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Speaker 1: Welcome to brain Stuff, a production of iHeart Radio, Hey

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Speaker 1: brain Stuff. Lauren vogebon here. Mark Bird of Miami, Florida

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Speaker 1: was thirty eight years old when he had his first

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Speaker 1: kidney stones. The pain started in his back, like he

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Speaker 1: had slipped a disk. Bird was used to back pain,

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Speaker 1: so he tried his standard routine of stretching, yoga, and

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Speaker 1: frequent trips to the chiropractor, but nothing helped. Then one day,

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Speaker 1: he was sitting in his office chair when it felt

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Speaker 1: like someone had sneaked up behind him and stabbed him

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Speaker 1: in the back of the bowie knife for the article.

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Speaker 1: This episode is based on hows to work? Spoke Bird

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Speaker 1: when he was forty eight and the veteran of two

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Speaker 1: excruciating kidney stone episodes. He said, the pain takes your

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Speaker 1: breath away. You're doubled over and thinking I need to

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Speaker 1: get to the hospital right now. Every year, half a

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Speaker 1: million people visit emergency rooms in the United States with

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Speaker 1: kidney's tones, and around one in ten Americans will have

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Speaker 1: a kidney stone at some point in their life. We

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Speaker 1: humans typically have two kidneys, and their main job is

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Speaker 1: to filter waste products out of our blood. Normally, those

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Speaker 1: waste products are flushed out of the kidney as urine.

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Speaker 1: Your kidneys filter some fifty gallons that's nine liters of

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Speaker 1: blood every twenty four hours and eliminate some sixty four

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Speaker 1: ounces or two leads of waste. In some cases, however,

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Speaker 1: there are excess waste products in the blood that aren't

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Speaker 1: flushed out of the kidneys. Those leftover waste products can

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Speaker 1: form tiny crystals that bunched together over time to form

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Speaker 1: increasingly large stones. Calcium oxalate is the most common component

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Speaker 1: of kidney stones, but there are others too, including uric acid, struvite,

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Speaker 1: and sistine. The real trouble starts when one of these

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Speaker 1: stones leaves the kidney and enters the uritor, which is

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Speaker 1: a narrow tube that transports urine from the kidney to

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Speaker 1: the ladder. That's when it can feel like you've been

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Speaker 1: stabbed in the back. Pain is a hard thing to quantify,

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Speaker 1: but the discomfort of passing a kidney stone is routinely

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Speaker 1: compared to childbirth or worse. But the source of that

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Speaker 1: pain may be surprising. How stuff works. Also spoke with

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Speaker 1: Dr Timothy Average, a kidney stone specialist at Prisma Health

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Speaker 1: Urology in Columbia, South Carolina. He said, the common belief

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Speaker 1: is that the stone itself causes the pain. Patients will

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Speaker 1: frequently say it must have a lot of rough edges

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Speaker 1: or spikes because this one hurts a lot, or it's

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Speaker 1: really large and that's what hurts so badly. That actually

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Speaker 1: has nothing to do with the pain. So if it's

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Speaker 1: not the stone, what the heck is causing that searing pain.

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Speaker 1: The thing is that if a kidney stone is large enough,

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Speaker 1: it'll get stuck in the narrow passageway of the uritor,

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Speaker 1: causing urine to build up behind it. With nowhere to go,

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Speaker 1: the urine exerts increasing pressure on the narrow eutor and

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Speaker 1: on the kidney, causing the tissues to stretch like balloons.

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Speaker 1: Average explained that stretching is what triggers the pain people

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Speaker 1: feel when they have kidney stones. You feel it in

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Speaker 1: your back first, and then it can radiate around the

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Speaker 1: front and down to the groin. It's pretty excruciating for

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Speaker 1: most and the body has all types of nerves for

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Speaker 1: sensing things like touch and temperature. The nerves and your

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Speaker 1: kidney in eutor detect distension or dilation, just like your intestines, bladder,

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Speaker 1: and bowels. An obstructed bowel is also very painful, but

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Speaker 1: kidney stones are far more common. The discomfort of kidney

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Speaker 1: stones is described as colic since it comes in waves.

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Speaker 1: That's because the orator uses involuntary wave like muscle movements

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Speaker 1: called peristalsis to move urine from the kidney to the

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Speaker 1: bladder in packets or bunches. If the pathway is blocked,

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Speaker 1: the pressure builds with every involuntary squeeze of the urotor,

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Speaker 1: and so does the pain. In both women and men.

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Speaker 1: Urine exits the bladder through the urethra and then out

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Speaker 1: from the body. Another common misconceptions as average is that

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Speaker 1: the most painful part of having a kidney stone is

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Speaker 1: passing it through the urethra, but he says those fears

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Speaker 1: are largely unfounded. He said the urethra and men and

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Speaker 1: women is much wider than the eurotor, almost twice the size.

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Speaker 1: Patients will frequently say to me, oh, I'll know one,

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Speaker 1: I pay it out. Often they actually don't. Bird, for

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Speaker 1: his part, disagrees. Even though treatment for his kidney stones

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Speaker 1: involved internally blasting them with shock waves to break them

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Speaker 1: into smaller particles, the largest fragments were still the size

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Speaker 1: of bebes. A bird says it felt like urinating and

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Speaker 1: I quote shards of glass. One of the many unpleasant

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Speaker 1: surprises of Bird's ordeal was that he had to have

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Speaker 1: a stent in aserted into his eudor to open the

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Speaker 1: passageway from the kidney to the bladder, and the stent

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Speaker 1: stayed in for two long weeks. Ural stents are ten

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Speaker 1: fifteen inch plastic tubes that's around that are inserted through

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Speaker 1: the urethra all the way up to the kidney to

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Speaker 1: let urine flow to the bladder again. A stent is

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Speaker 1: used in many kidney stone removals to keep the order

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Speaker 1: from becoming obstructed again by swelling. After the operation is complete,

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Speaker 1: Insertion of the stent is done under heavy sedation. But

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Speaker 1: removal isn't, a bird said, the nurses try to use

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Speaker 1: the element of surprise. They pull it out like a

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Speaker 1: rip chord. Today's episode is based on the article kidney

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Speaker 1: stones are excruciating, but the source of pain is surprising

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Speaker 1: on how stuff works dot Com, written by Dave Bruise.

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Speaker 1: A brain Stuff is production of by Heart Radio in

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Speaker 1: partnership with how stuff works dot Com and it's produced

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Speaker 1: by Tyler Klang. Before more podcasts from my heart Radio,

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Speaker 1: visit the heart Radio app, up Apple podcasts, or wherever

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