The Joys of Kidney Stones

emergency room

ANOTHER Medical Problem — Kidney Stones — that Can Strike Almost Anyone at Anytime, and the Pain is Excruciating

And this time, I was the one who wound up in the hospital. With kidney stones.

Four months ago, in the middle of the heat of an afternoon (my usual time to get out and around), I walked farther than usual going up up the road to pay the electric bill at a mall.

I remember being sort of hot, sweaty and tired, but that’s normal.

I ran that morning, one of my usual High Intensity Interval Training workouts, either four intervals lasting a little over a minute or eight intervals lasting a little over 30 seconds. That is normal for me, and it’s not uncommon for me to do that workout early in the morning, then later walk to everywhere I need to go.

At the mall, I paid the electric bill, had a snack with a cold drink, then entered the supermarket to buy something. While I was in there, I began feeling a slight but persistent twinge of pain in my lower left back.

Maybe I sprained a muscle walking, I figured. However, it began to get worse, so I cut my shopping short. I wanted to get back to my office.

I Could Barely Walk

The pain increased so much I gave up the idea of walking back, and boarded a tricycle. (In the Philippines, that’s a motorcycle with a lightweight frame with a passenger seat attached to the side. Like a Nazi officer staff car, but far smaller and less comfortable.)

The pain cramped me up. I couldn’t just sit, even lying back. I straightened as much as I could, then twisted. I don’t know what the driver must have thought. At least he got me quickly through the traffic, to get of me.

Back in my office, the pain didn’t let up.

I hurled my lunch and snack into the toilet.

That’s the first time I’ve used the world “hurl” as a synonym for “vomit.” It’s appropriate because I didn’t vomit as though I was nauseated. I wasn’t sick to my stomach.

It was as though the matter ejected itself out of my stomach.

I tried to lay down, but then I had to urinate. Only it was as though my prostate (not normally huge) had swollen up like a pumpkin. I stood at the toilet for five minutes, but nothing would come out.

So I’d try to lie back down, but with the extreme pain, I couldn’t relax, and I still wanted to urinate.

The Worst Pain of My Life

In the post about the book on shoulder pain, I said the pain I felt when I first hung by my hands to fix my shoulder pain was the most intense of my life.

And that’s true. It was the most intense. But at least it was under my control. After four or five seconds of enduring it, I dropped down.

The pain I felt in my lower left back that afternoon was the worst I ever felt because nothing I could do would relieve it.

And Just When I Thought It Couldn’t Get Worse

The urine I finally released was pink.

Now I’m afraid.

Pain deep inside my left abdomen. Did that mean I had appendicitis? I tried to remember which side the appendix is on, but couldn’t.

(Later, a doctor at the hospital laughed at me, and reminded me the appendix is on the right side.)

The Tough Guy Admits Defeat

I’m pretty tough, I like to think.

When I had ingrown toe nails, I let them grow out through the tops of my toes. I think I shocked the podiatrist when I finally went to one. “Didn’t they hurt?” she asked.

Sure, especially since I spent several hours in the evening and many hours on Saturday and Sunday walking around St. Louis selling cable TV door-to-door.

But I Hate to Go to Doctors and Hospitals

When I was two years old, I was admitted to the hospital to have my tonsils and adenoids cut out. It was a standard thing doctors did to us baby boomers.

But after that I’d never been a hospital inpatient, a sixty-year record I’m proud of.

When I had pneumonia a few years ago, I just took the antibiotics they gave me, and slept as much as possible considering I was working 70+ hours a week at my two jobs.

I admit I’ve been lucky. As a kid, somehow, I never broke any bones. Even my sister broke her collar bone. I played sports, including tackle football without equipment, jumped off the roof of my house, ran around in the woods, clambered up and down the Mississippi River bluffs, rode my bicycle around town and climbed lots of trees.

I never even fell out of a tree. Once I was sitting on a branch that broke, so I did fall, but not “out” of the tree. It startled me to hit the ground when I’d been sitting on the branch a split-second earlier, but I wasn’t hurt.

Anyway, I’m generally healthy. Overweight, but not as much as most people my age. I wasn’t planning to break my record of staying out of hospitals for over sixty years.

That Kidney Stone Broke Me

Not having ever experienced anything like it, the pain made me decide I better give up and go into a hospital.

I grabbed my cell phone, but I didn’t have any time (which you have to prepay here.) I’m not sure what happens. I used to buy it, and it’d last forever. Lately when I buy load, it’s gone a week later, so I stopped buying it.

I could have looked up someone’s phone number and used my office landline phone that comes with my DSL service, but I didn’t think of it. Too much pain.

Like the Cavalry, My Niece Rode to My Rescue

That’s when my niece showed up, right in the nick of time. Within a minute I was riding to the hospital, and went right in to Mary Mediatrix Hospital’s Emergency Room.

I’ve visited older hospitals in The Philippines where I would hate to spend much time. Mary Mediatrix is fairly modern, with some nice private rooms. And the Emergency Room was brand new, bigger than the old one.

The Agony Didn’t Stop for Several Hours

It didn’t take them long to let me know I had a kidney stone. I was still afraid of appendicitis or some kind of horrible infection.

I did have an infected kidney. The stone irritated my bladder, which was why I had to urinate about every five seconds. I guess it tore something inside on its way from the kidney to the bladder, causing the blood in my urine.

A doctor told I threw up because of the severe pain. That explains why it felt so weird. I was in extreme pain that was in my abdominal area, but not in the general way I associate with ordinary stomach nausea.

They took x-rays and an ultrasound, and gave me pain pills as well as an antibiotic via IV.

My niece, my godson and his wife stayed with in the room with me. In The Philippines, nobody stays alone in the hospital.

The next day, they wanted me to have a CT scan and remain overnight again, but I’d had enough. I no longer had pain, and wanted to return to work.

Against their wills, my urologist and doctor of internal medicine let me go.

Later, I learned my urologist had had them himself, but tried for a week to get by without checking himself into the hospital. (He and his wife are my landlords. She’s a pediatrician with her office on the first floor of this building, so I spoke with her a few days later.)

Some Say Kidney Stones are More Painful Than Pregnancy

She said, based on how he suffered, they hurt worse than pregnancy.

Never having been pregnant, I can’t comment on that comparison. I will say, though, the pain they cause must vary.

My urologist apparently carried on with his life while in pain. I was simply not functional. If I had such pain again, I wouldn’t run to the hospital, now knowing what it was, but I couldn’t work either.

I Ignored My First Appointments a Week Later

I was supposed to return to the internal medicine doctor and to the urologist and get a CT scan.

I waited a second week.

The CT scan showed I had still another pebble almost ready to go into my bladder.

It looked large on the scan, but I never felt it. I did see blood in my urine again one day after running, but that was it.

What Causes Them

They are hard, crystalline material that form within kidneys and urinary tracts. The medical term is nephrolithiasis

Most of them happen to people between the ages of 20 and 40, so me getting the first one at age 63 is apparently unusual. If you have one, you’re more likely to have others. Oh, joy, is that something I look forward to.

They are more common in men than in women. However, some pregnant women get them too.

The stones can be formed from various substances, but calcium, with oxalate or phosphate, are the most common type. I never saw or captured mine, so they didn’t get tested.

I Google Kidney Stones and Intermittent Fasting

I had a vague memory of having once seen kidney stones listed as a risk of intermittent fasting, so I googled that.

At that point I’d been fasting intermittently for about a year, using the two 24-hour fasting periods per week advocated by Brad Pilon in Eat Stop Eat. Could that have anything to do with my kidney stones? I wondered. I never got them when I ate every day.

I found a lot of entries, but almost all of them concerned the Middle East. It’s known as the “Kidney Stone Belt” for three reasons:

1. It’s a hot and dry climate. It’s easy for people there to become dehydrated.

2. Devout Muslims spend the month of Ramadan dry fasting from sun-up to sun-down. That means they not only abstain from food during the daylight hours, but from water as well. That encourages dehydration, especially when they’re already living in a hot, dry climate.

3. The typical diet there is lower in calcium and higher oxalic acid.

I Thought I was Drinking Enough Water

This is what gripes me. It’s not like I tried to go without water.

Years ago, Agora ran a famous magalog package for its Real Health Breakthroughs newsletter from Dr. William Campbell Douglass II, with the headline, “I Haven’t had a Glass of Water in 20 Years.”

It worked so well because so many people advocate we all drink eight glasses of water or more a day, and here was an alternative health doctor saying he hadn’t had a glass of water in 20 years.

He must live in air conditioning, is all I can say.

I don’t try to force 8 or more glasses down my throat every day, but I drink when I’m thirsty, and yet I still developed kidney stones.

According to the pamphlet the hospital gave me, eating too much oxalic acid can also cause them. When I visit the United States, I eat a lot of spinach in my Subway salads, but there are none here in The Philippines, at least around here.

A List of Possible Causes:

* Hypercalciriuria is an inherited condition that causes too much calcium to be in your blood

* Inherited metabolic conditions such as cystinuria and hyperoxaluria

I must not have any inherited condition, or I would have had kidney stones a lot earlier in life.

* Kidney diseases

* Diabetes

* High blood pressure

* Crohn’s disease

* Gout – increases uric acid in the blood

* Hyperparathyroidism

* Inflammatory bowel disease

* Intestinal bypass surgery

* Such medications as diuretics, antacids, calcium-channel blockers, alpha blockers and protease inhibitors (used to treat AIDS)

I don’t have these medical conditions, never has bypass surgery and don’t take any medications on an on-going basis.

* Eating unfermented soy products

* Overconsumption of beer

* Diet high in refined sodium chloride (I could be wrong, but I’m assuming sea salt would not be as risky.)

* Excessive sugar consumption (I’m guilty of this sometimes, but have been all my life. And have reduced my sugar consumption a lot.)

* Overconsumption of Vitamin D. I’m skeptical of this. I do take Vitamin D, but used to take more than now, without getting any kidney stones.)

* Excessive intake of foods high oxalic acid such as spinach, beet greens, chocolate, Swiss chard, cashews, soy products, rhubarb and peanuts

* Excessive intake of animal protein

* Overconsumption of apple and grapefruit juice

* Low levels of eating calcium

* Overconsumption of high fructose corn syrup, which is an extremely common sweetener in the American food industry, which all alternative health practitioners will tell you to avoid

* Obesity is associated with higher risk of kidney stones, but perhaps there’s no cause/effect relationship, but eating too much of all those other things causes kidney stones as well as obesity

* Low activity level

I should add here that based on what the research the various foods that cause kidney stones do so only in people who are at risk.

I ate plenty of salt, sugar and meat in my twenties and thirties without ever suspecting the possibility of kidney stones. So I doubt that any of those things causes me to get them now, in my sixties.

Some People Have Them Constantly

Based on my research, some people say they have a lot of kidney stones, which they know from the pain in their lower backs.

I found a lot of interesting videos on YouTube with people giving their “cures” for kidney stones.

How Long Do Kidney Stones Take to Form?

That’s a question I’m still researching. Does anybody know? Does medical science know? I was dehydrated the day I had mine. Did that cause it? But I’ve been dehydrated many times before without ever having kidney stones.

I must have had a pretty large stone that day. Was it really formed in just one day? Or had I been chronically dehydrated? Was dehydration really the cause?

If Ramadan dry fasting causes stones, that’s only a month.

If excess alcohol intake over Christmas to New Year’s causes stones, that’s just a week or so.

Home Care

Medical science doesn’t recognize any home remedy for kidney stones, of course. They wouldn’t if there were a thousand double-blind studies verifying one.

However, they do agree most stones go into the bladder within 48 hours. And they agree it’s good to take plenty of water to encourage that process.

Therefore, if you follow the YouTube videos and drink organic apple cider vinegar and lemon juice, that couldn’t hurt. I doubt taking the olive oil will help, but it is a healthy oil to add to your diet.

After I left the hospital, I fasted for three to four days, a lot longer than normal, but it seemed to help me recover from the infection and irritated urinary tract. And I drank a lot of water in that period.

The Size of Stone Must Matter a Lot

The second stone that I know of, which was detected by the CT scan two weeks after the first, didn’t cause me any pain.

Apparently, it’s quite possible to have kidney stones and pass them out through our urine without knowing it.

My urologist said running can help with this process because the movement shakes the stones loose from the ureter so they fall into the bladder.

Maybe I’ve had a lot of stones I don’t know about. Why did that one grow so large it caused me such severe pain? I don’t know. I don’t think I have any of those inherited diseases. The hospital tested me so I know I don’t have diabetes or high blood pressure. I don’t take any of those medications. I take Vitamin D, but not in excess, and not as much as I used to take. I don’t eat as much as I used to, especially since I began intermittent fasting. And that should reduce the risk of overeating anything. I do indulge in sugar/carbohydrates occasionally, but not for sustained periods.

water and fruit

Drink plenty of water and eat healthy fruits and vegetables

It seems to come back to dehydration. I sweat a lot that day just walking to the mall.

Also, my urologist told me the hospital saw a lot of kidney stone patients early in January because so many men became dehydrated by drinking so much alcohol over the Christmas through New Year’s holidays.

According to Wikipedia, 9% of the United States have had kidney stones. Being overweight is a risk factor. I fess up to that, though with the intermittent fasting my weight is going down.

They also recommend people at risk for them avoid drinking soda because it contains phosphoric acid. I’m sure that’s good advice, but that day I drank my first can of soda in two months.

There were 39 million cases around the world in 2013, with 15,000 fatalities. I wonder what killed those people. Untreated infections? Failure to drink enough water or other fluids?

My urologist also advises drinking fruit juice is good, and so is coconut water. Both are common around here, but I focus on drinking water. Fruit juice is high in sugar. There’s not as much coconut water available from street vendors as I used to see here in The Philippines that’s straight out of the coconut. What’s available in stores and mall stands as soft drinks contains extra sugar.

surgery for large kidney stones

Large kidney stones can require surgical removal

Sometimes Sound Wave Therapy or Surgery are Necessary

If stones are really big, they need help to get out. Hospitals try to dissolve them with sound therapy called extracorporeal shock wave lithotripsy (ESWL). My urologist’s wife told me that helped her husband for a while, but the pain returned.

There’s a procedure called ureteroscopy where the doctor inserts a long tube to take out the stones.

If the stones are big enough, they’ll require surgery (percutaneous nephrolithotomy). I’d rather drink a lot of water.

The Calcium Connection

Studies by the Women’s Health Institute and the Nurses’ Health Study show kidney stones are correlated with women who take supplemental calcium, but that calcium in the diet protects against them.

This seems a contradiction, but I’ve read criticisms of supplemental calcium not coming in the form of food. That’s a subject for another post someday.

Eating more potassium and magnesium protects against kidney stones. Maybe that contributed to my problem.

Remedies on YouTube

I don’t know what to say. I can’t promise you that drinking straight lemon juice followed by lemon juice and water will dissolve your kidney stones.

Yet, it can’t hurt, can it? I mean, lemon juice is healthy. Add stevia and you’ve got lemonade. Some say to add olive oil with the lemon juice.

Same with organic apple cider vinegar (I wouldn’t recommend Heinz nonorganic, which tastes nasty.). I used to buy another brand at a health food store, but the Bragg brand recommended on YouTube is the same, I’m sure. I can even buy it here in The Philippines.

Organic apple cider vinegar has a lot of health benefits. Whether it does anything specific against kidney stones, I can’t say.

The people in those videos didn’t have stones as large as mine, because I was not functional enough to drink something over time.

But consuming healthy liquids is good for you, and no doubt helps to flush the stone or stones into your bladder and out through your urine.

I just watched a video by a bodybuilder who recommends drinking both lemon juice and organic apple cider vinegar in a glass of water (both in the same glass of water) first thing in the morning.

This video had nothing to do with kidney stones, but he claims that’s very alkalinizing and healthy. Sounds interesting, but it must taste terrible. (Add about two tablespoons of the lemon juice and two tablespoons of the apple cider vinegar into an 8-ounce glass of water.)

Was I Low on Magnesium?

According to some sources, kidney stones can come from eating low magnesium. I wonder if that didn’t contribute to my problem. For several years I drank the largest size of Fruitas, basically a local brand of fruit smoothie.

I prefer the avocado and banana. I got half an avocado and a small (by American standards) banana mixed by a blender with crushed ice and some condensed milk.

When avocados were out of season or just plain out of stock, I’d go with strawberries, or mixes of orange or pineapple. Some delicious fruit. I ate one of those every day until early November, then decided I was paying too much to have fruit mixed up with ice.

The trouble is, looking back, I didn’t make enough effort to replace my daily Fruitas with fresh fruit and avocados.

Hence, I ate less magnesium and potassium, and got less hydration from all that crushed ice.

Kidney Stones Could Indicate Higher Heart Attack Risk

If you get calcium stones, that indicates more calcium deposits in your arteries as well, and so that’s an indication of high risk for heart disease.

That’s not what I want to hear, but it’s obviously something I need to pay attention to.

lemon in glass of water

Lemon juice does help prevent kidney stones

Lemon Juice is Good After All, Says Web MD

Maybe the YouTubers have a point. According to an article on Web MD, lemon juice contains large amounts of citrate. This helps prevent kidney stones two ways:

1. It makes your urine less acidic, and therefore less likely to produce stones

2. It binds with the calcium in your urine, thereby reducing the likelihood that calcium will accumulate into stones.

Conclusion?

Kidney stones are not a simple, one-size-fits-all problem. If you have one of those inherited diseases, you definitely need to consult with a doctor.

Much of the advice for preventing them consists of good health advice. Don’t gain too much weight. Remain active. Don’t eat too much animal protein, refined fructose or highly refined salt. Eat more fruits and vegetables.

However, the foods that are high in oxalic acid are healthy: spinach and other dark, leafy vegetables, sweet potatoes, nuts and so on.

Some say don’t take too much Vitamin C and Vitamin D, but they are healthy, and some say the connection is not proven.

Get plenty of moderate exercise. Drink lots of fluids, especially plain water.

Personally, I’m going to see about adding lemon juice to my morning glass of water.

I hope it’s at least another 60 years before I spend another night in the hospital.

References:
http://www.medicinenet.com/kidney_stones/article.htm
http://www.mayoclinic.org/diseases-conditions/kidney-stones/basics/definition/con-20024829
http://www.niddk.nih.gov/health-information/health-topics/urologic-disease/kidney-stones-in-adults/Pages/facts.aspx
http://www.webmd.com/kidney-stones/
http://www.webmd.com/kidney-stones/news/20150130/some-with-kidney-stones-might-have-calcium-buildup-in-blood-vessels-studyhttps://en.wikipedia.org/wiki/Kidney_stone

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Summary
The Joys of Kidney Stones
Article Name
The Joys of Kidney Stones
Description
I discovered the hard way that kidney stones truly are as painful as people say. I spent the first night in the hospital as an inpatient in 60 years.
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