Kidney Stones: A Beginner’s Guide…

Personal Health Update

I wasn’t exactly handed a winning ticket at the Genetic Lottery. As a kid, it would have taken less time to list the parts that did work as they should have. But things got under control and I am generally fine these days1.

However, God personally hates me and wants to make sure I know it. Which is why I belong to the statistically improbable demographic of young people with recurring kidney stone problems despite relatively healthy dietary habits2.

On a nearly regular basis, about once every two years, I get to enjoy the pain of childbirth, minus naming process and postpartum hormones rush.

On the plus side, with the years, the routine has started to take the edge off (or I am developing a much higher tolerance to pain): when a stone episode strikes, nowadays, I just casually recoil in a fetal position for a couple hours at a time while waiting for it to pass after a week or so; years ago: I would longingly stare at a kitchen knife while considering my options for self-surgery on the spot.

The other good thing is that I have learned to recognise early symptoms (as well as the time they are likely to occur: mine always happen in Winter, for no reason any specialist has ever been able to explain satisfyingly), which helps preventing me from making bad decisions… such as embarking on a 15 hour trip home to San Francisco from Paris via London (aka: the Story of my First Stone). Testament to the good old pre-911 days: when some security guy at Heathrow noticed the sweaty, grimacing guy waiting for his plane, went and asked “Sir, I must ask you: have you been consuming any drugs?” and got a near-hysterical answer of “No, but if you have any, I’ll take them!” through gritted teeth… he just walked away as he came.

These days, once the chest pain shows up, I would know better than trying to lob it with, for sole comfort, 2 aspirins and a cup of boiling hot tea purchased on the Eurostar.

Three days into the current episode, I finally went for a consultation at my nearby hospital: a CT scan confirmed the obvious and I was sent on my way with the usual advices and a couple prescription drugs.

Incidentally: I paid ¥5,000 (less than $50) for a full consultation and a CT scan, both of which took a grand total of 40 minutes, from the moment I stepped into my neighbourhood clinic. The actual cost, pre-universal-coverage, was ¥19,000, or about $200 (for that money, a US CT technician won’t even spit on you): dear US readers, aren’t you glad you live in a country gloriously free of such pesky Universal Healthcare and reasonable health costs.

Anyway, all that to say that I am slightly incapacitated at the moment, and lagging on communication (although oddly productive on whatever I manage to put my mind to, in between two bouts of holding my abdomen, wondering if downing a bottle of Draino might help). It will get better and I’ll catch up on email and everything, soon (i.e. anywhere from next week to next year).

That’s it for the immediate personal health update. Everybody with a normally working pair of kidneys and zero interest in the practice of hobbyist medicine at home can (and should) stop reading right now. Trust me, there’s nothing interesting under the fold.

Kidney Stones remedies

Like anybody confronted to their 4th or 5th stone in a decade, I have collected a good deal of empirical knowledge on the issue. It also helped that the first two episodes happened outside of the realm of modern medical medicine: the magic of timing, transatlantic flights and insurrance-less lulls between [proper] jobs in the land of proudly unaffordable healthcare3.

Googling and webbing of all stone-related issues tends to yield a mix of obvious, factual and completely moronic/batshit insane advices. With a recurring theme being the product-pushing agenda of the websites giving said advice. In light of this, I figured I would compile a few of my anecdotal findings on the matter, for the sake of the odd Google seeker who may end up here.

Note that:

1. I am not a doctor (unless you count that honorary degree in Love Potion and Curse Healing from Kinshasa’s University of Black Magic). I shouldn’t even have to tell you to consult with a professional, before anything else4. Once you have seen a physician, received a diagnostic, commiserating pat on the head, painkiller prescription (and little useful else): feel free to come back here.

2. These aren’t tips to prevent reoccurrence of stones. I’ll let you google/consult for these. Although, they may not always do the trick (take it from somebody who’s been drinking liters of water a day and depriving himself of chocolate for the past few years, and yet is currently contemplating removing the coating from his painkillers to try and snort them for faster absorption).

3. The focus here is on things that will help you deal with pain (and, possibly, but with absolutely no guarantee, help pass the stone faster… on the assumption that not wriggling in pain and spams, helps smooth the descent).

4. Any [already questionable] advice contained here applies only to calcium oxalate crystals (you know, the cool spiky-looking ones that seem designed to tear your insides while clawing their way out). Some might work for other types of stones, but no guarantee here.

That being said, and before going into things that work, let’s start with:

Things that don’t work

Cranberry juice and all other bullshit herbal grandma remedies. Not because they are bullshit herbal grandma remedies with usually zero evidence-based medical results, but because they all apply to a completely unrelated issue. Kidney stones (calcium oxalate ones, that is) aren’t UTI, nor even caused by UTI and rarely have anything to do with UTI. Whatever anecdotal health benefit cranberry juice (and dozens other Flower Power remedies) may have, are entirely geared at UTIs. Drinking cranberry juice while passing a stone has been proved to help, only insofar as drinking any fluid helps. So feel free to replace cranberry juice by gallons of gin&tonic and call it a family remedy: your chances are the same.

Things that work

Water goes without saying. Gallons and gallons of it. All the time, all day long. That stone isn’t gonna carry itself down (that being said, if/when your kidney shows sign of excessive straining on echo or CT scans, lots of water might no longer be a good idea: that’s what your doctor’s advices are for).

Painkillers obviously work. Although if you have tried, you already know that even the strongest painkillers have a very limited effect, in time and in strength. Dosage increases will barely help. And unless you fancy a life of addiction to opiates, they are rarely a good idea. NSAID are the standard fare (also: they are easier to keep on the stomach than opiates, which helps if you aren’t hooked to an IV feed). I have found antispasmodics to be more helpful in the long term (less direct pain relief, but less cramping, which is precisely the point).
Anyway, no real point discussing pharmaceuticals here: you will need a prescription (or a very good dealer), that, again, is what your family doctor is for.

Cannabis. Yep, herbal remedies aren’t completely useless after all. Surprisingly enough, medical cannabis isn’t just a hoax pulled by aging Californian hippies trying to ensure good-quality supplies at cheap price: there’s a reason cancer patients are told to smoke some reefer.
In addition to being a powerful analgesic, cannabinoids have antispasmodic and muscle-relaxant properties, which is precisely what your strained tubes need (less spasm/constriction = less friction = less pain). Trust me5, it works well. And if it doesn’t, you can always just put on some Bob Marley records and bob your head to it until you forget all your troubles (just kidding).

Of course, were you to choose the weedy path of natural remedies, you should probably avoid living in a country where possession of any drugs (that are not tobacco or alcohol) is a crime on par with killing kittens or having sex with underage schoolgirls6.

Which leaves you with:

Heating pads. No joke.
Heating pads (preferably the strong, chemical kind, universally available in Japan, where they are known as ‘kairo’) are a real life-saver. Staying warm is key: keeping one or two strong heating pads over your lower abdomen at all time, greatly helps with the background pain and seems to lower the recurrence of acute pain episodes. During last year’s episode, I was able to be nearly functional for three weeks, including a (very sober) New Year’s Eve party, patiently waiting for my two stones to go down their merry way7.
If you live in Japan (or another country where these awesome little pads are easily available), go to your nearest pharmacy and buy a few hundreds. If you don’t:

Hot baths are an obvious piece of advice. But just in case you had not noticed yet: dipping into near-boiling water at regular intervals will do miracles to subdue the pain. Just make sure not to get cold chills when you get out.

Things that Might Work

For pain management, the doctor at my local Japanese clinic only prescribed antispasmodics and told me to come back if I needed stronger (which didn’t bother me much, considering how little effect stronger meds usually have anyway).

Along with the antispasmodics, was a prescription for a slightly stranger medication called Urocalun, which turned out to be a rather Japan-specific drug, based on some plant extract (yes: another herbal remedy, but this one comes with somewhat scientific studies attached, rather than your crazy grandmother’s aunt recommendation). Most salient research papers I could find on the topic are in Japanese and only appeared in domestic publications (as is unfortunately typical of a vast amount of Japanese research) where methodologies are, ahem, not always of the highest scientific grade, or sometimes feature downright bizarre ideas (rope jumping as a way to pass stones, anybody?). More importantly, it is not always clear whether Urocalun is only effective as a preventive treatment or can also help during acute episodes.

But at least, there seems to be some scientific basis going for it (which is more than lots of pseudoscientific remedies like homeopathy ever had) and is the first I ever hear of a widely distributed drug treatment for kidney stones (other than palliative, that is). I have the tablets and will be taking them religiously for the next few weeks, we’ll see if it helps.

  1. beside that violent twitching on the left side of my face and the regular furball coughing, that is []
  2. people in their twenties who barely drink a can of coke a month aren’t supposed to get kidney stones, let alone chronic ones []
  3. needless to say: in between years of fully covered, perfect health… try to tell me God doesn’t have it in for me, after that []
  4. frankly, if you hadn’t figured that for yourself, you shouldn’t have the IQ required to operate a computer []
  5. err, I mean: trust my good friend who tried once, officer []
  6. just kidding, of course: the latter is perfectly OK and barely frowned upon by Japanese society, provided you are a well-off middle-aged businessman who doesn’t mind buying them Hello Kitty toys in return []
  7. or, more exactly: until a very nasty surgical device was inserted to bring them out once it was realised they wouldn’t come out on their own, but that’s beside the point []

16 comments

  1. I’m sorry that you’re suffering..but keep informing us..thanks
    i don’t know much about kidney but i want to tell you that God himself told me to tell you that He does loves you VERY MUCH!
    welcome to my almost daily updated home at this site and be well-entertained: )

  2. Btw, i learnt a lot of the english language and your witted, quoi-genius comments on life and religions, and i’m really thankful! -i hope there would be something that you also find funny sharing in my site.
    did you know? last night i clicked on an email who says i’ve got their lottery and acutally believed it and went to the bank and deposit my money(as insurance) at 2o’clock a.m. on my bike..i shall receive my bonus and my laptop within tomorrow -i’ll surely keep updated!
    cheers.

  3. Thanks for that – I just dropped by, purely coincidentally, after a night of excessive pain myself and am glad I’m not the only one who thinks longingly of self-surgery. I hope you continue to feel better. Even though God clearly doesn’t think you’re a *complete* bastard – otherwise you WOULD be in the States and get billed 3k without receiving any real medical assistance. & even in the post 911 dystopia that is the US you can be curled into a ball, sweating through your clothing and looking like a wax statue without security noticing. Although they WILL check your undies to make sure they’re not bombs.

    Feel better man.

  4. I wish I had seen this when I had my first kidney stone. I was seventeen, and the only remedy you listed that I didn’t try was weed. I spent a night in the ER, and finally got some sleep around that second shot of morphine when it actually stopped hurting. (Note: the doctor’s face when he went ‘Wait… are you still in pain? Me: YES!!!!! was pretty funny in retrospect.)
    Anyway, what I’m trying to say is that I’ve felt your pain. I know that one.

  5. Hello Dave, nice to glance through the other areas of your site after registering…. will get back to it. I am waiting for the other shoe to drop re my first not-so-rolling stone…… the final cut, as it were/should be. I read about skipping rope to help with the shake-down, but I prefer easy jogging downhill. Hoping you are enjoying yourself more often as not. Regards Robert.

  6. In octber 2011 I drank Soda when I felt the pain in back .
    Usually I used to drink soda with out mixing any thing means no water nothing else full concentrate Soda..
    The very next day it was horrible pain in back side just at the end of the spinal cord .
    I was not able to even walk as due to pain the left leg was stiff and straight.
    Unable to bend the leg , my knee was complete zammed.
    I dot’ t know whats happening as I never felt so much pain.
    I drank lots of water so that it will neutralize the kidney.
    I was sure that something happened to my kidney due to drinking of soda.
    But believe me the pain was there up to 12 days .

    Then after due to eating Chicken or some masla food I felt same pain.
    I never went to doctor but whatever I eat if pain start I stopped taking it second time.
    Like wise 2 months passed in Jan 2012 I had visited to a doctor .
    Who after the Ultra sound and digital x – ray test in KUB area confirmed me that my left kidney urinary pipe has got 0.5 mm kidney stones (calcium deposition ) . more on left kidney and less in right kidney side.
    But I felt pain major in left side.
    Then the treatment started
    Morning I took Kolthi Dal liquid every day
    One tablet of Cystone from Himlaya drugs 2 tablet daily . one morning and one in night for 6 months.
    Also homeopathy medicine “ocimum can Q” liquid 8 drops in a cup of water daily for 3 months.
    Also magnet therapy in back side to reduce pain I took 1 month
    Now after 3 months half pain reduced still 3 months I have to take these medicine.
    Remember during this medicine period lots of gastric will happen so take gastric medicine also.
    In my case lots of small stones were present in kidney so the doctor suggests me to keep on medicine the stone will melt and comes out through urine.

    This is how i cured myself for any further doubt please do write to me.
    [email removed]

  7. 4 weeks and a day and out she popped, After 5 days of initial screaming back pain, a pause, over night bleeding, then about 5 days of mild nausea from the nether regions, 2 weeks of mostly stomach pressure then the final day/ day and a half of a pinch at the end of peeing, a somewhat smooth 5x4x4 mm. stone kerplunked the side of the bowl. Not as bad at the end as I imagined it might have been, suppose I was lucky, but I’ll be sure to ease back on the doubling down of the oxalates, and more regular water drinker, like we all should anyway, right.
    Regards, Robert

  8. @Pravu: that sounds like horrible advice. If there was any link in your comment, I would have straight-up assumed you were a shill spamming on behalf of one of the snake’s oil mentioned in your comment. But I will give you the benefit of the doubt.

    Regardless, your mentions of complete quack remedies, such as homeopathy or “magnet therapy” say everything there is to say about the seriousness of your other “health advices”.

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