Kidney Stones: No! Please, NO!

You should show up to see if we've forgotten how to do this, to see a skate around on stage, nervously sure, doubting ourselves and eventually bringing the funnies. Yeah, hopefully. Where do they go? They go to s f AS in San Francisco, SF sketch Beest dot com. Click on the schedule and tickets link. There are tons and tons and tons of great shows. It's the best comedy uh festival in the country in my opinion, over the whole month of January. So go check us out and go

check out everybody else as well. Yep, it's also a full vaccination show, so you've got to show proof of vaccination and wear some masks. Don't be naughty. Don't be naughty, be nice. So we'll see you guys on Friday, January one in San Francisco, California. Welcome to Stuff You Should Know, a production of I Heart Radio. Hey you, and welcome to the podcast. I'm Josh Clark, and there's Charles w. Chuck Brian over there, and this is Stuff you should Know.

I should say, Stuff you should now. It's a good one. Thank you. It was off the cuff, Chuckers. You ever had a kidney stone? No, let me. I guess it's not good enough. No, I haven't. I have not. How about you? I have it. I think I'll probably get one one day. Yeah, you just know it's in the cards for you. Yeah, I mean I've got I don't have like a bad kidney issues. But you know, when you get to be my age, certain organs starts saying, Hi, pay attention to me a little bit. Oh yeah, yeah yeah,

And the kidney is one of those. But I'm not I'm not dying or anything. No, I know that. It's more just like, you know, what's it if if you got a inky kidney, you could conceivably get a kidney stone. For sure, that is certainly true. So, um, I, my friend, wish that you never ever, ever, ever get a kidney stone. I wish the same for Jerry. I wish the same for every person you know and like and love, and

same for me. That's right. But wishes and dreams do not bear any weight here, my friend, because I think you got about a ten percent chance if you're living a human of having a kidney stone, and besides being super painful, they can kill you. About sixteen thousand people year die from kidney stones or complications that arise. Yeah,

what a way to go, man, from kidney stones. And you're probably not going to die from your kid He's failing, because that would require both kidneys being blocked simultaneously so badly that they just shut down on you. That's probably not gonna happen. Um. But there's a lot of procedures that, um, that you would probably go through to treat a terrible kidney stone that that could kill you. An infection could

kill you. There's all sorts of ways that could lead to bring about your death, and that would not be very pleasant. I agree with you. Yeah, they are I mean there's different kinds. We're kind of gonna kind of gonna go through them here, but they're generally classified in a couple of ways. Um, where they are and what

kind they are, like how they were formed. They are all kinds of fancy schmancy doctor names for kidney stones, renal calculi, uh, euro lithiasis, But they're gonna call them kidney stones if it's a doctor that has an interest in being your friend. Right, So, Um, the where where they are, um is really important because they need to know where they are so they can help you figure out how to deal with these in the most particular way. And there's only like a certain number of places that

a kidney stone is going to be. And Chuck, I looked high and low and could not find a definitive answer, as I saw some places that seemed to say all kidney stones are all stones start in the kidneys. But I also saw like little snippets here there that made it seem like there's other places stones can form shoulder blade, right,

But regardless, that's my point. Regardless of where they form, they're going to form only in your urinary tract, which includes your kidneys, your eurotors, which are the tubes that take your pa from your kidneys down to your bladder, the bladder itself and then the urethra narrow or otherwise, which is where the peak comes out. Yeah, I'm gonna go ahead and say the eutors, they should have built

those a little wider. Are not a lot of heartache. Yeah, because one of the one of the big problems that you're going to have if you get a kidney stones, you're your readers are like two millimeters in diameter and they're not very flexible. So when you're passing a hardened stone, a crystallized stone of mineral through that that's larger than

two millimeters, it is going to cause some problems. Yeah, I'm sure that they didn't seem like they needed to be bigger at the time man and woman was created. But because all of it's going through, there's p but the lack of foresight on those stones is a big problem. Yeah. Tis tisk yahweh. That's that's right. So you've got stones

in the kidney nephro nefro liths lith means stone. You've got your eur readero liths which are in the your readers, and again that's a really terrible place for them to be. And you've got sister liths which are in the bladder, and I guess by proxy that the urethra too, right, that's right. Uh, the ones in upper tract, those are gonna be, um, a little more problematic, generally a little

more severe. Uh. If you're gonna get complications and long term problems, they're generally generally going to be because of those upper urinary tract stones. Um. But they're all, I mean, none of them. The only ones that aren't a big deal are the ones that are so tiny that you just and that's why I said that. You know of people probably thought I was joking, But you can urinate out kidney stones and not even though you ever had one, if they're small enough. Yeah, just pee yourself right now.

There's a chance you just peet out a little tiny maybe a stone of some sort. But for the right when you do know that you have a kidney stone, though you really really know it. Um. And we'll talk about the process of passing a kidney stone later. But UM. The other way to to define a kidney stone, and usually they're going to be defined by location and then also in this other way, by composition, because kidney stones

can be made up of a lot of different things. Um. But the upshot of them, Chuck, is that if you have too much of something in your p or two little p um or imbalanced p pH wise um, things can solidify that should be liquid. They can precipitate out of solution, and when that happens, it can start basically a snowball effect where more and more that stuff is attracted, and that's where your stone is formed. Yeah, I mean, it's just it's just mineral things that don't that can't

be dissolved basically, and they like to have company. They like to get together with our other non dissolved friends and party together and hang out together. And pretty soon, if you get a big enough party, you're you're gonna be in some kind of pain. Yeah, you're gonna have a pain party for you. But I guess we should

talk a little bit. This is sort of the about as wonky as we're gonna get in this next section, which is the makeup of these stones, and most of them are made up about six or calcium oxalate, and and that this is basically too much calcium or oxalate in your urinationary system, and it's you know, there are a number of things that can cause this, but they're generally all metabolic problems, although I think there's a little

genetics involved with the calcium oxalate as well. Yeah, that seems to be my take on it too, that that genetics have a large role in whether you're predisposed to having kidney stones or not. Diet and lifestyle can definitely affect it. But it's like if you have hyper parathyroidism and you're absorbing calcium too much calcium from your bones, that probably doesn't have much to do with your diet. UM. And that's one way that you can have too much calcium.

Your renal system might um not absorb enough calcium from UH into waste, and so there's more of it hanging around there than there should be. Um. There's a there's a few ways that it can happen, but the upshot of is either you have too much calcium or too much oxalate and they combine together to form would you say, like any percent of kidney stones, Yeah, that's sixty two eighty and I think the actually I don't have a percentage for struvite stones. UH. These are also called infection stones.

And there you know, if you get a lot of U T eyes, you might be more prone to struvite stones. Um. Sometimes there's just some kinds of bacteria and if you match that up with the right uh metabolic condition that's going wrong, it'll they'll get together and cause struvite stones. Yeah.

The struvite stones seemed to rely a lot on whether you're um like with if your your urine is out of balance pH wise, specifically that it's highly alkaline um, so it's above seven uh as far as pH goes, and that that combined with certain kinds of bacterial infections can can create that. It looks like stag horn seems to be the most common type, which I mean you do not want to mineral that fits the bill of stag or flowing through your urine. Yeah, you do not

good at all. Uh. Then you have about ten percent or lesser formed by uric acid. And this is sort of you know, if you have problems with your uric acid or gout, uh, you're probably gonna have kidney suns at some point. Uh. You know, the gout diet is it's sort of the same triggers. They're high in what's called purins, shellfish, organ meats, any kind of meat really beer, for sure, Like those are all on the list of things that you don't want if you're trying to keep

your uric acid and check. Yeah, because the uric acid is um metabolite of purine and um it crystallizes very easily. It can precipitate easily out of the P if there's too much of it, So yeah, that that can be a bad jam for sure. Um. There's also cysteine stones, cysteins, and amino acid. It's it's used throughout the body for a number of different ways. But unfortunately it's the least soluble amino acid, so that means that it can precipitate out of P fairly easily too. Luckily, those are kind

of rare. Um. You actually have probably a UM a congenital disorder that causes sistine stones. But unfortunately that means you have a congenital disorder that causes stones, which means it's probably a chronic condition, right, And I think that's the same for the rare xanthine stones, right. Yeah. And xanthine is another purine or purine. It's found in caffeine, tea, and Cola's. And it occurred to me Chuckle was researching this, is that what Purina is trying to get across with

their their brand name, that they're from chock full of purines. Um. Maybe I always kind of thought it was probably just a play on the word pure. Oh, it never occurred to me like that. I wonder maybe they're like, why can't it be both Josh and Chuck. Uh. And then there's of course the Infinity stones, which are a real problem for about half the population. Yeah, and one other thing also, um pass that one almost I'm glad I stopped and took a double take. Was that written down?

I can't see your notes? That was no notes? Wow? That was good then, man, I think you just won the World Cup for in the off the cuff stuff. You should know joke, okay, battle, I'll take it. Um. One other thing about uric acid stones is that that um is kind of the opposite of strew vite stones, where your p s two acidic, like it'll burn right through metal if you pee on a car. Right, should we take a break, Yeah, we should take a break. I need to regroup after that huge win by you.

Just we'll be right back and I'll say what I'm gonna say after this. Yeah, so I didn't know if you even I didn't think you watch those Marvel movies. I didn't know if you'd get that joke. Well, I mean like I'm I'm conscious, like I can form thoughts and observe like outside stimuli, So that means, yes, I'm familiar and aware with the Marvel cinematic universe and what goes on in it. Well, see, I would think if you didn't see the movies, you have no idea what

an infinity stone is. No, No, I mean, well, obviously I've seen I guess I saw the one that you're specifically referring to where half half of everybody just like dissolves. I saw that, should say spoiler alert. Oh yeah, if you don't know that by now, come on, those are the biggest movies in the world. So thank you for defending me. Like, no apologies necessary, no accountability here. But you'll have to watch the second one to find out

what happens after that. How about that, well, they come back. I haven't seen that one, but I'm just presuming there's no way to really much part in part two. Yeah, that's pretty funny. Yeah, I did not see the second one yet. I guess if you didn't like it much, you'd be like, well, am I going to spend another two hours and forty minutes? But because I did like it, I mean I was entertained and amused. I guess I just knew that at the very least everybody who was

anybody was going to come back somehow. I didn't know how, but I guess I didn't really care how. I just want to strip you in a chair and uh like clockwork clockwork orange style and make you watch the Beatles documentary. No, alright, so back to regular kidney sounds right, yes, um so um. We kind of talked about how they formed, but it's

worth just kind of saying one more time. It's basically, you've got stuff in your P minerals that that don't dissolve very easily, or there's too many of them or there's not enough P and they just go and they crystallize, and that's how it starts, and that kicks off this process um of where usually they form an actually in your kidney, but they can't form anywhere, but they'll hang on to like a little node in your kidney and

start to nucleate. They're kind of like a snowflake. Ed helps us with this one, and he's like, it's like a snowflake basically growing um from like a little dust moat when it's cold enough. Yeah, and like you said, they don't always have to form that way. Sometimes they can just form free floating in your urine, just moving about the party. But they do better for sure when they're attached initially to something. When one when one little tiny particle hangs onto something like uh, I know Ed

mentioned the renal papilla. Uh, those little projections and the kidneys papillia, that's a good place for them to get together. Uh. They may grow there for a little while, they may detach and then float away, but they also might attract friends at these attachment points, and that's when the problem starts. They're eventually going to detach, but they just like to congregate and like the cool area of the party. Yeah.

And see you just said made me think like you could probably form a stone anywhere in your urinary tract that whole system, as long as there's a place for it to kind of clamp onto, or it's bad enough that they're just forming right in the middle of your urine, so it doesn't necessarily have to just be your kidneys. Yeah, and they look like I think ED had the perfect DESCRIPTI here, it looks like a little granola chunk granula. Yeah. Some of them look a little more um, mean and

menacing than others. Some are even like smooth where you're like, jeez, I enjoy passing these. They make a very satisfying PLoP sound when they come out of the urethra um. But again, there's like stag horns, there's the widow maker, Um, there's the Judas Priest. They have terrible names, but they really kind of drive home how bad these things are. It's really the Judas Priest. Wouldn't never know doctors have a sense of humor with two of them? Wouldn't that be great? Though?

So I would I would think it would be this like looks like the double horn fist. I was thinking it was gonna look like that metal eagle. Oh that too, the screaming eagle mm hm living after midnight. The metal fist sounds worse though, for sure. Well, anything, and you know this is the case with kidney stones, anything, And that's why the stag horns are so bad if it's the spikier. I mean, you don't have to be a doctor to tell someone that the spiky or something is

the more painful. It's going to be, right. Yeah, they're describing your kidney stone too, and you're like, I didn't realize your doctor. They say, oh, I'm not a doctor. I just stayed at a holiday and expressed, yeah, anybody

could tell you that. Uh so the pain that you're gonna feel like when you get diagnosed for a kidney stone, You're probably gonna go into the doctor after feeling uh sort of lower groin pain for a while, maybe in your lower back or side or abdomen, and you might be going, man, this is like I didn't pull my back.

What's going on? And you may live with it for a little while just thinking it might be a pulled muscle or anything like that, or a strain groin even and then at some point, hopefully someone in your life is going to say you may want to go like that, maybe a kidney stone, get that checked out. You may want to get that checked out. One of the reasons

I didn't understand this, but it makes total sense. One of the reasons why there's it feels so much worse than just your urit or or your kidney saying ah, is that there's a bunch of really important nerves that pass right through the kidney, right through that that notch that gives the kidney its characteristic shape. Because the celiac plassics plexus, the inner mesenteric plexus, the lumbar splank nick. I like the splank nick or the splank nick. Yeah,

I like it too. I like the Celiac plexus though. It's got a pleasant, pleasant look to It's like cellar door. Yeah, you love cellar door. It wasn't just me. That's a Tolkien reference. He's I think he's said, I know, but you mentioned in London in the show, is what I mean. I just think it's such a great idea that somebody was like, I definitively say, this is the most beautiful word in the English language, and it just happened to

be Tolkien. So like there's an extra little twist at the end there, and it was used in Donnie Darko, so it's a pretty pretty great little thing. I have my favorite word though. It's not sellar door. It's it's moist pus. No, it's the Beatles, and it's used in the Peter Jackson documentary The Beatles. Is it really that good? It's amazing. I mean i'd say this, you would hate it. But if you're a casual Beatles fan, it's probably not

even for you. Or even if you're like, no, I like the Beatles, it's probably not even for you because it it's eight hours of just sitting in there, fly on the wall style, so you really got to be into Like did you see that look that George escaped Paul when he said that one thing? Like it's that kind of level. Yeah, I would not like that it at all. I've got I have a music documentary that, um you mean and I watched the other day. That's really good. Um it's on Sparks. Oh yeah, sure, I've

seen that. You saw it. I loved I had never heard of Sparks. I didn't real Sparks existed. I'm actually I've been disappointed in myself ever since that I didn't realize they were a thing. But that is a great documentary. One of the things I like about it is not just their music, but just like how like naturally and genuinely positive they are without trying to be positive and also actually being kind of fiendish in their sense of humor,

but they're still overall like very positive. It's pretty cool, pretty and I'll even go ahead and recommend even though I haven't seen it. It's on the list this week. I just got to get through the Beatles. Thing is the Todd Haynes Velvet Underground documentary. I hear it's just like ridiculously good, which I can't wait for because the best. I'm going to check that out. So that was documentary corner.

I got my movie crush fixed. Well we should. We need to take care berets often drop our cigarette holders

and get back to it. I think we were talking about those three nerves and they can cause uh nausea and vomiting because those three nerves run right through what's called the renal hillum and that's that little you know, if you look at a kidney or even a kidney being or kidney shaped swimming pool, you can imagine what it might look like a little notch inside that curve, and all three of those nerves run right in there. So if you're kidney is uh inflamed or spasming or something,

it's going to be tweaking those things like piano strings. Yeah, and spasming is right, you just said the magic word, because your kidney is well aware that it has something that shouldn't have in it, and it actually has a way to take care of that, and that is by spasm ing it out, trying to push it out. The kidney does that, and so do your your readers. UM, and your your reader actually like clomp down around it

and try to squeeze it out through spasms. So kidney pain is typically associated with UM basically the worst pain you could ever experience. I think, UM, people have given birth before, UM who did it without any kind of drugs say, Nope, kidney stone is actually worse than that. UM. And what's great is everybody can share in the fun of a kidney stone. Did you see what Ed's friend called it? Yeah? Ed has a friend who had kidney stones instead. It was like giving birth to a knife. Right.

That kind of says it all. It really does. UM, the worst of it from what I've seen. I found uh urology website, UM, and it's basically says the two worst by far is when it's in the kidney and then when it's in the your reader, and apparently when it's in the kidney it's even worse. That's the worst

of all. But the upshot of it is, in addition to feeling nauseated for your back and your abdomen to hurt um, you're you're actually going to be experiencing pain in your kidney and your your reader as there pushing this thing out, and it comes in waves of pain called renal colic, and they will give you narcotics to take care of it. It's that bad. Yeah, yeah, the best feel good drugs available are coming your way, and

they'll probably just barely make a dent. I don't know that that's true, but I'm really trying to drive home how painful kidney stones are. I wish one of us would have had it from experience. I'm actually glad that we aren't. Speaking from experience. I wish that person was, you know. Uh No, I'm glad we haven't had it. But I'll, you know, hopefully, over the next until we retire, I'll keep everyone up to date on whether or not to get kidney stones. Okay, all right, I think that's

fair squatted land than kidney stones. Those are my two lifelong updates. What about your teeth. Don't forget your teeth. Well, everyone knows I got to get that tooth done again. So man, I just had a deep, deep cleaning on two of my teeth and it was not pleasant. But my period onist was great, um like, very nice and general and apologetic. Uh. And I think I'm better off as a result. I'm a better was that the rooting

and scaling thing, I believe? So there was a gum treatment sort of yeah, and there wasn't like an incision. She didn't cut um. But they want me to do that again. Yeah. It's not fun at all, but you know that I'm done. It's done. I was about to say, as if it was any better, we should get back to kidney stones. But to get these things treated there, they are quite a few options, thankfully. Um. It depends on where it is, depends on how big it is. Uh, if it's in, if it's one of those uh your

ead stones, They're probably gonna say pass it. It might even take a few weeks. But drink tons of water and see if you compete that thing out. Yeah, once it gets out of the kidney. Yeah, And I think if it's five millimeters or smaller. You got about a nine chance of passing that thing through a year, and and it goes down to between five millimeters and ten millimeters.

And if you can eat and you can drink and you don't have a fever, they're probably going to send you home with some pain pills and some flow max to to relax your urethral sphincter so you can pee easier, and you're gonna pee all the time. And as it moves down into like your bladder, it's going to increase the pressure there because of the inflammation your bladders. So you're gonna have to feel like you have to pee

all the time, even though you don't necessarily. But they're gonna send you home and be like, best wishes, best of luck, keep us posted. Let us know if you spike a fever something like that, Right, you're also going to get all kinds of tests, um, blood test urine tests, things like that, just to see like you may have more than one stone, um the identification of the stone.

I mean there there could be a larger problem, you know, if we're talking about these metabolic imbalances, like if you may have chronic kidney stones or at least another one in the future. They want to kind of get you on the right tracks. So you're gonna do a lot of tests as well. Yeah, and um, one of you his friends used to get him a lot, and I think I didn't have a chance to ask him, but I think he might have outgrown him. I hope God willing. But I'm pretty sure he had to pee into like

a mesh cup to catch the stone. And I realized, now, it's not not because he was a weirdo. It was because they wanted to analyze the stone. Because again, you can tell a lot about what is driving you to produce kidney stones if you can just look at it, because you can see what it's made of. Well, you can see what it's made of, and that'll tell you a lot. I think i'd want to keep mine. Well that's the other thing too. You got a pretty nice trophy. You could get a grill made with it. That's what

I need on my fake front teeth. A couple of kidney stone, couple like stag horns, just sticking out, slicing into the back of your top lip. Uh. If they are larger, you're gonna need some more. Uh. What ED called direct intervention and that's pretty much says it all. They're gonna look at you with X rays. Uh, they might use an ultrasound. They're gonna find out exactly where that puppy is. They're gonna see if it's moving along or if it's kind of stuck in place, and uh,

then they're gonna go to work. It's it's a little more expensive, but I would stay just by reading this. If it's an option, and if you can afford it, I would go to the uhle thought such a hard word to say with thought tripsy method. Yeah, because it's non invasive. It's all ultrasound. Like they use ultrasound maybe X rays to find and then they use ultrasound to break it up. And Chuck had produced the sentence that seems innocuous until you realize that if you read it

like a monster truck ad announcer, it's really boss. Which one is it sounds without? Oh yeah, that's true. Yeah you should be a doctor. That'd be fun. I oh dude, everything would be called the Judas Priest whatever, right, I be like, this is a Judas Priest baby, Yeah, it's a Judas Priest fracture. We can fix that, no problem, Uh, if it's larger even than that, uh, like too large

and I guess this is a Judas Priest album. Too large for lathot trip tripsy um or if they can't find it, maybe if it's like exactly where it is or you know, or maybe you don't have it available to you because of money or wherever you live. You can go to a uteroscopy and that is a little bit more invasive, but not surgery yet. That's when they're going to send a scope up through the urethra, probably not a lot of fun uh, into the bladder, into

the uritor and then they capture it. It calls it like a little basket and they and they pull it out and then sometimes it is even bigger, they can use a laser to break it up and then pull it out right. But that's the key that your your reader you read roscopy is that they actually can remove

the stones, whereas um. I think with lithotripsy man it is uh that they actually they go in there and break it up, and a complication would be is like it's kind of like that stupid Russian um satellite missile tests that they just did, remember where they created way

more space chunk than there used to be. You're doing the same thing with the thought tripsy, where you're breaking up these stones, and so one of the complications can be like, now you've got a bunch of kidney stones, and yeah they're smaller, but not all of them are so small that you won't notice them, or that they

won't necessarily cause an infection or something like that. Right, Or in the case of the Guinness record holder, the man in Indian two thousand four, this thing was and I looked up different kinds of sports balls, and the closest I could find was it was about the size of a shot put. What, Oh my goodness, five inches

in diameter. I mean, it is never thought about it, like I even made that with my with my hands, and I think't thinking it's got to be circumference, it's gotta be that's no, it's diameter, because I went and looked too. But so for those people who have never seen a shop put and don't know what five inches is, that's like thirteen centimeters in diameter. Yeah, it's bigger than a softball. If you don't know what a softball is, it's about a regular grape fruitish size. Yeah, I would

say so. Yeah, So obviously that was a surgical removal, which is the last the sort of the last line of defense is to get that surgery. And it's called this one's mine, percutaneous nephro lithotomy, nicely done, and that they make a little notch, a little incision in the lower back. And it's that they scope it out too, so it's not some huge, huge thing, but they use a thin scope into kidney, break it up again, remove the pieces. Uh. And we should mention too that some

of these um, I think the uteroscopy is when they utero. Yeah, uteroscope. No, there's an extra vowel in there. It's not just me utero scoopy. Yeah, uteroscopy. Your read a roscarbe, you read a roscoe adding an extra vowel every time eventually pays off. You read a roscope. That is the one that, um, you still need anesthetic and you might eventually need a stint, which again goes back to my thing that the euritor

should be bigger. Yeah, if they're putting in stints, that means that's the size that it should have been to begin with. Absolutely, then anything could just passed there, even a five inch diameter kidney stone from India. Should we take a break. I think we should take our second break and come back and talk about what I think everybody wants to know is how do you make this

never ever happened to you? Okay, Chuck. So it's actually pretty simple unless you have some sort of congenital disorder that is producing chronic kidney stones in you, which is extremely sad and I feel very badly for you. Um, there's some really easy ways you can keep from probably

ever getting a kidney stone in your entire life. Yeah, I mean, I know you think drinking water is a scam, but yeah, I remember you went on entire right years ago about how that whole drinking egg glasses of water days. But oh no, so that is drinking egg glasses of water. That the number was made up. I think drinking water is good, but the number of glasses is just totally like made up. Well, this is two liters per yeah, so that's a number it is. But there was a

study that backed it up. Okay, they say the study that said if you drink a couple of liters of water a day, it resulted in a hundred and forty nine fewer stones per one thousand people, and it just makes sense, you know, to keep water flowing through your kidneys and flowing through your system and keeping everything nice and saturated, that it would help prevent the build up of those uh of those little particles, those minerals, right, because you've got enough p that those things, even the

toughest um solubles, are going to stay in solution rather than precipitate out. But also one thing that's easily overlooked is when you drink a lot of water, water is pretty much across the board a neutral substance, so it actually helps maintain the pH balance in your body. And as we've seen, there's at least two different kinds of kidney stones you can get depending on whether you're urine

is too acidic or two alkaline. And drinking a lot more water can make your urine a closer to neutral, which is a big big deal to Plus, it just mechanically helps flush awayte stuff before they get a chance to to really aggregate. Yeah, you can cut down on animal proteins, you can cut down your salt, you can cut down in your oxalate um. You won't find oxylating a lot of stuff, but it is uh there's a lot of oxalating spinach and apparently chocolate and rubar, but spinach.

You know, how much spinach are you really eating? I didn't see how much it would take to really start to get into the danger zone with kidney stones. But I mean, but it's more one of those things. It's like, man, you just can't win. No matter how how good you're trying to be, how healthy you're trying to be, you're still it's gonna get you. Yeah, always gonna get you one way or another. Uh, that's what the shirt says. The calcium. You might think, well, if it's a calcium

build up, then have less calcium. But that's a bit of a thing too, because oxalate is there and if you're if you're low on calcium, then it's going to increase excretion of oxalate. So just keep your calcium intake normal. Yeah, just don't overdo anything, but also don't under just don't do anything. Just lie. They're drinking water all day long and you might be Okay, that's right. That's all called

primary prevention. Things you can do on the front end. Uh, if you have chronic kidney problems and kidney stones, then secondary prevention is, uh, that's when that's gonna come into play. And that basically means you're gonna be on medication. Then you're gonna be checking your pH in, your urine and stuff like that a lot. Yeah, And usually, like if you have eight kidney soon as your first one ever, they're probably not going to do a whole lot of

investigative work. But if you start to show symptoms that you have chronic kidney stones, then they're gonna want to figure out what it is in your body, what it is in your diet, your lifestyle, your metabolism, whether it's a congenital disorder. Um, they're going to really kind of try to get to the bottom of it so that they can adjust you, either by meds or by lifestyle adjustments to make it less likely that you're going to produce any more stones. All right, should we talk about

it now? Is it time? Sure? How we passed these things? No, you don't want to What are we talking about? How we passed the stones? Oh? How we passed them? I thought you said, are we passed it? I was like, we're still in the thick of it as far as I could tell. So when the stones are forming, You're not gonna feel much pain. You're not gonna even know what's going on. I don't care how in tune you are with your body. You're not gonna feel those little

minerals getting together and having a party down there. Uh. When it detaches from the wall of the kidney or wherever it's meeting up, that is when you're going to start to feel the pain. You mentioned fever and chills that could certainly happen, and those spasms. I did mention that it might feel like a pulled muscle, And the spasms are pretty you know, chronic, like one to four spasms an hour of them trying to shake that thing loose. And I have a feeling that's about all the kidney

can manage, because it's probably doing about all I can. Yeah, and then once his kidney stones have moved on from there, that's kind of the worst part. Yeah, well that's comparatively speaking from what I can tell, it's the worst part. It still gets pretty bad. Um And by the way, big shout out to umu Urology of Greater Atlanta for spelling this out for us. But um they say that once you once you hit stage two, it's reached your eurrotors, and yes, you'll probably be like, Wow, that kidney pain

was pretty bad. This is not that bad compared to it. But if the average person just went into urin or pain, kidney stone pain, they would probably you know, big for you to lay on them with a pillow on their face. Yeah, that's an eight or nine. When they ask you that that awesome question. Yeah, and they're like, well, I don't understand the number you just said. Can you make the face on this chart? I always just say nine. That's my default, is it. I thought you had a high

pain threshold. I do have a high threshold for pain. I just like to I like to shock the doctors, shock the doctor's um. So still, like I said before, the uritor is not flexible. It's a very narrow opening um and it itself has that kind of mechanism where it clamps onto the stone and tries to pulsate the muscles above it so that it pushes it down, and

it occurs in spasms and waves as well. Finally, when this thing pops out into your bladder, that's when you might just not feel anymore pain, depending on the size of the stone, and if you don't have trouble passing urine, you're probably going to be able to pass this thing, uh, provided that it's it's smaller than the opening in your urethra um without any of their problems. The problem is is if you do have problems passing p that bladder can develop into a bladder, or that stone can develop

into a bladder stone where it just sits there. It doesn't get passed out of there very easily, and um, it can get worse there, and then you can have a whole other advent of pain. Yeah. And and is that when you're talking when it's stuck in the urethra or just uh no, it can stay in your bladder. Yes, it can also get stuck in your eurethra too, because your bladder, from what I can tell, is definitely the biggest part of your whole urinary tract. Yeah, if it's

stuck in your urethra you're you're you're close friends. So you're almost there, and you have to do what what sports teams talk about, which is trust the process, and that means every five or ten minutes you've got to go in there and give it another, give it the old college try, and it'll it'll come out. Apparently. Um, your urology of Greater Atlanta says that, Um, you need to push, and you need to push hard to get it to shoot out, and keep pushing until the stone

shoots out into the bowl of your toilet. Or I guess if you go to a different neurologist into your little plastic mesh thing that you're prying into, that you could wear his a hat later on. Uh. I can't imagine that the relief one might feel when that thing finally plops into that toilet bowl. I can't either. There's surely are tears involved. Yeah, I mean tears of joy, all kinds of tears, tears of triumph. I would have a ceremony. I would throw a party. Yeah. What would

you do to the stone then? If you wouldn't get it made into a grill, I just put it in a little form alde high jar and wear it around my neck on a chain. Okay, I like that one too. I mean the girls a little gaudy. I think a necklace is more appropriate. Um. Do you want to talk

about history? Yeah? I mean this is always fun. Um. Obviously there's been kidney stones since the beginning of time, and I just that's why I always love talking about old timey medicine, is because just the the confusion they all must have felt with with everything that happened to them, including something like this. Well, yeah, I mean think about it. If you're pre scientific, you would just you would feel like you were being punished for going in this if

you had no idea what was going on. And there were surely countless untold numbers of human beings who experienced kidney stones before we had any idea what they were. But the fact that that you were standing there trying to pee this thing out, whether this was a hundred and fifty thousand years ago or a thousand years ago, some people would pass them, and there would be some curious types around. He would say, let me see that thing,

what is that? Where'd that come from? And it started to get us to investigate and think about it, how to deal with these things. It's amazing. I think they found a mummy that clearly had kidney stones dated to what ce not bad uh. And then there's good old Alice Cornelius Celsus, who wrote a very very great detailed encyclopedia of surgical techniques of the time, which was around

fifty c E. And this is like legit. He he really goes into pretty good detail about surgical removal uh incisions in the perennium and locating the stone with his fingers and holding it there with a tool and cutting it out and with been removing it. So it's it's one of the first I mean, I say it worked. I think that was about mortality rate, but I would say one of the first semi successful surgical procedures that

people did right. And so this this it was called thought lithoto lithotomy with tutotomy um it uh ed makes a really good point that I think is easy to overlook that like if if this guy was writing this nearly two thousand years ago, and he was writing like, this is how you do this, and it seems like a pretty straightforward procedure, Like think about how much trial and error and terrible surgeries were performed to figure out how to perform that surgery to remove kidney stones. He

wasn't first try nailed it, Yeah, nailed it right. And apparently up until the nineteenth century, the mortality rate for a lithotomy was still around a quarter of people just died from that procedure. Which makes sense because in case you didn't notice, the perennium is the area between your growing and your anus, and that's what they were cutting into to get to your bladder to remove the stone.

Which is weird because by that time you would think you'd already gone through the worst of it, so it must have been bladder stone. Specifically that this this surgery was for aging dr taint. So so that means then, Chuck, that you already went through the worst of the pain stage one and stage two. It finally made in the bladder and now they're cutting in your perennium to get it out of there. So I just wanted to make sure that if you haven't fainted from queasiness in this episode,

we gave it one more chance. Okay, yes, I can uncross my legs. Now you got anything else? Nothing else. I don't have anything else either, And since I said that it's time for listener mail, uh, this is a fall out. We got a lot of good feedback on the dentistry episode. Um a theory on the worms. My name is Tony and I'm a dental nurse from London, UK. First of all, I have to let you know what a big phan. I'm in the podcast, have learned countless things and it always manages to perk me up on

even the most mundane days. I decided to write in on the listener mail because you were talking about the Babylonians describing a toothache's toothworms, and wonder where the phrase came from. It's a complete guess. We'll likely never know for sure, but I do have a eerie When a tooth is broken, oh or extensively decayed, the nerve can sometimes become exposed, and not only is extremely painful for the person whose tooth it is, but the nerve it

looks like a little pink string or worm. If you type into google tooth nerve or exposed tooth nerve you will find some images of what I mean. It's just a theory, but I hope it helps. Kindest regards from Tony in the UK, and I bet Tony is totally right. Yeah, man, that actually is a great guess. Like I, I subscribe to Tony's hypothesis because that's what those yokels did back then. They just said it looks like this, let's call it that. But dude, imagine your tooth being so broken that the

nerve is just sitting there dangling out. I can't imagine how bad that would hurt. Josh for one of my three teeth, I bit into a chicken wing and my tooth broken half man, and your nerve was exposed. My nerve wasn't exposed. It actually didn't hurt at all. I stayed for the rest of the football game even nice. Uh it was it a Falcons game? Yeah, but I

knew immediately this was the second one. I was like, man, I can't tell you what the words I said, but and I just kept my mouth shut the rest of the game and didn't I didn't even tell my friends, like you literally kept your mouth shut to like hold the tooth in place or something not holding place. But yeah, I kind of just kept my I mean I would talk, but I would generally keep my mouth close because boy, I had a sorry this is I can't not show us.

I had a root. Now like this past spring, and the dentist or the the end of honest, did such a good job getting the nerve out of that particular tooth. It came out on one piece and I was like, can I see And they held it in front of me and it really did look like a tiny little white worm. So I really think Tony might be onto something there. I think you're right, Tony, Tony, then I well, thanks a lot, Tony. You with an eye in jolly

old England. I believe jolly old England. And if you want to get in touch with us, like Tony with an I did, you can send us an email send it off to stuff podcast at iHeart radio dot com. Stuff you Should Know is a production of I Heart Radio. For more podcasts my heart Radio, visit the iHeart Radio app, Apple Podcasts, or wherever you listen to your favorite shows.