August 22, 2006 in Features

Water a big help in preventing kidney stones

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Jeffry’s voice woke me. “Stacie, I’m in terrible pain.” He was kneeling at his side of the bed, his arms and head resting on the covers. This is not where a woman expects to find her husband at 3 a.m.

Despite this unusual position, he couldn’t get comfortable. He could barely get himself back in bed. The pain was intense, the worst he’s ever felt.

A trip to the emergency room, a urinalysis and a CT scan gave us the diagnosis: Jeffry had a kidney stone.

It was lodged in his ureter, the tube that goes from the kidney to the bladder, trying to make its way to the outside world. That’s what was causing the pain, because even though the stone was only 3 millimeters in size (about a tenth of an inch) it had some sharp edges, and the ureter was objecting to its presence – strongly and forcefully.

The emergency room doctor sent Jeffry home with a prescription for narcotics, a strainer and instructions to drink LOTS of water.

Jeffry was one of the estimated 1.3 million Americans who seek medical care for kidney stones each year. As a white male, he fits the kidney-stone demographic: 80 percent of stone sufferers are men, and Caucasians are at greater risk than other ethnic groups.

So how did he get that pesky stone?

Our kidneys are marvelous organs. Each day they filter 200 quarts of fluid, returning 198 quarts back to our circulation. The rest ends up as urine, made up mostly of water and urea with a smattering of other compounds, including calcium, the most common component of kidney stones. Normally these minerals and chemicals remain dissolved in the urine. But if there is not enough water to keep them dissolved, or if there is too much of a particular mineral around, crystals may form in the filtering mechanisms of the kidney.

And sometimes, these crystals become large enough to form stones in the kidney.

Resting in the kidney, these stones don’t generally cause any problems. But when they begin to make their way down the ureter, it’s a different story.

Jeffry’s CT scan showed that his 3 millimeter stone was lodged in his ureter, close to the bladder. Stones up to 6 millimeters will usually pass within three days. With the help of lots of fluids and a healthy dosing of pain meds, that sucker passed the next day.

It’s now in the hands of a lab technician, analyzing its contents.

About 10 percent of stones won’t pass on their own and will need to be removed. The most commonly used technique these days, and the least invasive, is called lithotripsy.

Sound waves focused on the stone literally shatter it to pieces, and these remnants can pass easily. Since the procedure can cause some pain, a little dosing with some mind-altering drugs is often called for.

Rarely, a surgery might be necessary to remove a large stone from the kidney if it is causing infection, blocking the flow of urine or causing damage to the kidney.

There are lots of reasons that the minerals in urine can become so concentrated that stones can form. But according to our friendly family urologist, drinking eight to 10 glasses of water a day can help keep stones from forming.

In fact, despite what you’ve heard, this is probably the only medical condition that can be helped by drinking lots of water. Once the stone is there, water can help flush it out.

So I’m playing the dutiful (nagging?) wife, urging Jeffry to increase his water consumption. This is not an easy task.

But if the second stone that tests found lurking in his kidney begins to pass, I think he’ll get the hint. Because I know he won’t want to suffer from that kind of pain a third time.

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