Okay, there are probably a thousand other things that hurt worse than kidney stones, but I personally haven’t experienced those thousand other things. Although most common in men, some of the women who’ve both given birth and had kidney stone episodes say they’d much rather deliver a baby.
What’s this got to do with writing thriller novels, my new “The E Z Knight Reports” series, BRAINSTORM, DEAD RECKONING or JEZEBEL? Very little–except…well, you’ll see if you read further.
The newly crowned 2012 American Idol winner Phillip Phillips (and now Motley Crue’s Vince Neil, as well) has had a few bouts with kidney stones, as well. He seems to be a really good guy and a great singer. I hope he can gain control of these troublesome “little” things and they don’t get in the way of his career. From news accounts, I’d guess he has what is known as medullary sponge kidneys (MSK), not a disease, but a condition in which the passages in the kidneys are larger than normal, and thus allow for sediment to build up and create stones. If he is cursed with this condition, he has company.
I was diagnosed with MSK back in 1991 when x-rays revealed that I had over two dozen stones in my kidneys. I had a number of stones before that, and have had literally hundreds since. After numerous lithotripsy surgeries of various types, I’ve finally gotten this condition somewhat under control. Lithotripsy surgery doesn’t cure stones, it just removes them. Most times, these procedures are out-patient, occasionally requiring an over-night stay in the hospital ($30,000+).
For this procedure, they’ll either:
1. make a small incision and go after the stone (rarely done anymore from what I’ve read—and a little more extended hospital stay can be expected);
2. go after the stone with a long, thin catheter-type tool that has a tiny water nozzle, some tiny extractor arms and a camera on it (don’t worry, it’s not a 35 mm—all that stuff is really quite small). This is neat to watch as the camera passes through your body (but hey, this is personal stuff—make them promise the video won’t be posted on YouTube the next day!);
3. blast the stones with sonic waves (extracorporeal shock wave lithotripsy or ESWL). They’ll either put you out or use a drug called versed. They’ll tell you versed won’t put you to sleep in order to keep you from feeling the pain. Instead with versed, you just won’t remember the pain you have! I don’t know about you, but this makes me feel a bit uncomfortable — lying naked and in pain on a table, surrounded by people in masks, all the while being video-taped. If there’s ever a porn movie made from it, I want royalties!
If you’re lucky, you won’t need a stent—a tube that is temporarily inserted into the ureter on the affected side that makes the passageway larger so that the bigger stones and particles will pass more easily. These things will make you howl–hurt nearly as bad as the stone would when you go pee (I happen to be a freak with two ureters on my right side–which doubles the fun with stents inserted into both). Then you have to come back a month later and have the stent yanked out (and I do mean yanked).
When you have the first stone, you might think you’re dying (click here for symptoms)—especially if you don’t know what’s happening to your body. Don’t worry, you’ll probably live. Following that first one, it gets a little easier for the sole reason that you know what’s twisting your gut so badly. After passing a couple dozen, it becomes somewhat routine. When you’ve passed a couple hundred, with the help of the right pain reliever and/or nausea medication, it’s barely more than a mild inconvenience.
Many folks think that the pain is only in the passing of the stone when it leaves the body. For some crazy reason, they think that the only time you feel the pain is when it shoots through the urethra (penis if you prefer, guys). This is relatively painless compared to the dull but intense ache some sufferers feel in the back and flank, or the intense twisting agony most experience in the lower gut.
Something to watch out and be prepared for: some radiologists will tell you that you won’t feel back pain from a stone because the kidney doesn’t have the right nerve receptors, or some such nonsense. DON’T believe them! Although some stone sufferers never experience this discomfort, you might. The back pain isn’t from the kidney itself, but from the tissue surrounding it due to the kidney lobes swelling and adding pressure to that entire area of the back (can you guess that I’ve been told this before and that it really “pisses” me off?).
There are a number of different types of kidney stones and they’re formed by different things. The most common are the calcium type, followed by uric acid stones and several others. Diet is really the key to controlling these little bastards. Drinking lots of water is imperative with any type of kidney stone, as well.
Specifically for uric acid stones, what I understand the best thing you can do to reduce stone formation is to cut down on your animal protein intake—especially red meat (I know, guys and gals—ARGH!).
With the mean little sticker-bur calcium stones, reducing oxalates is the key (oxa-what?). Yeah, oxalates. This salt compound binds with the calcium being filtered out by your kidneys in order to pass from your body in your urine. Oxalates cause calcium to build up, eventually looking something like a very horny little quartz rock.
Generally, anything larger than 5 mm (about 3/16″) won’t pass without surgery. But even the tiniest of stones can cause you just as much trouble as the bigger ones that pass. They’ll scrape the lining of your ureter and may even block it. This creates pressure in the vessel from the build up of urine, stretching the canal and causing colic (spasms) that will…well, let’s say “rock” your world.
Here’s the problem with trying to limit oxalate intake. Oxalates are in all the good food you eat! That’s right, you can watch your diet and eat healthy according to most medical standards and still be literally plagued with kidney stones. Why? Because that healthy diet isn’t necessarily the best diet for calcium kidney stone sufferers.
Get this: oxalates are in chocolate (damn it!). They’re in nuts (sorry, I can’t help it: “nuts!”). They’re in spinach (okay, no big deal—just kidding, moms!). They’re in berries, many green vegetables, all kinds of really good and healthy food!
From over twenty years’ experience of dealing with these little hell-raisers, here’s my suggestions for if you suspect you’re having symptoms of a kidney stone passing, or think you might have MSK:
1. See a doctor, but not just any ol’ MD. Find a good urologist (pee-pee doctor) to take a look at your parts, as well as a good nephrologist (kidney specialist), who can tell you more about what kind of diet you need to follow.
2. If you’re diagnosed with calcium stones, and he/she doesn’t’ prescribe potassium citrate, ask for it—it truly works wonders for calcium stones. There are other meds like allopurinol and hydrochlorothiazide (a diuretic that makes you pee a lot), that might be prescribed as well. If you need pain meds, they’ll probably give you some kind of opiate like hydrocodone, oxycodone or Lortab as well. If you get sick from the stone pain, like many do, ask for ondansetron (generic for Zofran)—I’d much rather have the pain than that damn nausea.
3. Drink tons of water! Revised: But not just any water. Only drink purified water WITHOUT “minerals added for taste”. It’s those minerals you want to stay away from in the first place. Aquafina (this is not a commercial–and I don’t get paid for this mention!) is one of the many brands that don’t add minerals.
4. If you have calcium stones, learn how to identify foods with high levels of oxalates and limit your intake. If you have uric acid stones, lay off the red meat.
5. Okay, here’s a no-brainer, but since I obviously went without a brain for nearly twenty years until I did the ol’ V-8 slap…don’t drink cranberry juice. If you’ve been diagnosed as a calcium stone former, it might just be the worst thing you could do! Yes, I thought the little bit of oxalate in cranberry juice wouldn’t hurt me, and that the positive effect of drinking kidney-healthy cranberry juice would far outweigh the oxalate concerns in cranberries. WRONG! I’ve had stones, sometimes as many as two or more a week for over twenty years.
a. I drank cranberry juice about that long because I thought it’d help keep my kidneys healthy and happy considering all the Hell that the stones were putting them through. A few months ago, I ran out of cranberry juice and kept forgetting to get more on shopping trips to the store. I went for a week without the cranberry juice that I had been drinking at least twice a day. No stones. I went for a month without it. No stones. It’s been four or five months now and, although I have had some minor flare-ups since, there hasn’t been nearly as many as I had before I went cold cranberry—er, uh, turkey.
b. The conclusion? Drink more orange juice and/or lemon juice. The citric acid in these juices help break down and slow calcium stone formation.
So, you say, “What’s all this got to do with fiction writing, novel-writing, thrillers, etc.?” Well, guess what condition I’m going to give my protagonist E Z Knight from my new men’s action/adventure thriller series? That’s right! He’s going to suffer from MSK right along with me! Coming out in June in Knight’s Big Easy, tough-as-a-starving-grizzly-bear E Z Knight is going to be given kidney stones by a very wicked Voodoo queen.
I ain’t no doctor…(but I’ve written in their POV before, and it’s very scary), so don’t believe me or follow any of my advice without consulting your own physician. And, for a much more in-depth look at this condition and what you can do to reduce or maybe even eliminate kidney stone troubles, check out the resources below.
Books: No More Kidney Stones (this is my favorite), but Amazon lists a whole bunch here: (click!)
Websites: You’ll find a number of really good sites here: (click!)
Gordon A Kessler: Author of Thriller, Suspense & Mystery 