ROLLING STONES A PAINFUL KIDNEY CALAMITY

Dr. John Hall examined the X-ray film that showed a patient's kidney stones.

Anyone who has ever passed a kidney stone would agree that even once was too much. "Most men who've had a stone say it's the most painful experience they've ever had in their life," said renal specialist Gary Curhan, an instructor in medicine at Harvard. "And I've had women tell me they'd rather go through childbirth again than have another stone."

Kidney stones are hardened mineral deposits that form inside the kidneys and can begin to painfully work their way through the ureter and into the bladder. The pain from the ureter attempting to dislodge the stone can be excruciating and can incapacitate the patient. Most cases develop in men between age 20 and 40. Up to 10 percent of men and 3 percent of women will develop a stone at some point in their lives.

According to Dr. E. Randy Eichner, in an article written in Men's Health magazine, there are steps one can take to avoid getting the painful stones.

Drink plenty of water. At least eight glasses a day is recommended.

Cut down on beef. A diet rich in animal protein increases your risk of getting stones by boosting the amount of uric acid in the urine.

Lower salt intake. Sodium makes the kidney hold onto calcium crystals, which can turn into kidney stones.

Add potassium. The easiest way to boost potassium is to eat fresh produce, especially oranges, nectarines, bananas and potatoes.

Generally, there have been three basic choices of treatment for kidney stones: wait and hope the stones pass through the urinary tract; intervention through surgery; and most recently, percutaneous endourology in which a tube is inserted through a small puncture into the kidney and the stone is extracted by use of forceps or is broken into small particles with an ultrasonic probe.

Among drawbacks to these choices of treatment are postoperative pain and a lengthy convalescence.

An alternate treatment, developed at the University of Munich in the early 1980s and approved by the U.S. Food and Drug Administration in 1984, is extracorporeal shock wave lithotripsy or ESWL. Lithotripsy comes from the Greek words "lithos," meaning stone, and "tripsis," meaning to crush. ESWL is literally a method of crushing kidney stones without cutting into the body.

The principle behind lithotripsy involves shock waves and basic physics. Research showed shock waves generated outside the body can pulverize renal stones in the kidneys and ureters without damaging surrounding tissue. Shock waves are passed through a water-filled tub in which the patient sits. Once crushed, the small particles can often be passed with little or no discomfort.

Lithotripsy has been offered at St. Francis Medical Center since the late 1980s. Kathy McKinley, a urology nurse specialist, has been involved in the procedure at St. Francis since its inception.

"There are few side effects," McKinley said, adding there is moderate bruising and a little muscle soreness. For the most part, patients with no other health problems are able to go home the same day or at least within 23 hours.

Lithotripsy was called a "modern medical miracle" by former Secretary of Health and Human Services Margaret Heckler.

Dornier Medical Systems Inc., manufacturer of the lithotripter that St. Francis shares with other hospitals, estimates that as many as 90 percent of all kidney stone sufferers are candidates for lithotripsy. Primary candidates are those with single upper stones smaller than 3 centimeters in diameter, but large enough to be seen using X-rays.

In the years since the government approved lithotripsy for use in the United States, major complications have been rare. The overall safety record has been outstanding compared to other forms of treatment.