Ovarian Cancer: Early Diagnosis Is Essential

Monday, September 30, 2013 1:35 PM comments (0)

Dr. KirschnerCurrently there is no early detection test for ovarian cancer. Until such a test exists, raising awareness about the signs and symptoms of ovarian cancer is essential to early diagnosis. If diagnosed and treated early, ovarian cancer survival rates are over 90%. 

As part of Ovarian Cancer Awareness Month, Carolyn Kirschner, MD, Gynecologic Oncology, answers questions on ovarian cancer, from things you can do now to reduce your risk to the early symptoms you just might overlook. 

What are some early signs of ovarian cancer that might be overlooked or ignored? How do you know when it is time to see a doctor? 
Abdominal pain, bloating, being full after eating a little, new constipation or diarrhea, urinary frequency, fullness in the pelvis, low back pain, nausea/vomiting, fatigue are all possible symptoms of ovarian cancer—but are vague and may be symptoms of other problems. If symptoms occur several times per week for a month, medical care should be sought. Start with a good primary care physician who can do an exam and then possible imaging studies.

What is the most cost-effective screening test for early detection of ovarian cancer?
Most experts would say that screening should only be performed on women who are at increased risk of ovarian cancer, for example those with a BRCA gene or a strong family history of ovarian cancer. These people may be screened with ultrasound and serum (blood) CA125. Unfortunately, there may be false positives, especially in younger women, which may result in unnecessary tests or even surgery.

Is it possible to mistake ovarian cancer for fibroids on both a transvaginal ultrasound and a pelvic MRI?
Yes, mistaking ovarian cancer for fibroids can happen. Fibroids are common and ovarian cancer is not. Fortunately, imaging has greatly improved, so this mistake does not happen commonly these days. If there are any questions or concerns about a diagnosis, a woman who undergoes ultrasound and/or MRI imaging can and should request a disc with the images on them and get a second opinion.

If there is a family history of the disease but no BRCA gene mutations, is your risk for developing ovarian cancer still higher? What can you do to reduce that risk?
Most ovarian cancer is not hereditary, so risk should be the same as the general population, which is less than 2%. While never having children seems to be associated with an increased risk of ovarian cancer, I would never recommend getting pregnant just to decrease the risk. If you are premenopausal, oral contraceptives may decrease your risk. Birth control is protective because it prevents ovulation. It is theorized that breaks in the surface of the ovary, which occur with ovulation, may result in injuries that can lead to cancer. Vitamin D may also be protective. 

Diet is important. Cancer risk is increased with obesity. I recommend a plant-based, whole-grain diet. Limit saturated fats, white flour and refined sugar. I am a firm believer in exercise for weight control and sanity.

Keep in contact periodically with the genetics staff, in case there is a breakthrough in this area.  NorthShore has a high-risk clinic through Division of Gynecologic Oncology, and this may be a good way of staying on the "cutting edge.” 

What is the best scan for ovarian cancer? CT, MRI, ultrasound or PET?
Each has its advantages. The ultrasound is the least invasive, least expensive and does not use radiation. The CT and MRI look at anatomy. The PET looks at function. For screening, the ultrasound is best.

A Health Reporter's Personal Experience with Prostate Cancer - by Dr. Barry Kaufman

Friday, September 27, 2013 1:45 PM comments (0)

When the fourth biopsy in four years revealed some of the cancerous cells were now more aggressive than during the previous four years of active surveillance, I found it very hard to accept that the other shoe had actually dropped. I'd been sailing along with a Gleason 3 + 3, the least aggressive prostate cancer category. I hoped/believed the numbers would stay that way as I lived through the rest of my 70s and into my 80s and who knows how long from there. After all, my father had lived with prostate cancer and died from unrelated issues at 86.

As with so many other men, I had the first biopsy after a PSA test suggested a possible problem. In my case the PSA had risen slowly over a decade from 1.4 to 3.7, but being 67 at the time and research changing some of the previous thinking about PSA levels in older men, the initial urological surgeon and I decided a biopsy was a reasonable option.  

My fears after getting the news from the fourth biopsy were:

  1. How do I decide whether to stop active surveillance and treat the cancer?
  2. If I decide on treatment, which treatment and with whom?  

dr. KaufmanNavigating My Treatment Options
The urologist who had been following me urged surgery (he performs robotic prostatectomy) and I provisionally scheduled the operation for six weeks hence. I needed time for the biopsy site to heal, digest the diagnosis, and collect and process more information.   

As a dentist turned health reporter, my almost 40 years as a health journalist turned out to be a mixed blessing as I tried to intelligently navigate the daunting amount of often contradictory and confusing information, even for a health professional. I discovered one of my greatest strengths as a reporter—the ability to thoroughly and unemotionally research virtually any health topic—failed me dismally because this time I was too emotionally involved. I would read the same sentence or paragraph over and over or talk at great length to trusted sources and come away even more confused. Yes, get the cancer out. No, you can safely keeping watching. Surgery? Robotic or open? Radiation? But what type? Or perhaps one of the less tested treatment options? You can imagine the toll this emotional roller coaster took on my family: Arline my wife of 41 years and my two sons.

Finding My Advocate: A Six Week Journey
As the six weeks dwindled to two, I still felt uncertain—and frightened—about my decisions and options. While agonizing on the phone one night with my older son he said, “Stop it, Dad!  More than most, you are in a position to find one voice you can trust who can guide you to a decision that you and mom can live with. Find that voice."

I did: Dr. Charles Brendler, Co-Director of Northshore's John and Carol Walter Center for Urological Health.  I was referred to Dr. Brendler by a close personal friend of mine, who is also a physician and serves as a department head at a major Chicago medical center. He told me Dr. Brendler was the person he would see if he were in my position. Now I understand why.

During the nearly two hours Dr. Brendler spent with Arline and me, he painstakingly reviewed my medical records, gently and carefully examined me, and, for most of the two hours, engaged with us in heartfelt conversation. He reassured both of us, spoke caringly about our feelings on the personal and intimate issues unleashed by prostate cancer and its treatment, and offered compassionate understanding and objective advice.

Three decisions emerged from our meeting. Two involved additional confirmation of the status of my prostate cancer, one via MRI (Dr. Brendler supported my desire to have the scan) and the other through a second opinion of the interpretation of my four biopsies.  The third and most important was the deciding to accept Dr. Brendler’s recommendation to see a urologic surgeon, who, because of his unparalleled skill in performing open prostatectomies, would be the best fit for me. 

When Arline and I exited Dr Brendler's office and walked through the parking lot, we looked at each other and breathed the first sigh of relief in more than a month because we knew we had found peace with my prostate cancer journey. We followed through on each of the decisions and three weeks after our fateful meeting my prostate was removed by the surgeon Dr. Brendler recommended. The cancer was locally contained and completely removed.

Thanks to active surveillance, I had four years without treatment. And thanks in large part to Dr. Brendler, I remain totally continent and am on the road back to sexual function seven months post-surgery. I’m grateful beyond words that when my son urged me to find the one voice I could trust, the voice I heard was Charles Brendler's.  

 

Ready to Hit the Books: Healthy Kids Make Happy, Successful Students [Infographic]

Wednesday, September 25, 2013 1:51 PM comments (0)

The kids are back in school and already busy with homework, classes and practice. Don't let hectic schedules put your children’s health in detention. Parents can do plenty to help their children stay healthy and succeed in school—from ensuring they get adequate sleep and regular exercise to serving up balanced meals and more. After all, children’s health has been shown to be directly linked to success in school. 

Our latest infographic explores the connection between children’s health and academic performance with health information and tips from the experts at NorthShore University HealthSystem. Click on the image below to see the full infographic. 

Prostate Cancer: Knowing Your Risks and Options

Thursday, September 19, 2013 11:57 AM comments (0)

prostate cancerProstate cancer is the second leading cause of cancer death in men. If detected and treated early, prostate cancer survival rates are high and associated with good functional outcomes. As part of Prostate Cancer Awareness Month, Brian Helfand, MD, PhD, Urologist at Northshore, answers questions about prostate cancer risk, early signs and symptoms, recommended screening, as well as current treatment options for prostate cancer and recovery after treatment.  

If there is a family history of the disease, does that increase your risk? When should someone with a family history of the disease begin screening?
Prostate cancer is one of the most inheritable of all cancers. As such, risk factors that are most associated with prostate cancer are first-degree family history (father, brother, uncle, etc.) and race (i.e. African-Americans). Based on statistics, a man with a first-degree connection to the disease is almost two times more likely to be diagnosed with prostate cancer than a man without a family history. Although there is some debate regarding the routine use of PSA screening, I’m a firm believer that if there is a family history, one should start undergoing annual PSA screening by the age of 40.

After treatment, how often should a patient return to their physician for further tests and screenings?
After surgery, patients should have an initial post-operative PSA in about four to six weeks and then every three to four months (based upon their urologist's preference). After two years of having an undetectable PSA, I suggest my patients get PSAs every six months.

What is a normal PSA?
I always tell my patients that you should compare your PSA to what is "normal" for your age group. Most men age 50 and younger have a PSA below 0.7ng/ml. For simplicity, you could use a cutoff of 1.0ng/ml. It’s important to point out that having a PSA value that is above your age group does not mean that you have prostate cancer. It does, however, mean that you are statistically at a slightly increased risk for being diagnosed with the disease. For that reason, you should continue to be screened with PSA on an annual basis at least. 

There are other factors that should go into the interpretation of PSA before deciding to perform a prostate biopsy and these include: PSA values that have been rising over time, family history of prostate cancer, African-American heritage and history of benign prostatic hyperplasia (BPH). Remember, PSA is not a perfect test but it has saved many lives and it’s still the best test for prostate cancer screening.

Are there preventative measures that could potentially reduce one’s risk for developing the disease?
It’s possible that a heart-healthy diet low in fats and simple sugars may help reduce one’s risk of developing prostate cancer. There is emerging evidence that obesity is a driving factor for benign growth of the prostate (referred to as BPH or benign prostatic hyperplasia) and that it could also contribute to one’s risk for prostate cancer. Extra weight may also make it harder to detect the disease until it is advanced. Obesity also is thought to contribute to prostate cancer recurrence. That’s why it’s important for men to realize that a heart-healthy diet can help keep their prostates healthy too!

How likely is a patient’s sexual function to be affected after treatment? What surgical options result in the best possible outcome as far as recovering sex life?
I tell my patients that your post-operative sexual function is significantly related to your age and pre-operative function. In general, treatment for prostate cancer (radiation or surgery) has never improved a man's erectile function. However, if a man is young, not diabetic or obese and had good erectile function prior to surgery, he has a very good chance of having normal erections post-op.

I believe that good, nerve-sparing surgery significantly helps with the recovery of erectile function. This can be done by a urologic surgeon who is trained in the technique and frequently performs the operation. In addition, I believe that all men should start (at minimum) a rehabilitation program before and immediately after surgery that helps to recover nerve function. This could involve taking drugs like Cialis before and after surgery.

If you do suffer from sexual dysfunction after prostate cancer treatment, what can you do to aid/improve recovery?
Unfortunately, there is no universal solution for every man but there are many different options that are available for treatment of sexual dysfunction after surgery. Prostate cancer patients should have an assessment of psychological function and desire for sexual activity following surgery. Many men get nervous about intimacy following surgery and an evaluation by a trained professional can help relieve a lot of this anxiety.  

If there are erectile issues after treatment, many men respond to simple medical therapies like Viagra and Cialis. This is often a starting point. If you fail to respond to these therapies, other interventions such as a vacuum erection device or injection therapies can be used to obtain an erection. As always, regular exercise and a heart-healthy diet help increases your chances of a successful recovery.

What are the differences between robotic laparoscopic surgery and conventional open prostatectomy in terms of recovery?
I think the answer is surgeon experience. There are many urologists who can perform open surgery with excellent outcomes (great cancer control, erectile function and continence). And there are many urologists who can perform robotic surgery with similar outcomes. It’s most important to be treated by an urologist who is comfortable and experienced with a radical prostatectomy. Having said that, robotic surgery has recently become the most commonly used surgical intervention for prostate cancer. When compared to open surgery, robotic surgery offers significantly less blood loss and a shorter hospital stay. Although not proven, it’s likely that the robotic surgery offers increased visualization of the area by the surgeon which provides an opportunity to spare more nerves and create a nice connection between the bladder and urethra. These are both associated with increased erectile function and increased continence.

What does active surveillance involve? Why would someone choose to do that instead of actively treat their cancer?
We have come to a "new era" of understanding prostate cancer and realized that many men have prostate tumors that may not harm them during their lifetime (benign-type prostate cancer). This is because many prostate tumors grow very slowly and other medical problems may ultimately harm a man before the prostate cancer spreads

Unfortunately, there is currently no diagnostic test that can tell whether one has a lethal prostate cancer or more benign-type tumor; therefore, we have developed a program of surveillance in which we avoid treating patients with prostate cancer until there is evidence that it has an aggressive component. This involves actively and regularly monitoring men through the use of PSA tests and prostate biopsies. While this does increase the number of times that a man is evaluated by an urologist, it avoids overtreatment, like unnecessary surgery or radiation that could cause erectile problems and/or incontinence. Currently, NorthShore University HealthSystem has the largest program in the Midwest.

Leukemia: Knowing the Symptoms

Tuesday, September 17, 2013 9:29 AM comments (0)

Many typically associate cancer with a specific part of the body, like the breast, prostate or colon; however, it can develop and affect more just a part of the body. Approximately 43,000 people are diagnosed with leukemia each year. Leukemia is a cancer of the blood and bone marrow. Blood cells, both white and red, are made in bone marrow. With leukemia, bone marrow produces an abnormal amount of white blood cells, which cannot function like normal white cells. As the disease progresses, the accumulation of these abnormal cells can cause anemia, bleeding, infections and eventually could spread to other areas of the body.

Leukemia can develop in both children and adults, and is the most prevalent cancer found in children under 14 years old. Depending on the type of leukemia, symptoms may become apparent almost immediately or gradually develop and become more noticeable over the course of months or even years. Treatment plans will vary depending on the type of leukemia, as well as your age and current health.

Alla Gimbelfarb, MD, Hematology at NorthShore, identifies some of the signs and symptoms of leukemia that many overlook :

  • Anemia
  • Increased susceptibility to infections and illnesses
  • Consistent fatigue, tiredness and overall weakness
  • Bruising and bleeding
  • Weight loss
  • Frequent headaches
  • Swollen lymph nodes

Has leukemia touched someone in your family? During National Leukemia/Lymphoma Month help raise awareness about its signs and symptoms.

Tags: cancer

Youth Sports: Staying Active and Injury-Free

Friday, September 13, 2013 3:53 PM comments (0)

youth sportsPracticing multiple days during the week. Competing in tournaments on the weekend. Participating in rigorous training camps and leagues in the off-season. Playing the same or multiple sports year round. Does this resemble your child’s sports schedule?

Youth sports are becoming more competitive at younger ages, often requiring participation beyond the normal season to make the cut and see more starting time during games. As the pressure to participate increases and youth sports become more “professional,” your child’s risk for injury increases too. Sports are a great way to keep your child involved and active, but year-round practices for the same sport can lead to some health concerns as well, including stress fractures, ligament tears and musculoskeletal issues.  

Eric Chehab, MD, a NorthShore affiliated orthopaedic surgeon, offers some tips to help keep your kids active and injury-free:

  • Encourage participation in multiple sports. Not only will this prevent your child from overexerting the same muscle groups, it will also help develop different skills. A young athlete’s agility on the tennis court could be the key to helping him block the winning shot in the soccer net.  If your child does participate in multiple sports, try to ensure that he or she isn’t overlapping them in a season or throughout the week.
  • Limit your child to one committed sport per season. With more sports vying for year-round commitment, your child may be participating in multiple sports or leagues simultaneously.  If sport requires a great deal of practice time, this puts your child at increased risk for serious injury.  Here’s a useful rule of thumb to help prevent injury: “One sport per season and one league per sport.” 
  • Take one day off every week. Between all of the practices and games, it’s important for your child to have at least one day of rest each week.  A day off gives the body a chance to heal and recover.  You should also encourage your child to take one month off from sports and practices each year, especially if he or she is deeply involved in one or more sports. 
  • Ensure there is proper equipment and field conditions. Though this may appear obvious, much of the equipment used in recreational sports and travel leagues had been used previously and could be worn or defective.  This could expose your child to unnecessary risk. Field conditions are also important because a compromised field puts your child at risk for significant lower and upper extremity injuries.
  • Check in with the coach. The ability to teach safe technique is critical, particularly in contact sports like football and hockey.  Get to know your child’s coach and make sure he or she knows the rules of the game and how to play safety and prevent serious injury.

For additional information about sports injuries, including sports-specific tip sheets, visit the Stop Sports Injuries website: http://www.stopsportsinjuries.org 

What do you to keep your kids active?  How do you make sure they aren’t overdoing it?

Suicide Prevention: Identifying Risk Factors and Noticing the Warning Signs

Thursday, September 12, 2013 1:39 PM comments (0)

suicideAccording to the Centers for Disease Control, suicide was the 10th leading cause of the death in the U.S. in 2009. That year there were 37,000 suicides, with one million reported attempted suicides. In the same year, suicide was the third leading cause of death for young people between the ages of 15 and 24.

Suicide is a major health issue but it’s also a potentially preventable one. While there are several risk factors for suicide, any person who expresses suicidal thoughts or the intent to commit suicide should be taken seriously.  Risk factors for suicide include:

  1. Prior suicide attempts
  2. History and family history of mental disorders
  3. History and family history of substance abuse
  4. History of physical violence and sexual abuse
  5. Chronic illness and/or chronic pain
  6. Exposure to the suicidal behavior of family and friends

Knowing and acting on the signs of suicide exhibited by others could save thousands of lives each year. If someone appears depressed and/or expresses suicidal thoughts, it's important to listen closely and take that person seriously. It's especially important to be concerned if someone exhibits any of these signs and has also attempted suicide in the past, as most successful suicides were preceded by one or more attempts. 

Benjamin Shain, MD, PhD, Psychiatry at NorthShore, shares some of the warning signs of suicide and discusses what you can do to help a person who might be contemplating suicide:

  • Risk-taking behavior. Those who are contemplating suicide might “tempt fate” by taking risks that could lead to death, such as driving at dangerous speeds. 
  • Losing interest in previously important activities and friends. Unexplained loss of interest in things like sports, work and volunteer activities might also be combined with a withdrawal from interactions with friends and self-imposed isolation.
  • Researching methods of suicide. Searching suicide online or buying anything that could be used to commit suicide is an important sign to watch for.
  • Talking about death and hopelessness. Conversations and discussions might center on death and wanting to die or on feelings of hopelessness and lacking reasons to live. Potentially suicidal people might also talk about being a burden to family and friends or experiencing unendurable pain.
  • Extreme shifts in mood. Periods of deep depression could be punctuated by feelings of elation, happiness or rage.
  • Increased substance abuse. A history of substance abuse is a risk factor for suicide but increased use could be a warning sign of suicidal thoughts.
  • Noticeable changes in sleep patterns. This could either be exhibited as sleeping too much or suffering from insomnia. 
  • Giving away possessions. Suddenly giving away multiple items that seemed important to the person in the past.

What should you do if you notice these behaviors in a friend or family member?

First, discuss your observations or concerns with the person and/or other friends or family members. Make sure to listen to the person’s concerns and what might be stressful for them. It's essential to urge the person to speak to their primary care physician and/or a mental health professional. If you believe they are an immediate risk to themselves, call 911. 

How to Make the Most of Your Annual Visit

Friday, September 06, 2013 2:22 PM comments (0)

annual visit“How are you feeling?” is probably one of the first questions your doctor will ask during your annual visit. If you haven’t needed to see your doctor between physicals, your answer will most likely be, “Fine.” It won't be until later that you remember all the miscellaneous symptoms, heath issues, and aches and pains from the last year. 

Don’t miss another opportunity to maximize your time with your doctor. By planning and preparing beforehand, you ensure that you’ll remember to ask the correct questions during the limited time you have with your primary care physician.  

Curtis Mann, MD, Family Medicine at NorthShore, offers some tips on how to make the most of your time with your doctor:

  • Make a list of symptoms. Prepare a list of the aches, pains, symptoms and changes in your health that might have caused concern at some point between your annual visits. Prioritize your list of symptoms so that you can be sure to address those that are the most concerning. You might not be able to go over everything at your annual visit but you’ll be able to touch on everything during future visits. 
  • Have a list of important questions prepared. When pressed for time, questions that were high priority might get lost in the shuffle. Prepare a list of questions you want answered in advance and use it to jog your memory during your appointment.
  • Make another list of prescriptions and medications. Your list should include everything, from prescriptions to vitamins and supplements. You want to ensure you are giving your doctor your full health story. 
  • Come prepared to answer your doctor’s questions. This isn’t your first visit to a doctor, so come prepared to answer the basic topics: family health history, health concerns, etc. This will leave you more time to ask any specific questions you might have. 
  • Dress for the occasion. You might not have much face-to-face time with your doctor, so don’t wear clothing that requires lots of time to get on and off. To save even more time, ask to change into a gown before your doctor enters the room.
  • Write down what your doctor tells you. You’ll probably cover a lot of ground in very little time. Your doctor will write your prescriptions but lifestyle recommendations might be told to you. Write down recommendations your doctor makes so you can remember to follow them in the year between visits. 
  • Ask about a follow-up visit. If there are issues you have not addressed during your annual exam, ask your doctor about a follow-up visit before leaving the office.
  • Review printed materials after your visit. Don’t wait to read the materials your doctor provides, whether they are printed for you or provided through NorthShoreConnect. Are the medications listed correctly? Are your listed health issues up to date? This is where the teamwork between physician and patient can maximize healthcare outcomes.

Do you have a yearly physical? How do you make the most of your annual visit?

Kidney Stones: Risk, Treatment and Prevention

Wednesday, September 04, 2013 2:30 PM comments (0)

Kidney stones can cause pain that ranges from mild to excruciating; however, stones typically do not cause symptoms until they move from the kidney into the ureter (the tube that connects the kidney to the bladder). So how do they form? Kidney stones develop when urine consists of more crystal-forming substances than the urine can dilute. Often there is no single definitive cause of kidney stones but there are factors that increase one’s risk for developing them. Determining the type of kidney stone can be helpful in determining its cause and preventing recurrence.
kidney stones
Main kidney stone types:

  1. Calcium stones. The majority of kidney stones are calcium stones, most often calcium oxalate. Oxalate is found in food, including nuts, some fruits and vegetables, and chocolate.
  2. Struvite stones. This type of stone is associated with urinary tract infections (UTIs). They are composed of magnesium and phosphate.
  3. Uric acid stones. These are the second most common type of stones. Risk factors include diabetes, obesity, hypertension, gout and a high-protein diet.
  4. Cystine stones. These stones form in patients with a rare hereditary disorder called cystinuria.

Amanda Macejko, MD, Urologist at NorthShore’s Jon and Carol Water Center for Urological Health, answered several questions about kidney stones, including hereditary risk factors, and how best to treat and prevent recurrence:

If there is a family history of kidney stones, are you at an increased risk for developing them at some point?
Stones can certainly have a hereditary component. So, yes, if there is a family history one could be prone to developing stones. One of the best things you can do to decrease your risk is to make sure you drink plenty of water (2.5-3 liters of water daily).

Is there a particular group of people who are at higher risk of developing kidney stones?
Peak incidences of stones occur in people between the ages of 30-60. Caucasians and people who live in warm, dry climates are at higher risk of developing stones. Additionally, people with higher body mass index (BMI) are also at increased risk.

Aside from drinking a lot of water, what other preventative measures can be taken to avoid recurrence of kidney stones?
The stone prevention diet includes: limiting salt intake, avoiding foods high in oxalates and limiting consumption of animal protein. Salt intake increases calcium in the urine so we recommend avoiding canned, processed and fast foods which contain a lot of sodium.

For people with calcium oxalate stones, foods high in oxalate should be avoided, which includes tea, spinach, nuts, and, I’m sorry to say, chocolate. Animal protein, including red meat, chicken, fish, should also be limited. It is important to note that calcium restriction is not recommended.

I've had multiple stones over the years, do I need further tests?
For someone with multiple stones or a strong family history of stones , I highly recommend a metabolic work up. This involves blood work and a 24-hour urine collection (48 hours the first time). This helps your physician figure out what your specific risk factors are for stone formation, as well as look for possible underlying medical conditions. We perform this service in the Stone Clinic which is staffed by myself, Dr. Park (urology) and Dr. Sprague (nephrology).

Can kidney stones cause renal failure?
Nonobstructing stones in general should not cause renal (kidney) failure; however, untreated obstructing stones may eventually cause renal impairment.

Should you always go to the hospital for kidney stones?
This is really important. If your pain is tolerable with pain medication, whether over the counter or prescription, then you can probably follow up with your primary care doctor or urologist in the office to work out a plan. However, if your pain is not well controlled or you have significant nausea/vomiting, you will need to go to the emergency room. Typically they will be able to control your pain and/or nausea and you can return home. Most importantly, if you have fever (higher than 100.5˚ F.) or shaking chills, you need to go to the emergency room immediately. An obstructing stone associated with an infection is very serious and can be life-threatening.

If someone has a kidney stone but would rather attempt to pass it at home, what can he or she do to ease the pain from home?
Most patients take some form of pain medication whether it be over the counter or a prescribed narcotic while they are passing a stone. Additionally, we often prescribe an alpha-blocker. These are the same medications used to increase the flow of urine through an enlarged prostate. These medications have been shown to help relax the ureters and increase the rate of stone passage.

What can be done for larger stones that cannot be passed on their own?
Kidney and ureteral stones that are too large to pass often require treatment. Common outpatient treatments include shock wave lithotripsy or ureteroscopy. Shock wave lithotripsy is a procedure performed under anesthesia in which we break the stone using sound waves. After the procedure you then pass the fragments. In ureteroscopy, a small scope is passed through the urethra and bladder and into the ureter. The stone is broken up with a laser fiber and the fragments are subsequently removed with a tiny basket.

Have you ever had a kidney stone? What do you do to prevent them?

 

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