let him stew. We put it behind us by dinner time, with him apologizing for taking his stress out on me. 

The next day, we packed up his jug nice and secure, with some ice packs to keep it cold, and headed over to his GI consult. This ARNP had such a great attitude, with a good sense of humor, even going as far as to recommend that we watch the episode of Good Mythical Morning when Rhett & Link got their Bro-lonoscopies. 


We got him scheduled for his coloscopy on June 20th and got a personalized hand-out of what pills and drinks he’ll need, when to drink and take the pills, and what to expect during the prep and actual procedure (but that’s a post for another day). Then, back across town to the lab to drop off the pee, though it was way too busy to stick around for bloodwork (it was past lunch time and we were both hangry). We picked up food from Sonic and headed home. We’ll pop over to the lab in a few days to do the rest of what is needed. 

On Wednesday (June 5th), we met again with Dr. K and filled her in on the events of the past week or so. She found it interesting that he’d been dealing with Proteinuria since last year, and no one told him about it. She was okay with Dr. L taking the lead on his care, since it was seeming like there was a lot of kidney-related care that was needed, but asked that we continue to keep her in the loop with lab results and scan results. When we complained to Dr. K about Dr. L’s bedside manner she suggested that we ask for a new doctor within the practice (later, after discussing it again, he decided we should give Dr. L another chance, just in case this was a one-off bad day or something). 

After another night of insomnia (oh, that better not be coming back!), we got labs done again, and the high protein (1200mg/day) was still there, as well as a positive hit for random antibodies (nothing specific). His kidney function has dropped from 75% in 2023 to 66% in 2024. Dr. L reminded us to watch his diet (low sodium, no fast food, vegetarian options, no prepackaged food) which may improve his blood pressure and help with weight loss – which in turn may decrease the Proteinuria levels. 

On Friday (June 7) he woke up with that mysterious Left Lower Quadrant (LLQ) pain again, really bad pain this time. And hasn’t returned to work since. He put in for a second leave of absence, but Dr. K fears it will be denied, because there’s no medical proof that there’s anything wrong with him. At a follow up appointment a few weeks later, she said again that she was worried about it being denied (and she didn’t want him to lose his job because of this pain). The next Tuesday, he had a CT Urogram, which was a very easy test, and came back clean… No issues with the kidneys or bladder. Interestingly, they did see something on his L5 vertebrae, like an old stress fracture, but that has nothing to do with the current issues. 

On Thursday, June 20th, he had his colonoscopy, but wow… that was such an adventure in what not to do that I have a stand-alone post about that! 

We got lucky and scored an appointment for his Urology Consult the following week, and this doctor was a very direct, to the point, kind of man. He listened, but didn’t waste time, with small talk or unrelated questions. He palpitated the abdomen, fondled the goods (skipped the one-finger howdy, since his butthole was sore after his colonoscopy). He didn’t see or feel anything questionable, so he suggested a Cystectomy, where they use a small tube to go up the peeper and into the bladder, to see what’s happening up there. That’s set up for August. On the way home, I suggested that he take a few Tylenol before the procedure, similar to how women are told to take meds before an IUD insertion, just to be on the safe side (A bit of pressure is doctor-speak for This shit’s gonna hurt). Then, because I didn’t want him to be surprised on the day of the event,  I explained to him that Lidocaine would be delivered through a needle (spoiler alert… I was wrong abut the delivery method) into his peeper. He was freaked out, as any man would be! I patiently explained that Lidocaine is what the Dermatologist uses when they shave off my moles, and how it works instantaneously. The first shot would suck, but then he wouldn’t feel the other ones... I’m pretty sure he stopped listening at “they’re gonna put sharp needles on my dick head,” though. 

We followed up the next day with Dr. K again, and she was (rightly) frustrated that he still hadn’t gone back to work yet, and admonished him for thinking that he shouldn’t go to work when he has pain, like none of us wake up pain-free, we just deal with it. They set a date to return to work on July 8th. She recommended that we continue with Dr. L and find a local General Practitioner so that we have a hand-on doctor take a swing at this. Besides that, I asked her if she thought that this LLQ pain could be something as stupidly simple as muscle strain, or a pinched nerve, and she said it was definitely possible. Those types of things don’t show up on x-rays or CT scans. She agreed with me that he should be up and moving around – I’ve been saying this to him for weeks, but maybe having her say it would kick his ass into gear a little bit (spoiler alert… it didn’t). I mean… It’s gotta be a muscle thing, right? I am wondering now if he picked up something wrong, or bent over wrong? Did he pull something the last time we had sex? Or a small muscle sprain or tear? What else could it possibly be? I’m so frustrated! 

So at this point, we have a little bit of breathing room. We have additional labs and a 24-hour urine to do, but I don’t think there’s anything to do until July 8th, when he goes back to work, and then nothing until August. I’m hopeful that – once I get him up and moving again – that stretching and walking will help him some, especially if I can get him limbered up before he goes back to work. 

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