I've got stones!

[trxxyy]

Yep, I had a CT scan and have stones in both my kidneys. I have already had 2 KUB x-rays and the urologist's office just called to tell me that they need me to have another KUB done. Since I seem to be chock full of fecal matter I have been instructed to have an enema before hand, ack!

Anyone here have an enema post-DS? I can't imagine it would be any different after a DS but thought I would ask the DS community first. I would rather drink some grape flavored mag citrate and be a slave to the toilet for 6 hours then give myself an enema but I have never had an enema so I am imagining the worst.

-shelly

[Deleted]

I've not had to have an enema post DS. Had several over the years & I can't imagine the DS would make any difference. Seriously. Where the enema does its job is quite a ways from your re-arranged small intestines.

Having passed two stones since last September, you have my full sympathy.

[Sandra C.]

Hi Shelly,
What are your symptoms, back pain ? Do they have any idea what caused the stones?

I am at the urologist too, for bladder spasms. They think its from the acid of the protein lemonade, and chocolate protein bars, protein hot chocolate, milk allergy to Whey protein and aspartame. Splenda is approved and mint SF Splenda candies( my one vice). I am asking for a blood allergy test before I give up any of my limited methods of getting protein and fluids into me!! My daughter is allergic to milk protein, grapefruit, pecans, peanut butter and chocolate, my son is lactose intolerant. I have always had bad pains from full cream, 1/2 & 1/2, ice cream, and rich cheese.

Stones are really painful when you pass them, I heard. I may have had some a few years ago, since my extreme back pain disappeared suddenly one day, never to return. I wonder what a stone looks like after you pass it, what color? Only reason I ask is I thought I saw something red in the lou. the bladder can be irritated from stones. If I have stones, I can keep my lemonade!!! ;-)--probably not.
More research required on my part I'm afraid. There's always a mystery to be solved!!!

Enemas are not hard to tolerate. You could do a bit of pre enema work with Miralax a few days before the enema to make it easier. I don't think you would be able to reach the area of D.S. surgery, its way up there. All the exterior cuts from my lap surgery are at and above my belly button.
Best of luck for your tests and procedure!!

Sandra ;-)

[Deleted]

You can Google images of stones, but be warned: they ain't pretty. Mine were very dark brownish red. Not very big once out, yet inside they felt like boulders. Yes, they can cause bleeding as they pass on down the urinary tract. Once the stone is passed it can be analyzed for content. I have to collect my urine for 48 hours for another test. Not quite sure the value of it, but since both myPCP and the urologist wants it done, I'll drag my big red bottle to work and collect my pee. So glad I have some degree of privacy there .

[Deleted]

My sympathies. I get mostly little baby stones, have only had one that was ER worthy and none that needed help to pass, but they are bad enough. UGH.

Yeah, I've done the enema thing. It's the same as without the DS. Whether you do a laxative type cleanout or an enema type cleanout (or both) depends on why you're doing it and just HOW cleaned out you need to be.

[Deleted]

Oh duh, hit send too soon.

One clarification with this worry about DS and enema: An enema goes in your colon. Your DS was done on your small intestine. Two very very different locations. It's not just all one tube from stomach to asshole .

[keliblue]

Hello I'm queen of the kidney stones I've been to the ER 4 times in the last 10 years.. this last time was the worst ! It started with lower back pain that got soooo bad you want to scream !! 2am woke the hubby and off to the ER.. this one was 7mm HUGE in kidney stone speak.. and had backed up all the fluids which is potentially lethal..basically i was poisoning myself. ... Long story short 4 days in the hospital, drained my kidney thru a tube in my back, stint put it place then surgery to remove the sucker.... moral of the story.. don't mess with kidney stones, you have to have a LOT of liquide to pass it yourself or an IV drip.. I can handle pain but not this.. many people are pron to stones and take meds to prevent them, most just don't drink enough water daily to flush the sediment from the kidney... it's like a tiny pearl that forms over time, most the size of a grain of sand.. mine was the size of a pc of rice !!

[abright0]

I have been passing a stone a week for over a month now. Back pain that comes and goes, then it moves to the front, the the bladder and the out. Lather, rinse, repeat. I have fibromyalgia and RA so I am on 4-5 roxicodone a day and use that to treat my pain with the stones. Mine are super small, so small they are not always detected on the CT. You have my sympathy, it certainly isn't fun. They have told me on more than one occasion it is caused by calcium deficiency. When it leaches from your bones, it is more likely to bind with oxalate and form a stone. Good luck with yours.

[trxxyy]

I am pretty sure mine are a result of heredity, my dad was constantly being treated for stones and usually ended up have lithotripsy to break them up. I don't think I have passed a stone yet or at least haven't had the pain that others describe as passing a stone.

My issues started last August with flank pain and then blood in my urine. Urgent Care took an x-ray of my kidney but told me it was all clear for stones but that I was dehydrated and sent me on my way with some Cipro. I didn't have any further issues until the last week of December annd having the flank pain again but no other symptoms. I went to a new Urgent Care and the doc there just treated me for UTI with another round of Cipro but no scan or x-ray. He told me to follow up with a Urologist if it didn't get any better.

I decided that I was done dicking around with Urgent Care so the following day I scheduled an appointment with my father's Urologist who he sent me in for CT scan and KUB x-ray. By this time I was having burning issues so he switched me to Macrobid. The CT Scan came back showing stones in both kidneys but he hasn't been able to get a good look via a KUB since I must mass produce shit and I am ruining the x-rays with my busy plumbing. I am no longer in pain and have no other symptoms but I am always worried I am going to "drop" a stone. I feel like I am 9 months pregnant and any second will be going into labor.

I didn't think the enema would be a concern due to the DS. I did find a couple of sites online that instructed to let you doctor know if you recently had bariatric surgery prior to an enema. I also read about internal hemorrhoids, which I have, being an issue but that was only one site. Oh well, looks like I get a fun little saline treat in the next few days. I've been through worse so it is time to suck it up and mark off enema on my "things I hope I never have to do" list.

Thank you all for the feedback
-shelly

[mark540]

Jan 17, 2012 14:58:02 GMT -5 @k9ophile said:

...Once the stone is passed it can be analyzed for content. I have to collect my urine for 48 hours for another test. Not quite sure the value of it, ...

If they know the composition of the stone it is possible to modify the diet to decrease or eliminate stones. I passed a small one once and it hurt!

[bearmom]

I also have a long history of my own, and multi-generational with kidney stones, so I'm gonna paste my page from OH about stones, because it sounds like you are going to have to use everything available to keep them at bay.

As far as the enema, yes I've had one since my DS, and it's not an issue.

Kidney stones

Because I have read so many posts from people who are forming kidney stones, aka renal stones, I'll paste below some info about preventing them that I have collected from my urologist, nephrologist, and the most recent studies.

My family has at least four generations that have been kidney stone formers, and have had at least one related death, and one sister has a medullary sponge kidney, which basically means she makes LOTS of stones, at all times. We currently have 11 stone forming family members trying these things, and while that is certainly not enough for a study, we have had much better results than we have had from past prescriptions. There are several family members who have passed stones about twice per year, every year since 18 years of age, and are now over 80 (AAAARRRGH), and are FINALLY going years at a time without stones, so I'm sticking with these supplements until something better comes along.


My stones are calcium oxalate, which is the most common type. In order to slow the calcium being purged into the kidneys, and to help it bind to the oxalate to move it out via the intestines, I take some calcium carbonate to bind it with every meal, and lots of calcium citrate, as well as vitamin b6, magnesium citrate and potassium citrate. I make sure I drink at least 64 oz of water a day (which you should be if you've had WLS anyway), and if I can get more citrate in any form, such as making lemonade with real lemon juice and splenda, that's even better. Citrate helps prevent stones.

A few more things about drinks:

While I add some lemon juice (about 1/2 cup per 64 oz) to water through the day, I avoid other juices because some (like orange, cranberry and apple) raise oxalates. Grapefruit juice has been linked to stone formation as well, but I'm not sure why.

Drinks with phosphoric acid should be avoided (like colas) because it reduces citrate in the urine, but drinks containing citrate seem to be OK. Wine may also help prevent stones, but not beer or other alcoholic drinks with purines, as those can cause some other types of kidney stones.

Some research has reported a lower risk for stones in people who drink tea and both regular and decaffeinated coffee, but my urologist told me "no tea" to avoid oxalates, so I'm a bit confused about that.

Since I've had the DS, I have some malabsorption that others don't, so I can take much higher doses of many supplements that would be too much for "normal people". I wouldn't add anything more than the typical amounts you can buy at any vitamin store without the OK of your urologist, since some of them such as b6 in too high doses (500 - 2,000 mg daily over long periods) can cause serious stuff like nerve damage. I do take a b6 supplement, but also try to get extra b6 with meats, oily fish, poultry, whole grains, dried fortified cereals, soybeans, avocados, baked potatoes with skins, watermelon, plantains, bananas, peanuts, and brewer's yeast.

I have noticed that in the medical studies, most supplements, especially calcium, are best at preventing stones if you get them naturally in the diet. Sadly, I can only eat so much cheese, peanuts, fish, etc.

Many of these things are the exact opposite of what my doctors were telling me to do only a few years ago, so they are finding out new info regarding kidney stones still. Maybe by next year they will say that chocolate donuts are the perfect food to cure kidney stones, but until then I can dream.

Treatment

Treatment depends on the size and type of stone, the underlying cause, the presence of any urinary infection, and whether the condition recurs. Stones 4 mm and smaller (less than 1/4 inch in diameter) pass without intervention in 90% of cases; those 5–7 mm do so in 50% of cases; and those larger than 7 mm rarely pass without a surgical procedure. Patients are advised to avoid becoming too sedentary, because physical activity, especially walking, can help move a stone.

Medications called alpha blockers have been shown to increase the spontaneous passage of kidney stones, especially smaller stones in the lower ureter near the bladder. These medications have the ability to relax the muscle tension inside the ureter. This relaxation serves to improve spontaneous stone passage rates by about 30%. Examples of alpha blocker medications include tamsulosin (Flomax®), alfuzosin (Uroxatral® ), terazosin (Hytrin® ), and doxazosin (Cardura® ). If you are trying to pass a stone, ask your physician about trying one of these medications.

If possible, the kidney stone is allowed to pass naturally and is collected for analysis. The patient is instructed to strain their urine to obtain the stone(s) for analysis. It is important to analyze the chemical composition of kidney stones to help determine how to prevent recurrent stone formation. The urine may be strained using an aquarium net or another device. Each voiding should be strained until the physician instructs the patient otherwise.

Dietary changes may be required and fluid intake should be increased. Patients with stones must increase their urinary output. Generally, 2000 cc of urine per day (slightly more than 1/2 gallon) is recommended and patients should drink enough water to produce this amount of urine daily. In some cases (e.g., some cystine stone formers), even higher levels of fluid intake are required.

Dietary calcium usually should not be severely restricted. Reducing calcium intake often causes problems with other minerals (e.g., oxalate) and may result in a higher risk for calcium stone disease.

Preventative Testing
The only way to definitively identify the underlying causes for kidney stones is to perform a 24-hour urine collection analysis. This test ideally should be done after the painful kidney stone attack is over and the patient has resumed his or her usual diet and routine activities.

Performing the test is not difficult, but interpretation of the results can be complicated and many physicians have little or no experience in this type of complex laboratory analysis. If possible, try to find a specialist in kidney stone prevention analysis to help or ask your physician about his or her experience in this particular area. If your urologist is not comfortable analyzing this type of test data, ask for a referral to an expert.

Another problem with 24-hour urine testing is the need for long-term compliance by the patient. Most patients start with the best of intentions, but after 6 months or so many patients have given up on their preventive treatments and go back to their old ways.

In order to prevent as many stones as possible, patients must do the 24-hour urine test so the underlying causes can be identified. Then, they must find a physician skilled in this area and follow his or her advice on a long-term basis, even if they don't think it’s helping. Patients with stones are kidney stone formers for life and if preventive treatment is not continued, more stones will begin to form.

Also, even the very best preventive treatment plan may eventually fail. This is not due to bad science, but is due to the fact that preventing kidney stones is fighting against nature. Successful treatment often means not giving up even if an occasional stone develops.

The five most common findings on 24-hour urine tests are hypercalciuria (high urinary calcium), hyperuricosuria (high urinary uric acid), hyperoxaluria (high urinary oxalate), hypocitraturia (low urinary citrate) and low urinary volume.

Hypercalciuria

Thiazides, water pills (diuretics), are sometimes prescribed to reduce high levels of urinary calcium (hypercalciuria) and to increase urinary volume. Salt (sodium) intake needs to be reduced for thiazides to be effective. Patients with hypercalciuria who do not respond to thiazide therapy may be prescribed orthophosphates to reduce calcium absorption and may be given moderate dietary calcium restrictions.

Patients should not reduce their calcium intake unless their physicians advise them to do so. Overly aggressive oral calcium restrictions have been shown to actually increase calcium stone disease. The reason for this is that calcium binds other minerals and chemicals like oxalate in the digestive tract. If the oral calcium intake is too low, then there is no intestinal oxalate binding and the oxalate absorption and urinary excretion increases dramatically. This results in a net increase in kidney stone production.

Hyperuricosuria

Patients with elevated uric acid levels (hyperuricosuria) are advised to reduce excessive dietary meat protein. Potassium citrate (medication that maintains the antacid level in urine) and/or allopurinol (medication that stops the production of uric acid) may also be prescribed. If the blood level of uric acid is high, then allopurinol is usually used. If the stones are pure uric acid stones, then potassium citrate supplementation is generally recommended.

Hyperoxaluria ( I have this, and take extra calcium EVERY TIME I EAT to help bind the oxalates)

Hyperoxaluria (high levels of urinary oxalate) may be mild, enteric, or primary. Mild hyperoxaluria is usually caused by an excess of dietary oxalate (found in tea, chocolate, cola, nuts, and green leafy vegetables). Prevention consists of daily doses of pyridoxine (vitamin B-6), which reduces oxalate excretion, increased fluids, phosphate therapy, and sometimes calcium citrate supplementation.

A low-oxalate, low-fat diet, increased fluid intake, and calcium supplementation is prescribed for enteric hyperoxaluria. This rare condition is often severe and is usually caused by an intestinal disorder (e.g., Crohn's disease, colitis). Calcium citrate, magnesium, iron, and cholestyramine may be given to reduce oxalate levels.

Primary hyperoxaluria is rare, severe, and caused by an inherited liver disorder. Primary hyperoxaluria requires aggressive treatment to prevent severe renal stone disease and kidney failure. High doses of vitamin B-6, orthophosphates, magnesium supplements, and increased fluid intake (to produce 2 liters of urine/day) are prescribed. Rarely, kidney and liver transplants are necessary.

Hypocitraturia ( I also have this, and take Urocit-k, which is like potent potassium citrate, to help keep things dissolved)

Hypocitraturia (low levels of urinary citrate) usually requires a prescribed supplement, such as potassium citrate. The dosage depends on the level of urinary citrate, which is determined initially by the 24-hour urine test but can also be monitored by measuring the urinary antacid level (ph) with special dipsticks. Patients with renal tubular acidosis usually respond particularly well to treatment with prescription potassium citrate supplements. Citrus fruits and lemon juice can also be used as additional sources of natural potassium citrate.

Low Urine Volume

Low urinary volume is both the easiest and the hardest problem to solve. It can be very difficult for many stone patients to significantly increase their fluid level on a daily basis for long periods of time. Increasing fluid intake is the only known remedy that helps all types of stones, regardless of the chemical makeup of the stones.

While increasing fluid intake often is difficult at first, there are some helpful techniques to make the transition easier. First, try drinking a small glass of water, roughly 4 ounces, with each meal. Then, slowly increase the frequency of that extra small glass from mealtimes to in-between and other convenient times.

Follow the 24-hour urine volume—if the volume is close to 2000 cc (roughly ½ gallon), then you are probably doing fine. Once the urinary volume up to where it should be, your system will adjust and you will become used to this increased fluid. At that point, you will become thirsty if you skip some your usual water intake.

Measuring 24-hour urine volume is a far better way to manage fluid intake than an arbitrary number of glasses of water to drink. If you just can't stand any more water, try lemonade made with real lemon juice to break up the monotony. Real lemon juice also is rich in natural citrates.

Cystinuria

Treatment for high cystine levels in the urine (cystinura) includes substantially increasing fluid intake and raising the pH of the urine (usually with sodium bicarbonate or potassium citrate). Penicillamine (Cuprimine® ) and tiopronine (Thiola® ) may also be prescribed.

Pain Medication

Over-the-counter pain relievers (e.g., aspirin, Tylenol® , Advil® ) usually are not effective by themselves for the more severe pain caused by kidney stones.

Oral opiod analgesics, such as acetaminophen/codeine (Tylenol with Codeine® ), propoxyphene HCL (Darvon® ), hydrocodone/acetaminophen (Vicodin® ) and oxycodone/acetaminophen (Percocet® ) may be prescribed to minimize moderate pain associated with stones.

Injectable medications such as morphine sulfate (Duramorph PF® ), hydromorphone (Dilaudid® ), and ketorolac HCL (Toradol® ) may be administered intravenously (IV) or intramuscularly (by injection) for severe pain.

There is a risk for dependency with oral narcotic analgesics used for more than 3–4 weeks at a time and a small risk for accidental overdose if injectable medications are given directly into a vein.

[sherbearmama]

Shelly!!! I'm so sorry you've got to deal with stones now!!! I know next to nothing about them, but I wish you well and hope you can get some relief soon!

Hugs, Sheri

[reinventingangela]

Ok, new here but I have a family remedy that I know will help dissolve kidney stones, you have nothing to lose by giving this a try...

My uncle has 1 kidney and used to constantly get kidney stones that would drop him in the middle of the kitchen floor in tears when he felt it getting ready to pass (witnessed this as a kid). His doctor back then told him to drink 100% pure unstrained apple juice. You get it at the store sometimes in the juice section and sometimes in the organic section now that they have an organic section. Trust me on this, its not like the old "drink some cranberry juice" remedy....and when you buy this juice, I'll forewarn you it looks cloudy with bits of pulp etc floating around in it, thats ok, it tastes just like regular old apple juice minus some of the sugar.

Drink as much as you can at a time throughout the day or evening when you can lie on your sides an hour or so at a time each. Repeat this as often as you can until the stones pass.

I have had kidney stones 3 times in my life. The first time was under extreme circumstances that kept me from realizing what it was until it was too late and it blocked me from peeing which resulted in toxins from strep throat backing up into my kidneys sending me into the hospital for 5 days. The other 2 times, I did the apple juice thing and after the first day of symptoms, I never even felt the stones pass (although I did see these jelly like remnants in the toilet).

Give it a try, the juice works Im telling you and Im amazed that more doctors have never even heard of this remedy but in my family, we swear by it!

[keliblue]

Jan 18, 2012 4:12:05 GMT -5 reinventingangela said:

Ok, new here but I have a family remedy that I know will help dissolve kidney stones, you have nothing to lose by giving this a try...

My uncle has 1 kidney and used to constantly get kidney stones that would drop him in the middle of the kitchen floor in tears when he felt it getting ready to pass (witnessed this as a kid). His doctor back then told him to drink 100% pure unstrained apple juice. You get it at the store sometimes in the juice section and sometimes in the organic section now that they have an organic section. Trust me on this, its not like the old "drink some cranberry juice" remedy....and when you buy this juice, I'll forewarn you it looks cloudy with bits of pulp etc floating around in it, thats ok, it tastes just like regular old apple juice minus some of the sugar.

Drink as much as you can at a time throughout the day or evening when you can lie on your sides an hour or so at a time each. Repeat this as often as you can until the stones pass.

I have had kidney stones 3 times in my life. The first time was under extreme circumstances that kept me from realizing what it was until it was too late and it blocked me from peeing which resulted in toxins from strep throat backing up into my kidneys sending me into the hospital for 5 days. The other 2 times, I did the apple juice thing and after the first day of symptoms, I never even felt the stones pass (although I did see these jelly like remnants in the toilet).

Give it a try, the juice works Im telling you and Im amazed that more doctors have never even heard of this remedy but in my family, we swear by it!

I'll try anything.. thanks for the tip, can't hurt

[Deleted]

Jan 17, 2012 15:08:26 GMT -5 @en said:

Oh duh, hit send too soon.

One clarification with this worry about DS and enema: An enema goes in your colon. Your DS was done on your small intestine. Two very very different locations. It's not just all one tube from stomach to asshole .

EN - This made me spit my soup out!!!!!

Shelly - Sorry about the stones. I've done the enema (just from severe constipation due to pain meds) and I've also drank the crap to clean out in prep for colonoscopy.

[abright0]

I went to my doctor today to get some my 6 month lab results. She had me give a urine sample, in just a few tablespoons of urine, they found 3 stones. I am not sure what the deal is, but I am passing multiple stones consistently, and am in pain all the time, even with massive doses of oxycodone. They are trying to get me into the urologist asap, but I am a little frightened there is more to this than just stones. And they all seem to be coming from the same kidney.

[reinventingangela]

awww bright, I'll be praying for the best possible results for you, keep us posted and feel better soon!

[pandykorn]

Reading this has freaked me out .... i completly blocked out the searing kidney stone pain and ER visit of December.

I had a CAT scan in the hospital after i passed the stone b/c i was not sure what happened- they told me there is no more stones- can that be? can you have just 1?

[terilynne]

I feel for everyone that deals with this, having dealt with it myself... ended up in the emergency room 2 times for it. ugh.. the ONLY thing that took any edge at all off was oxcodone. Even that was minor.

I never noticed passing any, except for ONE, that I heard clink in the toilet basin.. lol

[trxxyy]

After reading all of your stories I HOPE I don't pass a stone! The only thing I know at this point is I have small pebbles in the right kidney and 2 big stones (at least .5 inch) in the left so my doc is already talking Lithotripsy.

I am still trying to get a clear KUD x-ray, I just had another one this past Friday and did another super bowel prep. Crossing my fingers!

[terilynne]

I've done 3 lithotripsys. For me, they werent bad at all, but i never noticed any stones pass afterwards. They were a good excuse for me to be lazy the rest of the day and the next, and the 3rd if I could milk it that far

[Girlrocker]

Sorry to hear. I knew nothing about kidney stones, except that I hope I don't get them, I've always heard they hurt :-( However after reading this thread, know a lot more now! Hope you get through this without too much grief.

[dsnuts]

This thread is freaky!

Are stones much more likely after surgery? I've never had one before.

[KathyF]

Well, I haven't had any stones since my surgery 11 years ago. I have had stones only once and that was years before my WLS. I believe I only got them then because I was always really bad about hydration.