An extensive conversation with my urologist about kidney stones and kidney functioning.

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* When my 2.03 result was taken, I hadn't eaten breakfast that morning or dinner the night before. My eating hasn't been particularly regular. I've also been dieting the past 6 weeks, I've lost 20 pounds. Could any of this have had an affect on that result? 
    * My BUN level was normal during this test.
    * He said that this could have had an effect, sure. Usually it's dehydration due to fasting that causes elevated creatinine, though. He also mentioned the NSAIDs could have been a factor as well. 
* At times I drank closer to 2-3L of water in a single sitting to try to flush out the stone, one such time was 8 hours before that first blood test. It certainly caused a lot of pain, which I assume was ureter dilation. Could that have also caused worsening hydronephrosis and consequently elevated creatinine in the following 8-hour period? 
    * He said that hydronephrosis wouldn't actually cause reduced kidney function, amazingly. So this was probably a non-factor. He also said that really you only need half of one kidney functioning in order to keep your creatinine levels at normal, so I probably have weaker kidneys that can't respond well to this sort of thing since mine went up to a 2.0. 
* If my high creatinine is caused by hydronephrosis, why would I go to the IV and get pumped full of another liter of fluid, probably exacerbating the hydronephrosis, thus worsening kidney function further and raising creatinine higher?
    * I know creatinine itself is just a proxy used to determine kidney function and its level in the blood in isolation doesn't matter much.
* We have well water at my house, could that have been a factor? 
    * Not any study that there's well water worse. 
* 
* Do I need to drink water regularly throughout the day or can I do it in two sittings, lunch and dinner?
    * It's the same. 
* Do I have another kidney stone? Why didn't it show up in the first CT, the first ultrasound, or the X-ray I had? 
* Should get the stuff from the outside company in ~6 weeks.

Calcium oxalate, calcium phosphate. 
Adding water, or could add lemon or citrus, that actually reduces the acid. Alchelize your urine.  Low salt diet. 

Spinach, tea, nuts, chocolate. 

Kits, work on prevention stuff. 

Make sure stone in right. 50% chance of staying it there forever. It's not going to pass since it's in the lower pole. 










Urologist


12 days ago, went to ER with severe pain and repeated vomiting. Quickly suspected kidney stone. Asked me to pee, saw blood immediately. CT confirmed. 3.8mm stone. Pain was bottom left stomach. Left with 800mg Advil as needed, taking Tylenol as needed, flomax as every day, Zofran as needed. Don’t want to use the opioid they gave, can handle the pain. 

Intermittent pain throughout the week. Usually when I decide to chug water quickly. Been drinking minimum 2 liters a day, except some of the hospital days. Occasional blood, only needed to take Zofran once. No fever. No difficulty peeing. With 2 liters a day, I’ve been peeing about once an hour. Passed two small stones, probably fragments of the big stone, each probably 0.25mm-0.5mm. 

5 days ago went to PCP for re-up on Flomax. PCP wanted to check in on cerantinine level. It was 1.25 when I was admitted to the ER. Later that day he called and told me he strongly advises going to the emergency room tonight or tomorrow morning because my results came back and cerantinine is 2.03 and I needed to talk to a urologist immediately because they may want to do emergency surgery tonight or tomorrow. I found this recommendation suspicious, given the stone’s size, given no change in symptoms, but after talking to my parents I decided to go. 

ER have an IV with fluids, took a urine sample, and did an ultrasound. 

Then I saw a urologist on Wednesday. He did an X-ray, blood test, and urine sample. Called me yesterday and told me my creatinine had gone down to 1.4. 




Lifestyle:
- [ ] Gained 40 pounds on Prozac in about 8 months in 2019. Went off Prozac early June and have been dieting significantly, large calorie reduction to ~1300/day. I’ve lost 20 pounds in the past 6 weeks. That has probably been accompanied by reduction in water intake. 
- [ ] Eat the same things every day: mini wheats, pasta with red sauce, ice cream or Oreos for dessert typically. Lunch is usually very minor, like a muffin. 
- [ ] Urine wise, I wasn’t entirely surprised by the kidney stone in hindsight mostly because my girlfriend and family have commented on how dark my urine since I was a child.