With the approval of your Family Dr. or Cardiologist please discontinue your blood thinner’s [such as aspirin, Eliquis, Coumadin, ibuprofen, Advil, Aleve etc.], no later than one week before your ESWL and for an additional three days past your ESWL.  If you need pain control before or after your ESWL you may use Tylenol, Tramadol or the Norco’s we prescribed you at your pre-operative consultation office visit but refrain from use of the above described.
 

During your right or left ESWL, you may have a right or left temporary ureteral placed to infuse dye in this manner a stone in your kidney may be better localized for treatment with sound waves.  These catheters are in use only during the procedure and will be removed prior to the determination of the procedure. If you need a stent placed because your stone is larger than 15 millimeters you will be told of this necessity in advance.  The stent generally will stay in place until more than 50% of the stone has passed on that treatment side.  Additional procedures may be necessary to relieve your stone burden and will be appropriately discussed in advance of surgery.
 

You will be given by Amy [Levaquin 750 mg #10 once daily and Norco 10 mg #30, one or two pills every 4-6 hours].  If you take your pain medication ahead of your procedure it is our option whether to renew or refill these medications as we deem necessary and proper. Also, please remember I encourage you to take stool softeners throughout your stone treatment surgeries to avoid possible constipation.
 

After your ESWL you will experience some blood in your urine for 24-48 hours then it should slowly stop.  You may also notice a reddened and painful area below your left or right rib cage this is the area where the sounds waves are applied to fragment your stone.  This may be red and painful for 7-10 days but will recede in time and please take your pain medication to treat this treatment symptom. If I leave a stent in after your ESWL I will tell your spouse, significant other or family member.  Amy, from my office will discuss with you the aftercare for the stent removal with the where and when aspects.
 

Please remember stones in the opposite sided kidney I will not treat simultaneously with your ESWL because of the chance of increased pain, additional bleeding and potential kidney failure. We will discuss the treatment of contralateral stones after your one side is stone free.   Shockwave lithotripsy with the use of sound wave to fragments stones is my preferable means of treating most stones in the kidney. It has also been found to have the fewest long-term side effects.
 

If you stone does not appreciable fragment after two ESWL’s we may need to refer you to Barnes Hospital for a more involved Percutaneous Nephrolithotomy approach to stone fragmentation.  With this approach a tube is placed directly into the kidney from outside your body and larger scopes are used with various types of energies to fragment and treat your stone burden.  If this becomes necessary I will discuss this referral with yourself and family members.