好些年前，一天夜裏邊上有個朋友膽結石發作，疼痛難忍送急診，從急診住院最後手術割掉膽囊，取出很大塊的結實。 後來我去他家時，他還拿出結石給我看過，好幾顆，而他描述當時送急診時的疼痛時，用了"上竄下跳"這四個字。
二月二十四，周日晚9:30左右，我突然間感覺到左下腹疼痛難忍，接著又是翻江倒海地嘔吐，最後隻得急匆匆趕去急診室。當CT最後發現是一顆六毫米大的腎結石在作怪時，我心底略略鬆了一口氣， 慶幸隻是一顆石子，並無其他大礙。那晚掛了點滴，打了止痛片，淩晨二點回到家昏昏睡去。
不料，就是這小小六毫米大的結石，在體內歇了兩天，周三上午2月27號11點多又開始發作，疼得渾身冒汗，連車也開不了，隻好叫某人來接我回家。 回到家中，才發現家裏普通止痛片根本不起作用，某人拿著急診醫生開的高強止痛片，手忙腳亂的，去藥房拿，等拿到已經下午兩點。 一顆止痛藥下去，疼痛沒有抑製住， 一個半小時後又開始狂吐。 我躺在床上打家庭醫生電話，打專科預約，那時候等待的每一分鍾都是煎熬。四點多家庭醫生與專科醫生的意見反饋過來，鑒於疼痛和嘔吐情況，建議再去急診。
周三五點的急診室人不少， 這次的我沒有那麽幸運被馬上送進病房，而是被晾在一邊。 我在大廳角落裏哼哼唧唧的，沒人理，又讓某人把自己推坐在醫務人員進出的口上，接著哼哼唧唧，還是沒人理睬。 估計不是什麽高危病人了，沒有生命危險， 服務人員見怪不怪。等了兩個小時，終於被推進入內。 這次用藥參照上一次，隻是沒有做ct，隻做了x光、血和尿檢。晚上10點20左右被放行回家。
兩次的劇痛，讓我對此心存幾分恐懼。 周四上午一上班， 我就開始打電話約專科醫生，心想馬上又到周末了，可不要三進ER。 一通電話，一通保險公司確認，終於約到了周五一位專科醫生。放下電話，上網一查，發現這醫生很年輕， 2018年才開始行醫的。 不過事已至此也管不了那麽多了，病急還真是亂投醫呢。
話說這六毫米的結石是個臨界狀態的石頭，說小不小，說大不大。當2月24晚查出是六毫米結石時，某人掏出手機上網查，當時網上的信息是70%的可能性會自動掉落。當2月27號再次進'ER， 我問醫生， 自動排出的可能性是多少時，醫生的回答是百分之五十。到3月1號再看專科醫生時，同樣的問題，答案是40%到60%的可能會自動排出。
從2月24到3月1號整整五天時間，我對結石自動排出的希望也隨著醫生的信息、時間的流逝而變得渺茫起來。 周五看專科時， 醫生給了一個白色的漏鬥，如果結石排出了，希望能接住做個化驗分析。 整個周末，我除了睡覺午休，不停地喝水，每次上廁所手拿漏鬥，滿懷希望，希望看到純白的漏鬥裏出現一塊小石頭，這種期盼不亞於當年淘金者大浪淘沙，希望從過濾的江河水裏看到金子的影子。無奈，整整兩天，不見一點蹤影。
周末很快過去，迎來了新的一周。周一上班後的第一件事又是打電話給家庭醫生，希望refer到另外一位專科醫生，尋求second opinion。我隱約覺得周五看的這位醫生太年輕 ,態度也一般，她匆匆看了急診的報告後，就準備安排手術時間。而我總覺得手術是最後一張牌，不得已而為之。
在網上看了網評後，我要求家庭醫生refer一位第一次急診時醫生推薦的專科醫生。一番電話懇求，終於約到第二天上午的一個appointment。
於此同時，周一上午在公司，自己又是拚命喝水，還在水裏加了很多新鮮檸檬。午飯前上完廁所，發現toilet裏有一顆褐色的小東西沉澱在那裏，就在我片刻猶豫想定睛再細看時，一聲自動衝水係統的嘩啦聲， 把水中物體衝得無影無蹤。我半信半疑地回到座位，腦子裏一直在糾結，我看到的是結石嗎？
周二上午十點多，我開車去了一個車程二三十分鍾遠的診所， 見到一位中等年紀中等身材的男醫生。醫生說了這樣一句話，CT上測出的6mm很可能實際上隻有4-5mm， 這個信息很關鍵，因為前麵講到6mm是臨界狀態，小於6mm，結石掉下來的可能性急劇增加。而隨後幾天的無症狀讓我越來越相信體內的石頭已經在一天前排出了。 我心上的石頭也隨之一天天滑落。 雖然最後的確診需要再做一次CT(Xray都無法查出)，我已經不把它當回事，也不準備再做一次CT了。
據網上的統計數據說，十個女性中會有一位得結石，而男性得結石的比例比女性大一倍。寫下這些流水賬，希望給網友們一些借鑒。雖然造成結石的原因眾說紛紜，成因不明，有可能是家族史，有可能是飲食，也有可能是某些人的體質就是容易得結石。雖說結石很多情況下是鈣化的結果，醫生並不建議減少鈣質食物。 另外，我個人對網上建議的、飲食上控製某類食物，比如，控製魚、肉(poultry)、深綠色蔬菜、巧克力等等，心存疑問，尤其是說到柚子(grapefruit)和富含維生素C的蔬菜水果會導致結石更是疑問重重---為什麽檸檬可以幫助排出結石，而柚子則在黑名單上? 但是，有一點我堅信不疑，那就是多喝水，少進鹽，少進糖。脫水（dehydration) 是結石的第一凶手，網上資料說到在極度惡劣環境下的士兵因為脫水會患結石，讓我聯想到馬拉鬆運動員等其實是需要及時補充水分的。
一直以來有種感覺，美國醫生的水平和素質是良莠不齊的。拿這次看病來說，一個急診醫生會告訴你每6小時服用止痛片，24小時不間斷，服用五天。而另一個專科醫生會告訴你，止痛片需要時才服用。又比如，四個醫生中，隻有最後一位醫生告訴你，CT上的六毫米結石實際有可能隻有4-5毫米這樣關鍵的信息。
隨著網絡的發展、信息的普及和交流，人們對疾病了解的渠道越來越廣。除去需要CT, MRI這樣高端儀器的診斷，人們在很多情況下對自我疾病的了解和用心觀察，會讓自己成為最好的醫生。
最後，借此感謝眾網友的關心，你們的問候和意見(例如可以用聲波擊碎，檸檬有助結石排出，茶葉不利於結石排出等)都讓我感動，給了我溫暖和信心。讓我們一起健康，遠離疾病苦痛!
"You’ve tricked me.” The nice young ER doctor said smilingly. “It is a kidney stone that travels like this in your body to the current UV junction.” The doctor gestured a diagonal line from a kidney to the left lower abdomen.
I felt a bit relieved at the conclusion from the CT scan, that it was a 6mm stone dropping from the left kidney that caused the acute pain and the vomit. Pain was gone by the time the high dosage pain-killer had been inside the body for an hour or so. Tired and dazed with sleep, I was home 2 am in the morning of 02/25/2019.
However, my second ER experience on 02/27/2019 wasn’t that lucky. Wednesday evening’s ER was much more crowded. Though nobody looked as painful as I did, I was left unattended in the check-in lounge groaning for almost two hours before being admitted. Then a nonchalant young doctor saw me, without much enthusiasm, without much advice, a bit inexperienced to me too. He followed the first ER doctor’s medication, and instead of another CT scan, which was unnecessary, I had an X-ray. But the X-ray could not detect the stone. I was released around 10:20 pm at the night, being told that I would have to take the pain-killer Toradol every six hours around the clock for the next five days.
When Thursday came, the first thing I did in the morning was to call and make an appointment with a urologist, but the referred urologist wouldn’t be available until March 8. Worrying about the coming weekend, I decided to go with any doctor available in the group. So, Friday morning I found myself talking to a very young specialist who started practicing since 2018. She suggested surgery and had it scheduled in advance if by the time the stone still would not pass on by itself. She dismissed the ER doctor’s around-the-clock pain killer advice, but to take it as needed. A white-color strainer was given to me upon my leave.
I started to drink water like a cow in the weekend and hoped that the stone would pass on. However, much to my disappointment, large quantity of water resulted in frequent pees, with no anticipated small stone filtered out in the strainer.
Then came Monday. I called my family doctor, asking specifically for a urologist in the network, who was referred by the first ER doctor, for a second opinion. Then I frequented the company kitchen for more water, squeezing fresh lemon to it as suggested online and a friend who left a comment in my blog. Then something happened. A brownish small stone was spotted at the bottom of a toilet when I went to restroom. Before I could take a closer look, it was flushed away automatically. I stared at the clean toilet, empty and void of anything. Within minutes, I started to question myself. Was it really a kidney stone I saw?
The doctor I saw the very next day on Tuesday obviously looked more experienced and confident. By the time I saw him, I did so much homework by myself that I know a 6mm kidney stone has about fifty percentage chance of passing on by itself. Stones smaller than 5-6mm have much higher possibility. What I didn't know or what the three doctors did not tell me is that a 6mm kidney stone diagnosed by a CT scan could be 4-5mm in reality. Hearing this from the last doctor I saw, who said with an affirmative expression, I was led to believe that the little stone I saw the day before must be it, as pain did not afflict me again ever since.
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