Post-it Sunday-Dehydration and summer

The gown card reads ‘Tell me the patient is dehydrated without telling me the patient is dehydrated. There is a kidney stone/appendicitis.’

Both are true stories.

Dehydration leads to stagnant urine making in the kidneys, which leads to kidney stones forming more readily. Which leads to said stones migrating from the tight fit renal pelvis in the kidney, to the very, very, very tight fit in the ureter, to the roomier accommodations in the bladder, to the very tight fit in the urethra to the outside world.

This is painful to the extreme. There is a reason that kidney stone pain is compared to childbirth. Ask my sister, she’s had both. And she texted “It is more painful that childbirth. Excruciating 10 out of 10 pain.”

Of course, being of the same genetic stock as I am, she worked the next day. And mowed the lawn.

I’m so proud. And it was absolutely what I would have done.

And what season is dehydration most prevalent? Summer!

Drink the fluids, folks. The next kidney with a stone could be yours. Not that dehydration is the only cause, but it can be a big one. Genetics may play a role. Some people are known ‘stoners’.

Yeah, we make that joke in the OR on repeat patients with repeat stones.

What are the symptoms of a kidney stone?

It, of course, is different for everyone. But many people have low back pain.

But, Kate, doesn’t everyone?

Yes, but this is mid to low back pain (depending on stone location) that actually is exacerbated by movement. There is also the difficulty in urination, blood in the toilet bowl. And let’s not talk about what happens if there is an associated kidney infection. This can lead to sepsis, can lead to an ICU stay or even death. It is nothing to fool around with.

Appendicitis can also be linked to dehydration. Appendicitis can be caused by a piece of poop that gets stuck in the neck of the bottle. The appendix only has one opening, like a bottle. And, like dropping Mentos into Diet Coke, the pressure is what leads to pain, nausea and vomiting, and ultimately surgery. And dehydrating poop makes it sticky, which makes it more likely to stopper up the bottle.

Drink your fluids. Push them often on family members. The best fluid is water. Although there is a folk remedy for kidney stones which is cheap beer. This leads to a host of other problems. such as impairment and tickets and, ultimately, the loss of your license if you choose to drive. Don’t do that.

Just drink your water.

Because urosepsis due to kidney infection due to a stopped-up ureter due to a kidney stone can kill you. Appendicitis can also be lethal.

Enjoy your summer, but don’t die.

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