Acknowledgments
Foreword by Martin I. Resnick, M.D.
Dear Gail: Talk Me Through the Hard Times Ahead	1
Introduction: Why I Rewrote This Book by Gail Savitz	3
Why I Helped Co-Author This Book by Stephen W. Leslie, M.D.	9
Chapter One The Pebble That Hurts	13
When Should a Person Call the Doctor? Tales of Torture: My First Kidney Stone Visions of My Mother Learning to Ask for Help Symptoms of Stones The Emergency Room
Chapter Two Are You Stone Prone?	23
What is a Kidney Stone? Understanding the Importance of Our Kidneys Renal Failure (Kidney Failure) Even Mummies Were Stone Prone The "Why Me?" Question Often has Answers The Five Most Common Kidney Stone Chemical Risk Factors Calcium Oxalate Uric Acid Low Urinary Citrate Inadequate Fluid Intake Urinary Track Infections Cystine "New" Stones (Protease Inhibitors) Don't Throw Away Any Stones! Can Vitamin C Make You Stone Prone? The Stone Prone Diet: Your Stone is What You Eat! Do You Live in the Stone Belt?
Chapter Three "There's No Pain Like Stone Pain"	39
Pain Medication First Line Medications Opioids Injectable Non-Opioid Medications Toradol Anti-nausea medications Patient Controlled Analgesia (PCA)
Chapter Four Your Visit to the Emergency Room	45
When to Go to the Emergency Room Don't Drive Yourself to the Emergency Room How a Kidney Stone is Diagnosed How to Find A Good Kidney Stone Doctor Staying in the Hospital "Admission" vs. "Observation" Straining the Urine Ask for Your X-rays
Chapter Five Diagnosing Kidney Stone Disease	53
Imaging Ultrasound Intravenous Pyelogram (IVP) Retrograde Pyelograms CT (Computerized Tomography) Scans Flat Plate or KUB (Kidneys, Ureters and Bladder) Plain Renal Tomograms
Chapter Six Suggestions and Tips for Selecting Realistic Preventive Treatment	59
Picking a Good Lab Motivation Compliance Issues Selecting Therapies Fluids Diet or Medication
Chapter Seven Uric Acid Stones "The Invisible Menace"	65
Allopurinol Gout and "Gouty Diathesis" Uric Acid Stones Treatment of Uric Acid Stones What is pH and Why Is It Important? Review Capsule
Chapter Eight Bones, Stones, Moans and Groans: Calcium and Stone Disease	73
Increased Intestinal Calcium Absorption (Absorptive Hypercalciuria) What is Renal Calcium Leak? A Hormonal Cause of Calcium Stones What Parathyroid Hormone Does Immobilization and Stone Disease in Space Hypervitaminosis D: Too Much Vitamin D Medullary Sponge Disease Milk Alkali Syndrome Renal Phosphate Leak Renal Tubular Acidosis Urinary Tract Infections Weight Loss Diets Overview of Treatment Methods for High Urinary Calcium: Dietary Measures Salt High Urinary Uric Acid Medications and Medical Therapies: Allopurinol Cellulose (Calcibind) Magnesium Orthophosphates Potassium Citrate Thiazides Summary of Calcium Stone Prevention
Chapter Nine Oxalate: Getting "Stoned" Isn't What It Used to Be	95
Mild or Idiopathic Hyperoxaluria Enteric Hyperoxaluria: Antacid Loss, Bowel Disease, Chronic Diarrhea and Fat Malabsorption Primary Hyperoxaluria Experimental Therapies for Oxalate Summary of Treatments for High Urinary Oxalate
Chapter Ten Why Patients Need to Demand Metabolic Stone Risk Testing	105
Finding the Cause Saves Health Care Costs Avoiding Inappropriate Treatment & Preventing Unexpected Complications Preventing Stone Attacks Problems With Preventive Testing How to Obtain Stone Prevention Therapy Five Commercial Laboratories
Chapter Eleven Why Patients Need to Demand Metabolic Stone Risk Testing	113
Obesity in Women and Stones Should Women with Stones Take Calcium Supplements? Stones and Pregnancy Diagnosing Stone Disease During Pregnancy Management of Urinary Stones During Pregnancy Surgical Procedures in Pregnancy Calcium Supplements During Pregnancy The Difference Between the Sexes
Chapter Twelve Infection Stones (Struvite)	121
How they Form Treatment Preventive Measures
Chapter Thirteen Preventing Urinary Tract Infections In Women	125
Wash Your Hands Before Wiping Wipe Front to Back Take Showers & Avoid Baths How to Wash Yourself Douches May be OK Use Tampons And Much More!
Chapter Fourteen Water, Water Everywhere	131
Without Water-They're Back! All You Have to Do is Micturate (Urinate) Give Me Water! But I Am Drinking Fluids! Coca- Cola° Says Drink Me How to Achieve Water Balance What About Mineral Water?
Chapter Fifteen The I.R.S.* Plan for Increasing Urinary Volume	141
*(Internal Renal Stone)
Chapter Sixteen Cystine and Cystinuria: The Stone Disease You Inherit	145
Therapeutic Measures Medical Therapy for Resistant Cystinuria
Chapter Seventeen Gail's Lithotripsy: The Second and Third Experiences	151
Chapter Eighteen Stone Treatment by Surgery Baskets, Lasers, Stents, and Parachutes	159
Urologists and the Decision to Perform Surgery How to Find the Most Qualified Urologist Surgical Procedures for Stone Removal Stone Basket Extraction "Dormia" or Spiral Basket "Segura" or Flat Wire Basket "Leslie" Parachute Basket Ureteroscopy Internal Stone Fragmentation Devices Ultrasonic Lithotripsy Electrohydraulic Lithotripsy (EHL) Lasers Lithoclast Extracorporeal Shock Wave Lithotripsy (ESWL) Percutaneous Procedures Open or Traditional Surgery Stents Stone Free-Now What?
Chapter Nineteen Nutrition: What You Eat May Lead You Down the Rocky Road of Life	175
A Highly Recommended Resource Nutrients that Prevent Stone Formation Good Food Sources for Calcium What About Vegetarians? Will Wine Make You Whine? Kidney Stones: The Disease of Affluence Dietary Fiber, Rice Bran Vitamin B6 and Magnesium Dietary Purines (High Stone Risk Proteins) Dietary Acid Ash Dietary Oxalate Q & A: Diet and Kidney Stones Charts: Food sources of oxalates-oxalate stones Low-calcium diet-Calcium stones Low calcium test diet Low-phosphorus diet Struvite stones Acid and alkaline ash food groups Summary of diet principles in renal stone disease Acid ash diet Low purine foods-Uric acid stones Low methionine diet cystine stones
Chapter Twenty Kidney Stones In Children	201
Our Special Patients
Chapter Twenty-One A Note to Kids Whose Parents Have Stones	207
by Jennifer Golomb
Chapter Twenty-Two Important Medical References to Read and Show to Your Doctor	211
Chapter Twenty-Three Questions and Answers	213
Why Kidney Stones Hurt What is a Stent? Will the Stone Pass? Chances of More Stone Attacks Dissolving Stones with Medicines What to Do When You Get a Stone Attack When to Use Lithotripsy Jobs Most Likely to Produce Kidney Stones What Kind of Diet to Eat Limiting Salt and Meat Is Reducing Calcium Intake a Good Idea? How to Avoid More Stones The Most Common Problems That Cause Stones Who Should Receive Stone Prevention Testing? How to Stay Motivated
Chapter Twenty-Four List of Medications	225
Chapter Twenty-Five Glossary	233
Chapter Twenty-Six Statistically Speaking	251
Chapter Twenty-Seven Stone Timeline	255
Chapter Twenty-Eight Beyond the Book: Resources	261
Index	271