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Old 22nd June 2009, 22:00   #1
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Default Removing kidney stones for a Heart Patient

Friends,

I hope there are lot of doctors here to help me.

Is there any way to remove the kidney stone (16mm), its for my dad and he already did a bypass surgery. But no one is ready to give him anesthesia.

But is there any way in india to remove it without surgery using shock waves?
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Old 22nd June 2009, 22:50   #2
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Many hospitals have LITHOTRIPSY treatment to remove stones using shock waves. It is slightly painful for the duration of the treatment. The whole thing gets over under 1 hour and it is usually an outpatient treatment. It breaks the stones into small pieces and then hopefully all the pieces gets flushed out.
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Old 22nd June 2009, 23:10   #3
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Is it possible without Anesthesia? Any reference in Chennai?
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Old 22nd June 2009, 23:12   #4
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I am no doctor.

What was applied on me is to drink more water. That solved the problem. Although this might be a bit off topic, install RO system at your place as soon as possible.

Also try PMing to " Tejas@perioimpl ". I dont what is the field of his speciality, but he is quite helpful in all subjects and might be able to direct you.
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Old 22nd June 2009, 23:12   #5
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I am not a doctor. However, the following info might be of help.

Lithotripsy is the use of high energy shock waves to fragment and disintigrate kidney stones. The shock wave, created by using a high voltage spark or an electromagnetic impulse outside the body, is focused on the stone. The shock wave shatters the stone, allowing the fragment to pass through the urinary system.

It should be there in most of the major hospitals.

You could check out www.rgstoneinternational.com
They seem to have a center in Chennai.
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Old 22nd June 2009, 23:13   #6
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The proccedure is ESWL-extracorporeal shockwave lithotripsy. i have done this proccedure on some patients myself when i was working in urology takes 15 mins to 30 mins
16 mm is pretty big so it may need 2 or 3 sittings but difficult to say depends on consistency of the stone sometimes 1 sitting is enough
its done as an outpatient proccedure and pain is minimal although some people with low pain tolerance may need some sedation
also usually if the stone is big than before the procedure they pass a DJ stent(has to be done in the ot under anesthesia) -its a fine tube with j shaped ends -from the kidney to urinary bladder to prevent pain due to the small fragments of the broken stone passing down from the kidney
the stent is removed after 3 weeks -removal does not require anesthesia

also is your father having any symptoms due to the stone like pain or haematuria(blood in the urine) or is it obstructing the kidney
if not just leave the stone alone and repeat scan after 3 -6 months and see if its increasing in size


drinking plenty of water is good but will help if stone is less than 6mm in size above that it will not pass down the ureter-the tube from kidney to urinary bladder

Last edited by dockap : 22nd June 2009 at 23:17.
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Old 22nd June 2009, 23:23   #7
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Quote:
also is your father having any symptoms due to the stone like pain or haematuria(blood in the urine) or is it obstructing the kidney
The stone was there in the path for more than 5 months and its not moving at all. We have consulted 3 or 4 doctors, but no one is ready to give him anasthesia as he has sugar, pressure and heart problems. He is not very old, around 52 only.

This is not the first time he is getting a stone as he has some problem in his kidney. Now he is suffering with severe pain now, but no blood in the urine. (He already did 2 laser treatments for kidney stones (before bypass) and he managed to get rid of 2-3 stones himself.
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Old 22nd June 2009, 23:38   #8
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Did you try Apollo?

Also google threw up this. Kidney Stone India.com - Overseas, International, Health care, Kidney and Urology treatments, Laser Stone removal, Ureteroscopy, Lithotripsy and more..

Best Wishes for your Dad.

Last edited by druva : 22nd June 2009 at 23:42. Reason: Added wishes
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Old 22nd June 2009, 23:39   #9
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if hes having pain than its obstructing the kidney
would advice to get the stone removed
like i said there is no need for anesthesia for eswl but since the stone is large(16mm) the urologist may decide to pass a stent before the proccedure which will take 5 mins but requires anesthesia
i am sure there are lots of good anesthestists in chennai
talk to your dads urologist he is the one who decides which anesthesist to call for the proccedure
just because he has undergone cabg dosent mean he cant undergo a 5 min proccedure under anesthesia the bypass itself required anesthesia right

also stay away from appolo they will rip you off
my friend studied there and you woudnt want to know what goes on there

Last edited by dockap : 22nd June 2009 at 23:41.
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Old 22nd June 2009, 23:44   #10
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Lithotripsy is done if stones are in the Kidneys, from what I could gather stones are there in the Ureters, Pelvoureteric junction. For this Anasthesia will have to be administered & a small procedure(Ureterorenoscopy) carried out.

Consult a good Physician/Cardiologist before the procedure to control other conditions.

P.S. - If you can come over to North, I have Lithotripsy & other equipment for surgery in my hospital & very efficient team of doctors.
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Old 22nd June 2009, 23:45   #11
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Didn't tried Appollo yet, as he is a SM, consulting at perambur railway hospital and tried vijaya/MMM also.

Will go to Apollo for ESWL tomorrow. Do they have any branch for kidney specialization?
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Old 22nd June 2009, 23:59   #12
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Quote:
Originally Posted by dockap View Post
also stay away from appolo they will rip you off
my friend studied there and you woudnt want to know what goes on there
I'm inclined to somewhat agree with you there!
Quote:
Originally Posted by ibm_jennifer
no one is ready to give him anasthesia as he has sugar, pressure and heart problems
The combination doesn't indicate that anesthesia CAN'T be given - after all, he underwent anesthesia during the CABG procedure... You've just got to find a good anesthesiologist.
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Old 23rd June 2009, 00:05   #13
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Quote:
I'm inclined to somewhat agree with you there!
My Bad, any alternative in Chennai?


Quote:
You've just got to find a good anesthesiologist.
This is true and we have to come out of the circle.
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Old 23rd June 2009, 00:29   #14
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Quote:
Originally Posted by dockap View Post
also stay away from appolo they will rip you off
my friend studied there and you woudnt want to know what goes on there
"Studied in Apollo", since when did Apllo started teaching!
Or probably you are talking about Management course or DNB.


Don't know the distances, but you could try CMC Vellore.
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Old 23rd June 2009, 00:35   #15
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Although am not an Urologist,I can tell you this much:

The suggestion given by dockap is the best at the moment.Try ESWL at first,with plenty of oral fluids,DO NOT try cranberry juice(it has been proved to have detrimental effect),maintain urinary pH and adequate analgesia because pain in the affected flank may at times be severe,as the big stone would try to pass down the ureter,which obviously it can't because of its size.

Surgery for renal calculus (kidney stone in lay man's parlance) are usually in this order:
  • Extracorporeal shock wave lithotripsy (ESWL)
  • PCN (percutaneous nephrolithotomy)
  • Endo-urology (endoscopic removal by Dormia basket with or without double-J stent)
  • Open surgery
All of them have their pros and cons.The treatment of choice depends on various factors including prevailing medical condition,tolerance of patient,predictable outcome of treatment,etc.

Much bigger stones are routinely and successfully removed from more morbid patients all over India.So do not worry,but discuss with your attending Urologist,who can surely arrange for the more experienced Anaesthetist,if the situation so arises.
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