The Georges in Peru

Last Thursday I did an ultrasound on a 46 y/o patient who had spent most of the night with fever and chills and was having difficulty urinating.  I saw a 2-cm stone in his bladder and when the patient moved it would sink to the lowest part of his bladder.  "You need to get that taken out!" I said to myself, who happened to be the patient.  

I called an orthopedic surgeon that I know and asked him if he could recommend a urologist.  I called the urologist's office, but no one answered.  Not a good sign.  Amy went with me in a taxi to the lab to give them a urine sample for culture and sensitivities before I started some Cipro and we went to the urologist's office.  We were told he'd show up in about an hour and a half.  He doesn't take appointments.  "Let's go be first in line," I said as we went to wait in his waiting room.  I was pretty miserable, with fever and an irritated bladder.  By 6:45 he saw me, but said that he couldn't take out the stones without cutting my belly open, since he didn't have the sort of equipment he needed, like a Holmium Laser.  I didn't care at that moment how he would operate, just that he'd get that stone out, but after 2 days of antibiotics, I felt a lot better and started searching for better options.  It didn't look like anyone in Lima had equipment either, so I checked with a urologist in Omaha, but I wouldn't be able to get the stones out until April 29th.  With that motivation, I did find a urologist in Lima with the laser, and it appears that I will be able to go to Lima and get the stones removed on Tuesday!  I always think things like this make physicians better doctors.  Pray for an uneventful procedure!