Transcription:

Scott Webb (Host): There are things that we wouldn't wish on our worst enemies, and kidney stones are one of them. Joining me today to tell us more about kidney stones and how hydration is the key to avoiding them is Dr. Daniel Hekman. He's a family doctor with the Franciscan Physician Network.

Host: This is the Franciscan Health Doc Pod. I'm Scott Webb. Dr. Hekman, thanks so much for joining me today. We're framing this as sort of kidney stones, how do we know if we have them? In my experience, doctor, I knew that I had them. But let's start here, what is a kidney stone?

Dr. Daniel Hekman: Sure. Thank you for having me, Scott. A kidney stone is essentially just usually a combination of calcium and some other element. Typically, it is calcium phosphate or calcium oxalate.

Host: All right. So, all I know about kidney stones is that it was painful and I knew I had them, but folks may have different symptoms, right? So, what are the symptoms and maybe is there a sort of a classic "symptom" that just screams, "I have a kidney stone"?

Dr. Daniel Hekman: You definitely will know when you have one, because they are described as some of the most painful symptoms other than childbirth that patient's report. So typically, you'll feel it as the stone leaves your kidney and travels down the tube from the kidney to the bladder. It gets kind of wedged in there, and that triggers those alarming nerve and pain symptoms to your side usually, to that side or your flank. And then as it travels down, you actually kind of feel it in your groin area.

Host: Yeah. That's where I felt it, in the groin area. And wedged sounds like the perfect word. It gets wedged in there. So, how do you unwedge it? How do you treat kidney stones?

Dr. Daniel Hekman: So, yeah, typically, you want to try to increase basically the flow of urine to help it travel down that tube. You basically have to drink more water to increase more urine. So, hydration is key. Hydration, hydration, hydration.

Host: So, that's what we do on our end at home, drink, you know, hydrate, lots of water, try to increase the flow of urine. What do you do then in terms of treatment? Like do you use lasers? How do you break up kidney stones?

Dr. Daniel Hekman: It does depend on the size of the kidney stone. So, the only way to know for sure if you have a kidney stone, first, we typically check a urine to see if there's typically blood in the urine, basically signs that that stone is kind of rubbing against that tube, the ureter it's called, and does put a little blood in your urine that we can see when we test the urine. But the only way to know for sure is to do a CT scan or a CAT scan, a big fancy test in the hospital. And so once we've determined the size, if it's under a centimeter, we should be able to get it out with just basically hydration and possibly a medication that opens up that urinary tube, that ureter, and that medication's called Flomax.

Host: And then, what about the ones that are bigger than a centimeter, like the really big boys, how do you break those up? What do you do to give patients some relief?

Dr. Daniel Hekman: That's going to be a urology referral, unfortunately. And, yes, sometimes they do the shock therapy where they actually go in and kind of vibrate at a high frequency to break up the stone into little pieces. And you still are going to feel that pain of each piece coming out, but it does make it smaller into fragments and does help it ultimately come out. And then, you know, if absolutely needed, they can do surgery, and even maybe put like a stent in there or like a plastic tube to keep that ureter open and help the stone kind of drain out.

Host: Are there certain risk factors, you know, who's at higher risk? And also, are you more prone to future kidney stones once you've had one?

Dr. Daniel Hekman: Yes. So, we mentioned hydration. So certainly if you are typically dehydrated or not drinking enough water or drinking too much caffeine, which is kind of a diuretic and can dehydrate you, and I think all of us are guilty of that at times.

Host: As I take a sip of my coffee right now while you're speaking, you mean? Yes. Right.

Dr. Daniel Hekman: Exactly. Yes. So, that plays a factor. But then when you're looking at actual like diet and types of foods, so high sodium, low amount of actual fruits and vegetables, high non-dairy animal proteins and high reduced sugars, so like lots of candy, people think energy drinks as well. And then actually, believe it or not, just the right amount of calcium intake, so not too little and not too much.

Host: Yeah. So obviously, yeah, there's some things that we, you know, can do for ourselves, hydrate, more, less coffee, that's a bummer for me. You know, it is like sort of all the good stuff. You know, easy on the candy, easy on the caffeine, all of that. You know, once a stone passes or gets broken up and passes, is there much recovery time? Or in my experience, I was like, "Okay. Now, I can start breathing and living again." Is it pretty much immediate?

Dr. Daniel Hekman: It is immediate. Once it does pass, it's almost like having a baby, like there is a significant relief right after that. So if somebody did have what's called lithotripsy or that shock treatment done or had a stent put in for a big kidney stone, there might be more residual pain and bleeding for several days to weeks after. But the ones that are smaller, once you pass them, your pain should be gone.

Host: Yeah. And it was, as my wife who gave birth to two children said, you know, she said, "Yeah, I know it's bad, but it wasn't as bad as the children." And I said, "We might be right there neck and neck." But one thing very pleasant, of course, children, awesome, family. Kidney stones, not pleasant. Is there anything that we can do to maintain kidney health? Is there any particular diet or vitamin regimen, like what can we do to try to prevent kidney stones? Or is it just one of those things that if you like coffee and you don't drink enough water or you have a family history, you're just probably going to get them at some point?

Dr. Daniel Hekman: Unfortunately. Yeah, that does seem to be the case. So, just do your best to stay hydrated. You know, drinking at least like six to eight ideally 12-ounce bottles of water a day just to keep yourself protected from the buildup of this calcium stones is key. But it does kind of depend on the type of kidney stone. Sometimes they're gout related, like it's called uric acid stones. Sometimes there's a bacterial infection called proteus that makes kidney stones that are unique to itself. But most commonly, these calcium oxalate stones, you prevent them with hydration and healthy diet.

Host: Yeah. And we could do a separate podcast on what it means to eat a healthy diet and where should we, you know, focus our attention when we're in the grocery store. Generally, I try to stay around the outside, you know, away from the canned and the process stuff and the fresher stuff. But good stuff today, doctor. You know, there's just these things, right? Just being human living a life loving coffee, whatever it is, kidney stones seem to be very common. And it's good to know that there's some things that we can do for ourselves and certainly things that experts can do to help us. So, thanks so much. You stay well.

Dr. Daniel Hekman: Oh, you're welcome. Thank you so much for having me, Scott,

Host: And for more information, go to franciscanhealth.org and search kidney stones.

And if you found this podcast helpful, please share it on your social channels. And be sure to check out the full podcast library for additional topics of interest. This is the Franciscan Health Doc Pod. I'm Scott Webb. Stay well, and we'll talk again next time.