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KIDNEY STONES: THESE TOO SHALL PASS

If you're a man, you'll never experience the excruciating, exhilarating pain of labor and childbirth. But if you ever pass a kidney stone, you'll come pretty darn close.

About 12 percent of Americans will develop kidney stones at some point in their lives. Men are about four times more likely to get them than women -- it's Mother Nature's way of getting even for the childbirth thing.

White men are most likely to be afflicted, especially between the ages of 30 and 60. If you have a close family member with kidney stones, your risk of getting one rises by 25 percent. High humidity, hot weather and dehydration seem to play a role: Most kidney stones are born in the summer months.

If you're about to give birth to a kidney stone, you'll know it. You may have never witnessed the passage of a kidney stone, but if you've ever seen a woman trapped in the throes of labor, you'll get the idea.

Kidney stone pain often strikes without warning, usually in the back or side of the abdomen. The pain is intense enough to evoke profuse sweating and vomiting, and most victims stay in constant motion in their unsuccessful efforts to find a tolerable position. Many victims feel an overwhelming urge to urinate, only to find that they're unable to produce more than a small amount of blood-tinged urine.

Kidney stones are conceived when salts -- especially those made of calcium -- begin to crystallize in the urine. Over time, these salt crystals begin to stick together, growing layer by layer, until a stone is formed. This process is especially likely to occur in people who have low urine volumes.

Athletes who perform in hot weather and periodically suffer mild dehydration have a greater risk for kidney stones. Certain medical conditions promote stone formation, and so can some medications, like diuretics or antacids. Taking vitamins A, D, and C in excess may also contribute.

Although your first kidney stone will undoubtedly rank as a major life event for you, don't be surprised if your doctor -- who has probably seen his or her share of kidney stones -- remains calm. He or she will quickly recognize the familiar writhing motions of the kidney stone dance, and will try to alleviate your pain as quickly and completely as possible.

You'll probably be asked to provide a urine sample, and you may be subjected to an X-ray to help pinpoint the exact location of the trouble maker. If your urine is flowing well, and you're otherwise healthy, you'll probably be sent home with your doctor's heartfelt sympathy, some heavy-duty pain pills and a strainer for your urine.

You'll be instructed to deliver the thing in the privacy of your own home. Once it arrives, your doctor may want to see it and send it to the lab for further analysis and evaluation.

Most people with kidney stones are able to pass them without assistance. Whether or not a stone passes spontaneously depends mainly on its size -- the smaller the stone, the more likely it is to pass. Stones smaller than 4 millimeters have an 80 percent chance of being washed out with your urine, but larger ones may require assistance.

If you're unable to deliver it on your own, your doctor may refer you to a urologist -- a specialist that's highly skilled in kidney stone midwifery. Thanks to modern technology, urologists have a lot of neat ways to get rid of your gravel without resorting to surgery.

If the pesky little rock doesn't plop out on its own, you can have it zapped out with laser or fiberoptic technology, electrical sparks or shock waves. These high-tech treatments for pulverizing your kidney pebbles are high priced -- Americans spend about $2 billion dollars a year trying to rid themselves of their little calcified gems.

People who've had a kidney stone will tell you that prevention is the very best medicine. One of the most important things you can do is drink a lot of fluid -- some experts recommend as much as two liters a day.

And it does matter what you drink. In one study, men who drank apple juice and grapefruit juice had at least a 35 percent greater risk of developing a stone. Cranberry juice, tea, coffee, beer and wine were all shown to reduce the risk.

If you should find yourself giving birth to a kidney stone, try to look at the bright side -- at least you don't have to send it to college.

Dr. Rallie McAllister is a family physician in Kingsport, Tenn. Her column appears three times a month on this page.

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