What are kidney stones?

Kidney stones are just what they sound like: small stones that form inside the kidneys. They form when salts and minerals that are normally in the urine build up and harden.

Kidney stones usually get carried out of the body when you urinate. But sometimes they can get stuck on the way out. If that happens, the stones can cause:

Pain in your side or in the lower part of your belly

Blood in the urine (which can make urine pink or red)

Nausea or vomiting

Pain when you urinate

The need to urinate in a hurry

 

How do I know if I have kidney stones?

If your doctor or nurse thinks you have kidney stones, he or she can order an imaging test that can show the stones.

What if I have kidney stones?

Once we have confirmed the stones, we also order additional type of tests to ascertain type, size and location so that we can create an individual treatment plan to get rid of the stones and also teach you how to prevent kidney stones in future.

Each person's treatment is a little different. The right treatment for you will depend on:

The size, type, and location of your stone

How much pain you have

How much you are vomiting

 

If your stone is big or causes severe symptoms, you might need to stay in the hospital. If your stone is small and causes only mild symptoms, you might be able to stay home and wait for it to pass in the urine. If you stay home, you will probably need to drink a lot of fluids. Plus, you might need to take pain medicines or medicines that make it easier to pass the stone.

Stones that do not pass on their own can be treated with:

A machine that uses sound waves to break up stones into smaller pieces. This is called "shock wave lithotripsy." This procedure does not involve surgery, but it can be painful.

 

A special kind of surgery that makes very small holes in your skin. During this surgery, the doctor passes tiny tools through the holes and into the kidney. Then he or she removes the stone. This is called "percutaneous nephrolithotomy."

 

A thin tube that goes into your body the same way urine comes out. Doctors use tools at the end of the tube to break up or remove stones. This is called "ureteroscopy."

 

How to prevent kidney stones from forming? 

One simple thing you can do is to drink plenty of water. You might also need to change what you eat, depending on what your kidney stones were made of. If so, your doctor or nurse can tell you which foods to avoid. Your doctor or nurse might also prescribe you new medicines to keep you from having another kidney stone.

 

Please tell me more about what dietary modifications I need to make?

It depends on the type of the stone. Ask us to do 24 hours urine test to understand what dietary contributing factors are responsible.  Based on that we can suggest changes. 

 

Some of the generic modifications we suggest are as follows.

From the viewpoint of diet, alterations in fluid, calcium, oxalate, potassium, phytate, animal protein, sucrose, fructose, sodium, and supplemental vitamin C intake may be beneficial. We therefore recommend the following for all patients with calcium oxalate stones:

Sufficient fluid intake distributed throughout the day to produce at least 2 liters of urine per day, including drinking at night (although it is not essential that the patient wake up several times per night to urinate). This will increase the urine flow rate and lower the urine solute concentration, both of which may protect against stone formation.

 

To reach this goal, the best strategy is to recommend how much additional fluid the patient should drink based upon his or her 24-hour urine volume. As an example, if the total urine volume is 1.5 liters, then we recommend two additional 8 ounce (240 mL) glasses of fluid each day to reach the goal of at least 2 liters of urine output per day.

 

Adequate dietary calcium intake. While excessive calcium intake should certainly be avoided, dietary calcium restriction is not appropriate, as it may increase the risk of stone formation and also lead to reduced bone mineral density. Several servings of dairy or other calcium-rich foods to reach 800 to 1000 mg/day are encouraged.

 

Avoiding excessive animal protein in the diet. Although it has not been proven that a low-protein diet will reduce the incidence of stone formation, a high-animal protein diet is a risk factor for renal stones in men and older but not younger women [13].

 

Limiting dietary sodium to 100 mEq/day. A low-sodium diet can enhance proximal sodium and calcium reabsorption, leading to a reduction in calcium excretion.

 

Increasing dietary potassium intake, as this is associated with substantially reduced risk in men and women.

 

Limiting dietary sucrose and fructose.

 

Limiting intake of high oxalate foods and supplemental vitamin C in patients with calcium oxalate stones. However, excessive restriction of oxalate is not likely to be helpful; patients should continue to consume a wide variety of fruits and vegetables.

 

Drug therapy is indicated if the stone disease remains active (as evidenced by the formation of new stones, enlargement of old stones, or the passage of gravel) or adequate improvements are not realized in urinary chemistries despite attempted dietary modification over a three- to six-month period.

Initial drug therapy varies with the metabolic abnormality that is present:

Thiazide diuretics for reducing urinary calcium excretion

Allopurinol for high urine uric acid

Potassium citrate or potassium bicarbonate for low urine citrate

Bacterial vaginosis (BV) is a common cause of unusual vaginal discharge. BV is not a sexually transmitted infection (STI), but it can increase your risk of getting an STI such as chlamydia.

 

Symptoms:

 

The most common symptom of bacterial vaginosis is unusual vaginal discharge that has a strong fishy smell, particularly after sex.

You may notice a change to the color and consistency of your discharge, such as becoming greyish-white and thin and watery.

But 50% of women with bacterial vaginosis do not have any symptoms.

Bacterial vaginosis does not usually cause any soreness or itching.

Diagnosis:

If physician feels that you have BV, she asks you to provide vaginal fluid sample. This sample collection can be done at our clinic and it is then sent to a lab for DNA amplification probe that tests for following infections.

 Candida species
 Gardnerella vaginalis
 Trichomonas vaginalis

The results then are typically available in two business days and if your sample is positive for any of these infections, appropriate medication is called in to your pharmacy. Your pharmacy will call you. 

 

You can get your results from the lab directly if you have an online account with them. You can also request a copy from us on your secure email or on the portal. 

Treatment:

Depending on the test results, we call in one of these medications to your pharmacy.

Metronidazole 500 mg orally twice daily for seven days

Metronidazole 250 mg orally three times daily for seven days

Clindamycin 300 mg orally twice daily for seven days

Why get treated:

The condition is not usually serious, but you'll need to be treated with antibiotics if you do have BV because BV increases your risk for getting other sexually transmitted diseases.

 

Prevention:

To help relieve symptoms and prevent bacterial vaginosis returning: 

  • use water and plain soap to wash your genital area
  • have showers instead of baths
  • do not use perfumed soaps, bubble bath, shampoo or shower gel in the bath
  • do not use vaginal deodorants, washes or douches
  • do not put antiseptic liquids in the bath
  • do not use strong detergents to wash your underwear
  • do not smoke

 

What to do if you still do not feel better after treatment?

 

Please book an appointment from online and see doctor once again face to face.  

Most people infected with HIV experience a short, flu-like illness that occurs 2-6 weeks after infection. After this, HIV may not cause any symptoms for several years.

It's estimated up to 80% of people who are infected with HIV experience this flu-like illness.

The most common symptoms are:

  • raised temperature (fever)
  • sore throat
  • body rash

Other symptoms can include:

  • tiredness
  • joint pain
  • muscle pain
  • swollen glands

The symptoms usually last 1-2 weeks, but can be longer. They're a sign that your immune system is putting up a fight against the virus. 

But having these symptoms doesn't necessarily mean you have the HIV virus. Remember: they're commonly caused by conditions other than HIV.

If you have several of these symptoms and think you've been at risk of HIV infection within the past few weeks, you should get an HIV test our clinic.

 

We have seen patients who were never checked this even with multiple hospital admissions and hence we are now proactively testing patients for this whenever your doctor feels it is necessary.  

There will be situations when you are admitted to hospital. Because of aggressive cost cutting by the third parties and other reasons, you are now instructed at the hospital to follow up with your physician. This follow up saves lot of harm to the patient.  Everyday we see patients who have been put on wrong medications with improper discharge planning. Hospitals are not only discharging patients quicker but also are using unsafe practice of using non physicians to discharge patients.

 

So getting a physician to properly go thorough your discharge papers and ensure that medications are proper and conditions are properly diagnosed is always a good idea. If hospital asks you to see your physician, book your office visit within 7 days of hospital discharge and bring your hospital discharge papers. Please do not mix your regular office visits with hospital discharge follow ups.  We provide same day or next day appointments when you need. 

Your body weight can regularly fluctuate, but the persistent, unintentional loss of more than 5% of your weight over 6 to 12 months is usually a cause for concern. Losing this much weight can be a sign of malnutrition, where a person's diet doesn't contain the right amount of nutrients.

You should pay particular attention if you experience other symptoms, such as:

  • tiredness
  • loss of appetite
  • a change in your toilet habits
  • an increase in illnesses or infections

If you believe you have unintentional weight loss, please get checked at the clinic to ascertain no serious issues exist.