12 Facts About Kidney Stones

Illustration by Mental Floss. Images: iStock
Illustration by Mental Floss. Images: iStock

Kidney stones are more common than ever. According to Harvard Medical School, every year more than 3 million people see a doctor for relief from these hard mineral and salt deposits, which form in your kidney when urine becomes too concentrated. Here's what we know about the condition formally called nephrolithiasis.

1. KIDNEY STONES TYPICALLY CAUSE REALLY PAINFUL SYMPTOMS.

At first you may notice your urine is cloudy, bloody, and foul smelling. Your back may begin to ache, and nausea may come over you. Then, as the stone moves from your kidney into your urinary tract or bladder, sometimes becoming trapped, there’s often an intense, stabbing pain that many people say they wouldn’t wish on their worst enemy.

2. MOST PEOPLE DEVELOP ONE TYPE OF STONE …

What kind of kidney stone you get depends on your diet, fluid intake, genetics, hereditary disorders, and even whether you take certain medications, but the vast majority of people get calcium oxalate stones. They're formed from a mix of calcium in urine and the compound oxalate, which is found naturally in food like nuts, chocolate, and some vegetables, including beets and spinach; oxalate is also produced by your liver. There's some evidence that people who take the seizure medicine topiramate can develop these stones in the form of calcium phosphate.

3. … BUT THERE ARE THREE OTHER KINDS TOO.

Struvite stones are fast-growing mineral deposits that typically develop in response to a urinary tract infection, and can grow large enough to block the kidney, ureter, or bladder before you notice any symptoms; they affect women more than men. Uric acid stones turn up in people who eat a lot of red meat, shellfish, and organ meats, which contain hefty doses of an organic compound called purine that can lead to more uric acid than the kidneys can excrete. Cystine stones are caused by a rare hereditary disorder called cistinuria in which your kidneys excrete excessive amounts of the amino acid cystine.

4. THEY'RE EXTREMELY COMMON—ESPECIALLY IN MEN.

There's a solid chance you could end up with a kidney stone. The National Kidney Foundation notes that one in 10 people will develop one during the course of their life. And if you’re male, take note: Your gender alone is considered a kidney stone risk factor. Men are twice as likely as women to develop them. Another factor is age: Although stones are most common from ages 20 through 50, they tend to peak around age 30.

5. IF YOU’VE HAD A KIDNEY STONE, YOU’LL PROBABLY DEVELOP ANOTHER ONE …

Sorry to say, but simply having a kidney stone puts you at risk for a recurrence. If you’ve had one, the U.S. National Library of Medicine notes that there’s a 30 to 50 percent chance more stones will form within five years.

6. … BUT YOU CAN TAKE STEPS TO PREVENT THEM.

Cutting back on sodium (i.e. deli meats, packaged soups, and processed foods) can help, because a stone can form from excessive salt consumption. You should also avoid too much animal protein—it produces urine containing more acid, which is known to increase your risk for kidney stones—and increase your intake of fruits, vegetables, whole grains, and low-fat dairy. And be sure to drink plenty of fluids, especially water—at least 12 glasses a day. (That's good advice for everyone, not just those prone to kidney stones.)

Don't drink much apple or cranberry juice as both contain oxalates and are linked to an increased risk of developing calcium oxalate stones. High doses of Vitamin C may boost the concentration of oxalate in urine; the Cleveland Clinic recommends a daily maximum of 500 milligrams.

7. IT'S A MYTH THAT CALCIUM CREATES SOME KIDNEY STONES.

Despite the fact that the word calcium is part of the most common kind of kidney stone, you don’t need to treat calcium as the enemy. In fact, having too little calcium can actually increase the odds you’ll get these types of stones. According to the Cleveland Clinic, eating about two or three servings of calcium-rich foods daily reduces oxalate absorption, helping to keep calcium oxalate stones away. So get out the cheese.

8. IF YOU PASS A STONE, CONGRATULATIONS! NOW TAKE IT TO A DOCTOR.

Ninety percent of kidney stones are passed through urination. Getting one out this way may hurt a lot, but once the stone has finished causing you agony, it could provide clues that could help you avoid developing another one. If you’re able to retrieve the stone, bring it to your doctor, who can order an analysis. Identifying its components can reveal the kind of stone it is and potentially point to a treatment or prevention plan.

9. IF YOU CAN’T PASS A STONE, TREATMENTS ARE AVAILABLE …

In an attempt to exit the body, a stone travels from the kidney to the bladder through a narrow tube called the ureter. If the stone is larger than a quarter-inch, it's simply too big to pass through the ureter, and will get trapped there. (If it can make it through to your bladder, it's small enough to pass out out of your body through the urethra.) This causes intense pain, blocked urine flow, and possible bleeding from urinary tract walls. That's when it's time for treatment.

There are several methods for getting rid of a kidney stone, all of which aim to break the stone into smaller pieces so they can leave the body. In an extracorporeal shock wave lithotripsy (from the Greek for "crushed stone"), high-frequency sound waves are applied externally to break stones up, allowing them to pass when you pee. Laser lithotripsy takes a similar approach: Stones in the ureter are broken up with a laser and also leave the body naturally. More invasive is percutaneous ultrasonic lithotripsy, which involves passing narrow instruments (including a fiberoptic camera) through your back to your kidney; ultrasound breaks the stones up, and then fragments are removed by an instrument. Finally, a ureteroscopy is a treatment option in which a small scope is inserted in the ureter towards the bladder to determine the stone's location. Then it's broken up for natural passage or removed altogether. Luckily, you're unconscious under general anesthesia during the last procedure.

10. … AND THEY'RE FAR SUPERIOR TO THOSE USED IN THE PAST.

Kidney stones are nothing new—mentions of the painful formations go back more than 5000 years, to Mesopotamian medical texts—and medical interventions have occurred for just as long. Stones made it into the Hippocratic Oath, in which physicians swore they would "not use the knife, not even on sufferers from stone," leaving the procedure to "such men as are engaged in this work" [PDF]. Surgeons in ancient Greece and India were attempting stone removal as far back as the 7th century BCE.

The 16th to 18th centuries were a heyday for stone surgeons, who were largely self-taught. The most notorious of them was Frere Jacques Beaulieu. He pioneered the lateral perineal lithotomy—which involved making an incision in the perineum, inserting a terrifying cutting instrument into the bladder, cutting up the stone, and then extracting the pieces with the instrument or his fingers—in the late 17th century. Unfortunately for his patients, he had no technical training, and his method was often deadly; in 1698, after 25 of his 60 patients died, he was banned from doing the procedure—but he didn't stop. He's thought to have performed more than 5000 lithotomies. (And no, the song doesn't seem to be about him.)

11. IF ALL ELSE FAILS, TRY RIDING A ROLLER COASTER.

If you’re a thrill seeker who happens to have kidney stones (and some vacation time), you may be in luck. After a "notable number" of patients reported that riding the Big Thunder Mountain roller coaster at Walt Disney World in Orlando helped them to pass their kidney stones, Michigan State University urologist David Wartinger decided to investigate. He created a kidney replica—complete with kidney stones—put it in a backpack, and let it ride the roller coaster 60 times. It worked—but passing the stones depended on where the backpack was placed in the coaster. Rides in the last car were the most effective, with the stones passing 64 percent of the time, while the front few cars yielded only a 16 percent success rate.

Big Thunder Mountain was the only ride in the theme park that was effective. Neither Space Mountain nor Aerosmith's Rock 'n' Roller Coaster did the trick, likely because they were too fast, with a G-force that pinned the stones in place. Of course, while this is an interesting finding, if you suspect you have kidney stones, speak to your doctor before you high-tail it to Walt Disney World.

12. A KIDNEY STONE THE SIZE OF A MOUSE WAS REMOVED FROM A MAN IN 2004.

The stone measured 5.11 inches at its widest point—a world record. Five years later, a whopping 2.5-pound stone was surgically removed from a man in Hungary in 2009. Perhaps seeing a bunch of kidney stones in one place other than originating from your own body will put you at ease. If that’s the case, check out the International Museum of Surgical Science in Chicago, where a collection of stones is on display in glass jars.

8 Enlightening Facts About Dr. Ruth Westheimer

Rachel Murray, Getty Images for Hulu
Rachel Murray, Getty Images for Hulu

For decades, sex therapist Dr. Ruth Westheimer has used television, radio, the written word, and the internet to speak frankly on topics relating to human sexuality, turning what were once controversial topics into healthy, everyday conversations.

At age 90, Westheimer shows no signs of slowing down. As a new documentary, Ask Dr. Ruth, gears up for release on Hulu this spring, we thought we’d take a look at Westheimer’s colorful history as an advisor, author, and resistance sniper.

1. The Nazis devastated her childhood.

Dr. Ruth was born Karola Ruth Siegel on June 4, 1928 in Wiesenfeld, Germany, the only child of Julius and Irma Siegel. When Ruth was just five years old, the advancing Nazi party terrorized her neighborhood and seized her father in 1938, presumably to shuttle him to a concentration camp. One year later, Karola—who eventually began using her middle name and took on the last name Westheimer with her second marriage in 1961—was sent to a school in Switzerland for her own protection. She later learned that her parents had both been killed during the Holocaust, possibly at Auschwitz.

2. She shocked classmates with her knowledge of taboo topics.

Westheimer has never been bashful about the workings of human sexuality. While working as a maid at an all-girls school in Switzerland, she made classmates and teachers gasp with her frank talk about menstruation and other topics that were rarely spoken of in casual terms.

3. She trained as a sniper for Jewish resistance fighters in Palestine.

Following the end of World War II, Westheimer left Switzerland for Israel, and later Palestine. She became a Zionist and joined the Haganah, an underground network of Jewish resistance fighters. Westheimer carried a weapon and trained as both a scout and sniper, learning how to throw hand grenades and shoot firearms. Though she never saw direct action, the tension and skirmishes could lapse into violence, and in 1948, Westheimer suffered a serious injury to her foot owing to a bomb blast. The injury convinced her to move into the comparatively less dangerous field of academia.

4. A lecture ignited her career.

 Dr. Ruth Westheimer participates in the annual Charity Day hosted by Cantor Fitzgerald and BGC at Cantor Fitzgerald on September 11, 2015 in New York City.
Robin Marchant, Getty Images for Cantor Fitzgerald

In 1950, Westheimer married an Israeli soldier and the two relocated to Paris, where she studied psychology at the Sorbonne. Though the couple divorced in 1955, Westheimer's education continued into 1959, when she graduated with a master’s degree in sociology from the New School in New York City. (She received a doctorate in education from Columbia University in 1970.) After meeting and marrying Manfred Westheimer, a Jewish refugee, in 1961, Westheimer became an American citizen.

By the late 1960s, she was working at Planned Parenthood, where she excelled at having honest conversations about uncomfortable topics. Eventually, Westheimer found herself giving a lecture to New York-area broadcasters about airing programming with information about safe sex. Radio station WYNY offered her a show, Sexually Speaking, that soon blossomed into a hit, going from 15 minutes to two hours weekly. By 1983, 250,000 people were listening to Westheimer talk about contraception and intimacy.

5. People told her to lose her accent.

Westheimer’s distinctive accent has led some to declare her “Grandma Freud.” But early on, she was given advice to take speech lessons and make an effort to lose her accent. Westheimer declined, and considers herself fortunate to have done so. “It helped me greatly, because when people turned on the radio, they knew it was me,” she told the Harvard Business Review in 2016.

6. She’s not concerned about her height, either.

In addition to her voice, Westheimer became easily recognizable due to her diminutive stature. (She’s four feet, seven inches tall.) When she was younger, Westheimer worried her height might not be appealing. Later, she realized it was an asset. “On the contrary, I was lucky to be so small, because when I was studying at the Sorbonne, there was very little space in the auditoriums and I could always find a good-looking guy to put me up on a windowsill,” she told the HBR.

7. She advises people not to take huge penises seriously.

Westheimer doesn’t frown upon pornography; in 2018, she told the Times of Israel that viewers can “learn something from it.” But she does note the importance of separating fantasy from reality. “People have to use their own judgment in knowing that in any of the sexually explicit movies, the genitalia that is shown—how should I say this? No regular person is endowed like that.”

8. She lectures on cruise ships.

Westheimer uses every available medium—radio, television, the internet, and even graphic novels—to share her thoughts and advice about human sexuality. Sometimes, that means going out to sea. The therapist books cruise ship appearances where she offers presentations to guests on how best to manage their sex lives. Westheimer often insists the crew participate and will regularly request that the captain read some of the questions.

“The last time, the captain was British, very tall, and had to say ‘orgasm’ and ‘erection,’” she told The New York Times in 2018. “Never did they think they would hear the captain talk about the things we were talking about.” Of course, that’s long been Westheimer’s objective—to make the taboo seem tame.

10 Things You Should Know About Asthma

iStock.com/Wojciech Kozielczyk
iStock.com/Wojciech Kozielczyk

To anyone with asthma, the feeling of an attack is unmistakable. Patients have compared an asthma attack's feeling of breathlessness, caused by inflammation in the lungs and airways, to being smothered by a pillow or having an elephant sit on their chest. Medical experts have already figured out some aspects of asthma, like how to diagnose and treat it, but other components, like what causes asthma and how to cure it, remain unclear. From the triggers people encounter at work to the connection to allergies, here are some facts about asthma symptoms and treatments you should know.

1. Asthma attacks are related to allergies.

The physical process that occurs when someone has a sneezing fit during pollen season is similar to what happens during an asthma attack. But while the former causes discomfort, the latter produces potentially life-threatening symptoms. When people with allergies are exposed to an allergen like pollen, they produce antibodies that bind to that allergen. This signals the body to release the chemicals that cause allergic symptoms. In most people, the symptoms are limited to the head, such as a runny nose or watery eyes, but in people with asthma, they're felt in the lungs. If the lungs are inflamed, the airways that carry air swell up and fill with mucus, constricting airflow and causing common asthma symptoms like coughing, wheezing, and shortness of breath. Such asthma attacks can be fatal when patients can’t get enough air to their lungs.

2. Asthma is the most prevalent chronic disease among children.

Asthma is common, affecting 25 million in the U.S. alone, and of those patients, about 7 million are children. Most people with the disease develop it during childhood. Asthma is the most prevalent chronic illness among kids, and each year, students miss 13.8 million school days because of it.

3. Asthma may be inherited.

Doctors aren’t entirely sure what causes asthma, but they know it sometimes runs in families. A 2010 study found that people with one parent with the condition were nearly twice as likely to have it themselves, and people with a parent and a grandparent with asthma were four times more likely to develop it. Because asthma is connected to allergies, a genetic disposition toward allergies, known as atopy, may explain some inherited asthma cases.

4. Asthma is surprisingly easy to diagnose.

One of the simplest ways to diagnose asthma is through a lung function test. If a patient is reporting asthma symptoms (coughing, chest tightness, a feeling of not getting enough air), their doctor may check the strength of their exhalations before and after having them use an inhaler. If their breathing improves with the medicine, they likely have asthma. An X-ray of the patient’s chest can also be used to reach an asthma diagnosis.

5. Kids who grow up around germs are less likely to have asthma.

A person’s environment early in life may also play a role in whether or not they develop asthma. People who grew up in rural areas, around animals, and in large families are less likely to have asthma than those who did not. One possible explanation is the hygiene hypothesis: According to this theory, kids who were exposed to germs and pathogens while their immune systems were developing are better equipped to deal with allergens, while kids who were sheltered from germs may be more likely to have an exaggerated (and in the case of asthma, potentially deadly) immune response to harmless substances. The hygiene hypothesis hasn’t been proven, however, and it’s definitely not an excuse to expose children to infections in an attempt to strengthen them against asthma attacks in the future.

6. Asthma triggers are everywhere.

To manage their symptoms, doctors tell asthma patients to limit exposure to their triggers when possible. Common asthma triggers include irritants and allergens like dust, tobacco smoke, car exhaust, mold, pet dander, and smoke from burning wood. Triggers that don’t come from the environment, like colds, sinus infections, acid reflux, and hyperventilation brought on by stress, can be even harder to avoid.

7. There's one asthma trigger patients shouldn't avoid.

Physical activity causes fast breathing, which can provoke asthma attacks in some people with the condition. There’s even a type of asthma called exercise-induced bronchoconstriction that specifically describes people who suffer from these kinds of attacks. But the risks of living a sedentary lifestyle outweigh those of exercising carefully, even with asthma. Instead of cutting out cardio altogether, doctors work with patients to come up with an exercise plan that’s safe for them. This might include warming up and using an inhaler before working out, practicing cool-down activities afterward, and wearing scarves or masks to limit exposure to irritants that may also trigger asthma symptoms.

8. There are two types of asthma treatments.

Long-term controllers and quick-relievers are the two types of medications used to treat asthma. Immediate medicines like short-acting beta agonists and anticholinergics relax muscles in the airways when flare-ups occur, and they’re typically administered directly to the lungs with an inhaler. Long-term medications help keep asthma symptoms under control over time are taken as often as once a day, regardless of whether symptoms are present. They include inhaled long-acting beta agonists and corticosteroids, biologic injections, and theophylline and leukotriene modifier pills and liquids. All of these medications suppress asthma symptoms by either relaxing muscles, reducing swelling, or preventing inflammation in the airways.

9. Asthma can be an occupational hazard.

Occupational asthma develops when a patient’s triggers come from their work environment. According to the National Institutes of Health, wood dust, grain dust, animal dander, fungi, and various chemicals are some of the most common asthma triggers that patients encounter in the workplace. Bakers, farmers, laboratory workers, millers, and woodworkers predisposed to asthma are all at higher risk.

10. There's no cure for asthma, but symptoms can lessen over time.

Though asthma is treatable, there’s no cure for the chronic illness. Some people, however, do appear to grow out of the condition after suffering from it as kids. It’s possible for asthma symptoms to become less severe and go into remission as patients get older, but once someone is diagnosed with asthma, the risk of an episode never goes away completely. Changes in hormone levels are a factor that could possibly bring asthma symptoms back in patients who haven’t experienced an attack in years.

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