I remember that first time.
I had gone out for one of my usual 10-mile runs. It was a typical hot summer morning with temperature and humidity levels in the 90s. Sweat was pouring from my forehead and my gray cotton shirt – I didn’t do wicking 18 years ago – was almost black with sweat.
This morning was not unlike any other during which I would test my physical capabilities. After all, I was a marathoner. A workout wasn’t a workout unless I taxed my body to its fullest limit.
That meant running hard while not replenishing the fluids my body had exhausted. After all, there was no water stop on my route and I certainly was not going to carry a bottle of water with me. Carrying water might result in a pace that could add a second or two to my mile splits. As competitive as I am, even during my workouts, I could not let anything negatively impact my speed – not even water.
But something happened later that morning. I began to experience a dull but intense pain in the region around my lower back and abdomen. I had never experienced this level of pain, even after I fell off a bench at the age of 10 and noticed my elbow had taken a trip to the other side of my arm.
I called a physician friend, got into his office immediately and received the attention I so desperately needed. After a few questions and tests, the verdict was instantaneous. “You have blood in your urine that I am certain is due to the presence of a kidney stone. Get into my car and I’m taking you to the ER.”
Once at the ER, my physician’s diagnosis was confirmed.
What are Kidney Stones?
Kidney stones form when there is a decrease of urine in the body, combined with the presence of additional stone-forming products. Most kidney stones contain calcium along with oxalate or phosphate. However, other chemical compounds in the body, such as uric acid, can initiate kidney stone development.
Often, kidney stones will result from a lack of fluid intake, especially during exercise. Remember my situation – no fluid intake and heavy sweating during very warm weather.
Let me be clear. Having one workout and not replenishing fluids will not produce kidney stones. It takes many repeated situations like those I experienced before kidney stones will form.
While a lack of fluid intake is one reason for kidney stone development, there are other reasons why people may develop stones. People who have gout are at increased risk of developing kidney stones due to the increased amount of uric acid in the blood. Some dietary factors also may play a role in the development of kidney stones. People susceptible to kidney stones may increase their risk of recurrence if they consume a high intake of animal protein, excessive sodium, a diet high in sugar or, possibly, foods containing a high amount of oxalate, such as spinach.
More Common Than You Think
Until I had my first encounter with kidney stones – I say first as there have been several episodes since – I thought I was an anomaly. Much to my amazement, I was not so unique. In the months and years that followed, I came across many others who were “stonies” like me.
Recent headlines in the media have highlighted just how prevalent kidney stones have become. According to the latest reports from scientists at UCLA and the RAND Corp., one in 11 Americans now develops kidney stones. Compare this to one in 20 Americans who developed kidney stones in 1994.
The increase is staggering. Kidney stones are more common than heart disease, stroke and diabetes. What is typically considered a condition that initially strikes those who are in their 30s, 40s and 50s is now being becoming a problem among teenagers.
The number of teens diagnosed as having kidney stones has tripled between 2003 and 2008 when compared to the number of cases from 1984 to 1990. The sharp increase may be related to the rise in obesity and diabetes. Further research is being conducted to determine whether there is a cause and effect.
Treating Kidney Stones
Assuming the typical symptoms are suspected, a CT scan would be in order. The scan is the most common test to detect stones in the kidney or urinary tract. If kidney stones are detected, there are several options to consider.
Most stones will pass through the urinary tract on their own, usually within 48 hours assuming fluid intake is sufficient. Generally, a person who has kidney stones will be given a strainer so as to catch the stone during urination. The stone can then be analyzed, providing a course of action in preventing future occurrences.
If treatment is needed, a physician can remove the stone by inserting a thin telescopic instrument into the urinary tract and removing it or breaking it up. Lithotripsy, the use of high-energy shockwaves to break up the stones, can also be an effective treatment. I’ve experienced both of these procedures.
In difficult cases, surgery may be required. Thank goodness I’ve not had to travel this route.
Prevention is the key to avoiding bouts with kidney stones. Depending on the cause, dietary adjustments or medications may be recommended. In my case, and for so many others like mine, drinking plenty of fluids is important. Depending on weather and workout conditions, I now consume a minimum of 64 ounces of water daily. That’s been enough to keep me out of the ER for the past eight years.
Dr. Phil Heit is Professor Emeritus of Physical Activity and Educational Services at The Ohio State University.
