“Keep an eye on her symptoms and temperature.” Believe me, I am. She’s been practically in the same room with me except when she’s sleeping in her bedroom at night ever since we went to the ER (except for four hours when she went with her friends to go stand in line at school - a mile down the road - to get their parking assignments). Her Dad is in CA helping with the fires and her sister went to college last week so it’s just the two of us in the house right now.
She also had a complication of getting a nasty looking rash on her inner elbow a couple of days after the ER visit. First I freaked out thinking it was an allergy to the pain meds and didn’t know whether to give her a benadryl (additional sedation - not good). Then I figured out that it was in the same area where the nurse scrubbed her with antiseptic for her IV in the ER. Did some research on that, and found out that she was most likely allergic to chlorhexidine, which some hospitals are using instead of alcohol. Confirmed that the ER did in fact use Chlorhexidine. Six days later, she still looks like she has a bad case of poison ivy on that arm, but it’s finally looking like it’s going away. So yeah, lots of attention going to this kiddo.
I’m also not encouraging her to be brave - I’m actually babying her and getting away with it because I can with the rest of the fam out of the house! The only time I’ve been strict with her is about the Percocet. I made it clear that she has to be honest with me about the pain she’s in because I can’t give her a narcotic every time she has a little twinge. I feel like she’s been very good about letting me know when she needs her pain managed and the best way to manage it (whether she needs a Percocet or OTC med).
And yes, she’s straining her pee - she has a strainer both upstairs and downstairs, but I doubt anything is going to move until the stone is broken up during the procedure. The Dr. has already talked to me about the different types of stones and that we’ll find out what we need to do (if anything) about her diet after the procedure. Some types of stones don’t have anything to do with diet. She’s Asian and thus more susceptible to stones according to my research.
Thanks again for all the comments and well wishes. She wants me to go snuggle with her (no pain, just wants more attention ) and watch TV so I’ll check back later.
I have passed 8mm stones several times along with one whopping 10mm or so the to the amazement of several doctors …also gave birth to 3 boys with zero pain relief drugs. But I am also someone who throws up with intense pain. Not a fun time for sure. Tell your D to go with lithotripsy and get it over with. I have never had that since mine have never gotten stuck long enough to actually do lithotripsy. I find I develop stones when my diet significantly changes so had them going off to college, while in Europe, shortly after I married, when I went on my one and only “diet” at age forty and so on so it is good to learn why the Stones form. I end up with a pile of them in one kidney so I pass stones for weeks on end, some big and some I can just barely feel moving through my body and some I don’t feel at all.
Son has had kidney stones at least twice, starting in 7th grade. He had lithotripsy on both sides prior to going off to college, in hopes that he wouldn’t have to deal with stones while there. Wound up going to the emergency room fist semester with a related issue, but hasn’t actually passed stones since.
IIRC, he was black and blue after the procedure, but he wasn’t in terrible pain for days or anything.
“I find I develop stones when my diet significantly changes”^^^
Hmmm… This is interesting. She became a vegetarian about 6 months ago. The Dr. said that a stone that large didn’t grow overnight, but I wonder if it could grow in 6 months? The anti-kidney stone diet calls for reducing meat consumption which she has done by 100% though.
I manage a large urology practice. We advise all patients scheduled for ESWL (lithotripsy)to avoid aspirin and ibuprofen a week prior to the procedure. She should be able to return to school after a few days depending on how well she tolerates stent placement. I am assuming they may need to leave a stent in place to allow safe passage of the broken up stone. They should be able to do stone analysis of the fragments she passes which may help determine the make-up of the stone. If she is a recent vegetarian and eats a lot of spinach that could contribute to stone formation. Spinach is high in oxalates. Also, watch her tea intake because excessive tea is also a culprit. Good luck! I’m glad you are monitoring her temperature closely.
Vegans and vegetarians can develop oxalate stones if the diet contain a lot of high oxalate veggies. How is her calcium intake? Does she eat dairy products?
Well, she’s more of a carbivore than a vegetarian. Small amount of fruits and veggies, and lots of veggiburgers, dairy and carbs. I’ll ask the Dr. to talk to her about that diet disaster.
I don’t think she’ll be getting a stent unless I’m misunderstanding what they’re going to do. I thought that the procedure isn’t invasive? Maybe I’ll have to do some more research on what it entails.
Physician (anesthesiologist) here, retired awhile. Had kidney stones after age 60. Went through the workup, had two kinds. Passed without need for intervention. Learned a few things. The pain is not proportionate to the size of the stone. Small ones can be just as painful as large. Irritation causes the pain and blood. Nausea happens. Going to the hospital not needed except for extra pain relief or fluids if can’t take them in. It IS worse than labor pain, having had both experiences (arguably so).
Diet to prevent stones- researched it a lot. Allopurinol can be useful for uric acid (found in meat). But calcium oxalate stones come from all sorts of good for you vegetarian foods- I researched some sites from major medical places. Add that to my other issues (think about what’s good for you) and basically water seemed to be the diet of choice- but definitely not a viable plan.
Good idea to get this taken care of since the stone won’t pass by itself. Lithotripsy breaks up stones into smaller pieces that will pass.
For the future to prevent more stones from forming. Plenty of water. This means 10 8 ounce glasses each day (I personally count other fluids in this). It is much easier to plan on 5 16 ounce glasses worth. Three with the usual three meals plus two other times works. Fluids in means fluids out. That prevents concentrated urine from sitting in the bladder and forming crystals. Having clear/pale urine indicates getting enough fluids. After awhile getting enough water becomes a habit. btw- emphasize water because other liquids likely will increase the calorie/caffeine/artificial sweetener load more than desirable. A squirt of lemon juice makes plain water more palatable (and is good for kidney stones). This is so much easier than eliminating the dozens of foods with oxalates.
I also found more fluids needed when hot and sweating a lot- like feeling down a quart. It becomes natural to drink a lot more than I did in the past. Easy to tell in the bathroom. Not a lifestyle changer otherwise. IF a medication is need for the common uric acid stones or other less frequent causes it is not expensive or time consuming.
The surgeon will determine the need for a stent et al based on the ureter.
Don’t worry. Straightforward procedure and problem. Getting in the habit of taking more fluids not cumbersome, needing the bathroom more often, well… I read so many articles and found my urologist to not be as up to date regarding diet advice as I would have wished. The chemistry (my undergrad major) of stone formation is basically so much oxalate/uric acid that crystals form. Dilute the urine and that doesn’t happen. Oh, to be more accurate there are reasons most don’t need the extra water. But, you deal with the body you have, not the one others have.
Fresh lemon juice, not bottled, afaik. Urologist told me citric makes the calcium absorb in the stomach rather than pass through to the kidneys, where some will concentrate it into stones. But that still leaves the question of whether one has oxolate stones. The majority are, but the diets are different. Frustrating.
And pain can also depend on whether there are spiky edges to the stone. I did not need a stent.
My doc said Allopurinol is not indicated in all cases. A 24 hour collection can test for uric acid. And what’s easier for some is to use a 16 oz water bottle or container you can carry with you.
One thing I do recommend after is make sure you’re satisfied with the urologist. If you don’t get the info and attentiton you feel she needs, change. But this is later, for the ongoing moitoring.
Real Lemon juice in the bottle works just fine for me (what is afaik?). Doing it for flavor. Lemons not convenient.
Allopurinol changes the uric acid metabolism (oh, those basic science course exams in medical school decades ago)- only useful for that.
Ah- that 24 hour collection. The big orange container kept in the refrigerator so it doesn’t spoil and lots of urine because you know to keep hydrated. Thankfully a one time thing. Very useful, though. I am reminded of why I majored in chemistry and went through medical school. Very interesting to me.
I had my first at age 21, another around 40. Glad you got an appointment soon for her! You can feel fine for a day or two, then it shifts and whammo. The pain is back.
One of mine came about six months after I’d switched to a diet heavy on spinach — was taking spinach salads to work for lunch every day. My doc said that could be a factor, and to cut back on it. I did, only eat it occasionally now, none since. Thought I would mention this, since you said she recently became a vegetarian.
The one I had they were able to analyze was calcium oxalate. Doc told me to avoid calcium supplements— okay to get it in other forms, just not concentrated in a supplement. That is challenging— OTC prenatal vitamins & women’s multi vitamins often have a lot of calcium.
Anyway — good luck to your D, I hope the procedure works and she feels better!
BB, I’m an info hog and the many conflicting resources is why I chose to get a consult with the kidney stone clinic RD LDN who specializes.
An old joke is that a doc’s secretary probably knows more about diet than the doc. Often, it’s not just “what” but when and with what else. “timing the calcium to go with the main oxalate containing foods during the day.”
I’m no expert. There’s so much conflicting info avaialble to the general public- even if you get into the university studies. Ime, overwhelming.
The main idea is simple: calcium “traps” oxalate in the gut preventing oxalate absorption. If it goes through without being absorbed, it does not end in the kidneys. Simple. Quite believable, chemistry-based. Cleveland Clinic confirms.
My son had his first kidney stone in college. He had the horrible pain and nausea. Evidently stones on one side cause more nausea than the other. He now drinks A LOT of water and feels like over the past few years he has passed a few stones. In college he knew where every bathroom on campus was.
Just an update - D’s imaging results were posted on her patient portal today. The stone is 8mm X 5mm sitting vertically. She also has another 2mm X 5mm stone in her kidney which neither the urologist nor the ER Dr. mentioned.
The fact that the diameter is 5mm makes me feel a little better but it doesn’t change anything re her treatment as that size is considered hard to pass also.
She also had fluid build-up in her left kidney and ureter which I was afraid of - I’m assuming that means a near blockage, although the hydronephrosis was labeled as mild for now. When I was doing research on that, I found that this is what causes much of the pain of kidney stones (unless one is unfortunate to have the kind that is spiky). She says her pain feels like a “tightness”, rather than a sharp pain.
) and watch TV so I’ll check back later.