When the pain is so much that it feels like labour

There is nothing crazier than a group of men heading out for a night about town. The universal male code for such nights is that what happens in Vegas stays in Vegas.

This was the case when Carlos* came home from Belgium for the first time in two years since he had emigrated. He had gotten a job with an international organisation headquartered in Brussels and a year later, he was transferred to the head office.

Settling into a high level of work responsibility, a new culture and a new climate was not easy for Carlos and though he had time out from work, he had not managed to come home for a while. Despite this, he kept in touch with his friends and remained in the loop though remotely.

He celebrated his friends’ achievements with them even though he was not in town, caught up on the progress in their lives as they got married, became fathers and earned remarkable promotions at work. He was also there for the long WhatsApp group arguments and discussions about their relationship lives and when one of them was going through a tough divorce.

Carlos was excited to hop on a train for a two-hour ride to London for a weekend to meet up with Alexx* and Kimo* when they came for a work conference, and they crowned the visit by attending a live Chelsea match that Saturday, a lifelong dream for Kimo and Carlos.

It was only natural for the gang to get together when Carlos came home, and paint the town red. The Saturday afternoon started easily with the boys glued to the big screen televisions at their favourite sports lounge as drinks flowed freely. They cheered their teams with fervour as they picked on light snacks.

DIFFERENT CLUBS

As darkness set in, they ordered for food, mainly meats, and settled into a more conversational mood, catching up on their lives and making fun of each other without reservation, as only life-long friends can. They flirted with the waitress and heckled about politics. The drinks were taking effect and they were getting louder.

They debated changing venues, arguing about which club to move to. Everyone had a different opinion of which club Carlos needed to see, since so many fancy places had come up in his absence. Failure to agree meant that the now fairly tipsy bunch made it to three different clubs before settling down in one.

However, their fun was cut short when Carlos started experiencing sudden sharp pains on the right side of his abdomen. Not wanting to spoil the party, he wandered off to the patio, leaning over the guard rail and taking in the fresh air, hoping to get some relief. The pain felt like it was subsiding, bringing a surge of relief, but this did not last.

Before Carlos knew what was happening, the pain washed over him again, searing like a hot iron rod stirring his insides. He could feel it travelling all the way down from his abdomen to his testicles. He did not realise he was clenching so hard on the rails and though the night was cool, his forehead was covered in beads of sweat. He had a strong urge to throw up, but he struggled to hold back as he pulled out his phone and started calling his friends.

It took a third try to get someone to go out to the patio to find him. He must have looked ghastly because Alexx immediately rounded everyone up, bills were hastily paid and the bunch trooped off to their cars and sped off to the hospital. Kimo kept complaining about having to leave the cute girls behind, just when he was about to get a phone number. Everyone yelled at him to save his complaints for later.

DRENCHED IN SWEAT

By the time they pulled into the emergency department, the security officer had rang the emergency bell because Carlos had opened the car door and was vomiting uncontrollably on the pristine marble floor at the entrance. He was put on a stretcher, curled up into a tight ball, his face taut with excruciating pain and his cardigan drenched in sweat.

He was mostly incoherent, but he managed to tell the nurse that he was definitely in labour. The sight of Carlos looking so frail had a sobering effect on his friends and they all kept asking the nurses to make it stop as they wheeled him to an examination room.

The doctor asked them to step out while he rapidly fired a volley of questions at Carlos to establish what was wrong while simultaneously giving instructions to the nurses. In 10 minutes, Carlos had an intravenous line running fluids and a second one running painkillers. He was swaddled in warm blankets and he could feel the spinning in his head slowing down. The vomiting had stopped and the pain was very gradually easing off.

An hour later, Carlos was wheeled out of the radiology unit with a diagnosis. He had a ureteric stone that was finding its way down the ureter to the bladder. As he was still in marked pain, he was admitted to the ward for observation and review by the urologist. It was sunrise by the time his friends had settled him in the ward and were finding their way home. They were all mostly sober by then.

Stones in the urinary system are formed when urine contains excess stone-forming compounds such as calcium, uric acid or oxalate. These may then precipitate and form stones over a long period of time. Stones forming within the kidney may grow to large sizes without much symptoms. Stones in the ureter can cause untold grief as they attempt to pass down or grow too big, stretching the narrow lumen of the ureter beyond normal. Those in the bladder cause symptoms on and off.

Complications, including urinary tract infections, may be life-threatening if not aggressively treated. The stones may block the flow of urine and ultimately cause kidney failure.

Luckily for Carlos, he did not develop any complications, except that his pain did not subside enough to let him go home. He underwent extracorporeal shockwave lithotripsy, a procedure that uses high frequency sound waves that fragment the stone, producing small fragments that will pass out in urine without trouble.

Today, Carlos is grateful to be well and doubly so for his caring friends. He was screened for possible medical conditions that could predispose him to getting urinary tract stones and he celebrates the negative results. He watches what he eats and drinks no less than three litres of water daily to keep his urine dilute. He also knows never to take childbirth for granted. He knows the pain involved.

Dr Bosire is an obstetrician/gynaecologist