this is a post to pick the brains of the medical types here.you don't need and i don't want you to give me information,just a link to a place where i can get some good info on what to do and what to have avalible to treat a kidney stone attack in a wilderness/survival situation.
i could Google this but i know i would have to plow thru pages to come up with anything..heres the story.i have a history of stones and this week i was at my local hospital
passing one again.luck was with me as i knew what was going on and the Vets Hospital where i retired from is only minutes away .but in the 25 minutes or so it took to get signed in and have the RN give me the once over and the Dr to show up..it was the weekend the Vets is not 911
and does not have a full staff..i was in alot of pain.
things moved along fast after the Dr orders and i knew the RN's and was able to chat and joke a bit to take the edge off.i'll have a follow-up with my Dr in clinic next week and i'll run this past him also..it of course struck me---what would i do on a wilderness canoe trip if this hit?..the Codeine tabs from my Dr would only mask the pain and in the past have not helped much.could i arf down a bunch of those and hop up and down to jar them loose?
i don't think so..hit the 911 on my spot only to pass the stone on my own--sorry guy's--false alarm...at the VA i got a IV of fluid with some really impressive pain meds but of course am not going to be able to hang a bag from a tree and give myself a IV on some remote lake.
anyway the last few days have been a wake-up call on the subject of stones and the pain involved.any ideas about links or whatever??

CANOEDOGS,

I built a home for a urologist here in my neighborhood. I will probably see him sometime tomorrow. I will bring the general idea up, but I bet he tells me to carry a SAT phone and call for help.

I am sure that is what his lawyer and insurance company would want him to say. More later.

Not a doctor, don't play one on television, just an EMT.

If it were me, I would drink a lot of water, take whatever pain meds I had and try to urinate while laying down in an effort to get the stone moving.

That's what I would do, I am not advocating that anyone else does this.

JohnE

I've never even thought of this.

I have a wilderness medicine text, put out by the Wilderness Med society. I'll scrounge it up in a few days (it's in MI, I'm in CA) and see what it says, if anything.

Meanwhile, I'll see if I can find anything online.

Any chance you know what type of stone you tend to get? Some are related with diet, and maybe planning accordingly can decrease the chance of getting one.

Of course this won't help in the woods, but I read from those who've suffered the experience that sitting in a hot bath really helps alleviate the pain. This was on advice from thier physician.

Oh, that's an idea that just hurts - I know, I got a stone last night - luckly, I'm already on pain killers for my leg, so it's a "smile" and wait till I can see the doc next week

Hopefully, it'll pass before then

Saw the doc and I was right, first thing he said was SAT phone. He then spoke of copious amounts of water and prescription pain killers if one had to self-rescue.

His last bit of wisdom was: "Don't worry, this too shall pass".

Sorry I can't be of more help.

This brings up a host of other possible issues as well. Is there a good, comprehensive medical book for treating yourself for more than just first aid? I have heard good and bad about the book "where there is no doctor". Any medical types ever read it? What do you think? I have had quite extensive training in wound management and treating combat type wounds and injuries, but little in how to find the right meds when I am traveling in a third world country or how to use them. I am often on my own in countries where I do not speak the language and the medical care is suspicious at best. Any thoughts guys?

I noticed the location of North Carolina. Is that kinda near Fayetteville by chance??

Best thing I have done in the past is get all the shots in advance, and talk to a doctor that can research the region. Then I kindly ask him for advance scripts of anything he might find useful, along with good written instructions as to what's for what.

I also start taking Pepto twice a day three days in advance of leaving, continuing until three days after I return. It seems to coat the tummy and let the bugs slide on thru.

You could also make friends with an SF 18D (Medic). I promise they can steer you in the right way.

I live in Fayetteville. I spent 24 years in the Army , 21 in Special Forces. They have the SF medic handbook, but this is not a handbook for the untrained. I usually carry Cipro and Imodium.

My 18D friends have helped, mostly with knowledge and training.

Were you an "18" Desperado?

Nope, 95B20-B4. I thought I was going to be a cop, I was basically heavily armed scout with wheels.

We had an 18D that went 95B because he couldn't jump anymore due to an ear issue. (or something like that)
He was in our second HMMWV when we kicked off on 24FEB91 and turned east. Our rigs looked like something from "Sanford & Son" with all the crap inside and out. He was packing a small hopital, and some goodies an 18C he knew gave us. I had as much "BANG" as I could find and two rifles to deal with. The driver had the 203 and the gunner had the M2. The 18D had rigged an M60 on the door like you see mounts made for now. We were definitely a cross between "Rat Patrol" and "Sanford & Son". Probably the only low rider HMMWV's in the army.

Over thirty years ago, I passed kidney stones twice about a year apart. Then I ran across Adell Davis’ Let’s Get Well (can still be found on Amazon.com) and it said there were many types of stones; but, the most common could be dissolved if the acidity of the urine were increased and this could be achieved if one took Magnesium Oxide (the best form of Mg for bodily absorption) and Vitamin B6. After that second stone, I could sense a presence (unpassed stones?) in the kidney. So I bought small bottles of magnesium oxide and B6 and experimented—the presence went away. When the bottles were empty and I did not purchase more, the presence came back. So I took these and other vitamins regularly for a long time. About ten years later money was tight and I did not buy vitamins—the stones came back. Again about 3 years ago I stopped taking vitamins and kidney stones came back. I also have noticed that I do not get leg cramps when I take Mg and B6.

A web site I found recently listed the types of stones as:
1-3. Dicalcium phosphate, Monocalcium phosphate, & Tri-calcium phosphate: Also causes common arthritis, hardening of arteries, and spurs. Eliminate or largely decrease phosphate-rich food such as meat, breads, cereals, pastas, and carbonated drinks. Increase fruit and vegetables and milk 2%, take magnesium oxide (300mg/day) and Vitamin B6 (250 mg/day). Drink a lot of water.
4. Oxalate: Common cause of lower back pain. Stones caused by oxalic acid in regular Orange Pekoe tea including iced tea (15.6 mg oxalic acid per tea bags). Also eliminate cocoa drinks and chocolate of all kinds
5. Uric acid: Also causes gout and arthritis. Meat produces urea and its by-products. It is also highly acid-forming which requires more calcium from living vegetable sources to neutralize these acids.
6. Cysteine: Sulfur containing.

You probably already have figured this next thought out: You said the Codeine masks (as to completely suppresses) the pain. I would never take something to completely override the pain because if a stone completely blocked the ureter, then the kidney could become damaged. The amount of pain signals if immediate surgery is needed. I have found that if the stone is moving (though seemingly at a glacial rate) one can follow its path (pain).

If you ever completely pass a stone (you’ll know when that happens), get it analyzed for composition.

Another web site I found recommends the phosphoric acid in colas. It may work but there is no real nutrition involved in this treatment.

As to a hot bath that LED mentioned to help with the discomfort of passing a stone: I usually use the shower instead—but the water bills skyrocket. When I pinched a nerve lately between my shoulder blades, I used a hot shower and also a heating pad—found an extra large one at Walmart.

So it is not what to take when one gets a stone (wherever you are located); but rather, getting good nutrition continually so the stone does not form in the first place.

To sidetrack this topic just a bit, I have found the site http://www.doctoryouself.com to be most useful and interesting. I am a 61-year-old graduate student in engineering. A while back, whenever I moved, it felt like I was moving through water—my limbs felt heavy. Further, my mind had the same heavy feeling and the dissertation research was not proceeding at a good rate. I remembered B12 was supposed to help the mind and it produced a day and night difference in my attitude in just a day or so. However, there was still some lingering depression. In searching the doctoryourself.com I found that niacin (B3) is good for many psychological disorders including depression. Further, it lowers blood pressure. Why treat a symptom with a counter symptom producing medicine (i.e., allopathic medicine) when the problem is a nutritional deficiency?—although the pharmasutical companies do not make money. This particular web site uses medical and nutritional research literature to document its statements. After taking nonflushing niacin I felt even better and there was a new spring in my step.

In searching out spinal stenosis (http://www.doctoryourself.com/stenosis.html ) for my advisor’s wife, I found it most interesting that Vitamin C can be used to mask the pain of those with terminal illness leaving at least their minds clear to the end (search on “One of the biggest surprises in analgesia occurred during the 1970's in Scotland at the Vale of Leven Hospital.”). And a person with incapacitating sciatica that the doctors said he had to learn to live with “grabbed the chain saw, and set to the task of cutting up a load of slab wood that I’d neglected for the last three months” after taking megadoses of Vitamine C for four days (search on “In 2004, I was disabled to the point of being unable to put on my own socks and underwear”).

some good advice here..i have been told that the stones that were recovered from filtered urine were oxalic of some sort and the common ones..and the first time i had this problem i was sent home with a bottle of pain meds and told to drink alot of water.i fact the Dr said i had a good heart and that would be the best bet..i was back the next day and got an IV flush which worked like a charm..untill now the problem was a "maybe".after kicking the table legs in the exam waiting for the RN it turned into "survival issue"..my plans up to now were meds,water,lots of activity which seems to help move the stone--you can't just lay down--and wait..now i'll want to ramp up my first aid kit with something to help flush those damm things out..
when i was in that room waiting i was thinking "if this hit back in Beartrack Lake i would be in a world of hurt with no help"--when i see my Dr next week i'll do a follow-up post and let you know what he said---and yes--i drink alot of tea--

Have you tried researching any Native American or Wilderness/frontier medical treatments involving plants??

I'll look around and see if I can find any references.

Wildman..i'm a strong believer in modern medicine.a very good buddy of mine,an Ex Marine,college friend from the 70's,best men at each other weddings,so on is not. he tried to treat his diabeties with "natural" holistic methods.the result was a massive stroke.he also did the "i'm hard,this headache will go away" stuff with his family. i was at his bedside at the VA 4 or 5 nites a week for most of the fall and now he is in a nursing home getting rehab.the only bit of light in all this is that the VA said his CVA was related to diabeties and diabeties is a result of his exposure to agent orange in the Nam so now he gets a %100 service connected rateing and $3000 a month.but damm---
sorry about the run on story..i was too up close and personal with the subject this week..

Good explanation of hows, whys, prevention, and treatment: http://www.mayoclinic.com/health/kidney-stones/DS00282

In older, unenlightened days, we would send folks home from the ER with a strainer and a recommendation to drink beer (provided volume and anesthesia).

Keep well hydrated, watch what you eat, and have pain meds handy if needed

Kidney stones form in the renal pelvis, where the plumbing diameter is pretty big. If they come loose, they have to pass through the ureter, where the plumbing space is pretty small. Probability of passage is related to size of stone, as described here . Kidney stones are shaped like broken glass, and poke holes in the ureter, causing some of the pain. The real pain-pain worse than most heart attacks, 10 on the scale of 10-is caused by the stone blocking the ureter, which spasms and causes renal colic. Conservative treatment involves pain management and iv fluids, which relax the patient and maybe the ureter, and help flush the stone through. If the stone doesn't flush the resulting pain can be incapacitating, and resulting damage to the kidney can be severe. All the stuff suggested to decrease the likelihood of stone formation is good information. The IV fluids and parenteral analgesics and antinausea drugs needed to do this probably don't belong in a first aid kit, tho I have seen them there. An obstructed ureter is a surgical emergency, and toughing it out is not an option. Cat scans can identify the number and size of the stones that are sitting in your kidney, and an obliging doc might prescribe one for you to help assess the risk before a major trip. Otherwise, this would be a good time for medevac. A kidney is a terrible thing to waste.

Yep, wife had a stone once, and said it was far worse than labor pains even. Said she would rather go through a C-section without any anethesia than to go through another stone like the one she had.

Mike,
Yep - luckly, as this is like my 3rd stone, I know that the pain being intermitant and moving down is a "good thing" - and I know to get to the ER if it gets bad. This one seems like it will pass. That said, I have an IVP Tuesday to make sure things are working

The last one was cylindrical in shape, 5mm x 20mm. It stuck in a bad spot, but was letting fluid around it, so they waited for it to move about 3 inchs down - then they were able to go in with a laser and break it up. Hurt like heck for 2 days afterwards, but I was happy to have it done, as one 30 minute attack was worse than those 2 days

Oh - and I can't decide which is worse - Gall stones, or kidney stones. I've had both, both are BAD, just different.

My take on getting one in the woods - this is a vaild time to call for a Medivac if you can - and if you do have opiates, and the person has no know problems with them, it would be a good thing (my urologist handed me a srcipt after the surgery, said 'fill this, keep it on the shelf, in case you get another - take and call me')

I was working on the early stages of a site that required us to use plate and jumping-jack tampers extensively to prep the loose soil. Nasty work working in mud and dirt but a necessary part of the job. Everybody lends a hand when things got rough. Even the senior guys.

Anyway, one of the old hands had kidney stones and had been told to push the water. Hottest days of the year and everyone is humping and sweating. He is taking his pills and chugging the water. He takes a turn on one of the old jumping-jack compactors where the dampers are shot so it really rattles your teeth. After about twenty minutes he hops out of the hole and gets a drink. On the way back he stops off at the porta-jon.

At first it is just a few yips. Then a scream that would curl your hair followed by a minute of swearing, a few mixed prayers, more cussing, a few whimpers and another minute of screaming and crying like a woman.

Then silence.

After a few minutes we figured we had to check to see if he fell in and drown. A friend knocked on the door and he replied that he was fine.

After another couple of minutes he came out. He was still pale, his clothes were soaked in sweat and looked like he he had slept in them for a month but he had the biggest SEG I have ever seen.

The stone had passed.

To this day he credits drinking lots of water and the bone cracking vibrations from a worn out soil compactor.

There is lots of folklore about 'acidifying' your urine to dissolve any stones. I doubt that any of it makes much of a difference. Which explains why there are so many different, and contradictory, versions. If you push fluids, pretty much any fluids, most stones pass on their own. Consult your doctor.

I would just push water and if it got too painful I would get medical help. If a stone goes in sideways, sticks and stops up the works your going to need professional help. Failure to get help can cost you a kidney and, rarely, with complications, cost you your life. Lady down the way had one that backed up and it tore into a blood vessel. She almost bled to death internally and, after a week in the hospital, finally gave it up due to an infection. Not something I want to mess around with.

Pushing fluids helps - IF the stone is small enough. One of the classic problems is the tube gets narrower, and you can get to the point it won't move. Mine seems to be moving.

Running a tammper - heh - with a stone, that MIGHT just kill you <grin>

I would find someone with a multi year degree and massive amounts of malpractice insurance.

My sis in law, cardiac nurse, tried several versions of home therapy for painful stones for several years, finally, pain won out, she went to the specialist, he discovered "crystallized"(?) stones that would have been in his opinion impossible to pass, so she just had the surgery to get removed, all good now.

He also told her that it is likely she will have more. It's her body's way of dealing with whatever causes them.

Somewhere I heard that cranberry juice is good for keeping the stones away. Also, lots and lots of water as mentioned already. And then some more water on top of that.

Fun stuff... you really start wondering what's going on when you start peeing blood! Ugh.

I don't know about kidney stones, however, cranberry juice is great for preventing urethritis, and bladder infections.

I believe that it is equally effective for kidney health but I have NO evidence to support that belief.

Few folks know as much about pain as you do.

I worked at a facility that did ultrasonic lithotripsy-busting renal stones up with sound waves. Laser is better, but the pieces they create do not look like ping pong balls-they look like broken glass, and it takes a bunch o' opiates to get them out. Colic pain-pain created by a muscular tube-like organ pushing on an obstruction, is as bad as pain gets, and gallstone colic, renal colic, and childbirth are that kind of pain. I've taken care of women who get gallstones or kidney stones late in pregnancy, which just ain't fair.

Oh, There are lots of people who know about worse pain than I do - look at cancer patients. Compared to what they go through, what I have is minor stuff

I will say today was a bad day - sometime during the night, my leg bandages shifted, so they had dried out, plus I was having another kidney stone attack - at the same time. I was past the 6 hour window, so I took a pill, changed the lag bandage (made the leg feel better) and laid down for a couple of hours


And roger on the broken glass shaped pieces (floating in blood <g>)