Stoned Again (Renally)

A rocky recurrence sheds light on a growing health concern.

It’s been 20 years since I first felt a certain distinctive, incapacitating pain I have come to know all too well.

I woke up one morning with a sharp, cramping ache in my lower back that I assumed was just muscle strain that would work itself out. But as I showered, dressed, and got ready for my commute, the discomfort continued to intensify until I found myself panting and doubled over. I made it to my car, but just barely.

Taking the wheel, the torment inside me grew blinding, monumental. In my near-delirium, I envisioned the clattering of Continental Army bayonets as my body spasmed with each stabbing sensation. Somehow I made it to the ER, where my immediate assessment seemed insultingly routine: kidney stones.

For the blessedly uninitiated, a kidney stone is a hard lump of minerals and salts that forms inside your urinary tract — basically, a tiny rock that’s grating its way through a system built for liquids. They can be as small as a grain of sand, or, in rare cases, as big as a golf ball.

Imaging soon confirmed the size and location of my particular “renal calculi”; an examination ensured my plumbing was indeed functioning. Nothing left to do but see this jagged interloper out! I was given medication towards this end (along with some for pain), and was sent off with a special strainer to catch the damn thing when it finally made its excruciating exit.

🏆 Worst Club Ever 😭

Misery loves company, as they say, but it brings me no comfort to learn that kidney stones are trending globally, with North America leading the pack. In the 1970s, kidney stones only afflicted about 3% of us; today, that number has more than tripled to 11%. And while the condition historically has mostly affected men, new data shows this gender gap is closing fast.

And it’s not just adults. The Children’s Hospital of Philadelphia now has a leading Pediatric Kidney Stone Center for the diagnosis and treatment of this chronic and growing condition. Childhood cases have doubled in the last 20 years and, more troubling, have consistently increased by 10% every year this last decade.

What’s going on? There seems to be a correlation between kidney stone disease and increasing external factors in the last decades:

• The popular use of certain antibiotics, particularly the sulfas (broad spectrum) antibiotics, which lower urine pH and suppress beneficial bacteria that help control the buildup of lactic acid.
• Obesity — this growing condition tends to create inflammation and high calcium/uric acid levels that can contribute to the formation of stones.
• Diabetes — insulin resistance makes it harder for kidneys to produce ammonium, which affects pH in ways that invite kidney stones. Indeed, if you are one of 37.3 million Americans (and rising!) with diabetes, you’re 60% more likely to experience kidney stones than the general population.

☀️ Bad Influences 🧂

Summer itself is another likely culprit. In warm weather, we go outside, we’re more active, we sweat and maybe get a little dehydrated, which means there’s less fluid in our bodies flushing out our kidneys. So crystals have an easier time forming.

And then on top of this, summer tends to provide a lot of salty, high-protein food choices (hamburgers, hotdogs, cruise buffets, vacation brunch) and some of the heaviest alcohol consumption happens this time of year too. All this stuff stresses our kidneys, and invites stony complications.

The feeling of a calculi moving from inner kidney through the urinary tract and out the ureter has been compared to natural childbirth — although I cannot attest to this personally. For me, it’s more like sitting on a chainsaw full of gas. There’s a sense of panic with this pain, it’s a whole-body upheaval that feels unhinged, intrusive, and beyond imagination: What is happening?!

⚡Make It Stop 🚫

Once you experience it, you’ll do anything to avoid a recurrence. For kidney stones, the best prevention is to stay hydrated with 13 8-ounce glasses every day. It’s also a good idea to limit salt and protein, which induce kidneys to excrete stone-producing byproducts. Avoid cola, which contains phosphoric acid and drink lemon/lime water instead (the citrate helps break down crystals before they make stones).

For some of us though, kidney stones are hereditary, and our bodies are just genetically predisposed to making them. Lucky us! After the first onset, I had 15 blissful years before the affliction returned during the COVID shutdown. Now, every back twinge reminds me that the next attack could launch at any time.

And here we are. As I am typing this, another gravelly rascal is inching its way through my left ureter. It can take as long as six weeks for a stone to pass, and at this point I’m  feeling equal parts resigned and hopeful. It’s kind of like having a bad houseguest  — you can’t always stop them from showing up, but you can at least look forward to seeing them out.

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