Chapter 1

Chapter 1 - Kidney

Written March 10th, 2018, less than 24 hours after discharge from hospital.                       

As a veterinarian, working in the medical field makes you see some CRAZY things, but I never knew the strangest thing I’ve ever heard would happen to ME... 

A little over a year ago, I began having back pain. I didn’t sustain an injury and I can’t tell you the exact date it started. I just know it started approximately late November to early December 2016, at age thirty-two. I have been in some degree of pain since that time, varying on a scale of 10 from a 3 on my best day to a 7 on my worst. 

Around December of 2016, I went to an urgent care facility. They put me on pain meds and a muscle relaxer, and told me to return if it didn’t get better. I returned 2 weeks later. I was told I needed physical therapy. After 6 visits, ending around mid-February, my PT said physical therapy wasn’t helping me. In fact, my scores had gotten worse since I started. She felt I should be seen by a Rheumatologist to be worked up for an autoimmune condition. I was. The Rheumatologist seemed very stumped by my case. My symptoms didn’t fit any specific disease and my initial labs were normal. I requested an MRI of my back, but she discouraged it because she wanted to try other things first. 

I continued to get worse, and the pain would fluctuate in intensity, but it occurred daily and affected my quality of life. I couldn’t bend down, reach for things, or lift anything above 5 lbs without causing pain. It even pained me to get up and down off the floor after examining a large dog. (I’m too short to examine tall dogs on the table.) The meds the Rheumatologist put me on started to cause me to forget what I was saying mid-sentence. I would be talking to a client about their pet’s care and I would forget what I was talking about. I stopped the medicine, and planned to see my Rheumatologist at the upcoming follow-up in May, tell her what happened, and ask for more tests.

The back pain continued. I was monitoring a dog’s dental cleaning one day in May 2017 and I subconsciously put my hand on the right side of my abdomen because of a subtle pain I felt. There was a bulge there, protruding just below my ribs. I never leave work except for an emergency, but it concerned me enough that, after my patient woke up from anesthesia, I went immediately to urgent care. My husband, David, met me there. The doctor couldn’t feel it but told me to go to the hospital the next day if I still felt it, because they had better diagnostic imaging options. (He even wrote “Feared complaint without diagnosis” as a diagnosis on my discharge papers, implying that I had imagined a problem). The next day came. I still felt it, but worried that I would be perceived as crazy by another doctor, I hesitated. David got home and encouraged me to listen to my body. If it doesn’t feel right, let’s go to the hospital. We did. 

The emergency room doctor felt the mass immediately. He was openly confused at its location and consulted with a radiologist to determine the best imaging modality to identify the mass. Shortly thereafter, a CT scan revealed I had SEVERE hydronephrosis (enlargement of the kidney from urine build-up) of my right kidney. My right kidney was approximately five times the size of the left, taking up the right side of my abdomen and pushing all my intestines to the left side. It was not caused by a stone, but rather two blood vessels crossing perpendicularly over my right ureter (which connects your kidney to the bladder). This caused a kink and slow build-up of urine over months to years. One urologist thinks it had been developing slowly since childhood. Your kidneys are deep within your abdomen toward your back; you should not be able to feel them from the front!

I would read later that this condition, UPJ (ureteropelvic junction) obstruction, is more common in male children on the left side. If found in adults, it typically will occur acutely after heavy alcohol intake. I was a 33 year old woman with a UPJ on the right, and I hadn’t been drinking. As strange as it seems, I was thrilled. Hurray! They found out the problem with my back. After an upcoming surgery, it will all be fixed! 

It wasn’t.