ON THE ROAD WITH THE STONE CENTER

Behind the scenes at The Stone Center of New Jersey on UMDNJ's Newark campus, there's always been the motto, "Whatever It Takes" or "WIT," but lately, this modus operandi has taken on even more meaning. Officially open six days a week, from 5:45 a.m. to 6 p.m., "We are the busiest center in North America for treatment of kidney stones and our business is physician driven," explains Eneida Cruz, RN, MA, Director of Clinical Operations. "If need be, the staff has been known to stay until 9 p.m. to accommodate patient needs." More than 130 urologists from offices and hospitals across northern New Jersey rely on the Center and its two lithotripsy machines designed to crush stones non-invasively. "Last year we treated more than 2,700 people," Cruz says.

Now, to handle even more patients, the staff has been carefully packing up one of its expensive lithotriptors and taking their expertise on the road once a month since January. "You definitely have to have WIT to work here," Cruz laughs. Sometimes, it's still dark when Roger Weber, Chief Lithotripsy Technologist, who's been on the job since 1987 when the Center's doors first opened, climbs into the driver's seat of their white truck and pulls out of UMDNJ- University Hospital's traffic circle to head down the Garden State Parkway to Monmouth Medical Center in southern New Jersey. "Conscientious and a perfectionist, Roger is one of the most experienced lithotripsy technologists in the country," Cruz says. "He is a cautious driver and physicians love to work with him."

Millions of people are biologically prone to develop kidney stones, rock-like masses which form from incompletely metabolized crystals in urine. Stones range in size from a grain of sand to a golf ball, in shape from smooth and round to irregular and jagged, and in chemical composition from calcium salts, struvite, uric acid to the amino acid cystine. They certainly aren't a modern phenomenon and word has it that at least one 7,000-year-old Egyptian mummy showed evidence of kidney stones. One thing is certain: a kidney stone attack can be very painful and any treatment that hastens a cure is always applauded. In the past, sufferers were routinely advised to drink lots of water so the stone would pass naturally out of the kidney, down the ureter and out the urethra, a route that still works fine for small, smooth stones but that could entail days of agony. In the case of larger stones, or those lodged in dangerous positions, surgery was another consideration.

First introduced in the 1980s, lithotripters are able to crush stones non-surgically using shock waves, until all that is left are tiny sand-like particles easily passed in a trip to the bathroom within days after treatment. The procedure requires no overnight hospital stay, can take less than an hour and the newest machines are transportable. This flexibility allows hospitals like Monmouth Medical Center to provide lithotripsy service to patients without the expense of purchasing equipment, says R. Arlyn Rayfield, FACHE, Chief Executive Officer of the Center. "We can also provide an experienced lithotripsy technologist to assist the physician."

After several months of making this journey south, the team carefully sets up the lithotripter in the hallway of The Stone Center the night before, having arrived a little earlier than usual on those Thursday mornings. After loading and strapping it all down in the back of the truck, they drive for one and a half hours. "The sidewalk out front of the hospital is a little bumpy," Cruz admits, "but that's going to be fixed soon." A few bumps are no problem, she says. "Being ready to do whatever it takes just comes naturally for us. We've got WIT."