If pain builds character, then kidney stones are surely the path to salvation. Mothers will tell you they would rather give birth to twins, breech, than pass one. Men who have faced combat would prefer to take a bullet than pass one. So, when Eric Tygenhof, MD, a board-certified urologist with expertise in kidney stone treatment joined St. Jude Medical Center in Fullerton three years ago, he was troubled by the number of repeat patients he saw suffering severe pain from these vicious rock outcroppings.
The new St. Jude Kidney Stone Center is Dr. Tygenhof’s brainchild and for kidney stone patients, just what they need. The Center brings a holistic approach with experts in urology, nephrology and nutrition for the treatment of stones and ongoing prevention strategies. “There is a 50 percent chance that someone who has had a kidney stone will have another within 5 years; and an 80 percent chance within 10 years,” says Dr. Tygenhof. “There are risk factors such as genetics but just because your parents didn’t pass a kidney stone, doesn’t mean you won’t.”
Stones can be as small as a grain of salt or the size of an egg or larger. They are made of salt and minerals that, over time, amass into a kidney stone. Most primary care doctors are not equipped to treat them, and often lack the expertise to counsel the patient on management and prevention after the first stone makes its death march through one’s urinary tract.
A kidney stone episode can begin with a sudden sharp pain, or with a little irritation that amplifies over a few hours to crushing agony and nausea. In some cases, there are no symptoms at all. They can be lodged in the kidney or bladder or somewhere along the ureter. “The first step is to get the pain under control,” says Dr. Tygenhof. “The size and location of the stone is the biggest factor in determining the treatment. There is a bit of an art to choosing the right approach.”
“In the past, surgery to remove a stone was the best option, but today there are many more treatments that are effective and less invasive.” In layman’s terms, there is the camera method or the laser method. In the first, a tiny camera is inserted to locate the stone and remove it. The laser option is generally used on larger stones. It is inserted through the back, directly into the kidney where the stone is broken apart and removed.
With the high probability of a recurrence, the real value of the Kidney Stone Center is the individualized management program. Many people are not aware that kidney stones can be prevented. According to Dr. Tygenhof, “For everyone who has had a kidney stone I recommend a lot of hydration. Patients should aim for 96 ounces of water every day and avoid caffeine, sugar and alcohol. I also recommend that they adopt a low salt diet because to get rid of salt, the body dumps both salt and calcium through the urinary system which sets the patient up for another stone.”
The next step is a variety of blood and urine tests that assess the patient’s unique metabolic profile. “Based on the results we can make specific diet, supplement or medication recommendations that reduce the risk of a recurrence.”
Patients who have gout have a greater chance of recurrence. In addition, diabetes, obesity, excess meat consumption and laxative abuse can also contribute to the problem. Since it opened the center has treated more than 200 patients, most of them have opted to remain in the prevention and management program.
There are some who suggest a ride on a roller coaster will help pass kidney stones. But if your idea of medical intervention does not include riding Big Thunder Mountain while experiencing excruciating pain and nausea, then St. Jude’s Kidney Center is worth considering.