Had pain in the bladder for a week or so. This happened on the New Year’s week. Ireland pretty much shuts down around that time as not many people are working. Pain felt like UTI so I bought a test kit from the pharmacy. There were 2 strips, I did 2 tests and both were negative.

Urgent Care

So the first step as I was advised is to go to the VHI Urgent Care first thing on a Saturday. VHI is my insurance provider and they have urgent care centers for non-life threatening emergency. There I met Dr Amjad, speaks smattering of Bahasa Malaysia when I told him I was from Malaysia. He said he worked in Brunei for 7 years and did one of his medical exams in Penang.

Well he checked me up, did some quick test with the urine. Confirmed there’s no signs of UTI but dip stick detected traced of blood in urine. Best he can do is to refer me to the the “emergency department” and asked that I go to a private hospital for this. The urgent care does not have lab and limited imaging facilities, so this has to get looked at in a larger hospital

Registration in Private Hospital

I was one of the earliest to show up in the Mater Private Emergency Department on Monday. I took a chance, knowing that normally Monday would be busiest of the week. Made worse by the fact that this is the first day back from the long holiday for most people. There is also an outbreak of flu in Ireland and generally crowded hospitals

Registration was easy, just fill up a form that is mainly name, address, phone number and insurance number. I heard them calling my insurance and then they called me to the desk. Apparently my insurance is pay and claim, but for today they will take €250 for consultation. They will charge me for the test and procedures, bill will be sent to my address in a couple of weeks. It is hospital policy that the bill will be limited to the max of €750, except for the CT scans. I think this is a good policy as it avoids extreme cost for the doctor’s visit.

Some of the cost can be claimed back from the insurance and the rest can be used for income tax relief for the year.

Examination

A nurse, who was from India, took me in to an exam room. I changed into their hospital gown. He put a canula, took blood and urine for lab test. He asked and I told him I was from Malaysia, specifically Penang. He said he used to have friends in Penang and asked if I know the restaurant Ananda Bahwan. We are just that famous for food.

I was then moved to a different examination room to wait for the doctor. I think there’s only one doctor covering the whole emergency department so there is a bit of wait. Waiting and being patient is the theme of the day

Doctor came, asked some question like what I feel, etc. He pressed around and explained his next steps. Blood and Urine will be sent to the lab. They will check whether there’s bacteria and count the cells they see in the urine. I will also be sent for CT scan.

Shortly after that, I was asked to follow the staff who took me to the imaging department. I waited for a while before being asked to go in to the CT scan room. The radiologist is a Filipino, sister lives in Petaling Jaya and he has been to KL before. Friendly chap. He asked some question like was my symptoms, told him there’s blood in the urine.

He asked me to lie down in the bed of the CT scan and raised me up to the level. Hooked me up to the contrast dispenser machine and explained what I would feel. He then went in to his room. I was waiting for the machine to start but it didn’t. He came out shortly after to tell me that he may need to consult the doctor on my scan

CT Take Two

So apparently the doctor has asked for a normal CT scan. He said with my complain, the normal CT scan with contrast won’t detect kidney stones. He said he will recommend to the doctor for a different scan and asked that I wait on the CT scanner. He managed to call the doctor and he agreed with the change, surprisingly.

At this time, I am already impressed with the system where the radiologist is able to suggest different diagnostics with the doctor. I think it is better they get it right the first time. Well apparently he needed the doctor to make the change in the system before he can start but doctor is in a sterile procedure. So I was asked to wait outside till the change come in so that others can use the CT scanner.

When the change came in, I was then asked to go into the CT scanner again. They had to do 2 passes of the scanner and it’s pretty much automated. The machine first pushed contrast through the canula. It is a weird feeling of warmth and tingly sensation that slowly flows through the body. The radiologist explained that it could feel that I have wet my pants, I certainly felt that. After the contrast going in, the bed went through the scanner.

Then they came out from the room and push in another medication in the canula. This is the one supposedly to detect kidney stone. The system will countdown from 8 mins. At the 7th minute, contrast is pushed in, the warmth and tingly sensation passing through the body again and into the scanner I go.

After that, I’m back to the emergency department to wait in a treatment room to wait for the results. There are about 6 patients in that room including me, all waiting for something. Couple of them were waiting for room to free up for admission. Another lady was going in and out of imaging, guess they keep finding something to scan,

The results

Was quite a long wait. Unfortunately I had missed the lunch cart while I was in imaging, otherwise I would have gotten myself a sandwich. I could have asked the nurse to get me a sandwich but really not that appetizing. There is a coffee and tea cart just beside me but I could not bring myself to drink.

The nurse then called me into the Doctor’s room. He showed me the CT scan, pass the kidney and then into the bladder. The made a horizontal and vertical scan (don’t know what is the medical term for that). That’s where we saw the stone. He said it’s about 10mm and should pass out. 10mm feels very long to come out. We did look at it from a few angle, I felt the stone only showed up in about 3 slices of the scan. He said he will drop a referral letter to the urologist to see if he will want to take up my case. If the urologist take up my case, his secretary will call me in 2 weeks.

I remember asking the doctor if it’s 10mm long, how wide is it? He said we don’t measure the width, only the length. Makes no sense to me but I did want to imagine of the stone would ever fit in the tube to pee out. Also thought that the stone would be smooth and I was later proven wrong.

Apparently the stone was formed in the kidney, then it got flushed out and now sitting in the bladder. Doctor kept saying that the hard work is done and now just waiting for it to pass out. At least I know it is something normal like a kidney stone, otherwise the mind will go wondering if I only have months to live.

After changing out from the hospital gown and the nurse removing my canula, I just walk out of the hospital. Very surreal feeling and not have to go to “billing” department. The bill will be sent to my house, it is a system based on trust. I always wondered what is it that keep people from not abusing the system.

In all, I went in around 9am and came out at 3.30 pm. I suppose it was a whole day for scans and tests. As I said earlier, a lot of waiting and patience.

Here it comes – the day after

Was in the office the day after and into my second cup of coffee. Went to the toilet to pee as there was an urge. I can feel a sharp thing coming out when I pee. Feels like a bullet went through the pee and onto the urinal. Lucky there were some trap and I managed to pick it up. It was really sharp. Some parts came off when I washed it. I managed to save it and take home for the kids to see. Now I can imagine why it hurts, can really feel the sharpness of the stone and see the crystalline formation.

The doctor did ask that I pee in a sieve to catch the stone. He also said it’s absurd and people would not be able to follow more than 2 days. He was right and I thought I would know when the stone came out as I won’t feel the pain in the bladder anymore. I was not expecting to literally feel the stone coming out.

Anyway, not sure how much the bill would come up to. Will know in a few weeks and hopefully not too shocking.