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Kidney Stones

Pain that's worse than child birth.

You know that pain scale chart that providers show to help assess your pain? Well, you were probably given the abridged version because beyond that red, frowning face labeled "10" is a 1cm kidney stone trying to make its way out of the body. There are few bodily pains that are comparable to mineral deposits of greater than 5mm in diameter pushing against the plumbing system that empties from our kidneys. The only pain comparable is the pain of childbirth. But in a 2017 survey of women who have had both, the majority felt renal colic was by far worse. The childbirth analogy, by the way, is one that gives emergency room providers endless comedic fodder. After several hours of IV fluids, IV morphine and ketorolac, with antiemetics to keep the nausea under control, a stone empties into the urine strainer. “Congratulations! You’ve given birth to a calcium stone!” or “what a big, beautiful uric acid stone you’ve got there,” or worse yet, “you sure they’ve got the same daddy, cuz that struvite sure don’t look anything like the cystine stone you’ve popped out previously.”

So it’s this fear of the indescribable pain and the bad humor that sometimes follows that makes us do everything in our power to prevent kidney stones. We guzzle water throughout the day to increase the urine flow rate and lower the urine solute concentration. We eat plenty of fruits and vegetables because observational studies have found a substantially lower risk of incident stone formation in those with diets rich in potassium. For those of us who tend to give birth to calcium oxalate stones, we eat a normal calcium (but not excessive or more than 1,500 mg per day), low animal protein, low-salt diet. We stay away from vitamin C supplements and avoid foods that contain very large amounts of oxalate like spinach, potatoes, and certain nuts. And if dietary modifications fail, we strategize with our doctors to consider preventative medications specific for our stones. 

But despite our efforts, sometimes, immaculate kidney stone conception just kind of happens. If we are lucky, the mineral blobs will be less than 5mm and will pass without much problem. If we’re not so fortunate, it may be another trip to the emergency department. And if we’re really unlucky, the stone will be 2 cm in diameter. A stone baby of that size (or smaller in many cases) will put us under the care of urologists, who have plenty of neat surgical equipments and good humor to boot.


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