0:00

Good luck. Hey

0:03

everybody. We are super excited to return

0:05

to the sketch Fest stage and do

0:07

a live show again. We missed it so

0:10

so much last year and we can't wait to get

0:12

back to San Francisco. Yeah, it's

0:14

our first live show in two

0:16

years, chuck, and we're going to be there

0:18

at the Sydney Goldstein Theater and beautiful

0:21

San Francisco, California at seven

0:23

thirty on Friday, January

0:25

one. Is a straight up stuff you

0:27

should know live show, and it's going to be

0:30

off the chain, that's right. You should

0:32

show up to see if we've forgotten how to do this, to

0:35

see a skate around on stage, nervously

0:37

sure, doubting ourselves and eventually

0:40

bringing the funnies. Yeah, hopefully.

0:42

Where do they go? They go to s f AS

0:44

in San Francisco, SF sketch

0:46

Beest dot com. Click on the schedule

0:48

and tickets link. There are tons and

0:50

tons and tons of great shows. It's the best comedy

0:53

uh festival in the country in my opinion,

0:56

over the whole month of January. So go check

0:58

us out and go check out everybody else as well.

1:01

Yep, it's also a full vaccination show,

1:03

so you've got to show proof of vaccination

1:05

and wear some masks. Don't be naughty. Don't

1:08

be naughty, be nice. So we'll see you guys

1:10

on Friday, January one in San

1:12

Francisco, California.

1:15

Welcome to Stuff You Should Know, a production

1:18

of I Heart Radio. Hey

1:25

you, and welcome to the podcast. I'm Josh Clark,

1:28

and there's Charles w. Chuck Brian over

1:30

there, and this is Stuff you should Know. I

1:33

should say, Stuff you should now. It's

1:39

a good one. Thank you. It was

1:41

off the cuff, Chuckers. You

1:43

ever had a kidney stone? No, let

1:45

me. I

1:48

guess it's not good enough. No, I haven't. I

1:50

have not. How about you? I have it.

1:53

I think I'll probably get one one day. Yeah,

1:56

you just know it's in the cards for you. Yeah,

1:58

I mean I've got I don't have like a bad kidney issues.

2:00

But you know, when

2:02

you get to be my age, certain organs starts

2:04

saying, Hi, pay attention to me a little

2:07

bit. Oh yeah, yeah yeah, And the kidney is one

2:09

of those. But I'm not I'm not dying or

2:11

anything. No, I know that. It's more

2:13

just like, you know, what's it if if

2:15

you got a inky kidney, you could

2:18

conceivably get a kidney stone. For sure,

2:20

that is certainly true. So,

2:22

um, I, my friend, wish that

2:25

you never ever, ever, ever

2:27

get a kidney stone. I wish the same for Jerry.

2:29

I wish the same for every person you know

2:31

and like and love, and same for me.

2:34

That's right. But wishes

2:37

and dreams do not bear any

2:39

weight here, my friend, because I

2:41

think you got about a ten percent chance if you're living

2:44

a human of having a kidney

2:46

stone, and besides being

2:48

super painful, they can

2:50

kill you. About sixteen thousand people year die from

2:52

kidney stones or complications that arise.

2:54

Yeah, what a way to go, man, from kidney stones.

2:57

And you're probably not going to die from

2:59

your kid He's failing, because that would require

3:02

both kidneys being blocked

3:04

simultaneously so badly

3:06

that they just shut down on you.

3:09

That's probably not gonna happen. Um.

3:11

But there's a lot of procedures

3:13

that, um, that you would probably go through

3:16

to treat a terrible kidney stone that

3:18

that could kill you. An infection could kill you. There's

3:20

all sorts of ways that could lead to bring about

3:23

your death, and that would not be very pleasant. I agree

3:25

with you. Yeah, they are I

3:27

mean there's different kinds. We're kind of gonna kind

3:29

of gonna go through them here, but they're

3:32

generally classified in a couple of ways.

3:34

Um, where they are and what

3:37

kind they are, like how they were formed. They

3:39

are all kinds of fancy schmancy doctor

3:43

names for kidney stones, renal

3:45

calculi, uh, euro

3:48

lithiasis, But they're

3:50

gonna call them kidney stones if it's a doctor

3:52

that has an interest in being your friend.

3:54

Right, So, Um, the

3:57

where where they are, um

3:59

is really important because they

4:01

need to know where they are so they can

4:03

help you figure out how to deal

4:06

with these in the most particular way.

4:08

And there's only like a certain number of places

4:10

that a kidney stone is going to be. And

4:12

Chuck, I looked high and low and could not find

4:15

a definitive answer, as I

4:17

saw some places that seemed to say

4:20

all kidney stones are all stones

4:23

start in the kidneys. But

4:25

I also saw like little snippets here

4:27

there that made it seem like there's other places

4:30

stones can form shoulder

4:33

blade, right, But regardless,

4:35

that's my point. Regardless of where they form,

4:37

they're going to form only in your urinary

4:40

tract, which includes your kidneys, your

4:42

eurotors, which are the tubes that

4:45

take your pa from your kidneys down to your

4:47

bladder, the bladder itself and

4:49

then the urethra narrow or otherwise,

4:52

which is where the peak comes out. Yeah,

4:54

I'm gonna go ahead and say the eutors,

4:57

they should have built those a little wider. Are

5:00

not a lot of heartache. Yeah, because one

5:02

of the one of the big problems that you're

5:04

going to have if you get a kidney stones, you're your readers

5:07

are like two millimeters in diameter

5:09

and they're not very flexible. So when you're

5:11

passing a hardened stone, a crystallized

5:14

stone of mineral through

5:16

that that's larger than two millimeters,

5:18

it is going to cause some problems. Yeah,

5:20

I'm sure that they didn't

5:22

seem like they needed to be bigger at the time man

5:27

and woman was created. But

5:30

because all of it's going through, there's p but the

5:33

lack of foresight on those stones is a big

5:35

problem. Yeah. Tis tisk yahweh.

5:38

That's that's right. So

5:40

you've got stones in the kidney nephro

5:43

nefro liths lith means stone.

5:45

You've got your eur readero liths

5:48

which are in the your readers, and again that's

5:50

a really terrible place for them to be. And you've got

5:52

sister liths which are in the bladder, and I

5:54

guess by proxy that the urethra

5:56

too, right, that's right. Uh,

5:59

the ones in upper tract, those

6:01

are gonna be, um, a little

6:04

more problematic, generally a little more

6:06

severe. Uh. If you're gonna get

6:08

complications and long term problems,

6:10

they're generally generally going to be because of those

6:13

upper urinary tract stones.

6:16

Um. But they're all, I mean, none of them.

6:18

The only ones that aren't a big

6:20

deal are the ones that are so tiny that you

6:22

just and that's why I said that. You know of

6:25

people probably thought I was joking, But you can urinate

6:27

out kidney stones and not even though you ever had one, if

6:29

they're small enough. Yeah, just pee yourself

6:32

right now. There's a chance you just peet out a little

6:34

tiny maybe a stone of some

6:36

sort. But for the right

6:39

when you do know that you have a kidney

6:41

stone, though you really really know it.

6:44

Um. And we'll talk about the process of passing

6:46

a kidney stone later. But UM.

6:49

The other way to to define a kidney

6:51

stone, and usually they're going to be defined

6:53

by location and then also in this other

6:55

way, by composition, because kidney

6:57

stones can be made up of a lot of different things.

7:00

Um. But the upshot of them, Chuck, is that

7:03

if you have too much of something in

7:05

your p or two little p um

7:09

or imbalanced p

7:11

pH wise um,

7:13

things can solidify that should be liquid.

7:15

They can precipitate out of solution, and when

7:17

that happens, it can start basically

7:19

a snowball effect where more and more that stuff

7:21

is attracted, and that's where your stone is formed.

7:24

Yeah, I mean, it's just it's just mineral things

7:27

that don't that can't be dissolved basically,

7:30

and they like to have company. They like to get

7:32

together with our other non dissolved friends and

7:35

party together and hang out together. And

7:37

pretty soon, if you get a big enough party, you're

7:40

you're gonna be in some kind of pain. Yeah, you're

7:42

gonna have a pain party for you. But

7:44

I guess we should talk a little bit. This is sort of the

7:47

about as wonky as we're gonna get in this next section,

7:50

which is the makeup of

7:53

these stones, and most of them

7:55

are made up about six or

7:57

calcium oxalate, and

8:00

and that this is basically too much calcium

8:02

or oxalate in your urinationary

8:04

system, and it's you know, there are a number

8:06

of things that can cause this, but they're generally

8:09

all metabolic problems, although I think there's

8:11

a little genetics involved with

8:13

the calcium oxalate as well. Yeah,

8:15

that seems to be my take on it too, that

8:18

that genetics have a large role

8:20

in whether you're predisposed to having

8:23

kidney stones or not. Diet and lifestyle

8:25

can definitely affect it. But it's like

8:27

if you have hyper parathyroidism

8:30

and you're absorbing calcium

8:33

too much calcium from your bones, that

8:35

probably doesn't have much to do with your diet.

8:37

UM. And that's one way that you can have too much

8:39

calcium. Your renal system might um

8:42

not absorb enough calcium from

8:45

UH into waste, and so there's more of it

8:47

hanging around there than there should be. Um.

8:49

There's a there's a few ways that it can happen,

8:52

but the upshot of is either you have too

8:54

much calcium or too much oxalate and they

8:56

combine together to form would

8:58

you say, like any percent of kidney

9:01

stones, Yeah, that's sixty two

9:03

eighty and I think the actually

9:05

I don't have a percentage for struvite stones.

9:09

UH. These are also called infection stones.

9:12

And there you know, if you get a lot of U T

9:14

eyes, you might be more prone to struvite

9:17

stones. Um. Sometimes

9:19

there's just some kinds of bacteria

9:21

and if you match that up with the right uh

9:24

metabolic condition that's going wrong, it'll

9:27

they'll get together and cause struvite stones. Yeah.

9:29

The struvite stones seemed to rely a

9:32

lot on whether you're um like with

9:34

if your your urine is out of balance

9:36

pH wise, specifically that it's

9:39

highly alkaline um, so

9:41

it's above seven uh as

9:43

far as pH goes, and that

9:45

that combined with certain kinds of

9:47

bacterial infections can can create

9:50

that. It looks like stag horn

9:52

seems to be the most common type, which

9:55

I mean you do not want to mineral

9:58

that fits the bill of stag or flowing

10:00

through your urine. Yeah, you

10:02

do not good at all. Uh. Then you have

10:05

about ten percent or lesser formed by uric

10:07

acid. And this is sort of you

10:09

know, if you have problems with your uric acid or gout,

10:13

uh, you're probably gonna have kidney suns at some

10:15

point. Uh. You know, the gout

10:17

diet is it's sort of the same triggers.

10:20

They're high in what's called purins, shellfish,

10:23

organ meats, any kind of meat

10:25

really beer, for sure, Like

10:27

those are all on the list of things

10:29

that you don't want if you're trying to keep your uric acid

10:32

and check. Yeah, because the uric acid

10:34

is um metabolite of

10:37

purine and um

10:39

it crystallizes very easily. It can precipitate

10:41

easily out of the P if

10:44

there's too much of it, So yeah, that

10:46

that can be a bad jam for sure. Um.

10:48

There's also cysteine stones, cysteins,

10:51

and amino acid. It's it's used throughout

10:53

the body for a number of different ways. But unfortunately

10:56

it's the least soluble amino acid,

10:59

so that means that it can precipitate

11:01

out of P fairly easily too. Luckily,

11:04

those are kind of rare. Um. You actually

11:06

have probably a UM

11:08

a congenital disorder that causes

11:10

sistine stones. But unfortunately

11:12

that means you have a congenital disorder that causes

11:15

stones, which means it's probably a chronic

11:17

condition, right, And I think that's

11:19

the same for the rare xanthine

11:22

stones, right. Yeah. And xanthine is another

11:24

purine or purine. It's

11:26

found in caffeine, tea, and Cola's.

11:29

And it occurred to me Chuckle was researching this, is

11:32

that what Purina is trying to get across

11:34

with their their brand name, that

11:36

they're from chock full of purines. Um.

11:40

Maybe I always kind of thought it was probably

11:42

just a play on the word pure. Oh,

11:45

it never occurred to me like that. I wonder maybe

11:47

they're like, why can't it be both Josh and Chuck.

11:52

Uh. And then there's of course the Infinity stones,

11:54

which are a real problem for about half the population.

11:57

Yeah, and one other thing also, um

12:02

pass that one almost I'm glad I stopped

12:04

and took a double take.

12:07

Was that written down? I can't see your notes? That

12:10

was no notes? Wow? That was

12:12

good then, man, I think you just won the World

12:14

Cup for in

12:16

the off the cuff stuff. You should know joke,

12:18

okay, battle, I'll take it. Um.

12:21

One other thing about uric acid

12:24

stones is that that um

12:26

is kind of the opposite of strew vite stones,

12:28

where your p s two acidic, like

12:31

it'll burn right through metal if you pee on a car.

12:35

Right, should we take a break,

12:37

Yeah, we should take a break. I need to regroup

12:39

after that huge win by you. Just

12:42

we'll be right back and I'll say what I'm gonna say after

12:44

this. Yeah,

13:07

so I didn't know if you even I didn't think you watch

13:09

those Marvel movies. I didn't know if you'd get that joke. Well,

13:12

I mean like I'm I'm conscious, like

13:14

I can form thoughts and observe like outside

13:16

stimuli, So that means, yes, I'm familiar

13:19

and aware with the Marvel cinematic universe

13:21

and what goes on in it. Well, see, I would

13:23

think if you didn't see the movies, you have no idea what an infinity

13:26

stone is. No, No, I mean, well, obviously

13:28

I've seen I guess I saw the one that you're

13:30

specifically referring to where half half

13:32

of everybody just like dissolves. I

13:34

saw that, should say spoiler alert.

13:37

Oh yeah,

13:40

if you don't know that by now, come on, those are the biggest

13:42

movies in the world. So thank you for defending me.

13:44

Like, no apologies necessary, no accountability

13:47

here. But you'll have to watch the second

13:49

one to find out what happens after that. How about

13:51

that, well, they come back. I

13:56

haven't seen that one, but I'm just presuming

13:58

there's no way to really much part in part

14:00

two. Yeah, that's pretty funny.

14:03

Yeah, I did not see the second one yet.

14:05

I guess if you didn't like it much, you'd be like, well, am I going to spend

14:07

another two hours and forty minutes? But because

14:09

I did like it, I mean I was entertained

14:12

and amused. I guess I just knew that at

14:15

the very least everybody who was anybody

14:17

was going to come back somehow. I

14:19

didn't know how, but I guess I didn't really care

14:21

how. I just want to strip you

14:23

in a chair and uh like

14:25

clockwork clockwork orange style and make you watch

14:27

the Beatles documentary. No, alright,

14:33

so back to regular kidney sounds right,

14:36

yes, um so um.

14:38

We kind of talked about how they formed,

14:41

but it's worth just kind of saying one more time. It's

14:43

basically, you've got stuff in your P minerals

14:45

that that don't dissolve very easily,

14:48

or there's too many of them or there's not enough P and

14:50

they just go and they crystallize,

14:52

and that's how it starts, and that kicks off this

14:55

process um of

14:58

where usually they form an actually

15:00

in your kidney, but they can't form anywhere,

15:02

but they'll hang on to like a little node

15:04

in your kidney and start to nucleate.

15:07

They're kind of like a snowflake. Ed

15:09

helps us with this one, and he's like, it's like a snowflake

15:12

basically growing um from like a little

15:14

dust moat when it's cold

15:16

enough. Yeah, and like you said,

15:18

they don't always have to form that way. Sometimes

15:20

they can just form free floating

15:23

in your urine, just moving about

15:25

the party. But they do better

15:27

for sure when they're attached initially

15:30

to something. When one when one little

15:32

tiny particle hangs onto something like

15:35

uh, I know Ed mentioned the renal papilla.

15:38

Uh, those little projections and the kidneys

15:40

papillia, that's a good

15:42

place for them to get together. Uh.

15:44

They may grow there for a little while, they

15:46

may detach and then float away,

15:49

but they also might attract friends

15:51

at these attachment points, and

15:53

that's when the problem starts. They're eventually going to detach,

15:56

but they just like to congregate and like the cool area

15:58

of the party. Yeah. And see you just said made

16:00

me think like you could probably form a stone

16:03

anywhere in your urinary tract that whole

16:05

system, as long as there's a place for it

16:07

to kind of clamp onto, or it's

16:09

bad enough that they're just forming right in the

16:11

middle of your urine, so it

16:13

doesn't necessarily have to just be your kidneys.

16:16

Yeah, and they look like I think ED had the perfect

16:19

DESCRIPTI here, it looks like a little granola chunk granula.

16:22

Yeah. Some of them look a little more

16:24

um, mean and menacing than

16:26

others. Some are even like smooth where you're

16:28

like, jeez, I enjoy passing

16:31

these. They make a very

16:33

satisfying PLoP sound when they come out

16:35

of the urethra um. But again,

16:37

there's like stag horns, there's the widow

16:39

maker, Um,

16:41

there's the Judas Priest. They

16:44

have terrible names, but they

16:46

really kind of drive home how bad these things are.

16:50

It's really the Judas Priest. Wouldn't

16:53

never know doctors have a sense of humor with two of them?

16:55

Wouldn't that be great? Though? So

16:57

I would I would think it would be this like looks

17:00

like the double horn fist. I

17:02

was thinking it was gonna look like that metal

17:04

eagle. Oh that too,

17:07

the screaming eagle mm hm living

17:10

after midnight. The metal fist sounds

17:12

worse though, for sure. Well,

17:15

anything, and you know this is the case with kidney

17:17

stones, anything, And that's why the stag horns

17:19

are so bad if it's the spikier. I

17:22

mean, you don't have to be a doctor to tell

17:24

someone that the spiky

17:26

or something is the more painful. It's going to

17:28

be, right. Yeah, they're describing

17:31

your kidney stone too, and you're like, I didn't realize

17:33

your doctor. They say, oh, I'm not a doctor. I just stayed

17:35

at a holiday and expressed, yeah, anybody

17:37

could tell you that. Uh

17:39

so the pain that you're gonna

17:42

feel like when you get diagnosed for a kidney stone,

17:44

You're probably gonna go into the doctor after

17:47

feeling uh sort

17:49

of lower groin pain for a while, maybe

17:51

in your lower back or side or abdomen,

17:54

and you might be going, man, this is like I

17:56

didn't pull my back. What's going on? And

17:58

you may live with it for a little while just thinking it

18:01

might be a pulled muscle or anything

18:03

like that, or a strain groin

18:05

even and then at some point, hopefully

18:07

someone in your life is going to say you may want

18:09

to go like that, maybe a kidney stone, get that checked

18:11

out. You may want to get that checked out. One

18:14

of the reasons I didn't understand this, but it

18:16

makes total sense. One of the reasons why there's it

18:18

feels so much worse than just your

18:20

urit or or your kidney saying

18:23

ah, is that there's a

18:25

bunch of really important nerves that pass

18:28

right through the kidney, right through that that notch

18:30

that gives the kidney its characteristic shape.

18:33

Because the celiac plassics

18:36

plexus,

18:40

the inner mesenteric plexus,

18:44

the lumbar splank nick.

18:47

I like the splank nick or the splank nick. Yeah,

18:50

I like it too. I like the Celiac plexus

18:52

though. It's got a pleasant, pleasant look

18:55

to It's like cellar door. Yeah,

18:58

you love cellar door. It

19:01

wasn't just me. That's a Tolkien reference. He's

19:03

I think he's said, I

19:05

know, but you mentioned in London in the show, is what I mean. I

19:07

just think it's such a great idea that somebody

19:09

was like, I definitively say, this

19:11

is the most beautiful word in the English language,

19:14

and it just happened to be Tolkien. So like there's an

19:16

extra little twist at the end there, and

19:18

it was used in Donnie Darko, so it's

19:20

a pretty pretty great little thing. I

19:23

have my favorite word though. It's not sellar door. It's

19:26

it's moist pus. No, it's

19:28

the Beatles, and it's used in the

19:30

Peter Jackson documentary The Beatles. Is

19:33

it really that good? It's

19:35

amazing. I mean i'd say this, you

19:38

would hate it. But if you're a

19:40

casual Beatles fan, it's probably not even for

19:42

you. Or even if you're like, no, I like the

19:44

Beatles, it's probably not even for you

19:46

because it it's eight hours of just

19:49

sitting in there, fly on the wall style, so you really

19:51

got to be into Like did you see that look

19:53

that George escaped Paul when he said that one

19:55

thing? Like it's that kind of

19:57

level. Yeah, I would not like

19:59

that it at all. I've got I have a music

20:02

documentary that, um you mean and I watched

20:04

the other day. That's really good. Um

20:06

it's on Sparks. Oh

20:08

yeah, sure, I've seen that. You saw it. I loved

20:11

I had never heard of Sparks. I didn't real Sparks

20:13

existed. I'm actually I've been disappointed

20:15

in myself ever since that I didn't realize

20:18

they were a thing. But that is a great

20:20

documentary. One of the things I like about it is not just

20:22

their music, but just like how like

20:26

naturally and genuinely positive

20:28

they are without trying to be positive and

20:30

also actually being kind of fiendish in

20:32

their sense of humor, but they're still overall

20:35

like very positive. It's pretty

20:37

cool, pretty and I'll

20:39

even go ahead and recommend even though I haven't seen it.

20:42

It's on the list this week. I just got to get through the

20:44

Beatles. Thing is the Todd Haynes Velvet

20:47

Underground documentary. I hear it's just like ridiculously

20:50

good, which I can't wait for because the

20:52

best. I'm going to check that out. So

20:55

that was documentary corner. I

20:57

got my movie crush fixed. Well we should. We need

20:59

to take care berets often drop

21:01

our cigarette holders and get back to it.

21:04

I think we were talking about those three nerves

21:06

and they can cause uh

21:08

nausea and vomiting because those three nerves

21:11

run right through what's called the renal

21:14

hillum and that's that little

21:16

you know, if you look at a kidney or

21:19

even a kidney being or kidney shaped swimming pool,

21:21

you can imagine what it might look like a

21:23

little notch inside that curve, and all

21:25

three of those nerves run right in there.

21:27

So if you're kidney is uh

21:30

inflamed or spasming or something, it's going to be

21:33

tweaking those things like piano strings.

21:35

Yeah, and spasming is right, you just said the magic

21:37

word, because your kidney is well aware that

21:39

it has something that shouldn't have in it, and

21:42

it actually has a way to take care

21:44

of that, and that is by spasm ing it out,

21:47

trying to push it out. The

21:49

kidney does that, and so do your your readers.

21:52

UM, and your your reader actually like

21:55

clomp down around it and try to squeeze

21:57

it out through spasms. So kidney

22:00

pain is typically associated

22:02

with UM basically the worst pain you

22:04

could ever experience. I think, UM, people

22:06

have given birth before, UM

22:09

who did it without any kind of

22:11

drugs say, Nope, kidney stone is actually

22:13

worse than that. UM. And what's

22:16

great is everybody can share in the fun

22:19

of a kidney stone. Did

22:21

you see what Ed's friend called it? Yeah?

22:24

Ed has a friend who had kidney stones instead. It was

22:26

like giving birth to a knife. Right.

22:28

That kind of says it all. It really does. UM,

22:31

the worst of it from what I've seen. I

22:34

found uh urology website,

22:36

UM, and it's basically

22:38

says the two worst by far is

22:41

when it's in the kidney and then when it's in the your

22:43

reader, and apparently when it's in the kidney

22:45

it's even worse. That's the worst of all.

22:48

But the upshot of it is, in addition

22:50

to feeling nauseated for your back

22:52

and your abdomen to hurt um,

22:55

you're you're actually going to be experiencing

22:58

pain in your kidney and your your reader as

23:00

there pushing this thing out,

23:02

and it comes in waves of pain called

23:05

renal colic, and they

23:07

will give you narcotics to take care

23:10

of it. It's that bad. Yeah,

23:13

yeah, the best feel good drugs available

23:15

are coming your way, and they'll probably

23:17

just barely make a dent. I

23:20

don't know that that's true, but I'm really trying to drive

23:22

home how painful kidney

23:24

stones are. I wish one of us would

23:26

have had it from experience.

23:29

I'm actually glad that we aren't. Speaking

23:31

from experience. I wish that person was,

23:33

you know. Uh

23:35

No, I'm glad we haven't had it. But I'll, you know, hopefully,

23:38

over the next until we retire, I'll

23:41

keep everyone up to date on whether or not to get kidney

23:43

stones. Okay, all right,

23:45

I think that's fair squatted land than kidney

23:47

stones. Those are my two lifelong updates.

23:49

What about your teeth. Don't forget your teeth. Well,

23:52

everyone knows I got to get that tooth done again.

23:54

So man, I just had a deep, deep cleaning

23:57

on two of my teeth and it was not pleasant.

23:59

But my period onist was great,

24:02

um like, very nice and general

24:04

and apologetic. Uh. And I

24:06

think I'm better off as a result. I'm a better

24:08

was that the rooting and scaling thing, I

24:11

believe? So there was a gum treatment

24:14

sort of yeah, and there wasn't like an incision. She

24:16

didn't cut um.

24:19

But they want me to do that again. Yeah. It's

24:21

not fun at all, but you

24:23

know that I'm done. It's done. I

24:26

was about to say, as if it was any better, we should get

24:28

back to kidney stones. But

24:31

to get these things treated there, they are quite a few

24:34

options, thankfully. Um.

24:36

It depends on where it is, depends

24:38

on how big it is. Uh,

24:40

if it's in, if it's one of those uh

24:42

your ead stones, They're probably

24:44

gonna say pass it. It might even

24:46

take a few weeks. But drink tons of

24:48

water and see if you compete that thing out. Yeah, once

24:51

it gets out of the kidney. Yeah, And I think

24:53

if it's five millimeters or

24:55

smaller. You got about a nine chance

24:59

of passing that thing through a year, and and it

25:01

goes down to between

25:03

five millimeters and ten millimeters. And

25:05

if you can eat and you can drink

25:08

and you don't have a fever, they're

25:10

probably going to send you home with

25:12

some pain pills and some flow max

25:14

to to relax your urethral sphincter

25:17

so you can pee easier, and you're gonna pee all

25:19

the time. And as it moves

25:21

down into like your bladder, it's going

25:24

to increase the pressure there because of the inflammation

25:26

your bladders. So you're gonna have to feel like you have to pee

25:28

all the time, even though you don't necessarily.

25:31

But they're gonna send you home and be like, best

25:33

wishes, best of luck, keep us posted. Let

25:36

us know if you spike a fever something

25:38

like that, Right, you're also

25:40

going to get all kinds of tests, um,

25:43

blood test urine tests, things like that, just to

25:45

see like you may have more than one stone, um

25:48

the identification of the stone. I

25:50

mean there there could be a larger problem, you know, if we're

25:52

talking about these metabolic imbalances,

25:55

like if you may have chronic kidney stones

25:57

or at least another one in the future.

26:00

They want to kind of get you on the right tracks. So you're gonna do

26:02

a lot of tests as well. Yeah, and um, one

26:04

of you his friends used to get him a lot, and I

26:06

think I didn't have a chance to ask him, but I

26:08

think he might have outgrown him.

26:10

I hope God willing. But I'm

26:13

pretty sure he had to pee into like

26:15

a mesh cup to catch

26:17

the stone. And I realized, now, it's not

26:20

not because he was a weirdo. It was because they wanted

26:22

to analyze the stone. Because

26:25

again, you can tell a lot about

26:27

what is driving you to produce kidney

26:30

stones if you can just look at it, because you can see what it's

26:32

made of. Well, you can see what it's made

26:34

of, and that'll tell you a lot. I think i'd

26:36

want to keep mine. Well that's the

26:38

other thing too. You got a pretty nice trophy. You

26:40

could get a grill made with it. That's

26:46

what I need on my fake front teeth. A couple

26:48

of kidney stone, couple like stag horns,

26:50

just sticking out, slicing into the back

26:52

of your top lip. Uh.

26:55

If they are larger, you're gonna need

26:57

some more. Uh. What ED called

27:00

direct intervention and that's pretty

27:02

much says it all. They're gonna look

27:04

at you with X rays. Uh, they might

27:06

use an ultrasound. They're gonna find out

27:08

exactly where that puppy is. They're

27:10

gonna see if it's moving along or if it's kind of

27:12

stuck in place, and

27:15

uh, then they're gonna go to work. It's it's a little

27:17

more expensive, but I would

27:19

stay just by reading this. If it's an option,

27:22

and if you can afford it, I would go to

27:24

the uhle thought such a

27:26

hard word to say with thought tripsy method.

27:30

Yeah, because it's non invasive. It's

27:33

all ultrasound. Like

27:35

they use ultrasound maybe X rays to find and then

27:37

they use ultrasound to break it up. And

27:39

Chuck had produced the sentence that

27:41

seems innocuous until you realize

27:44

that if you read it like a

27:46

monster truck ad announcer,

27:48

it's really boss. Which one is

27:50

it sounds

27:56

without? Oh

27:59

yeah, that's true. Yeah

28:02

you should be a doctor. That'd be fun. I oh

28:05

dude, everything would be called the Judas Priest

28:08

whatever, right, I be like, this

28:10

is a Judas Priest baby, Yeah,

28:12

it's a Judas Priest fracture. We can fix that, no problem,

28:16

Uh, if it's larger even than that,

28:18

uh, like too large and I guess

28:20

this is a Judas Priest album. Too large for lathot

28:23

trip tripsy um

28:26

or if they can't find it, maybe if it's like exactly

28:28

where it is or you know, or maybe

28:30

you don't have it available to you because of money or wherever

28:33

you live. You can go to a

28:35

uteroscopy and that is

28:38

a little bit more invasive, but not surgery

28:41

yet. That's when they're going to send a scope up through

28:43

the urethra, probably not a lot

28:45

of fun uh, into

28:47

the bladder, into the uritor and

28:50

then they capture it. It calls it like a little

28:52

basket and they and they pull it out and then

28:54

sometimes it is even bigger, they can use a laser to

28:56

break it up and then pull it out right.

28:58

But that's the key that your your reader

29:01

you read roscopy is that they

29:03

actually can remove the stones,

29:05

whereas um. I think with lithotripsy

29:09

man it is

29:12

uh that they actually they go in there and break

29:14

it up, and a complication would be is like it's

29:16

kind of like that stupid Russian

29:19

um satellite missile tests that

29:21

they just did, remember where they created way

29:23

more space chunk than there used to be. You're doing

29:25

the same thing with the thought tripsy,

29:28

where you're breaking up these stones, and so one

29:30

of the complications can be like, now you've got

29:32

a bunch of kidney stones, and yeah they're smaller, but

29:35

not all of them are so small that you won't

29:37

notice them, or that they won't necessarily

29:39

cause an infection or something like that. Right,

29:42

Or in the case of the Guinness record holder, the

29:46

man in Indian two thousand four, this thing

29:48

was and I looked up different kinds

29:50

of sports balls, and the closest

29:52

I could find was it was about the size of a shot put.

29:56

What, Oh my goodness, five

29:58

inches in diameter. I mean, it is never

30:00

thought about it, like I even made that with my with

30:02

my hands, and I

30:04

think't thinking it's got to be circumference, it's

30:06

gotta be that's no, it's diameter,

30:09

because I went and looked too. But so for those

30:11

people who have never seen a shop put and don't know what five

30:13

inches is, that's like thirteen centimeters

30:15

in diameter. Yeah, it's bigger

30:18

than a softball. If you don't know what a softball is,

30:20

it's about a regular

30:22

grape fruitish size. Yeah, I would

30:24

say so. Yeah, So obviously that was

30:27

a surgical removal, which is the

30:29

last the sort of the last

30:31

line of defense is to get

30:33

that surgery. And it's called this

30:36

one's mine, percutaneous

30:39

nephro lithotomy, nicely

30:41

done, and that they make a little notch,

30:44

a little incision in the lower back. And

30:46

it's that they scope it out too, so it's not some huge,

30:48

huge thing, but they use a thin scope

30:50

into kidney, break it up again,

30:53

remove the pieces. Uh. And we should

30:55

mention too that some of these um,

30:58

I think the uteroscopy is when they

31:01

utero. Yeah, uteroscope.

31:03

No, there's an extra vowel in there. It's not just me

31:06

utero scoopy.

31:09

Yeah, uteroscopy. Your read a roscarbe,

31:11

you read a roscoe adding

31:14

an extra vowel every time eventually

31:16

pays off. You

31:18

read a roscope. That is the one

31:20

that, um, you still need anesthetic

31:23

and you might eventually need a

31:26

stint, which again goes back

31:28

to my thing that the euritor should

31:30

be bigger. Yeah,

31:33

if they're putting in stints, that means that's the

31:35

size that it should have been to begin with. Absolutely,

31:38

then anything could just passed there, even a five

31:40

inch diameter kidney

31:43

stone from India. Should we take a

31:45

break. I think we should take our second break

31:47

and come back and talk about what I think

31:49

everybody wants to know is how do you make this

31:51

never ever happened to you? Okay,

32:17

Chuck. So it's actually pretty simple

32:20

unless you have some sort of congenital disorder

32:22

that is producing chronic kidney stones

32:24

in you, which is extremely sad and I

32:26

feel very badly for you. Um,

32:30

there's some really easy ways you can

32:33

keep from probably ever getting a kidney

32:35

stone in your entire life. Yeah,

32:39

I mean, I know you think drinking water

32:41

is a scam, but yeah,

32:44

I remember you went on entire right years ago about

32:46

how that whole drinking egg glasses of water days.

32:48

But oh no, so that is drinking

32:51

egg glasses of water. That the number was

32:53

made up. I think drinking water is good,

32:55

but the number of glasses is just totally

32:57

like made up. Well, this is two liters

32:59

per yeah, so that's a number

33:02

it is. But there was a study that backed it up.

33:05

Okay, they

33:07

say the study that said if you drink a couple

33:09

of liters of water a day, it resulted

33:11

in a hundred and forty nine fewer stones per one

33:14

thousand people, and

33:16

it just makes sense, you know, to keep

33:18

water flowing through your kidneys and flowing

33:20

through your system and keeping everything nice

33:23

and saturated, that it would help prevent

33:25

the build up of those uh of those little

33:27

particles, those minerals, right, because you've

33:29

got enough p that those things, even

33:31

the toughest um

33:34

solubles, are going to stay in solution

33:36

rather than precipitate out. But also one

33:38

thing that's easily overlooked is when you

33:40

drink a lot of water, water is pretty much

33:42

across the board a neutral substance,

33:45

so it actually helps maintain the pH

33:47

balance in your body. And as we've seen,

33:50

there's at least two different kinds of kidney stones

33:52

you can get depending on whether you're urine

33:54

is too acidic or two alkaline.

33:57

And drinking a lot more water can make your

33:59

urine a closer to neutral, which is a big

34:01

big deal to Plus, it just mechanically

34:04

helps flush awayte stuff before they get

34:06

a chance to to really aggregate. Yeah,

34:09

you can cut down on animal proteins,

34:12

you can cut down your salt, you

34:14

can cut down in your oxalate um. You

34:17

won't find oxylating a lot of stuff, but it

34:19

is uh there's a lot of oxalating spinach

34:22

and apparently chocolate and rubar, but spinach.

34:25

You know, how

34:27

much spinach are you really eating? I

34:29

didn't see how much it would take to really

34:31

start to get into the danger zone with kidney stones.

34:34

But I mean, but it's

34:37

more one of those things. It's like, man, you just can't

34:39

win. No matter how how good you're trying

34:41

to be, how healthy you're trying

34:43

to be, you're still it's gonna get

34:45

you. Yeah, always gonna get you one way or another.

34:48

Uh, that's what the shirt says. The calcium.

34:51

You might think, well, if it's a calcium build up, then have

34:54

less calcium. But that's a bit of

34:56

a thing too, because oxalate

34:59

is there and if you're if you're low on calcium,

35:02

then it's going to increase excretion of oxalate.

35:05

So just keep your calcium intake normal.

35:07

Yeah, just don't overdo anything, but

35:10

also don't under just don't do

35:12

anything. Just lie. They're drinking water

35:14

all day long and you might be Okay,

35:17

that's right. That's all called primary prevention.

35:20

Things you can do on the front end. Uh,

35:22

if you have chronic kidney

35:25

problems and kidney stones, then secondary

35:27

prevention is, uh, that's

35:29

when that's gonna come into play. And

35:31

that basically means you're gonna be on medication.

35:33

Then you're gonna be checking your pH in, your urine and stuff

35:35

like that a lot. Yeah, And usually, like if you

35:37

have eight kidney soon as your first one ever, they're

35:40

probably not going to do a whole lot of investigative

35:43

work. But if you start

35:45

to show symptoms that you have chronic kidney

35:47

stones, then they're gonna want to figure

35:49

out what it is in your body, what it is in

35:51

your diet, your lifestyle, your metabolism,

35:53

whether it's a congenital disorder. Um,

35:56

they're going to really kind of try to get to the bottom

35:58

of it so that they can adjust you, either

36:00

by meds or by lifestyle adjustments

36:02

to make it less likely that you're going

36:04

to produce any more stones. All

36:07

right, should we talk about it now? Is it time? Sure?

36:11

How we passed these things? No, you don't want to What

36:14

are we talking about? How we passed the

36:16

stones? Oh? How we passed them? I thought

36:18

you said, are we passed it? I was like, we're

36:21

still in the thick of it as far as I could tell.

36:24

So when the stones are forming,

36:27

You're not gonna feel much pain. You're not gonna even know what's

36:29

going on. I don't care how in tune

36:31

you are with your body. You're not gonna feel those little minerals

36:33

getting together and having a party down there. Uh.

36:37

When it detaches from the wall

36:39

of the kidney or wherever it's meeting up,

36:42

that is when you're going to start to feel the pain. You

36:44

mentioned fever and chills that could certainly happen,

36:47

and those spasms. I

36:49

did mention that it might feel like a pulled muscle,

36:52

And the spasms are pretty you

36:54

know, chronic, like one to four spasms

36:57

an hour of them trying to shake

36:59

that thing loose. And I have

37:01

a feeling that's about all the kidney can manage, because

37:03

it's probably doing about all I can. Yeah,

37:08

and then once his kidney stones

37:10

have moved on from there, that's

37:12

kind of the worst part. Yeah,

37:15

well that's comparatively

37:17

speaking from what I can tell, it's the worst

37:19

part. It still gets pretty bad.

37:22

Um And by the way, big shout

37:24

out to umu Urology

37:27

of Greater Atlanta for spelling this out

37:29

for us. But um they

37:31

say that once you once you hit stage

37:33

two, it's reached your eurrotors,

37:35

and yes, you'll probably be like, Wow, that

37:38

kidney pain was pretty bad. This is not

37:40

that bad compared to it. But if the average

37:43

person just went into urin or pain, kidney

37:45

stone pain, they would probably you

37:48

know, big for you to lay on them with a

37:50

pillow on their face. Yeah, that's an eight

37:52

or nine. When they ask you that

37:54

that awesome question. Yeah,

37:57

and they're like, well, I don't understand the number

37:59

you just said. Can you make the face on this chart?

38:02

I always just say nine. That's my default, is

38:05

it. I thought you had a high pain threshold.

38:07

I do have a high threshold for pain. I just like to I

38:10

like to shock the doctors,

38:12

shock the doctor's um.

38:15

So still, like

38:17

I said before, the uritor is not flexible.

38:19

It's a very narrow opening um

38:22

and it itself has that kind of mechanism

38:25

where it clamps onto the

38:28

stone and tries to pulsate

38:31

the muscles above it so that it

38:33

pushes it down, and it occurs in spasms

38:35

and waves as well. Finally, when

38:38

this thing pops out into your bladder,

38:41

that's when you might just not feel anymore

38:43

pain, depending on the size of the stone,

38:46

and if you don't have trouble passing urine,

38:49

you're probably going to be able to

38:51

pass this thing, uh, provided

38:54

that it's it's smaller than

38:56

the opening in your urethra

38:58

um without any of their problems.

39:01

The problem is is if you do have problems

39:03

passing p that bladder can develop

39:05

into a bladder, or that stone can develop into

39:08

a bladder stone where it just sits

39:10

there. It doesn't get passed out of there very

39:12

easily, and um, it can get

39:14

worse there, and then you can have a whole other

39:17

advent of pain. Yeah.

39:20

And and is that when you're talking when it's stuck in the urethra

39:22

or just uh no, it can stay

39:24

in your bladder. Yes, it can also get

39:26

stuck in your eurethra too, because your bladder, from

39:29

what I can tell, is definitely the biggest part of your

39:31

whole urinary tract. Yeah,

39:33

if it's stuck in your urethra you're you're

39:36

you're close friends. So you're almost

39:39

there, and you have to do what

39:42

what sports teams talk about, which is trust

39:44

the process, and that means

39:47

every five or ten minutes you've got to go in there

39:49

and give it another, give it the old

39:51

college try, and it'll it'll come

39:53

out. Apparently. Um,

39:56

your urology of Greater Atlanta says

39:58

that, Um, you need to push, and

40:00

you need to push hard to

40:03

get it to shoot out, and keep pushing

40:05

until the stone shoots out into the bowl

40:07

of your toilet. Or I

40:09

guess if you go to a different neurologist into

40:11

your little plastic mesh thing that you're prying

40:14

into, that you could wear his a hat later on.

40:17

Uh. I can't imagine that the relief

40:20

one might feel when that thing finally plops into

40:23

that toilet bowl. I can't either. There's surely

40:25

are tears involved. Yeah,

40:28

I mean tears of joy, all kinds

40:30

of tears, tears of triumph. I

40:32

would have a ceremony. I would throw a

40:34

party. Yeah. What would

40:36

you do to the stone then? If you wouldn't get it made

40:38

into a grill, I just put

40:40

it in a little form alde high jar and wear

40:43

it around my neck on a chain. Okay, I like that

40:46

one too. I mean the girls a little

40:48

gaudy. I think a necklace is more appropriate. Um.

40:52

Do you want to talk about history? Yeah?

40:54

I mean this is always fun. Um. Obviously

40:57

there's been kidney stones since the beginning

40:59

of time, and I just that's why

41:01

I always love talking about old timey

41:04

medicine, is because just the

41:08

the confusion they all must have felt

41:10

with with everything that happened to them,

41:13

including something like this. Well, yeah,

41:15

I mean think about it. If you're pre scientific, you

41:17

would just you would feel like you were being

41:19

punished for going in this if you had no

41:21

idea what was going on. And

41:24

there were surely countless

41:26

untold numbers of human beings who

41:28

experienced kidney stones before we had

41:31

any idea what they were. But the

41:33

fact that that you were standing

41:35

there trying to pee this thing out, whether

41:38

this was a hundred and fifty

41:40

thousand years ago or a thousand years

41:42

ago, some people would pass

41:44

them, and there would be some curious types around.

41:47

He would say, let me see that thing, what is that? Where'd

41:49

that come from? And it started to get

41:51

us to investigate and think about it, how

41:53

to deal with these things. It's amazing.

41:56

I think they found a mummy that clearly had kidney

41:59

stones dated to what ce

42:03

not bad uh. And then there's good old

42:06

Alice Cornelius Celsus,

42:09

who wrote a very

42:11

very great detailed encyclopedia

42:14

of surgical techniques of the

42:16

time, which was around fifty c

42:19

E. And this

42:21

is like legit. He he really

42:24

goes into pretty good detail about surgical

42:26

removal uh incisions

42:28

in the perennium and locating

42:30

the stone with his fingers and

42:32

holding it there with a tool and cutting

42:35

it out and with been removing it. So it's

42:37

it's one of the first I mean,

42:39

I say it worked. I think that was about mortality

42:42

rate, but I would say one of the first semi

42:44

successful surgical procedures that people

42:47

did right. And so this

42:49

this it was called thought lithoto

42:51

lithotomy with tutotomy

42:54

um it uh ed makes

42:56

a really good point that I think is easy to overlook

42:59

that like if if this guy was writing

43:01

this nearly two thousand years ago, and

43:03

he was writing like, this is how you do this,

43:06

and it seems like a pretty straightforward procedure,

43:09

Like think about how much

43:11

trial and error and

43:13

terrible surgeries were performed to

43:16

figure out how to perform

43:19

that surgery to remove kidney stones.

43:21

He wasn't first try nailed it, Yeah,

43:24

nailed it right. And apparently up

43:26

until the nineteenth century, the mortality

43:28

rate for a lithotomy was still around

43:32

a quarter of people just died from that procedure.

43:35

Which makes sense because in case you

43:37

didn't notice, the perennium is

43:39

the area between your growing and

43:41

your anus, and that's what they were cutting

43:43

into to get to your bladder

43:45

to remove the stone. Which

43:48

is weird because by that time you would think

43:50

you'd already gone through the worst of it, so

43:52

it must have been bladder stone. Specifically

43:55

that this this surgery was for aging

43:58

dr taint. So so that

44:00

means then, Chuck, that you already went through the

44:03

worst of the pain stage one and

44:05

stage two. It finally made in the bladder and now they're

44:07

cutting in your perennium to

44:09

get it out of there. So I just wanted

44:11

to make sure that if you haven't fainted from queasiness

44:13

in this episode, we gave it one

44:15

more chance. Okay,

44:18

yes, I can uncross my legs. Now you

44:20

got anything else? Nothing else. I

44:23

don't have anything else either, And since I

44:25

said that it's time for listener mail, uh,

44:30

this is a fall out. We got a lot of good feedback on the dentistry

44:33

episode. Um a theory

44:35

on the worms. My name

44:37

is Tony and I'm a dental nurse from

44:39

London, UK. First

44:41

of all, I have to let you know what a big phan. I'm in

44:43

the podcast, have learned countless things and it always

44:46

manages to perk me up on even the most mundane days.

44:48

I decided to write in on the listener mail because you

44:51

were talking about the Babylonians describing

44:53

a toothache's toothworms, and wonder

44:55

where the phrase came from. It's a complete guess.

44:58

We'll likely never know for sure, but I do have a eerie

45:00

When a tooth is broken, oh or

45:03

extensively decayed, the nerve can

45:05

sometimes become exposed, and not only is extremely

45:08

painful for the person whose tooth it is,

45:10

but the nerve it looks like a little pink string

45:13

or worm. If you type into google

45:15

tooth nerve or exposed

45:17

tooth nerve you will find some images of what I mean. It's

45:20

just a theory, but I hope it helps. Kindest

45:22

regards from Tony in the UK, and

45:24

I bet Tony is totally right. Yeah,

45:27

man, that actually is a great guess.

45:29

Like I, I subscribe to Tony's hypothesis

45:33

because that's what those yokels did back then. They just

45:35

said it looks like this, let's call

45:37

it that. But dude, imagine your

45:39

tooth being so broken

45:41

that the nerve

45:44

is just sitting there dangling out. I can't

45:46

imagine how bad that would hurt. Josh

45:49

for one of my three teeth, I

45:53

bit into a chicken wing and my tooth

45:55

broken half man, and

45:58

your nerve was exposed. My nerve wasn't

46:00

exposed. It actually didn't hurt at all. I stayed for the rest of the

46:02

football game even nice. Uh

46:05

it was it a Falcons game? Yeah, but I knew immediately

46:07

this was the second one. I was like, man,

46:09

I can't tell you what the words I said, but and

46:13

I just kept my mouth shut the rest of the game and

46:15

didn't I didn't even tell my friends,

46:18

like you literally kept your mouth shut to like hold

46:20

the tooth in place or something not holding

46:22

place. But yeah, I kind of just kept my I mean I

46:24

would talk, but I would generally keep my

46:26

mouth close because boy,

46:32

I had a sorry this is

46:35

I can't not show us. I had a root. Now like

46:37

this past spring, and

46:40

the dentist or the

46:42

the end of honest, did such a good

46:44

job getting the nerve out of that particular

46:47

tooth. It came out on one piece and I

46:49

was like, can I see And they held it in front of me and it

46:51

really did look like a tiny little white

46:53

worm. So I really think Tony

46:55

might be onto something there. I think you're right, Tony,

46:57

Tony, then I well, thanks a lot, Tony.

47:00

You with an eye in jolly old

47:02

England. I believe jolly

47:04

old England. And if you want to get in touch

47:06

with us, like Tony with an I did, you can send

47:08

us an email send it off to stuff

47:10

podcast at iHeart radio dot com.

47:15

Stuff you Should Know is a production of I Heart Radio.

47:18

For more podcasts my heart Radio, visit

47:20

the iHeart Radio app, Apple Podcasts,

47:23

or wherever you listen to your favorite shows.