Gail R. Savitz

Gail Savitz is a nice Jewish girl who forgot one day to take her son to Bar Mitzvah practice nine years ago. Instead, she found herself lying in the hallway of an overly crowded HMO hospital wreathing in the worst pain known to mankind. When the doctor said "kidney stone" she thought of all the back surgeries her mother had undergone with her own kidney stones. When the Rabbi walked by to see how she was doing, she knew she was beginning a long journey to help others with kidney stones. Either that or it was final rites.

Nine years ago, there were no books written in an easy-to-understand language for patients. There were plenty of books and material written in Doctor Java. Savitz worked as medical reporter for several hospitals after graduating from California State University Long Beach. When stricken numerous times with kidney stones, and undergoing lithotripsy three times (once in the left kidney, once in the right kidney, and then yet again to further break up the stone in the right kidney), Savitz had had enough! Discovering little consumer information, she used her painful experiences, extensive research and journalism background to write this book. Since publication of her book, she has been free of new kidney stones.

Savitz is a member of The American Medical Writers Association, The American Lithotripsy Society, and The American Urological Association Allied. The Kidney Stones Handbook: A Patient's Guide to Hope, Cure and Prevention is recommended by C. Everett Koop, M.D., former United States Surgeon General.

Savitz is the publisher of The Kidney Stones Network Newsletter and offers Physician Referral. Savitz can be contacted for speaking engagements through 1-800-2-KIDNEYS. This professional medical reporter and motivational speaker brings a humorous talent into bookstore signings, hospital patient education programs, and consumer research centers. She has been called "The Mother Teresa" of stone formers.

"I am most definitely an activist for kidney stone patients. This pain can be prevented in 95% of all patients. There is no reason for them to become repeat stone formers," Savitz said.

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Current Titles

The Kidney Stones Handbook ISBN=0963706861 Gail R. Savitz, Dr. Stephen W. Leslie, M.D. - Four Geez Press - (Quality Trade Paperback) New, revised edition NOW available 100+ more pages! Medicationlist, important medical references you can read and show your doctor, medical conditions associated with stones, suggestions and tips for treatment selection, stones in children, summary of dietary therapies and how to find the best specialists and much, much more! This book provides kidney stone patients with information about their disease, how it can be treated, and the prevention of recurrence. Written by a woman with a medical journalist background who had kidney stones, this resource includes ten chapters covering topics such as symptoms of kidney stones; diagnostic issues; risk factors; the different types of stones.

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Q - Where can I get more information?
A - Questions about kidney stones, to order The Kidney Stones Handbook, subscription information for the Kidney Stones Network Newsletter, and Kidney Stone Support Groups can be directed to: Four Geez Press at gsavitz@earthlink.net; by calling 1-800-2-KIDNEYS, or by writing to Four Geez Press, 1911 Douglas Blvd., Suite 85-131, Roseville, CA 95661. Book price: $12.95, plus $3 s/h. Calif. residents add $ .94 sales tax.

Q - Why Do Kidney Stones Hurt So Much?
A - A kidney stone attack is described as the most painful experience possible to live through. It's more painful than gunshot wounds, major surgery, broken bones, burns and even childbirth. The pain is unrelated to the size of the stone and is not caused by the stone "moving" or scratching as many people believe. In fact, the pain is caused by the dilating or stretching of the urinary system caused by the blockage the stone produces when it gets stuck in the ureter. (The ureter is the tube that drains urine from the kidneys into the urinary bladder). When the urine that the kidney produces cannot pass the blockage, the ureter and urinary system stretches. This stretching is what causes the intense pain. (The same process causes the pain from intestinal gas that we all get from time to time). This also explains why the stones don't cause pain when they are inside the kidney. Since they don't produce any blockage, stretching or dilating of the urinary system, they don't usually produce any pain until they pass out of the kidney and get stuck. The degree of pain is unrelated to the size of the stone which is why it is possible to have excruciating pain from a stone smaller than a grain of rice.

Q - What Are My Chances of Having Another Stone Attack?
A - If there are no additional stones in your kidneys right now and this was your first stone attack, then your chances of forming another stone is about 10% a year although this will vary according to the specific chemical problems that are involved with each individual patient. Younger patients and those with a close family member or blood relative with stones are at greater risk. The peak ages for kidney stone production are between thirty-five and fifty years of age. On the average, the risk of having another stone problem if you've just had your first stone attack is about 70% to 80%.

Q - Will My Stone Pass Without Surgery?
A - If the stone is smaller than 5 mm or about 1/4 inch in diameter, then it will probably pass without surgery. Should your stone be greater than 10 mm in size, then it almost certainly will not pass. Stones that are between 5 and 10 mm may pass, but it's increasingly unlikely as the stone gets larger. Whenever possible, we like to give the stone every chance to pass by itself before resorting to surgery.

Q - Can't You Dissove the Stone with Medicine?
A - Unfortunately, most stones are made of a variety of calcium mineral combination that cannot be dissolved with any known medicine. About 10% of all stones are made up of uric acid. Only these uric acid stones can sometimes be dissolved with proper medication. But the majority of stones are made of calcium which cannot be dissolved.

Q - What About Using the "Stone Machine" to Break It Up?
A - The kidney stone machine, a procedure known as lithotripsy, fragments stones by using shock waves. The origninal machine produced shock waves with a special spark plug located at the bottom of a tank of water. These shock waves are then focused at a predetermined spot in the tank. The patient is anesthetized and placed on a special frame which is lowered into the tank. The patient and frame are then gently maneuvered inside the tank until the stone is positioned precisely at the focal point of the shock waves. X-rays are used to pinpoint the location of the stone and to make certain it remains exactly at the correct spot. The shock waves literally vibrate the stone so intensely it eventually shatters and fragments without injury to the surround tissues. In order to use the machine, the stone needs to be large enough to be seen clearly under the X-rays used for positioning. The stone also has to be in a location such as the kidney where the shock waves can reach it easily without striking bone.

Many newer machines have eliminated the water tank and do not require full anesthesia. Most of these newer machines are not as powerful as the original so there is a greater chance that a second treatment will be needed before all the stone material is completely fragmented.

It may take three months or longer to pass all the stone fragments after a successful treatment and there is a weight limitation on most available machine of 300 pounds. Patients who weigh more cannot use this technology.

In her book, author Gail Savitz has written two excellant chapters on lithotripsy including what to expect before, during and after lithotripsy. She includes some tips to make the procedure more comfortable.

Q - What Causes Kidney Stones?
A - The answer to this question is that at some point there was simply not enough water in the urinary system to dissolve all the chemicals and minerals that were produced by the kidneys. It's like trying to dissolve a ten pound bag of sugar in a cup of coffee. There is just not enough fluid in just one cup to dissolved all that sugar. But if you throw that same ten pound bag of sugar in a swimming pool full of water, it will certainly dissolve. In order for a stone to form, there must not be enough water to dissolve all the chemicals and minerals the kidneys are trying to eliminate through the urine.

At the same time, many patients will also have a chemical or mineral imbalance in their systems. Some patients are just unable to produce urine with sufficient chemical inhibitors to prevent stones from forming. Other patients will absorb a higher percentage of minerals through the intestinal tract than the average person. These excess minerals will then be excreted by the kidneys and will tend to form new stones.

Q - How Can I Avoid Getting More Kidney Stones?
A - While we have excellent methods of fragmenting stones with shock wave machines, lasers and lithotriptors, it is much more efficient and cost effective to elimate the true, unerlying causes of kindey stone formation whenever possible.

The first essential step in the prevention of kidney stones is to guarantee that there will always be sufficient water intake to produce enough urine to easily dissolve all the minerals and chemicals the kidneys normally produce and excrete. In other words, if you could drink enough water and liquids to always keep the chemical and mineral content of the urine from becoming too concentrated, you would never form any kidney stones. Without sufficient fluid intake, no prevention program has any chance of success. In general, we recomend increasing fluid intake throughout the day and dietary moderation of some food groups. Patients should also avoid excessive dietary intake of meat and salt. "The Kidney Stones Handbook: A Patient's Guide to Hope, Cure and Prevention" has complete charts of foods to avoid by type of stone formed as well as a complete nutrition chapter.

Q - How Can I Learn About My Risk for Stone Disease?
A - The only way to identify the specific chemical or mineral imbalances that contribute to kidney stone formation in any individual patient is to perform a comprehensive series of blood and urine chemistry tests. This testing series, called metabolic testing, is absolutely essential in order to identify the specific risk factors in a particular patient. Knowing the chemical composition of any previous kidney stones or stone fragments is extremely helpful, but without a metabolic testing program, it is impossible to identify the particular cause of an individual's production of stones.

Therapy usually consists of various but specific dietary adjustments or nutritional supplements. Sometimes medication is required when dietary treatment alone has failed to correct the chemical imbalance. The patient must be motivated to follow treatment suggestions for an indefinite period for any prevention program to be ultimately successful.

Conservative treatment measures such as dietary moderation and increasing fluid intake can reduce recurrences by about 60%. Metabolic testing consisting of comprehensive blood and urine chemistry analysis, together with a specific treatment plan can reduce the risk of new stone formation by up to 98%!

Q - What Exactly is Involved in Metabolic Testing?
A - Comprehensive blood and urine chemical testing is needed to identify the specific risk factors in kidney stone formation for any individual patient. Two separate 24-hour urine collections are required along with a blood test. These samples are then tested extensively to uncover any predisposing chemical problem which could lead to kidney stone formation. Any stone material that has been passed must be recovered to be chemically analyzed. This will help in developing a treatment plan to prevent more kidney stones from forming. For more information, or to find a physician in your area who is interested in kidney stone prevention, call the National Kidney Stone Prevention Physician Referral Service at 1-800-2-KIDNEYS.

Q - One Last Question, Should I Limited Milk and Dairy Products?
A - Many kidney stone patients severly restrict their calcium intake without realizing that such a reduction in dietary calcium can actually increase their risk of calcium stone disease. Dietary calcium has an important role to play in binding other minerals within the intestinal tract. A significant reducation in calcium intake can cause an increase in absorption of some of these other minerals which are normally bound or attached to the calcium. When no calcium is available for these minerals to bind to, they are left free to be absorbed by the body and eventually excreted in the urine where they can help form stones. The net result is an increase in the risk of forming more calcium stones if calcium intake is restricted too severly!

Please feel free to send your questions to gsavitz@earthlink.net. I will try to answer as many as I can in the next post.

Copyright 1997 Stephen W. Leslie, MD, FACS reprinted with permission for Four Geez Press

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