If you’ve never experienced the “joy” that only kidney stones can bring, drop to your knees right now and give thanks. Short of suffering through an entire reading of War and Peace by comedian Gilbert Gottfried, I can’t imagine anything more painful. Recently, I had a doosey.
One moment, you’re cheerfully enjoying life’s simple pleasures – taking a bath with your favorite rubber ducky or walking to the mailbox to collect that winning Publisher’s Clearing House check – only to find yourself suddenly clutching your groin, twirling around in search of some assailant who must have stabbed you with a Bowie knife.
Doubling over in agony, you drop to the ground and flail around like a dying king crab on TV’s Deadliest Catch. You proceed to crawl along the floor, climb over furniture, and twist your writhing body to hopefully (but unsuccessfully) find some position that offers relief.
The cause of this misery is a tiny crystalline mineral deposit, or “stone,” that has formed in your kidney over many months and suddenly decided to make its excruciating passage down the ureter, the ten inch tube that carries urine to the bladder. Until that journey ends, your life will come to a screaming – and I do mean screaming – halt.
While some people are just more genetically prone to kidney stones, for others diet is the culprit (eating too many foods high in oxalates – spinach, tea, chocolate, nuts – and/or not drinking enough water).
Small kidney stones (< 2 mm) will usually pass unnoticed, but problems arise when larger stones (3-4 mm) head south. These stones cause grief because they block the ureter which is only about 3 mm wide, causing the urine to back up. And no good ever comes from stopped up pipes. At this point you will quickly appreciate why narcotics can be our friends.
Even larger stones (> 1 cm) have been known to make a break for freedom, but it’s rather futile. (I imagine that would be like a woman trying to give birth to a water buffalo). These large stones are usually treated by an evil medical procedure known as lipotripsy, to which I was recently subjected.
Under anesthesia, your urologist (whom you may, at various times, want to praise or murder) will blast large stones with sound waves strong enough to crumble the walls of Jericho – hopefully – to atomize them into “sand” so they can easily and painlessly be passed.
But that doesn’t always happen, as I learned.
While I ended up with hundreds of harmless fragmented stones (< 2 mm), some remained larger. And these guys wanted out! One by one, they made their painfully slow journey over several days, leading to numerous ER trips for pain meds (Oh Dilaudid, how great thou art!). This also included two hospital admissions for stent insertion, a truly cringe-worthy medical procedure.
The urinary stent is a thin plastic tube, about ten inches long, which is inserted into the ureter for reasons that I was too delirious to appreciate at the time. The medical folks said it helped maintain the flow of urine into the bladder. But I suspect it merely enables your urologist to increase your medical bill by a factor of 20.
Nor would I be surprised to learn that stents were invented by the vicious 15th century European ruler/torturer, Vlad the Impaler.
Without getting too graphic about stent impalement, there in only one way to get it into the body, and that’s via the bladder into which there is only one obvious entry point. (Guys, your eyes should be watering now).
The good news is that you are completely anesthetized when the stent is inserted; bad news is you are wide awake when they yank the bloody thing out.
So if your doctor ever recommends stent insertion, run – don’t walk – out the office. Change your name, flee to Norway, and hide in an isolated cabin in some distant fjord under a bed with a flagon of narcotics.
Of course, prevention is almost always better than the medical cure. Along these lines, you can take precautions to reduce the risk of developing some kidney stones.
The general medical consensus is to drink lots of water, limit foods that contain oxalates, and reduce salt and calcium intake. Some urologists suggest drinking a little milk with oxalate-rich foods because the milk calcium will bind and remove the oxalate before it gets to the kidney.
So please, be kind to your kidneys. Several times a day, raise a glass (of water) and toast their good health.
Nick Thomas has written for more than 200 magazines and newspapers, including the Washington Post, LA Times, Chicago Tribune, Boston Globe, San Francisco Chronicle, and Christian Science Monitor. He can be reached at firstname.lastname@example.org
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