Kidney Stone, on a buget

[M5ward]

How timely ��I am scheduled for laser lithotripsy on Friday. This is the second time I will have had this procedure. I have one stone in my left kidney and two or three in the right kidney. One stone in the right kidney is too large to pass so they are going to break it up. It has been moving and causing some discomfort. My last laser lithotripsy was for a stone that tried to pass and couldn't causing a septic infection that landed me in the hospital for five days. I have had regular lithotripsy three times going back as far as the old tub and water lithotripsy; I have also had a basket retrieval of a stone. I have done the 24 hour urine collection twice. I don't drink anything caffeinated and don't drink tea or coffee. My body does produce a lot of calcium which bugs me because I also have osteoporosis. My stones are calcium oxylate stones.
If you are in pain you need to see your urologist; my septic infection was no fun. I know treatment is expensive but most places will work with you on a payment plan. If you have a full blown kidney stone attack you will feel like you got hit by a train.

 

[dawnball]

Is there such a thing as passing a kidney stone on a buget???

Any fianacial advice would be appreciated.

Call your urologist, or your GP - tell them you're pretty sure that you're passing another kidney stone and ask if something like Flomax might help. I'm not sure if that's a male-only thing or not, since it's my husband who gets kidney stones, not me. An office visit with either doctor will be cheaper than the ER. Having them order an ultrasound will be cheaper than an emergent one, and you may be able to do it just as quickly.

If you do have to go to the ER, ask if IV toradol will provide sufficient evidence that this is a stone small enough to be passed, or if an ultrasound would be enough. Both are much cheaper than a CT. If you need a CT, the doctor should be able to tell you why you really need a CT. Unless you're pretty forceful, it's hard to get out of the emergency room without a CT, so you have to be willing to ask questions. If you're not capable of asking questions in that situation - take someone who is.

If you have a choice of hospitals, call them up and ask how much things cost. The ER 3 miles to the North of me is about a third the price of the ER 3 miles to the South of me. The waits are significantly shorter, too. They probably can't tell you how much you'll pay, but they should be able to give you the uninsured, full-freight cost of an abdominal CT, or the base, uninsured cost for an ER visit.

All that said, though? Don't take stupid risks because you're worried about the money. I ended up not going to the ER for my appendix until it was necrotic and leaking, because every other time I'd gone for the same pain, it was nothing, and I knew that it would cost me 5K to go to the ER. Waiting until morning to see my regular doctor would have been a phenomenally poor decision to make.

 

[Liberty Belle]

They're not something to ignore.

If they are causing you pain when they didn't before, they've moved (or your kidney is infected) and could be causing a blockage now.

I don't know what your income is, but it's possible that you qualify for the DSH program. I do not have the guidelines in front of me, but it's based on income and family size. I used to screen people for this program.

If your income is too high for the DSH program, the hospital likely has some kind of financial assistance program. If you do not have insurance, never leave the hospital (ER or INPT) without asking to speak to a financial counselor. If one is not available, call after you get home. They are there to help you.

 

[Liberty Belle]

Unfortunately, I can relate, having had a lot of experience with kidney stones. The pain they can cause is one of the worst pains you can experience.

OP, if your stones are too large to pass on their own, they are eventually going to try to get out and you will end up in the ER. You really should be reevaluated by a urologist, who can explain your options. It has to be cheaper than an ER bill.

Changing your diet won't help a lot of people with stones, but trying to increase your liquid consumption is always a good idea.

For the poster who suggested taking ibuprofen for kidney stone pain, that would be the equivalent of using a BB gun to stop a charging elephant.

Ain't that the truth!

 

[MrsDoubtfire]

I'm sorry that I do not have any budget advice as far as passing kidney stones, however I experienced my first (and hopefully last) attack which was attributed to a kidney stone on this most recent New Years eve. OMG - the pain was so awful - worse than being in labor with no epidural, IMO (been there, done that). I almost had to go to the ER...but after 3 hours when I finally decided that I had to go - the pain subsided.

I followed up with my PCP 2 days later. He ordered some lab work and a renal ultrasound - even though I know a Cat Scan would show a stone better than an ultrasound (I'm an X-Ray Tech). The U/S was negative, but the urinalysis showed blood - so I'm pretty sure that it was a stone and hopefully I passed it. To me, the pain was worse than the gallbladder attacks I had a few years back - and they were no walk in the park either. So far this "stone" has only cost me a $15 co-pay and a script for Vicodin, which I haven't filled yet. I'm not sure that I'll bother filling the script since I was vomiting so much during the attack that a pill had zero chance of staying down, LOL.

OP - I hope you are feeling better soon. I was told by my PCP to drink LOTS of fluids to keep the ureters open. But since you have a chronic condition, you probably already know that

 

[plummer925]

Having kidney stone issues myself (currently in the middle of one - ugh)...

I have to say - do NOT drink excessive amounts of fluid without a CT or xray of the kidney! If you have a large stone lots of fluids could lodge it and cause you all sorts of problems. I had 2 5.3mm stones last spring and had a lithotripsy done - I was told to NOT drink more than normal so they did not get lodged in my ureter, which would have caused an emergency surgery.

Go to your urologist. Don't skimp on medical. Really.

 

[tink_n_pooh]

Here's my financial advice: Ignoring chronic health conditions can lead to more expensive and permanent conditions that can have a negative impact on the quality of your life.

Get to a doctor and be evaluated.

Exactly.

Purchasing good medical insurance also seems like it would be more budget friendly than paying for these kinds of services out of pocket

 

[disfan07]

Exactly.

Purchasing good medical insurance also seems like it would be more budget friendly than paying for these kinds of services out of pocket

Easier said than done for those with chronic medical conditions...

 

[HayGan]

OP - the advice you have been given by urologists in the past is certainly the "old school" approach to stones. Today, urologist are far more likely to try and address the stones before they get any larger. You should certainly see a urologist and have the issue addressed. Diet and some medications can certainly help prevent future stones as well as keep them from forming as large.

I have actually had 9 ESWLs (lithotripsy) over the past 4 years. My stones (2) were so extremely large and don't break up easily. After the first procedure my stent slipped and a fragment became lodged between the stent and the kidney causing me to eventually go into septic shock. I had to have emergency surgery and spent 4 days in the ICU. My doctor as well as the other specialists that we brought in said I was within 24 hours of death! So kidney stones are no laughing matter!!! While my story is extreme it goes to show that you can't ignore stones. If they are too large to pass, they need to be addressed and you need to be monitored so that you don't find yourself in a bad situation. It is far better to deal with them when they are small! I'm lucky that we have been able to eliminate all but a few small fragments with all the procedures but I have to be monitored regularly to make sure that I don't form any new large ones. Diet and a very small dose of a very cheap medication have helped me not form any new stones - yeah! Thankfully I have health insurance otherwise my OOP costs would have been well over $200,000 for everything over the past few years.

Get yourself treatment & good luck!

 

[North of Mouse]

HayGan

Wow, you had quite the experience. Thankfully, your condition is the extreme. Glad you are ok.

Diet and medication can not always keep you from having repeat stones though - maybe in your case. The make-up of stones are different. In my dh's case, the Dr. told him what he was eating/not eating had nothing to do with his body making his stones. The ONE thing he could do to help (not entirely prevent) was to drink plenty fluids. He has done that and *so far* no more attacks.

 

[HayGan]

HayGan

Wow, you had quite the experience. Thankfully, your condition is the extreme. Glad you are ok.

Diet and medication can not always keep you from having repeat stones though - maybe in your case. The make-up of stones are different. In my dh's case, the Dr. told him what he was eating/not eating had nothing to do with his body making his stones. The ONE thing he could do to help (not entirely prevent) was to drink plenty fluids. He has done that and *so far* no more attacks.

It has been a journey to say the least! Thankfully even though I have a few fragments remaining no more ESWLs are planned for now!

It is true that people form stones differently. While changes in diet & some medications can help nothing will completely prevent anyone from forming them. Everyone should drink plenty of fluids not just those who are prone to stones.

 

[Twende]

It has been a journey to say the least! Thankfully even though I have a few fragments remaining no more ESWLs are planned for now!

It is true that people form stones differently. While changes in diet & some medications can help nothing will completely prevent anyone from forming them. Everyone should drink plenty of fluids not just those who are prone to stones.

It is interesting to see what different physicians feel. My physicians do not want to do ESWL anymore due to recent studies that show some pretty strong side effects.

http://www.news-medical.net/news/2006/04/13/17318.aspx

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2900184/

I had 2 lithotripsy procedures done a few years apart and when testing showed more large stones they recommended that I not have any more ESWL's.

Instead they did the initially more invasive basket capture (ureteroscopy). They then manually crushed the stones with the basket device. Also my stones are calcium oxalate and they some times do not respond well to lithotripsy.

I did want to mention that the "Jump and Bump" activity should obviously only be done on stones that are going to pass. It just speeds up the process so you are in pain for a much shorter period of time.

 

[dawnball]

Exactly.

Purchasing good medical insurance also seems like it would be more budget friendly than paying for these kinds of services out of pocket

Looking for budget friendly options doesn't preclude having good insurance. I have fairly good insurance, and my husband's stone still cost $2K after insurance - and that was just for diagnosis and a cheap prescription for flowmax/pain pills. We'd look for more cost-effective options if we thought he had another one, now that we've been through it once.