Compared to cancer or the slow paralysis of amyotrophic lateral sclerosis, kidney stones are a relatively minor ailment. They seldom cause serious health problems, but they're extremely painful and debilitating while you're waiting for one to pass. Traditional treatments including drugs to subdue the pain or surgery for unusually large or dangerous stones, but in recent years lithotripsy has become the main form of therapy. It uses the impact of high-frequency sounds to dissolve the stones, letting them pass easily.
Your body manufactures kidney stones out of a variety of materials, most often calcium or uric acid. When your body passes a stone, it has to travel from your kidney to the bladder through a tiny tube called a ureter. After the bladder, it has to travel through another small tube called the urethra before it finally makes its way out of your body. Squeezing a big stone through a small tube can be pretty painful, and if one gets stuck you might develop a dangerous infection. Lithotripsy streamlines the process by breaking up your kidney stones.
When your patients arrive, they'll usually have some last-minute questions or concerns about the procedure. Once you've explained the process and put them at ease, you're ready to begin. Older lithotripsy machines place the patient in a bath, where the water transmits the shock waves. With newer machines you'll place the patient on a table, much like an examination table, where the treatment is administered. Many machines incorporate MRI or CT scanning ability, so you can see the stones break up in real time. The whole process takes about an hour. It's slightly uncomfortable, and some individual patients might need painkillers.
As with any other health care profession, it will be your responsibility to review the patient's paperwork, verifying their identity and checking that they've signed their consent forms. The patient's doctor should have explained the process thoroughly, but it's good practice to remind the patient what to expect after the treatment. Most patients will pass some blood during the first few days, and you should encourage them to drink lots of fluids. They'll have a routine followup with their urologist in about two weeks, but if they experience severe abdominal pain they should contact the doctor immediately.
Most technical staff perform lithotripsy as part of their other duties. Doctors and nurses can be certified in lithotripsy, but usually the procedure is done by radiologic technologists. You'd start by qualifying as an X-ray technologist, sonographer or nuclear medicine technologist, then learn lithotripsy on the job. Once you've mastered the skills, you can apply to the Council for Urological Interests for certification in lithotripsy. You'll need to pass the council's certification exam, which is usually offered once each year.
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