Kidney stone prevention, where to begin

The following is designed to entertain and inform, not provide medical advice. Always consult your doctor before starting any treatment.

Welcome back to the Kidney Stone Diet podcast, the show about reducing your kidney stone risk and living your best life. I'm your host and fellow student, Jeff Sarris.

And I'm Jill Harris, your kidney stone prevention nurse.

We're back at it again with another show in person. This is always fun.

Yes, it is.

But, yeah. So, we have a listener question.

Okay, great.

And we're going to dive right into the middle of this one. It's a little bit longer. There's some more personal information up-upfront, but this is from Barbara.

So, why don't we just go right into it?

Okay, let's do it. So, I'm on the calcium oxalate diet. I have been to nutritionist, they're no help.

They give me a handout, they don't know the answers to my questions. I'm desperate to find answers. I've got millions of questions.

I don't know who to ask. I really, really would love to, I wrote down, I have three pages of questions. And every time I went to the nutritionist, they said, "Oh, well, I don't know that answer.

I don't know that answer. I'll look it up." I mean, simple questions like, you know, "Can I have carob since I'm not allowed to have chocolate? What flour is the best flour since they're all bad besides oat flour?

What bread can I have? I'm dying for a piece of bread." Every single bread in the supermarket I have been four places, even Whole Foods, which is a natural place, Trader Joe's, which is a natural place, two other health food stores here, nobody has bread that doesn't either have soy or bad flours in it that I'm not allowed to have on this low oxalate diet.

I'd love to have a sandwich. Desperate to find out about bread, desperate to find out about quinoa, and like I said, carob is really important. I have a lot of questions.

If you could find it in your heart to give me a call back, I would so much appreciate it, because I don't know at this point where to go. My doctor doesn't know what to do. She doesn't know about oxalates.

All right. My name is Barbara. My number– You know, this– Now, I did listen to this one, because it was very long, and we really didn't know how we were going to tackle this question, simply because there's so many different things in this, right?

And so the beginning of this call was about Barbara and how this journey, her kidney stone journey, started with an infection that led to stones, and she was septic and a PICC line, and she was very ill. And so, the reason I'm bringing this up is because kidney stone patients can become very ill, almost dying ill because of these infections they can get.

So, it's serious, guys. It's serious. And so now you have a serious medical condition.

She's been through hell. She gets these lists thrown at her. Everyone's saying, "You know, lower your oxalate." And so every single list will be different.

And she said that she went to nutritionists, and they didn't have the answers to her questions. And I'm going to just throw this out. So, nutritionists specialize in what they specialize.

If somebody asked me about heart disease, I'm not going to know. I do kidney stones. That– the nutritionist she talked to could have been nutritionists that deal with chronic kidney disease or diabetes.

They don't know a lot about stones. They're not getting trained in kidney stones. So, it's not their fault.

Although Barbara could be sitting there going, "I don't care. I just want help, okay?" So, and of course, Barbara does. I run into this every day.

So, her ques– She said she has three pages of questions. Let's just start with the bread. Now, Barbara, there is a YouTube video on this channel that talks about bread.

She said, Barbara said, "I'm going to the store, and I'm looking at the ingredients, and all the ingredients are junk I can't have because of all the different flours." But, but you can, Barbara. Let me tell you why. It's about the portion.

Do I have a portion, not perfection t-shirt? She has a portion, not perfection t-shirt on, which is one of the Kidney Stone Diet mantras. And so, Barbara, even if there was some, you know, quinoa in the bread, some weird flour that was, a lot of people will say, "Well, Jill, whole wheat flour's high in oxalate." But it's a cup of flour that's higher in oxalate.

You're not having a cup of flour in that slice of bread. So, Barbara, you can still have a sandwich. She can still have a sandwich, Jeff.

Not a problem. Well, how much oxalate's in that sandwich, Jill? I don't know how much.

It ain't going to be 100 mg, and that's your, that's your cap for the day. So, maybe there's 10. I just estimate bread to be like 10 for a sandwich.

You got 90 left, Barbara. You can certainly have more. Quinoa, I think there's a video on this channel on quinoa.

Harvard did not study it, but it is known to be higher in oxalate. Does that mean you can't have quinoa, Barbara? No, you can have quinoa.

Just don't have it every single day. So, the problem with the oxalate portion of the Kidney Stone Diet is that, you know, a lot of foods haven't been studied, and so that freaks people out. Is that– That's not a judgment, it's a fact.

It freaks people out because they've been sick. So, they don't know what to do, and they don't want to get another stone. They don't want to get septic.

They don't want to lose a kidney, all the things that happen with kidney stone formers. Very anxiety producing. I have a lot of empathy for that with my own illness.

I get it. And this illness, as most illnesses, have to do with food. So, now Barbara's thinking she can't have a sandwich because no one's giving her the answers she needs.

So, Barbara, if you go to kidneystonediet.com, there's so many answers on that website. I mean, our blog, Jeff has so much stuff on there. This YouTube channel has over 150 videos on so much of what you're asking about.

So, all kinds of free information. And of course, you I, you can go to kidneystonediet.com and book a consult with me, and I can answer all your questions. But as far as the food aspect of the Kidney Stone Diet, specifically oxalate, remember you get 100 mg of oxalate a day.

Get the Harvard list from kidneystonediet.com, and then you can see how much oxalate you're eating. Anything that doesn't have an oxalate value, or Harvard did not study that food, have it once or twice a week in a normal portion size. Get your calcium needs met every day, and you will have lower oxalate.

Barbara, also, you didn't mention if you did a urine collection. Get that done. Have the doctor order a 24-hour urine collection.

It's where you need to start this process because although you made a calcium oxalate stone, it doesn't mean that, it doesn't mean that you had really high oxalate levels, okay? So, there could be other things going on that you won't know about unless you've done a 24-hour urine collection. And I can't tell you how important that is.

That is where all of you kidney stone formers should be starting, every single one of you. Does it hurt to do the Kidney Stone Diet if you haven't done that? No, of course not.

It's just a healthy diet. We're asking you to lower salt, get enough calcium, don't add, don't use a lot of added sugar, eat within portion, get your fluids, lower your oxalate, yes. But more important, there are things on that test that you don't know you have unless you do that urine collection that can be causing this problem, and then it gets undiagnosed year after year.

So, you must get that checked. But Barbara, I just want you to know that you definitely, you can definitely have a sandwich. All right, I would suggest doing a consult with me.

If you can't afford a consult, you can definitely, go on this YouTube channel and we have talked about so many foods and the oxalate levels in it. Get your Harvard list. If it's not on that list, the food you're looking for, please just eat that food once or twice a, a week in a normal portion size.

For 25 years, that advice has not screwed anybody up because I'm looking at follow-up urine collections all day long, okay? So, I know that advice works. So, email me also, Barbara, at [email protected] with more questions, okay?

Yeah, lots of resources. It's understandable to not know where to turn, because, I mean, like you said, a nutritionist has their lane. The surgeon has their lane.

Like, this is your lane. This is– You know this like the back of your hand. Thousands of patients, 25 years this month.

Like, there's– there's plenty. There's You are an abundant resource, and the channel, too, 150 episodes of the show. I mean, to listen to all of them, you're not going to listen in one go, so there's a lot to sort of focus down and be like, "Okay, where do I begin?" And I always think that's so important, the "what do you do if it's not on the list?" Because there's so many lists.

People are always like, "Oh, but this site says this, Harvard says this," but you have the experience to know Harvard has never steered you wrong thus far, and then to have sort of "if it's not on there, do this." I think that's so valuable.

That's the thing, yes.

Yeah, and one more thing that you mentioned, you said "get your calcium needs met." What– what are those again?

So, calcium, in order to lower urine oxalate, you must, and also you don't want osteoporosis, so you need to get your calcium needs met. 1,000 mg of calcium for men and women, 1,200 for women who no longer get their period, and it's up to those goals, not over. Too much calcium is not good, okay?

We don't want the excess in the urine, so that's very important, too. So, up to those goals, not over, spread throughout the day. Very important to lower urine oxalate, and also to get to make sure you don't get osteoporosis or osteopenia, for sure.

Yeah, and spread throughout the day, too, like just like fluids. You don't want to just flood yourself at one point and be like, "I had my fluids for the day, I'm done," because that's just– it's not how we're built.

That's right, but that's what people do, or they'll say, "I'm having three glasses of milk for breakfast, Jill, so I don't have to worry about it." Your body won't absorb all that, and the excess will wind up in your urine. And if you're not peeing, also you can get calcium deposits. Also, if you're taking in too much calcium through supplements specifically, you can also, increase your risk.

There's been studies done specifically for women, increase your risk of heart disease. That's one of the reasons we don't like calcium supplements when people take too much of them. And typically when people are been told to take calcium supplements, they're already getting some calcium from food.

So, if you've been told, say, a postmenopausal woman to get up to 1,200 mg of calcium a day and the average person gets about 2- 250 mg of calcium through food, well, now you're over 1,400. And 1,400, the studies have shown that over 1,400 mg of calcium can increase your risk for, heart disease and heart attacks. So, we've got to be careful of that.

Too much, people, of something doesn't mean it's better. We always have to remember that. Same with salt.

"Oh, she said to go to 1,500 mg a day. I'm going down to 400 mg a day." Less doesn't mean it's better, too. So, we as human beings tend to extrapolate what somebody has told us and do it how we just interpret it, how we interpret it, interpret it, and more or less, we really want to strive for the goals of what we're asking for, right?

Yeah, and again, it's not perfection, either.

It's not perfection.

Like, it's not 1,200 exactly, but it's just like, here's your limit. Here's basically a range of where you want to go. Like, before we were recording, we were talking about walking, getting steps in.

I mean, you go for your range of 12,000 to 15,000 steps a day, because, you know, some days will be much lower, other days you can hit that, maybe even more, but it's the–

Average.

Yeah, the average, and what we do in a life that makes our, and across our entire life, like our lifestyle and everything that we do, that makes us who we are and how we're going to feel and how we're going to sort of be able to approach the next day.

Yeah, absolutely. Why this is so important is you can hear in Barbara's voice that she's frustrated. You know, she's anxious.

Again, this isn't judgment. This is– these are facts, and this is what I'm dealing with every day on the phone and in the Kidney Stone Prevention Course. People are scared.

They never want to go through this again. Now, they don't know who to trust. There's so much misleading information, not just misleading information on the internet, contradictory information.

So, now people have a disease that they never want again, and in Barbara's case, again, we cut off the beginning of that message, but she's been through hell and back. And now she has to figure out on her own how to get help to make sure this never happens again. So, this is a terrible, terrible scenario for patients, and this is exactly why I wake up with renewed energy every single day after 25 years, because I know I'm going to hear a story like Barbara's today.

This is what we hear. It's not just, "I had a kidney stone, it wasn't so bad." Otherwise, I mean, they're terrible. And this is, you know, the extreme, but this, I have this every day.

Somebody has had something really terrible happen to them. And so, you know, now they're left to their own devices to figure out a diet and how to do it and everything else. And it's not just about looking at a goal sheet.

It's about, "Okay, I see all these goals, but how do I do that? And what does this mean for me? And by the way, I got diabetes, too.

So, now what?" I mean, it's complicated. No matter what kind of diet you're trying to do, it's very complicated. You need help, you need support, you need all that.

That's why we have the Kidney Stone Prevention Course. I mean, it's so valuable and very cheap, people. It's very cheap!

I'm a nut ball, it's so cheap! 25 years of experience, she's selling shit. I am, because I'm proud of it.

It's $189. You go on the internet now, people have copied me over $300 for the for a course. That I'm I'm telling you right now, they're also not giving over six hours of support calls with them each week, by the way.

So, join. It's, you're not going to find anything cheaper with the most experience on the internet. I'll tell you that right now.

And I don't mind selling that. I don't– Well, I'm saying it because I'm proud of it and it has helped thousands and thousands and thousands of people, so I beg of you, think about it. And it's cheaper than a private consult, by the way.

Yeah. Yeah, and to touch on the group calls real quick. I mean, when you when you purchase the course, you have the videos forever.

Those are always yours. And Jill does the group calls. How many days?

Three days a week.

Yeah, so three days a week and you said six hours a week.

Yeah, they're two hours each time, typically.

Yeah, and after you purchase the course, you have the first month included, and then if you want to continue, you're just auto billed the $19 a month to continue to have those six hours a week with Jill in a group setting, but the group setting is so valuable. It's not just one-on-one. One-on-one isn't the only value.

The value does also come from being with everyone who has questions that maybe you didn't think to ask in our call, in our consult with Jill. You're building this, just this– You're building up your knowledge. You don't know what you don't know.

Again, when it comes to urine analysis, the doing all the different things, this is all to just better equip you to have a better experience.

Yes, what people will say about those group calls is this: the support and understanding. It's not just about kidney stones, it's about how do we navigate life with food when we're vacationing, when we have celebrations, going out to eat, socializing, having a crappy day. How am I getting through all that, Jill, and staying compliant with the Kidney Stone Diet, and also, by the way, people stay for $19 a month to lose weight, and we have people that have lost over 90 pounds, over 50 pounds, and they stay in those group calls to talk about the obstacles that get in their way, because everyday obstacles get in your way from a healthy diet.

That's why people can't stick to one. "Oh, well this stuff happened and this stuff happened." And so, you're going to have to learn how to cope with stuff, because it happens every single day. It's called life.

And so those group calls, they're amazing. They're also amazing for me. I charge myself $19 a month, as well.

They're that amazing. But, no, I'm saying that because we all get support from each other. I go through stuff, too, so you'll find out personal things about me in those group calls that I'm certainly not saying on YouTube.

So, it's a family and it's, I don't know, we just feel really loved and valued and supported, and it's a safe place for us to talk about what's going on. And if you have a place that you can do that in, you ain't going to be grabbing those, you know, Ding Dongs from the cabinet, because you're going to be able to come and talk to people that understand you, so that you can continue making healthy choices even when shit hits the fan.

So, they're they're wonderful. They're a huge part of my life, just as much as they are for my students' life. They're a huge part of mine, too.

We're a family in those calls, for sure. We all feel that way.

Yeah, absolutely. But, yeah, so if you want to dive deeper and find more information about the course, sign up for the course and the group calls, Kidney Stone Diet meal plans, everything is at kidneystonediet.com. You can find it all there, plus all the free resources, the blog, the weekly email newsletter where Jill keeps you on track.

You can find the link to the Kidney Stone Prevention group on Facebook, which is a huge group, so much activity there, because it's again, it's it's the family. It's joining and helping people who are also going through what you're going through. So, again, Barbara, thank you for the question.

If you're out there with a question, the number is 773-789-8763 and we'd love to feature your voice on a future episode. If you're outside of the States of the US, you can email a voice memo, so just an audio recording from your phone, email that to [email protected] and we will we'll feature you in the future.

Yeah.

Barbara, I–

Don't forget the mic.

Shift this mic. Barbara, write me at [email protected], okay? But until then, look at all the YouTube things.

We have one right on bread that will help you a lot, I promise, okay? Thanks for writing. You've been through hell and my heart does feel that.

So, thank you for thank you for calling us. We appreciate it and sharing your story.

Yeah, and thanks for everyone for tuning in and we'll see you next week.

Bye.