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Doc says surgery - how do I get a 2nd opinion?
Peter Principle
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Kidney stones. Ouch. Not moving like they should. The urologist I went to says that if a stone doesn't pass in 30 days then surgery is necessary to remove it. I'd prefer not to have surgery since it's dangerous and expensive (even with health insurance). How do I go about getting a 2nd opinion? Tips and tricks? Hacks and cheatcodes? Any advice appreciated.
"A man is likely to mind his own business when it is worth minding. When it is not, he takes his mind off his own meaningless affairs by minding other people's business." - Eric Hoffer, _The True Believer_
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Step Two: Schedule with the new urologist.
I am not a doctor, but that seems to be the common consensus told to relatives of mine with bad kidney stones. Has the 30 day window passed?
I though this too .... maybe something to bring up to your current doc and your second opinion doc
You're likely going to need surgery. Also lay off the dark soda (and caffeinated soda), coffee, and tee.
As the above responses correctly describe, lithotripsy is not applicable to many types of stones. Also, these will take multiple treatments to shatter the stone.
For what it's worth, a kidney stone that cannot be shattered with ultrasound will come out naturally or by removal. If it doesn't, it can block a number of structures within the kidney and produce acute renal failure or other pathologies you want nothing to do with.
The removal by cystoscopy takes about an hour and is relatively complication free. Your options for anesthesia are going to sleep 'general anesthesia' with a breathing device in place or a spinal anesthetic where we put a local injection of numbing medication near the spinal cord, causing you go to numb from the waist down similar to what is typically done for c-sections. Both are very safe.
Either way, the stone is going to come out. I'd actually tell you NOT to get a second opinion. The second urologist is going to tell you the same thing the first one did. You have a stone, it can't be shattered, and if it isn't out in 30 days your risk of complications goes up. That's pretty much the end of the story.
Finally, my good buddy is an ER attending and he told me there are two kinds of real pain in the world. Kidney Stones and Childbirth.
Right now my health insurance covers ~ 80%. I'd like to bump that up to the 90% option (because I imagine this surgery is expensive), but if I do this improved coverage won't kick in until January 1st. Possible to put the operation off until then?
Do you know how long recovery time typically is for this procedure, if there are no complications?
Yes. You do not know pain until you have had a kidney stone try to pass through your ureter. The first time I had one, I thought I had somehow ingested strychnine.
On the plus side, the prospect of unavoidable, self-inflicted internal nausea and agony is a great motivator for sticking to a diet.
Drink lots of water, kids.
I am not a urologist so I cannot answer that question directly. However, I will say from my experience that no urologist will tell you that is okay to wait because the standard of treatment is 30 days until surgical removal, stating it's okay to wait longer only increases the physician's liability were anything to go wrong. I can't say I know the numbers directly, but a 10% savings isn't worth risking your renal health.
Provided you are a relatively young person (< 40 years of age) with no medical conditions and no prescribed medications and more or less at a healthy weight you would be discharged from the hospital approximately 2-3 hours after completion of the procedure. The cystoscopy involves passing a small camera up the urethera to visualize the kidneys and bladder. The urologist uses a small wire attached to a net to snag the stone and remove it. You will be comfortable at all times from the anesthetic and receive pain medications during and immediately after the procedure. You won't be able to drive yourself home, but you'll feel yourself again the next morning from the anesthesia and there is virtually no recovery from the procedure itself, barring the instructions they give you when you go home (no heavy lifting for 2-3 days, drink lots of water, etc.)
If you want to send me a PM with your pertinent medical history (age, sex, height / weight, allergies, current medical conditions for which you are receiving treatment, medications you are on, anesthetic / surgical history) I would be glad to answer this more completely.
No one should have to go through this multiple times. Change your diet, man.