What We Didn’t Know About Kidney Stones

What a week it has been!  We thought my mother had a stomach bug. It turns out she had a kidney stone. According to the National Kidney Foundation, she certainly isn’t alone – each year more than half a million people go to the emergency department for kidney stone problems. I always thought if you had a kidney stone, you’d experience some serious pain. My mother, who is in her early 80s, was nauseous, had discomfort across her belly, and just didn’t feel well at all. After a weekend of little change in her symptoms and increasing weakness, I took her to the doctor’s office. The physician assistant also thought it might a stomach bug, but decided to test her blood and urine just in case it was something else. The tests showed microscopic blood in her urine and a decrease in kidney function. Next, she had a CT scan and lo and behold, the cause of her malaise was a stone far too big to pass on its own, lodged in one of her ureters.

What causes kidney stones?
Kidney stones are hard crystallized deposits that form inside the kidney. While the exact causes aren’t completely understood, stones form because of excess amounts of minerals and other substances in the urine. The substances form tiny crystals that harden over time and gradually grow larger.
They may stay in the kidney or may travel down the urinary tract. Time for a short anatomy lesson: the urinary tract includes the kidneys; the ureters, which are the tubes that connect your kidneys to your bladder; the bladder; and the urethra, which is the tube from the bladder to the outside of your body.

Four types of kidney stones

  • Calcium stone
    This is the most common type of stone and is made up of calcium and oxalate or calcium and phosphate. For example, calcium that is not used by bones and muscles goes to the kidneys where it is excreted in the urine. Stones form if some calcium stays in the kidneys and collects over time.
  • Uric acid stone
    If you eat a high-protein diet, have received chemotherapy, or have gout you may be at risk for this type of stone. It can form if you have too much uric acid in your urine.
  • Struvite stone
    This kind of stone is more common in women and usually forms after a chronic urinary tract infection.
  • Cystine stone
    This is an uncommon stone caused by a rare genetic disorder called cystinuria.

Some risk factors

  • being a man
  • diabetes
  • dehydration or living in a hot climate
  • obesity
  • diet high in protein
  • gout
  • urinary tract infection
  • extreme stress
  • being bedridden
  • high blood pressure
  • family or past history of kidney stones
  • sedentary lifestyle

Common symptoms

  • severe pain on either side of your lower back
  • vague pain or stomach ache that doesn’t go away
  • blood in the urine
  • nausea or vomiting
  • fever and chills
  • urine that smells bad or looks cloudy
  • extreme exhaustion

Treatment
Most kidney stones eventually pass on their own, but because it can be a painful process anti-inflammatory and pain medications may be necessary.  Lithotripsy, a procedure that uses shock waves to break a large stone into smaller pieces can also be used. In my mother’s case, lithotripsy wasn’t an option and the stone was too big to pass on its own. It had to be removed because it was blocking the flow of urine and causing it to back up into the kidney. Instead the urologist did a cystoscopy – he threaded a tiny scope into the bladder and up into the ureter. Using a laser, he zapped the stone into small fragments that could easily pass. The procedure was done in the operating room, under general anesthesia.

Preventing kidney stones
My mother’s stone appears to be the common variety, made of calcium and oxalate. To prevent future stones, she will need to drink lots and lots of water. She may also have to cut back on certain foods such as her one and only addiction: chocolate! We have to wait for an analysis of her stone to know for sure what she should and shouldn’t eat.

By the next morning, my mother was obviously feeling better and although physically weak from the ordeal, her spirit and sense of humor had returned. She is home now and definitely on the mend!