Ultimate (as in, last) Health update

[drwex]

As I mentioned in the last entry, one of the side effects of dusting the stone was that they didn't get enough for a lab sample. That means we don't really know what caused it, so there's no sensible medical intervention. Instead, we get a series of diet recommendations that are generally seen as effective against stones of all kinds. Herewith, in bullet-point form:

• Increase urine volume. A fancy form of "drink more water. No, really, more than that." Some of the associated literature gets very specific, including a suggestion that if you don't have to get up in the middle of the night to go pee you're not drinking enough. That's a hard no for me because although I can do it if need be I definitely get much worse sleep if I'm interrupted and sometimes I can't even get back to sleep at all. My sleep is already bad enough, let's not make it worse. They also suggest one 2-L bottle of water per workday, which is a lot more than I'm currently going through.
  
  Among the tips for increasing water intake are having a glass at "transitional times" like upon waking, before leaving the house, when arriving at work, after using the restroom. Add frozen bits of lemon, lime or orange in place of ice cubes both for flavor and to acidify urine. Choose moist foods over dried - cooked rice, for example, carries water about equal to its grain weight.
  
  Interesting side note - it's suggested to avoid grapefruit juice. Since other citrus is encouraged I'm not sure why this is. Have to look into that.


• Consume adequate calcium. Despite some stones being formed from calcium deposits, it's not advised to avoid or reduce calcium intake from food. Calcium supplements are disrecommended. Considering how many Tums I chew in a given week that's going to be a challenge. One source says if you're going to take them, take with food - the problem is that I take them to control reflux, which causes me not to eat.


• Decrease sodium. Generally good advice, but particularly here excess sodium tends to go out in your urine and it does so by binding to a lot of calcium. If you get calcium stones this is a primary formation pathway. As with other discussions of dietary sodium, it's the hidden sources that get you. Obvious things like salty snacks aren't as problematic as packaged foods, sports drinks, and the like that have tons of sodium we don't recognize.


• Decrease protein intake. I mentioned this early on. The most recent literature I was given differentiates meat protein (which should be limited) from dairy or vegetable protein, which are apparently not sources of stone formation. I don't understand why that is, but there you go.


• Watch out for oxalates. That's mostly spinach, rhubarb, almonds, and miso soup though there are oxalates in lots of things. Spinach is the biggest culprit, by a large margin, which is unfortunate since it's my main source of leafy greens. Bother.

Comments

[reedrover]

Grapefruit apparently does all kinds of evil things to body chemistry and can bind with calcium.

The biggest sodium and sugar sneak in my pantry is pasta sauce.

[drwex]

Ah, binding with calcium would be a good reason not to have it on this diet plan.

[c1]

To put another spin on this, for people on statins, grapefruit juice is a huge no-no.

[silentq]

Once I started reading the sodium line on packaged snacks, I pretty much stopped eating them. :-)

[drwex]

I don't generally eat that many packaged snacks but when I do it's something I expect to be salty, like chips. What gets me is other packaged foods, like sauces, which I don't expect to have that much salt.

[redbird]

Grapefruit is weird. There are a significant number of medications that it interacts with, making them either more or less potent. When this first came out, the articles I read were specifically saying that if you were currently taking your pills with a glass of grapefruit juice, continue doing so until you could talk to your doctor about it. Along with the more obvious that if you aren't, don't start without consulting a doctor.

That said, I eat grapefruit when I'm in the mood, and don't worry that it may make my antihistamine less effective. (Low-level cat allergy, so I take an antihistamine unless I'm on vacation away from my cats.)

[drwex]

I don't tend to drink grapefruit juice unless there's no orange available as I vastly prefer a citrus juice to apple juice. Interesting note about the interaction with medication.

[omly]

It can be frustrating when things are inconclusive like that. I am glad you are thinking about what might help in the future though.

[drwex]

Thanks. I'm glad this episode is over - you may understand what it's like just to be able to walk around normally again after months of not even that.

[jducoeur]

They also suggest one 2-L bottle of water per workday, which is a lot more than I'm currently going through.

Ayep, but it's the important one. I cheat and do some of that as iced green tea (not optimal, since it has *some* oxalates, but it's not too awful in moderation), but I've mostly gotten into this habit.

I found that the key for me is to *always* -- always, always, always -- have water to hand, and just get into the habit of sipping it constantly. If you look, you'll notice that when I'm out-and-about I almost always have a refillable water bottle with me. When I go on a long drive (more than half an hour), I usually have two: a well-insulated one full of ice, and a second for refills.

It took me about a year to really nail this habit down, and I occasionally slip. But I've mostly gotten to the point where, if I'm *not* drinking enough water, I feel thirsty, so it mostly self-reinforces.

Considering how many Tums I chew in a given week that's going to be a challenge.

Um -- how much *are* you taking? Past a certain point, there are better solutions.

(Reflux has been the bane of my existence my entire adult life, so I've played this game a lot.)

[drwex]

Tums, anywhere from 1-4/day depending. I do take more serious meds but I prefer not to if I don't have to.