I was awoken at 0225 this morning by acute abdominal pain. It was located in the right lower quadrant and radiated around to my right flank. My abdomen was slightly tender to pressure and my temperature was normal. I got up and walked around a bit and it did not improve. I took a hot shower, felt nauseous but did not vomit, and had an episode of shaking chills in the shower. The pain subsided at first and then increased to about a level five. I woke up my wife at 0400, told her that I was concerned that I had developing appendicitis, renal colic or diverticulitis and it was time to go to the local ED.
We arrived at about 0440, was triaged and then seen by the ED physician. Although I did not know him, I worked with his group and we chatted a bit about risk management and then did the history and physical. He thought I had a kidney stone and mentioned he had seen 'three old guys (including me) just that morning for kidney stones. He said that being an old guy working outside in the summer and not drinking enough water was a dangerous combination. A white count was normal, indicating no infection, and the urinalysis also showed no infection. We had a abdominal CT scan done; the good news was that the appendix and bowels were normal, ruling out appendicitis or diverticulitis; the bad news was that there was a 4.5 mm right kidney stone, about halfway from the kidney to the bladder.
So I am home with a bunch of meds, and a followup appointment with urology. I wonder if they will recommend that nature take its course, or if they feel they should go after it.