Stuff You Should Know - Kidney Stones: No! Please, NO!

Episode Date: December 16, 2021

Kidney stones are widely considered the most painful affliction a person can endure, even worse than labor. And in rare cases they can even kill. Learn all about how these things you really, really don’t want form and pass in this faint-inducing episode. Learn more about your ad-choices at https://www.iheartpodcastnetwork.comSee omnystudio.com/listener for privacy information.

Hey, I'm Lance Bass, host of the new iHeart podcast Frosted Tips with Lance Bass. Do you ever think to yourself, what advice would Lance Bass and my favorite boy bands give me in this situation? If you do, you've come to the right place because I'm here to help. And a different hot sexy teen crush boy bander each week to guide you through life. Tell everybody, yeah, everybody about my new podcast and make sure to listen so we'll never, ever have to say bye, bye, bye. Listen to Frosted Tips with Lance Bass on the iHeart radio app, Apple podcast, or wherever you listen to podcasts. I'm Munga Chauticular and it turns out astrology is way more widespread than any of us want to

believe. You can find in Major League Baseball, International Banks, K-pop groups, even the White House. But just when I thought I had a handle on this subject, something completely unbelievable happened to me and my whole view on astrology changed. Whether you're a skeptic or a believer, give me a few minutes because I think your ideas are about to change too. Listen to Skyline Drive on the iHeart radio app, Apple podcast, or wherever you get your podcasts. Good luck, good luck. Hey everybody, we are super excited to return to the sketchfest stage and do a live show again. We missed it so, so much last year and we can't wait to get back to San Francisco. Yeah, it's our first live show in two years, Chuck, and we're going to be there

at the Sydney Goldstein Theater in beautiful San Francisco, California at 7.30 on Friday, January 21st. It is a straight up stuff you should know live show and it's going to be off the chain. That's right. You should show up to see if we've forgotten how to do this. To see us skate around on stage nervously. Sure. Doubting ourselves and eventually bringing the funnies. Yeah, hopefully. Where do they go? They go to SF as in San Francisco, SFsketchvest.com. Click on the schedule and tickets link. There are tons and tons and tons of great shows. It's the best comedy festival in the country, in my opinion, over the whole month of January. So go check us out and go check out everybody else as well. Yep, it's also a

full vaccination show. So you've got to show proof of vaccination and wear some masks. Don't be naughty. Don't be naughty. Be nice. So we'll see you guys on Friday, January 21st in San Francisco, California. Welcome to Stuff You Should Know, a production of iHeart Radio. Hey, and welcome to the podcast. I'm Josh Clark, and there's Charles W. Chuck Brian over there. And this is Stuff You Should Know. I should say Stuff You Should Know. Ow. That's a good one. Thank you. It was off the cuff, Chuckers. You ever had a kidney stone? No, let me find some wood. I guess it's close enough. No, I haven't. I have not. How about you? I have it. I think I'll probably get one one day.

Yeah, you just know it's in the cards for you. Yeah, I mean, I've got... I don't have like bad kidney issues, but when you get to be my age, certain organs start saying, hi, pay attention to me a little bit. Oh, yeah, yeah, yeah, for sure. And the kidney's one of those, but I'm not dying or anything. No, I know that. It's more just like, you know, once it... If you got a hinky kidney, you could conceivably get a kidney stone for sure. That is certainly true. So I, my friend, wish that you never, ever, ever, ever get a kidney stone. I wish the same for Jerry. I wish the same for every person you know and like and love, and same for me. That's right, but wishes and dreams do not bear any weight here, my friend,

because I think you got about a 10% chance if you're a living human, of having a kidney stone, and besides being super painful, they can kill you. About 16,000 people a year die from kidney stones or complications that arise. Yeah, what a way to go, man, from kidney stones. Now, you're probably not going to die from your kidney's failure because that would require both kidneys being blocked simultaneously so badly that they just shut down on you. That's probably not going to happen, but there's a lot of procedures that you would probably go through to treat a terrible kidney stone that that could kill you, an infection could kill you. There's all sorts of ways it could bring about your death, and that would not be very pleasant. I agree with you.

Yeah, they are. I mean, there's different kinds. We're kind of going to go through them here, but they're generally classified in a couple of ways where they are and what kind they are, like how they were formed. There are all kinds of fancy schmancy doctor names for kidney stones, renal calculi, urolithiasis, but they're going to call them kidney stones if it's a doctor that has an interest in being your friend. Right. Where they are is really important because they need to know where they are so they can help you figure out how to deal with these in the most particular way. There's only a certain number of places that a kidney stone is going to be, and Chuck, I looked high and low and could not find a definitive answer. I saw some places that

seem to say all kidney stones or all stones start in the kidneys, but I also saw little snippets here or there that made it seem like there's other places stones can form. That's a shoulder blade. Right, but regardless, that's my point. Regardless of where they form, they're going to form only in your urinary tract, which includes your kidneys, your ureters, which are the tubes that take your pee from your kidneys down to your bladder, the bladder itself, and then the urethra, narrow or otherwise, which is where the pee comes out. Yeah, I'm going to go ahead and say the ureters, they should have built those a little wider. Agreed. They could have stopped a lot of heartache. Yeah, because one of the big problems that you're going to have if you get a kidney

stone is your ureters are like two millimeters in diameter, and they're not very flexible. So when you're passing a hardened stone, a crystallized stone of mineral through that that's larger than two millimeters, it is going to cause some problems. Yeah, I'm sure that they didn't seem like they needed to be bigger at the time when man and woman was created. Right. Because all that's going through there's pee, but the lack of foresight on those stones is a big problem. Yeah. Tisk, tisk, Yahweh. That's right. So you've got stones in the kidney, nephroliths, lith mean stone. You've got your ureteroliths, which are in the ureters. And again, that's a really terrible place for them to be. And then you've got cystoliths, which are in the bladder,

and I guess by proxy that the urethra too, right? That's right. The ones in the upper tract, those are going to be a little more problematic generally, a little more severe. If you're going to get complications and long-term problems, they're generally going to be because of those upper urinary tract stones. But they're all, I mean, none of them, the only ones that aren't a big deal are the ones that are so tiny that you just, and that's why I said that you know of. Right. People probably thought I was joking, but you can urinate out kidney stones and not even though you ever had one if they're small enough. Yeah. Just pee yourself right now. There's a chance you just peed out a little tiny stone of some sort. Yeah. Small baby.

When you do know that you have a kidney stone though, you really, really know it. And we'll talk about the process of passing a kidney stone later. But the other way to define a kidney stone, and usually they're going to be defined by location, and then also in this other way, by composition. Because kidney stones can be made up of a lot of different things. But the upshot of them, Chuck, is that if you have too much of something in your pee, or too little pee, or imbalanced pee, PHYs, things can solidify. That should be liquid. They can precipitate out of solution. And when that happens, it can start basically a snowball effect where more and more of that stuff is attracted, and that's where your stone's formed.

Yeah. I mean, it's just mineral things that can't be dissolved, basically. And they like to have company. They like to get together with their other non-dissolved friends, and party together, and hang out together. And pretty soon, if you get a big enough party, you're going to be in some kind of pain. Yeah, you're going to have a pain party for you. But I guess we should talk a little bit. This is sort of about as wonky as we're going to get in this next section, which is the makeup of these stones. And most of them are made up about 60 to 80% or calcium oxalate. And this is basically too much calcium or oxalate in your urinary system. And there are a number of things that can cause this, but they're generally all metabolic problems, although I think there is

a little genetics involved with the calcium oxalate as well. Yeah, that seems to be my take on it, too, that genetics have a large role in whether you're predisposed to having kidney stones or not. Diet and lifestyle can definitely affect it. But it's like, if you have hyperparathyroidism, and you're absorbing calcium, too much calcium from your bones, that probably doesn't have much to do with your diet. And that's one way that you can have too much calcium. Your renal system might not absorb enough calcium from into waste. And so there's more of it hanging around there than there should be. There's a few ways that it can happen. But the upshot of it is either you have too much calcium or too much oxalate, and they combine together to form, what did you say,

like 60 to 80% of kidney stones? Yeah, that's 60 to 80. And I think the, actually, I don't have a percentage for struvite stones. These are also called infection stones. And there, if you get a lot of UTIs, you might be more prone to struvite stones. Sometimes there's just some kinds of bacteria. And if you match that up with the right metabolic condition that's going wrong, it'll get together and cause struvite stones. Yeah, the struvite stones seem to rely a lot on whether your urine is out of balance pH-wise, specifically that it's highly alkaline. So it's above seven as far as pH goes. And that combined with certain kinds of bacterial infections can create that. It looks like staghorn seems to be the most common type, which I mean, you do not

want a tiny mineral that fits the bill of staghorn flowing through your urine. Yeah, you do not. Not good at all. Then you have about 10% or less are formed by uric acid. And this is sort of, you know, if you have problems with your uric acid or gout, you're probably going to have kidney stones at some point. You know, the gout diet is, it's sort of the same triggers. They're high in what's called purines, shellfish, organ meats, any kind of meat really, beer for sure. Like those are all in the list of things that you don't want if you're trying to keep your uric acid in check. Yeah, because the uric acid is a metabolite of purine and it crystallizes very easily. It can precipitate easily out of the P if there's too

much of it. So yeah, that can be a bad jam for sure. There's also cysteine stones. Cysteine's an amino acid. It's used throughout the body for a number of different ways, but unfortunately, it's the least soluble amino acid. So that means that it can precipitate out of P fairly easily, too. Luckily, those are kind of rare. You actually have probably a congenital disorder that causes cysteine stones, but unfortunately, that means you have a congenital disorder that causes stones, which means it's probably a chronic condition. Right. And I think that's the same for the rare xanthine stones, right? Yeah, and xanthine is another purine. It's found in caffeine, tea, and colas. And it occurred to me, Chuck, while I was researching this, is that what purina is

trying to get across with their brand name? No. That their food is chock full of purines? Maybe. I always kind of thought it was probably just a play on the word pure. Oh, it never occurred to me like that. I wonder, maybe they're like, why can't it be both Josh and Chuck? And then there's, of course, the infinity stones, which are a real problem for about half the population. Yeah. And one other thing also... Chuck, I'm glad I stopped and took a double take. Was that written down? I can't see your notes. That was no notes? Wow. That was good, then, man. I think you just won the World Cup for 2021 and the off the cuff stuff you should know joke. Okay. Battle. Okay. I'll take it. One other thing about uric acid stones is that that

is kind of the opposite of struvite stones where your P is too acidic. Like it'll burn right through metal if you pee on a car. Right. Should we take a break? Yeah, we should take a break. I need to regroup after that huge win by you just a moment ago. All right. We'll be right back and I'll say what I'm going to say after this. Hey, I'm Lance Bass, host of the new iHeart podcast Frosted Tips with Lance Bass. The hardest thing can be knowing who to turn to when questions arise or times get tough or you're at the end of the road. Okay. I see what you're doing. Do you ever think to yourself, what advice would Lance Bass and my favorite boy bands give me in this situation? If you do, you've come to the right place because I'm here to help this. I promise you.

Oh, God. Seriously. I swear. And you won't have to send an SOS because I'll be there for you. Oh, man. And so my husband, Michael, um, hey, that's me. Yep. We know that Michael and a different hot, sexy teen crush boy band are each week to guide you through life step by step. Oh, not another one. Uh-huh. Kids, relationships, life in general can get messy. You may be thinking this is the story of my life. Just stop now. If so, tell everybody, everybody about my new podcast and make sure to listen so we'll never, ever have to say bye, bye, bye. Listen to Frosted Tips with Lance Bass on the iHeart radio app, Apple podcast or wherever you listen to podcasts. I'm Mangesh Atikular. And to be honest, I don't believe in astrology. But from the moment I was

born, it's been a part of my life. In India, it's like smoking. You might not smoke, but you're going to get second hand astrology. And lately, I've been wondering if the universe has been trying to tell me to stop running and pay attention. Because maybe there is magic in the stars, if you're willing to look for it. So I rounded up some friends and we dove in and let me tell you, it got weird fast. Tantric curses, major league baseball teams, canceled marriages, kpop. But just when I thought I had a handle on this sweet and curious show about astrology, my whole world came crashing down. Situation doesn't look good. There is risk to father. And my whole view on astrology, it changed. Whether you're a skeptic or a believer,

I think your ideas are going to change too. Listen to Skyline Drive and the iHeart radio app, Apple Podcasts, wherever you get your podcasts. So I didn't know if you even, I didn't think you watched those Marvel movies. So I didn't know if you'd get that joke. Well, I mean, I'm conscious. I can form thoughts and observe outside stimuli. So that means, yes, I'm familiar and aware with the Marvel Cinematic Universe and what goes on in it. Well, see, I would think if you didn't see the movies, you'd have no idea what an infinity stone is. No, no, I mean, well, let me see. I've seen, I guess I saw the one that you're specifically referring to where half of everybody just like dissolves. I saw that one. Should we say spoiler

alert? Oh, yeah. If you don't know that by now, come on. Those are the biggest movies in the world. So thank you for defending me like no apologies necessary, no accountability here, but you'll have to watch the second one to find out what happens after that. How about that? Well, they come back. I haven't seen that one, but I'm just presuming there's no way to really watch part one or not part two. Yeah, that's pretty funny. Yeah, I did not see the second one yet. I guess if you didn't like it much, you'd be like, well, am I going to spend another two hours and 40 minutes about it? But the thing is I did like it. I mean, I was entertained and amused. I guess I just knew that at the very least, everybody who was anybody was going to come back somehow. I didn't know how,

but I guess I didn't really care how. I just want to strap you in a chair and... Like clockwork orange? Clockwork orange style, make you watch the Beatles documentary. No. All right. So back to regular kidney sounds, right? Yes. So we kind of talked about how they form, but it's worth just kind of saying one more time. It's basically you've got stuff in your pee minerals that don't dissolve very easily or there's too many of them or there's not enough pee and they just go and they crystallize and that's how it starts and that kicks off this process of where usually they form initially in your kidney, but they can form anywhere, but they'll hang on to like a little node in your kidney and start

to nucleate there, kind of like a snowflake. Ed helped us with this one and he's like, it's like a snowflake basically growing from like a little dust moat when it's cold enough. Yeah. And like you said, they don't always have to form that way. Sometimes they can just form free floating in your urine, just moving about the party, but they do better for sure when they're attached initially to something. When one little tiny particle hangs on to something like, I know Ed mentioned the renal papilla, those little projections in the kidneys. That's a good place for them to get together. They may grow there for a little while, they may detach and then float away, but they also might attract friends at these attachment points

and that's when the problem starts. They're eventually going to detach, but they just like to congregate in like the cool area of the party. Yeah. And see what you just said made me think like you could probably form a stone anywhere in your urinary tract, that whole system, as long as there's a place for it to kind of clomp onto or it's bad enough that they're just forming right in the middle of your urine. Right. So it doesn't necessarily have to just be your kidneys. Yeah. And they look like, I think Ed had the perfect descriptor here, it looks like a little granola chunk, granula.

Yeah. Some of them look a little more mean and menacing than others. Some are even like smooth where you're like, geez, I enjoy passing these. They make a very satisfying plop sound when they come out of the urethra. But again, there's like stag horns, there's the widow maker, there's the Judas Priest. They have terrible names, but they really kind of drive home how bad these things hurt. Is it really the Judas Priest? No. Okay. I mean, you never know, doctors have a sense of humor with two of them. Yeah. Wouldn't that be great though? So I would think it would be this like, it looks like the double horn fist. I was thinking it was going to look like that metal eagle. Oh, that too, the screaming eagle, living

after midnight. The metal fist sounds worse though, for sure. Well, this is the case with kidney stones, anything, and that's why the stag horns are so bad. If it's the spikier, I mean, you don't have to be a doctor to tell someone that the spikier something is, the more painful it's going to be. Right. They're describing your kidney stone to you and you're like, I didn't realize you're a doctor. They say, oh, I'm not a doctor. I just stayed at a holiday and expressed myself. Yeah. Anybody could tell you that. Right. So the pain that you're going to feel like when you get diagnosed for a kidney stone, you're probably going to go into the doctor after feeling sort of lower groin pain for a while, maybe in your lower back or side or

abdomen. And you might be going, man, this is like, I didn't pull my back. What's going on? And you may live with it for a little while, just thinking it might be a pulled muscle or anything like that, or a strained groin even. And then at some point, hopefully someone in your life is going to say, you may want to go like, that may be a kidney stone. Get that checked out. Yeah. You may want to get that checked out. One of the reasons, I didn't understand this, but it makes total sense. One of the reasons why there's, it feels so much worse than just your ureter or your kidney saying, ah, is that there's a bunch of really important nerves that pass right through the kidney, right through that notch that gives the kidney its characteristic shape.

You can read these. You get the celiac plexus. Yeah. Plexus. I don't see. Screwed up right out of the cake. The inner mesenteric plexus. Nice. The lumbar splonknic. I like the splonknic or the splonknic. Yeah. I like it too. I like the celiac plexus though. It's got a pleasant look to it. It's like cellar door. Yeah. You love cellar door. It wasn't just me. That's a Tolkien reference. I think he said it was the... I know, but you mentioned it a lot in the shows, what I mean. You love that whole thing. Well, I just think it's such a great idea that somebody was like, I definitively say this is the most beautiful word in the English language and it just happened to be Tolkien. So like there's an extra little twist at the end there and it was used in Donnie

Darko. So it's a pretty, pretty great little thing. I have my favorite word though. It's not cellar door. It's moist puss. No. It's the Beatles and it's used in the Peter Jackson documentary, The Beatles. Is it really that good? It's amazing. I mean, I'll say this. You would hate it, but if you're a casual Beatles fan, it's probably not even for you. Right. Or even if you're like, no, I like the Beatles. It's probably not even for you because it's eight hours of just sitting in there, flying on the wall style. So you really got to be into like, did you see that look that George escaped Paul when he said that one thing? It's that kind of level of wonkiness. Yeah, I would not like that at all. I have a music

documentary that you mean I watched the other day that's really good. It's on Sparks. Oh, yeah. Sure. I've seen that. You saw it. I loved it. I had never heard of Sparks. I didn't know if Sparks existed. I've been disappointed in myself ever since that I didn't realize they were a thing, but that is a great documentary. One of the things I like about them is not just their music, but just like how naturally and genuinely positive they are without trying to be positive and also actually being kind of fiendish in their sense of humor, but they're still overall like very positive. It's pretty cool, pretty good documentary. It was great. And I'll even go ahead and recommend even though I haven't seen it. It's on the list this week. I just got to get

through the Beatles thing is the Todd Haynes Velvet Underground documentary I hear is just like ridiculously good, which I can't wait for because Todd Haynes is the best. I'm going to check that out. So that was documentary corner. I got my movie crutch fix. We need to take our berets off and drop our cigarette holders and get back to it. I think we were talking about those three nerves and they can cause nausea and vomiting because those three nerves run right through what's called the renal hillum. And that's that little, you know, if you look at a kidney or even a kidney bean or a kidney shaped swimming pool, you can imagine what it might look like. It's a little notch inside that curve and all three of those nerves run right in there. So if your kidney is

inflamed or spasming or something, it's going to be tweaking those things like piano strings. Yeah. And spasming is right. You just said the magic word because your kidney is well aware that it has something it shouldn't have in it. And it actually has a way to take care of that. And that is by spasming it out, trying to push it out. The kidney does that and so do your readers. And your reader actually like clomp down around it and try to squeeze it out through spasms. So kidney pain is typically associated with basically the worst pain you could ever experience. I think people have given birth before who did it without any kind of drugs say, nope, a kidney stone is actually worse than that. And what's great is everybody can share in the fun of a kidney

stone. Did you see what Ed's friend called it? Yeah. Ed has a friend who had kidney stones and said it was like giving birth to a knife that kind of says it all. It really does. The worst of it from what I've seen, I found a urology website and it basically says the two worst by far is when it's in the kidney and then when it's in the your reader. And apparently when it's in the kidney, it's even worse. That's the worst of all. But the upshot of it is in addition to feeling nauseated for your back and your abdomen to hurt, you're actually going to be experiencing pain in your kidney and in your reader as they're pushing this thing out. And it comes in waves of pain called renal colic. And they will give you narcotics to take care of it. It's that bad.

Yeah. Yeah. The best feel good drugs available are coming your way. Yeah. And they'll probably just barely make a dent. I don't know that that's true, but I'm really trying to drive home how painful kidney stones are. I wish one of us would have had it just so we could speak from experience. I'm actually glad we aren't speaking from experience. And I wish that person was you. No, I'm glad we haven't had it, but hopefully over the next until we retire, I'll keep everyone up to date on whether or not to get kidney stones. Okay. All right. I think that's fair.

Squatted land and kidney stones. Those are my two lifelong updates. What about your teeth? Don't forget your teeth. Well, everyone knows I got to get that tooth done again. Man, I just had a deep, deep cleaning on two of my teeth and it was not pleasant, but my period honest was great, like very nice and general and apologetic. And I think I'm better off as a result. I'm a better person. Was that the rooting and scaling thing? I believe so. It's like a gum treatment sort of.

Yeah. And there wasn't like an incision. She didn't cut. Yeah. It's the worst. They want me to do that again. Yeah. It's not fun at all, but hopefully now that I'm done, it's done. I was about to say as if it was any better, we should get back to kidney stones. But to get these things treated, there are quite a few options, thankfully. It depends on where it is. It depends on how big it is. If it's one of your reader stones, they're probably going to say, pass it. It might even take a few weeks, but drink tons of water and see if you can pee that

thing out. Yeah. Once it gets out of the kidney. Yeah. And I think if it's five millimeters or smaller, you got about a 90% chance of passing that thing through a year and it goes down to 50% between five millimeters and 10 millimeters. And if you can eat and you can drink and you don't have a fever, they're probably going to send you home with some pain pills and some flow max to relax your urethral sphincter so you can pee easier. And you're going to pee all the time. And as it moves down into like your bladder, it's going to increase the pressure there because of the inflammation in your bladder. So you're going to have to feel like you have to pee all the time,

even though you don't necessarily, but they're going to send you home and be like, best wishes, best of luck, keep us posted. Let us know if you spike a fever, something like that. Right. You're also going to get all kinds of tests, blood tests, urine tests, things like that, just to see like you may have more than one stone. The identification of the stone, I mean, there could be a larger problem, you know, if we're talking about these metabolic imbalances, like if you may have chronic kidney stones or at least another one in the future, they want to kind of get you on the right track. So you're going to do a lot of tests as well. Yeah. And one of Yumi's friends used to get them a lot. And I think I didn't have a chance to ask

him, but I think he might have outgrown him, I hope, God willing. But I'm pretty sure he had to pee into like a mesh cup to catch the stone. And I realized now it's not because he was a weirdo, it was because they wanted to analyze the stone. Because again, you can tell a lot about what is driving you to produce kidney stones. If you can just look at it, because you can see what it's made of, well, you can see what it's made of. And that'll tell you a lot. I think I'd want to keep mine. Well, that's the other thing too. You got a pretty nice trophy. You could get a grill made with it. That's what I need on my fake front teeth. Yeah. A couple of kidney stones. A couple of stag horns just sticking out, slicing into the back of your top lip. If they are larger,

you're going to need some more, what Ed calls, direct intervention. And that's pretty much says it all. They're going to look at you with X-rays. They might use an ultrasound. They're going to find out exactly where that puppy is. They're going to see if it's moving along or if it's kind of stuck in place. And then they're going to go to work. It's a little more expensive, but I would say just by reading this, if it's an option and if you can afford it, I would go to the lethaw, such a hard word to say, lethawtripsy method. Sure. Yeah, because it's non-invasive. It's all ultrasound. They use ultrasound, maybe X-rays to find it, and then they use ultrasound to break it up. And Chuck, Ed produced a sentence that seems innocuous

until you realize that if you read it like a monster truck ad announcer, it's really boss. Which one is it? Focus ultrasound shockwaves are directed at the zone, crushing into smaller pieces without damaging the surrounding tissue. Oh yeah, that's true. You should be a doctor. That'd be fun. Oh dude, everything would be called the Judas Priest. Whatever. Right. I'd be like, this is a Judas Priest baby. Yeah, it's a Judas Priest fracture. We can fix that, no problem. If it's larger, even than that, like too large, and I guess this is a Judas Priest album, too large for lethawtripsy. Or if they can't find it maybe, if it's exactly where it is, or maybe you don't have it available to you because of money or wherever you live,

you can go to a uteroscopy. And that is a little bit more invasive, but not surgery yet. That's when they're going to send a scope up through the urethra. Probably not a lot of fun into the bladder, into the ureter, and then they capture it. It calls it like a little basket, and they pull it out, and then sometimes it is even bigger. They can use a laser to break it up and then pull it out. Right, but that's the key. The urethra, urethroscopy is that they actually can remove the stones, whereas I think with lethawtripsy, man, such a hard word, it is, that they actually, they go in there and break it up, and the complication you'd be is like, it's kind of like that stupid Russian satellite missile test that they just did. Remember where

they created way more space junk than there used to be? You're doing the same thing with lethawtripsy, where you're breaking up these stones, and so one of the complications can be like, now you got a bunch of kidney stones, and yeah, they're smaller, but not all of them are so small that you won't notice them, or that they won't necessarily cause an infection or something like that. Right, or in the case of the Guinness record holder, the man in India in 2004, this thing was, and I looked up different kinds of sports balls, and the closest I could find was it was about the size of a shot put. What? Oh my goodness. Five inches in diameter. I mean, it is, I never thought about it, like I even made that with my hands. I know, I kept thinking it's got to be circumference.

It's got to be. That's, no, it's diameter because I went and looked too, but so for those people who've never seen a shot put and don't know what five inches is, that's like 13 centimeters in diameter. Yeah, it's bigger than a softball if you don't know what a softball is. It's about a regular grape fruitish size. Yeah, I would say so. Yeah, so obviously that was a surgical removal, which is the last, the sort of the last line of defense is to get that surgery, and it's called, this one's mine, percutaneous nephrolithotomy. Nicely done. And that they make a little notch, a little incision in the lower back, and it's, they scope it out too, so it's not some huge, huge thing, but they use a thin scope, end of the kidney, break it up again, remove the pieces.

And we should mention too that some of these, I think the uteroscopy is when they, utero, yeah, uteroscopy. No, there's an extra vowel in there. It's not just me. Uteroscopy, yeah, uteroscopy. Your uteroscopy. Your uteroscopy. Oh my God. Adding an extra vowel every time eventually pays off. Your uteroscopy. That is the one that you still need the anesthetic, and you might eventually need a stint, which again goes back to my thing, that the ureter should be bigger. Yeah. If they're putting in stints, that means that's the size that it should have been to begin with. Absolutely. Then anything could just pass through, even a five inch diameter kidney stone from India.

Should we take a break? I think we should take our second break and come back and talk about what I think everybody wants to know is how do you make this never, ever happen to you? Hey, I'm Lance Bass, host of the new iHeart podcast, Frosted Tips with Lance Bass. The hardest thing can be knowing who to turn to when questions arise or times get tough, or you're at the end of the road. Okay, I see what you're doing. Do you ever think to yourself, what advice would Lance Bass and my favorite boy bands give me in this situation? If you do, you've come to the right place because I'm here to help. This, I promise you. Oh God. Seriously, I swear. And you won't have to send an SOS because I'll be there for you. Oh man.

And so my husband, Michael. Um, hey, that's me. Yep, we know that Michael and a different hot, sexy teen crush boy band are each week to guide you through life step by step. Oh, not another one. Kids relationships life in general can get messy. You may be thinking this is the story of my life. Just stop now. If so, tell everybody, yeah, everybody about my new podcast and make sure to listen. So we'll never ever have to say bye, bye, bye. Listen to Frosted Tips with Lance Bass on the iHeart radio app, Apple podcast, or wherever you listen to podcasts. I'm Mangesh Atikular. And to be honest, I don't believe in astrology. But from the moment I was born, it's been a part of my life in India. It's like smoking. You might not smoke, but you're going

to get secondhand astrology. And lately, I've been wondering if the universe has been trying to tell me to stop running and pay attention. Because maybe there is magic in the stars. If you're willing to look for it. So I rounded up some friends and we dove in and let me tell you, it got weird fast. Tantric curses, major league baseball teams, canceled marriages, K-pop. But just when I thought I had a handle on this sweet and curious show about astrology, my whole world came crashing down. Situation doesn't look good. There is risk to father. And my whole view on astrology, it changed. Whether you're a skeptic or a believer, I think your ideas are going to change too. Listen to Skyline Drive and the iHeart radio app,

Apple podcast, or wherever you get your podcasts. Okay, Chuck. So it's actually pretty simple unless you have some sort of congenital disorder that is producing chronic kidney stones in you, which is extremely sad. And I feel very badly for you. There's some really easy ways you can keep from probably ever getting a kidney stone in your entire life. Yeah. I mean, I know you think drinking water is a scam, but... Yeah, I remember you went on a tirade years ago about how that whole drinking eight glasses of water day is booked. Oh, no. So that is drinking eight glasses of water that the number was made up. I think drinking water is good, but the number of glasses is just totally like made up.

Well, this is two liters per day. Yeah. So that's a number. It is, but there was a study that backed it up. Okay. They say there's a study that said if you drink a couple of liters of water a day, it resulted in 149 fewer stones per 1,000 people. Right. And it just makes sense, to keep water flowing through your kidneys and flowing through your system and keeping everything nice and saturated that it would help prevent the buildup of those little particles, those minerals. Right. Because you've got enough pee that those things, even the toughest solubles are going to stay in solution rather than precipitate out. But also one thing that's

easily overlooked is when you drink a lot of water, water is pretty much across the board, a neutral substance. So it actually helps maintain the pH balance in your body. And as we've seen, there's at least two different kinds of kidney stones you can get, depending on whether your urine is too acidic or too alkaline. And drinking a lot more water can make your urine closer to neutral, which is a big deal too. Plus, it just mechanically helps flush away stuff before they get a chance to really aggregate. Yeah. You can cut down on animal proteins. You can cut down on your salt. You can cut down on your oxalate. You won't find oxalate in a lot of stuff, but there's a lot of oxalate and spinach and apparently chocolate and rhubarb.

But spinach, how much spinach are you really eating? I didn't see how much it would take to really start to get into the danger zone with kidney stones, but I mean... I like spinach, but I don't like that much of it. It's more one of those things. It's like, man, you just can't win. No matter how good you're trying to be, how healthy you're trying to be, it's going to get you. Yahweh's going to get you one way or another. That's what the shirt says. The calcium, you might think, well, if it's a calcium buildup, then have less calcium, but that's a bit of a thing too, because oxalate is there. And if you're low on calcium, then it's going to increase excretion of oxalate.

So just keep your calcium intake normal. Yeah. Just don't overdo anything, but also don't under... Just don't do anything. Just lie there drinking water all day long and you might be okay. That's right. That's all called primary prevention, things you can do on the front end. If you have chronic kidney problems and kidney stones, then secondary prevention is... That's when that's going to come into play. And that basically means you're going to be on medication and you're going to be checking your pH and your urine and stuff like that a lot. Yeah. And usually if you have a kidney stone, it's your first one ever. They're probably not going to do a whole lot of investigative work, but if you start to show symptoms that you have

chronic kidney stones, then they're going to want to figure out what it is in your body, what it is in your diet, your lifestyle, your metabolism, whether it's a congenital disorder. They're going to really try to get to the bottom of it so that they can adjust you, either by meds or by lifestyle adjustments, to make it less likely that you're going to produce any more stones. All right. Should we talk about it now? Is it time? Sure. How we pass these things? No. You don't want to? What are we talking about? How we pass the stones? Oh, how we pass them. I thought you said, are we past it? I was like, we're still in the thick of it as far as I could tell. So when the stones are forming, you're not going to feel much pain. You're not going to even know

what's going on. I don't care how in tune you are with your body. You're not going to feel those little minerals getting together and having a party down there. When it detaches from the wall of the kidney or wherever it's meeting up, that is when you're going to start to feel the pain. You mentioned fever and chills. That could certainly happen. And those spasms, I did mention that it might feel like a pulled muscle. And the spasms are pretty chronic, like one to four spasms an hour of them trying to shake that thing loose. And I have a feeling that's about all the kidney can manage because it's probably doing about all I can. And then once this kidney stones have moved on from there, that's kind of the worst part.

Yeah. Well, comparatively speaking from what I can tell, it's the worst part. It still gets pretty bad. And by the way, big shout out to Urology of Greater Atlanta for spelling this out for us. But they say that once you hit stage two, it's reached your ureters. And yes, you'll probably be like, wow, that kidney pain was pretty bad. This is not that bad compared to it. But if the average person just went into ureter pain, kidney stone pain, they would probably, you know, beg for you to lay on them with a pillow on their face. Yeah, that's an eight or a nine when they ask you that awesome question. Yeah. And they're like, well, I don't understand the number you just said. Can you make the face

on this chart? I always just say nine. That's my default. I thought you had a high pain threshold. I do have a high threshold for pain. I just like to shock the doctors. Shock the doctor. That's right. So still, like I said before, the ureter is not flexible. It's a very narrow opening. And it itself has that kind of mechanism where it clamps on to the stone and tries to pulsate the muscles above it so that it pushes it down. And it occurs in spasms and waves as well. Finally, when this thing pops out into your bladder, that's when you might just not feel any more pain depending on the size of the stone. And if you don't have trouble passing urine, you're probably going to be able to pass this thing provided that it's smaller than the

opening in your urethra without any further problems. The problem is, is if you do have problems passing P, that stone can develop into a bladder stone where it just sits there. It doesn't get passed out of there very easily. And it can get worse there. And then you can have a whole other advent of pain. Yeah. And is that when you're talking, when it's stuck in the urethra or just? No, it can stay in your bladder. But yes, it can also get stuck in your urethra too. Because your bladder, from what I can tell, is definitely the biggest part of your whole urinary tract. Yeah. If it's stuck in your urethra, you're close friends. You're almost there. And you have to do what sports teams talk about, which is trust the process. Right. And that means every five

or 10 minutes, you got to go in there and give it another, give it the old college try. And it'll come out. Apparently, your urology of greater Atlanta says that you need to push and you need to push hard to get it to shoot out and keep pushing until the stone shoots out into the bowl of your toilet. Or I guess if you go to a different urologist into your little plastic mesh thing that you're paying into, that you could wear as a hat later on. I can't imagine the relief one might feel when that thing finally plops into that toilet bowl. I can't either. There's surely tears involved. Yeah. I mean, tears of joy, all kinds of tears. Tears of triumph. I would have a ceremony. I would throw a party.

Yeah. What would you do to the stone then if you wouldn't get it made into a grill? I'd just put it in a little formaldehyde jar and wear it around my neck on a chain. Okay. I like that one too. I mean, the grill's a little gaudy. I think a necklace is more appropriate. Okay. Do you want to talk about history? Yeah. I mean, this is always fun. Obviously, there's been kidney stones since the beginning of time. I mean, that's why I always love talking about old-timey medicine is because it's just the confusion they all must have felt with everything that happened to them, including something like this. Well, yeah. I mean, think about it. If you're pre-scientific, you would feel like you were

being punished for going through this. If you had no idea what was going on, and there were surely countless untold numbers of human beings who experienced kidney stones before we had any idea what they were. But the fact that you were standing there trying to pee this thing out, whether this was 150,000 years ago or 1,000 years ago, some people would pass them and there would be some curious types around who would say, let me see that thing. What is that? Where did that come from? And it started to get us to investigate and think about it, how to deal with these things. It's amazing. I think they found a mummy that clearly had kidney stones dated to what, 4,800 BCE? Yeah.

Not bad. And then there's good old Alice Cornelius Celsus who wrote a very, very great detailed encyclopedia of surgical techniques of the time, which was around 50 CE. And this is like legit. He really goes into pretty good detail about surgical removal incisions in the perineum and locating the stone with his fingers and holding it there with a tool and cutting it out and removing it. So it's one of the first, I mean, I say it worked. I think there was about a 24% mortality rate, but I would say one of the first semi-successful surgical procedures that people did. Right. And so it was called lithotomy. Lithototomy. Ed makes a really good point that I think is easy to overlook that. If this guy was writing this nearly 2,000 years ago

and he was writing like, this is how you do this. And it seems like a pretty straightforward procedure. Like think about how much trial and error and terrible surgeries were performed to figure out how to perform that surgery to remove kidney stones. He wasn't like first try. Nailed it. Yeah, nailed it. Right. And apparently up until the 19th century, the mortality rate for a lithotomy was still around 25%. A quarter of people just died from that procedure, which makes sense because in case you didn't notice the perineum is the area between your groin and your anus. And that's what they were cutting into to get to your bladder to remove the stone, which is weird because by that time you would think you'd already gone through

the worst of it. So it must have been bladder stones specifically that this surgery was for. Paging Dr. Tate. So that means then Chuck that you already went through the worst of the pain, stage one and stage two. It finally made in the bladder and now they're cutting in your perineum to get it out of there. So just wanted to make sure that if you haven't fainted from queasiness in this episode, we gave it one more chance. Okay. Yes, I can uncross my legs now. You got anything else? Nothing else. I don't have anything else either. And since I said that, it's time for listener mail. This is a follow. We got a lot of good feedback on the dentistry episode. A theory on the worms.

My name is Tony and I'm a dental nurse from London, UK. First of all, I have to let you know what a big fan I am at the podcast. I've learned countless things and always managed to perk me up on even the most mundane days. I decided to write in on the listener mail because you were talking about the Babylonians describing a toothache as toothworms and wonder where the phrase came from. It's complete guess. We'll likely never know for sure, but I do have a theory. When a tooth is broken or extensively decayed, the nerve can sometimes become exposed and not only is it extremely painful for the person whose tooth it is, but the nerve looks like a little pink string or a worm. If you type into Google tooth nerve

or exposed tooth nerve, you'll find some images of what I mean. It's just a theory, but I hope it helps. Kindest regards from Tony in the UK. And I bet Tony is totally right. Yeah, man. That actually is a great guess. I subscribe to Tony's hypothesis. Because that's what those yokels did back then. They just said it looks like this. Let's call it that. But dude, imagine your tooth being so broken that the the nerve is just sitting there dangling out. I can't imagine how bad that would hurt. Josh, for one of my three teeth, I bit into a chicken wing and my tooth broken half. Oh man. And your nerve was exposed? My nerve wasn't exposed. It actually didn't hurt at all.

I stayed for the rest of the football game even. Nice. It was at a Falcons game. Yeah, but I knew immediately this was the second one. I was like, man, I can't tell you what the words I said, but here we go. And I just kept my mouth shut the rest of the game and didn't didn't even tell my friends. Oh, like you literally kept your mouth shut to like hold the tooth in place or something? Not hold it in place. But yeah, I kind of just kept my I mean, I would talk, but I would generally keep my mouth closed because. Yeah, you're like, go, go, Raj. Oh boy. I had a, sorry, this is, I can't not show this. I had a root canal like this past spring. And the dentist or the endodontist did such a good job getting the nerve out of that particular

tooth. It came out on one piece and I was like, can I see and they held it in front of me and it really did look like a tiny little white worm. So I really think Tony might be onto something there. I think you're right, Tony. Tony with an eye. Well, thanks a lot, Tony with an eye in Jolly Old England, I believe. Jolly Old England. And if you want to get in touch with us like Tony with an eye did, you can send us an email, send it off to stuffpodcastsatihartradio.com. Stuff you should know is a production of I heart radio. For more podcasts, my heart radio, visit the I heart radio app, Apple podcasts, or wherever you listen to your favorite shows. Hey, I'm Lance Bass, host of the new I heart podcast frosted tips with Lance Bass. Do you

ever think to yourself, what advice would Lance Bass and my favorite boy bands give me in this situation? If you do, you've come to the right place because I'm here to help and a different hot sexy teen crush boy bander each week to guide you through life. Tell everybody you everybody about my new podcast and make sure to listen so we'll never ever have to say bye bye bye. Listen to frosted tips with Lance Bass on the I heart radio app, Apple podcast or wherever you listen to podcasts. I'm Munga Chauticular and it turns out astrology is way more widespread than any of us want to believe. You can find it in major league baseball, international banks, kpop groups, even the White House. But just when I thought I had a handle on this subject, something completely

unbelievable happened to me and my whole view on astrology changed. Whether you're a skeptic or a believer, give me a few minutes because I think your ideas are about to change too. Listen to Skyline Drive on the I heart radio app, Apple podcast or wherever you get your podcasts.