Ever Heard North Carolina Called the “Stone Belt?” Here’s Why
“You stones, you worse than senseless things!”
– Julius Caesar, Act 1, Scene 1
William Shakespeare wasn’t referring to kidney stones when he wrote that line, but he sure captured my feelings on the matter. It is said that the only thing more painful than a kidney stone is giving birth to a child. When I heard this, it raised my admiration for mothers to a whole new level.
Kidney stones are small lumps of mineral and acid salts that form in your kidneys, sometimes remaining lodged there and sometimes passing through a ureter, the tubes that lead out of each kidney. And yes, kidney stones hurt. A lot. Five millimeters doesn’t sound very big, but a stone of that size can cause crippling pain.
I know, because I’m among the 1-in-10 Americans who has had a kidney stone. In fact, I’ve had three kidney stone episodes in the last 10 years. And once you’ve had one, you become extremely interested in learning what kidney stones are and how you can prevent them.
Here in North Carolina, we’re in what many doctors call “The Stone Belt,” where kidney stones are more common. Why? For starters, it’s hot here and that causes us to get dehydrated. And here in the Tar Heel State, our daily diets are the perfect recipe for kidney stones. Beyond that, we eat too much, and being overweight is another kidney stone risk factor.
There are a lot of factors that can cause a kidney stone. We eat and drink things that contain what are called soluble salts, substances that can bind together and harden into “stones.” If you pour some sea water into a pan and let the water evaporate, the white crust that remains in the pan will be the soluble salts.
A lot of southern meals are rich in the things that cause kidney stones, things like fried foods, mayonnaise, dressings, salty meats, even sodas.
Normally, a person drinks enough fluids – most importantly, water – to dissolve these soluble salt substances and flush them out of the kidneys before stones form. But when we’re not drinking enough, granules in our kidneys can start crystalizing, clinging together until they’re finally big enough to cause pain. In the South, we have to drink more because we lose moisture in the heat.
There are a few different kinds of kidney stones. The most common are made from calcium oxalate or calcium phosphate, substances found in a lot of everyday foods, like fruits, vegetables, nuts and chocolate. High doses of vitamin D can also contribute to calcium stones.
Other types of kidney stones include struvite stones (formed in response to infections like urinary tract infections), uric acid stones (usually found in people who don’t drink enough fluids or have certain genetic factors) and cystine stones (caused by hereditary factors).
My urologist told me I’m prone to kidney stones because I simply don’t drink enough fluids. I told him I don’t drink much during the day because I don’t feel thirsty. He explained that I can be dehydrated without being thirsty. So I try to keep sipping from drinks throughout the day. For me, kidney stone prevention was a matter of starting a habit rather than quitting one.
Why Do Kidney Stones Hurt So Much?
If you’re lucky, the stone will pass. To pass a stone, you need to drink plenty of water to get the stone moving out of your kidney.
Passing a stone can be painful, but it can be even worse if the stone gets stuck in a ureter. In fact, most people with kidney stones have no symptoms at all until the stone becomes lodged as it moves from a kidney to the bladder.
The pain can come on suddenly. The first time it happened to me, I simply stood up from my desk at work and instantly felt a crippling pain deep in my lower back on the right side. Now, I broke my collar bone when I was eight years old, and I had a bout of pancreatitis when I was 25. Those really hurt, but what I felt from that first kidney stone was on a whole other planet from anything I’d ever experienced – or imagined.
When a stone gets stuck, it can require surgery to remove the stone or break it into pieces with a laser so the smaller bits will pass. After surgery, the doctor is likely to leave behind a stent that helps your kidneys keep draining properly; the stent stays for a week or so before being removed. Ironically, having the stent can be even more painful than the stone itself.
Can Kidney Stones Be Prevented?
Fortunately, there are things we can do to minimize our chances of suffering a kidney stone attack.
- Drink plenty of fluids. Staying properly hydrated is probably the best way to avoid kidney stones. Doctors advise we drink 3 to 4 liters of fluids every day to flush out our kidneys. Water is best, and lemonade and cranberry juice are known to help dissolve stones that may be forming.
- Avoid foods high in oxalate. I’ll be honest: giving up spinach and rhubarb wasn’t exactly a challenge for me. But I do miss peanuts and chocolate. Still, if it meant I’d never get another kidney stone, I’d give up virtually any food you could name.
- Listen to your doctor. If you have a kidney stone episode, chances are pretty good that you’ll eventually have another one. For many people, that happens because they fail to make the diet and lifestyle changes their doctors suggest. My doctor advised me to drink a lot more throughout the day – a habit I’ve found difficult to acquire. Since I’m not thirsty, I tend to simply forget that I’m supposed to be drinking something.
- Don’t drink tea – or drink more of it. There is a lot of contradictory research on whether drinking tea can lead to kidney stones. Many health experts believe that Southerners are more prone to kidney stones because we drink a lot of tea, but others say tea might actually help prevent stones. Personally, I fall into the No Tea Under Any Circumstances camp. Maybe tea is the culprit and maybe it’s not, but I’m not taking any chances. Like I said, I’d give up just about anything to avoid another kidney stone.
If you’ve never had a kidney stone, you don’t want one. And if you’re already in the Stone Club, do whatever you can to get out of it. Watch your diet, drink plenty of water and follow your doctor’s orders.