Those Who Have Had Kidney Stone Surgery: Safety Precautions for Tinnitus Sufferers?

[Mystery Reader]

Hello, Folks!

So, it's possible that I might need surgery for kidney stone removal. (Of course! During a pandemic!)

I have a 6 mm stone that has been stable for quite some time, and so opted to let it alone. Over the past few days, I have had two instances of lower back pain on the side where the stone is located (relieved with a cold compress), and frequent, though decreased urine flow.

I have read that a 6 mm stone can pass on its own, but that it is on the "cusp," of that happening without surgical intervention. I have been using apple cider vinegar to try to help dissolve it, although I know this type of home remedy has advocates and detractors, and frankly I'm not sure it's doing much good.

I have not called my doc yet as I wanted to ask some questions and perhaps get some specific advice from anyone on the forum who has had this procedure done so that I can at least feel like I'm taking steps to prepare myself in terms of what to expect and "what to tell them."

What do I want to avoid in terms of

a) Sedatives used to knock you out during the procedure; is there one agent that is (statistically) considered safer than others?

b) Antibiotics administered through IV during or after the procedure; again specifics to avoid or request?

c) Pain relievers, or any other medication that might have to be administered during the procedure, or prescribed afterwards if I have to have this done?

What are the safest sedatives/antibiotics/medications for us to use or request prior to and after surgery (or conversely, what do I ask them not to use)?

It would be helpful to have an idea of all this if I have to have this scheduled (which will likely take time because of the pandemic), or if I wind up having to go to the ER. I have not taken any kind of pain reliever at all since the onset of tinnitus and hyperacusis (in my case, mostly sensitivity to certain sound frequencies) and have taken one course of oral Amoxicillin once after tooth extraction without a problem. I do have acetaminophen in the house, but have never used it.

Obviously, with these conditions, we try to avoid anything that could exacerbate them. But if this has to be done, then I just want as much information as possible so I am prepared, and at least have an idea what to tell them in order to try to make this as safe as possible. I can't assume that simply by saying "I have tinnitus" that they are going to know what to do to try and accommodate that.

I researched lithotripsy, but the procedure is so loud I'm not sure I could tolerate it. It seems that it also has a variable success rate, so not sure it's worth the risk, although on the plus side, it is not invasive surgery.

Thanks in advance to anyone who has any advice on these specific questions. If you have advice on any other aspect of this procedure, I'd appreciate that, as well!

I hope you are all doing well, and staying safe and healthy during the pandemic.

Mystery Reader

 

[FGG]

My opinion on some of your questions:

a) I'm not aware of any sedatives that are a major risk factor for tinnitus. In some people, propofol may even give a temporary reprieve.

b) I would avoid any "-mycin" antibiotic (aminoglycosides and macrolide antibiotics) and anything in the Fluoroquinolone class (e.g.. Cipro and other "-floxacins"). Since you have tolerated Amoxicillin in the past, they could probably use that or other Penicillin class drugs (e.g. Penicillin or Ampicillin) unless they were looking to address some specific bacteria not covered in that spectrum.

The kidney has great antibiotic penetrance so they hopefully wouldn't need to give you a high dose of whatever they use.

c) Most pain relievers are relatively safe at small doses given short term. However, some people do get worsening from them--I'm not sure how common that is.

NSAIDs are probably the most ototoxic, so Tylenol would be safer but fyi there have been reports of ototoxicity and even hearing loss with a Tylenol plus opioids in combo but I think this is very, very rare and probably only occurs after prolonged use (abuse?).

https://pubmed.ncbi.nlm.nih.gov/10733182/

Gabapentin is very hit and miss on this forum. Some people have reported pretty bad spikes so I would personally avoid that one.

If it were me, I would just take Tylenol and use a lidocaine patch on my back (being careful not to put heat on it so it doesn't increase absorption--at regular doses it can actually help tinnitus but higher or prolonged doses, I could speak to) or if that wasn't enough, a short (1 week) course of opioids without the Tylenol.

How loud in decibels is Lithotripsy?