Women and Children are Getting Kidney Stones More Often

For the past several decades common thinking was that   a kidney stone usually develops in males who are middle-aged, obese. It was attributed to men who follow an unhealthy diet and take less water. The books taught us the same but with the recent studies we may need to rewrite and rethink regarding stones. A recent study done in US suggest that the overall incidence of kidney stones is going up and also mentioned that children and women who were not considered high risk before are now forming more stones.

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Why do we form kidney stones?

Kidney stones develop due to crystallization (akin to Mishri/Rock Sugar) of certain chemicals in the urine (most commonly calcium oxalate, phosphate or uric acid. Small crystals can pass from your body through the urine without you ever knowing about them. When the crystals grow larger and become stones, they can get stuck in the ureter and block the flow of urine. This causes infection and pain.

What Are the Risk factors for stone formation?

Risk factors are

·         Diet: typical western diet including high intake of animal protein, sodium, and sugar.

·         Chronic dehydration, low intake of fluids

·         Health Issues like  gout, diabetes, obesity, Inflammatory bowel disease (Crohn's disease and ulcerative colitis) or intestinal bypass(Bariatric Surgery or ostomy surgery)

·         Family history: kidney stones can run in families (incidence increases with number of effected close relatives. Some rare disorders can cause kidney stones. Some of those disorders are:

·         Renal tubular acidosis, sometimes a hereditary disease

·         Cystinuria (crystals of cystine form)

·         Hyperoxaluria (crystals of oxalate form)

·         Absorptive hypercalciuria (the body takes in too much calcium from food)

·         Medications:  calcium supplements, Protein supplements, diuretics or calcium-based antacids 

While a specific cause may be impossible to identify, kidney stones are common, affecting about 19% of men and 9% of women by age 70.

Doc why should I bother regarding stones?

I will suggest just ask someone who had a recent episode of ureteric colic. Believe me it’s akin to labor pain!!!

Seldom will you find that kidney stones are discovered incidentally and pass on their own, never causing symptoms or needing treatment. By and large they become stuck (usually at vesicoureteric junction) leading to pain, blood in urine or infection.

They can become stuck anywhere in the urinary system, including the kidney, the ureters (the narrow tubes connecting each kidney to the bladder), the bladder, or the urethra.

 In addition to pain and urinary problems, kidney stones can also cause bleeding and resultant kidney damage. They can increase the risk of a urinary tract infection and have even been linked to cardiovascular disease. So yes it’s high time you start bothering.

Recent Research and Evidence

A latest study published in the Clinical Journal of the American Society of Nephrology describes an analysis of over 150,000 people in US with kidney stones.

 The study findings were:

·         The frequency of kidney stones increased by 16% over a period of 15 years.

·         The principal increases were among children, women, and African Americans.

·         While more men than women had kidney stones (as has been noted in the past)

·         In the age group (< 25 years) women outnumbered men.

Why are we forming more stones?

This study like the ones in the past is not been able to elucidate the reason kidney stones seem to be on the rise. The postulated theories may be increase rate of obesity especially among children and global warming (leading to dehydration). We need more research to understand why stones are becoming more common. Bottom line: it’s an enigma. If we can figure it out why  there’s a good chance we can find superior ways to stop them.

What’s one should do?

If you have symptoms of kidney stones, see a Urologist. The most common symptoms are waves of pain in the back or lower abdomen, pain with urination, or blood in the urine.

If you’ve already been diagnosed with a kidney stone, it’s important to figure out why it happened (if possible) and take steps to avoid recurrence. See your urologist to discuss dietary measures and medications to take (or avoid). The details vary depending on the type of stone you had and the results of your blood and urine tests.  

PREVENTION IS THE KEY

AS mentioned above its better to prevent stones by following healthy life style and taking plenty of water. Ask anyone who has had pain due to stones it is definitely not your cup of tea.

Spinal Cord Stimulation

Spinal cord and brain are part of the nervous system. In order to understand the working of the spinal cord stimulators and their effect on back pain, the working of the nervous system can help us to a large extent.

Electrical currents sent into the spinal cord interrupt the pain signals much before they can reach the brain; this reduces the symptoms and the effect of the back pain. The spinal cord stimulation method has a large effect on the back pain and its reduction of the same.

Comparing the Types of Stimulation

Spinal cord stimulation is a technique which is very specific patient based.  There are many methods which offer this technique, every one of it having its advantages and disadvantages. Which will work for one, can only be decided, once the patient is properly examined and diagnosed by the treating doctor.

Tonic Spinal Cord Stimulation

This is the longest used method of spinal cord stimulation. Also referred to as the low frequency spinal cord stimulation.

Here, lower frequency impulses of the strength of less than 1000 Hz are given to the patient. This makes the patient feel a slight tingling or a special vibration sensation, which changes the sensation of strong back pain to very slight tingling sensation. The stimulation electrodes placed into the spinal canal will stimulate spinal cord pathways, reducing the activity within separate pain pathways which carry pain signals up to the brain.

High Frequency Spinal Cord Stimulation

This is a more new form of spinal cord stimulation which involves high frequency electrical impulses of the frequency of 10,000 Hz. The electrodes placed into the spinal canal directly stop or inhibit the pain pathways, making them unable to carry pain signals to the brain.

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This is the most effective methods of the spinal cord stimulation, nevertheless the patients get more comfortable in responding to tonic or burst techniques of spinal cord stimulation. An important part of how spinal cord stimulators can help your back pain is that they allow for trial periods. If one type of stimulation doesn’t provide effective results, you can try another.

Burst Stimulation

This technique is the most recent form of spinal cord stimulation which is performed by giving intermittent bursts of high frequency impulses to the patient who is experiencing the back pain. The stimulation electrodes work with a two way solution, not only do they inhibit the pain from reaching the brain but it also reduces the emotional effects of the pain on the individual. 

The result is that patients typically feel less or no pain. If pain still exists, patients often report it as much less severe than their typical experience.

What to Expect?

The first step in spinal cord stimulation treatment is to place the stimulator. Both the trial and the permanent implantation involve outpatient procedures that may be performed either awake or asleep, depending on the type of stimulation that is being used.

Your surgeon will use an X-ray to visualize your spine and guide wires with small electrodes to the area where the pain is located. After that, they will activate the generator and you will work together to decide where exactly the electrodes should be placed. Your feedback during this stage may be important (depending on the waveform being used) — make sure that you tell your surgeon where you feel the stimulation so that they can place them accurately.

Once you and your surgeon have settled on the right place for the electrodes, the trial stimulator will be left in place. Immediately after the operation, the electrodes in your spine will be connected to an external generator, where they will stay for about a week. To determine whether the treatment is working properly, your surgeon will ask that you record your pain levels at different times of the day and in different situations.

If, after your trial period, you aren’t satisfied with the results, you can easily redo the procedure using a different waveform. Once you identify a waveform that is working well, you will return to your surgeon to have a permanent spinal cord system implanted. This procedure, like the electrode placement procedure, is relatively simple and done on an outpatient basis.

Final Thoughts

Spinal cord stimulation is an effective way to address back pain that hasn’t responded well to other forms of treatment, and it comes with a high level of flexibility.

Take the next step toward a more active and comfortable lifestyle and schedule a consultation today.