When do I need to see a nephrologist for kidney stones?

So as a kidney stone former, when do you have to see a nephrologist? Let's talk about that.

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. Hello, Jeff. Hello, Jeff.

Always great to see you and we're back at it again in our remote studio recording, but it's always fun in person. And every time I say it, we need to do it more often, but travel's funky right now, so we're going to figure it out and do it, do it remote for today. But we are going for basically, nephrologist versus urologist today.

So, when do people need to consider one or the other?

Well, it's a great question and one that is brought up a lot on the Facebook group. And the Facebook group is called Kidney Stone Diet with Jill Harris on Facebook. It's a private group, so you can look for that.

So, if you make kidney stones, all of you will need a urologist. The urologist is the surgeon that will take out your stone. It's a doctor that specializes in diseases of the bladder, the kidneys, all of that.

So, if you have a kidney stone, say you have bladder cancer, prostate issues, the urologist is the surgeon that will take care of those things. The nephrologist is also a doctor, but he is not a surgeon. So, the nephrologist takes care of specific diseases related to the kidney, like CKD, which stands for chronic kidney disease.

He will take care of things like metabolic disorders. He will take care of things, diabetes. He will take care of the medical issues that happen with the kidneys.

And, they can also be used in kidney stone prevention. So, a lot of people will get one stone and they're like, "Oh, Jill, I got a urologist. Should I get a nephrologist, too?" Most stone formers do not need both.

You do not need both. Most stone formers do not need both. And why do I say that?

"Well, Jill, I just want both." Listen, as a patient myself, more doctor office visits, trying to get in, scheduling, you don't need it in most cases. But when do you need a nephrologist? You should see a nephrologist when you have many stones and your urologist is not helping you.

Surgical Focus of Urologists Versus Prevention

Now,

People will say, "My urologist just wants to make money, Jill. That's all he cares about. That's all she cares about.

She don't tell me nothing, and they just want to make money." That's not true. I'm not saying it's not true for all, but it's not true for most. Urologists specialize in surgery.

I've said this a million times. It's like asking the hairdresser to paint your nails. That's not what they do.

The plumber's not going to fix your lights. The electrician's not going to fix your toilet. Everybody in healthcare as well, they're specialized in what they do.

The nephrologist, who's the medical doctor that manages kidney issues, is not going to do surgery on you. So, I mean, everybody does what they do. And many urologists are very upfront.

They're like, "You know, I'm going to take them out, but as far as diet and stuff," they'll say go see Jill. I get a lot of doctor referrals. Or they'll say, "I'm going to send you to a nephrologist," and then they can help you.

But a lot of urologists, when you guys are armed with the right information, "I want a urine collection. I want to change my diet," they can help you. They can.

So, ask. If they're like, " I'm not sure. I'm going to refer you to a nephrologist," fine.

That's fine. But I have saved many a patient from going then to see another doctor, i.e., a nephrologist, simply by doing a consult with me. We get the diet stuff going, they do a follow-up urine collection with their urologist, and everything's okay.

So, most of you will not need it.

So, when do we need to look at a nephrologist? Well, if you have kidney stones, recurrent ones, and they're just getting worse and worse, and the urologist is not able to help you, you need to see a nephrologist. If you have other medical conditions, like chronic kidney disease, like you're a diabetic, those things may also promote kidney stones, so you can get all those things managed with a nephrologist, so you can do that, too.

So, nephrologists are for complex cases that the urologist cannot help you with, then it is time to go to a nephrologist. Right. Nephrologist.

Now, now, listen. This is very important. Don't be clicking off right now.

I want you to sit here and listen to what I'm going to say. When you are looking for any doctor—I have learned my lesson here—but when you are looking for a new doctor for whatever you have, but in this case, you want a nephrologist, who is a doctor that specializes in kidney problems, you want to look at their bio and say, "Does this person also care about kidney stones or are they just doing dialysis?" Because you're going to waste a lot of time waiting for that appointment, finally getting in there, and the doctor's like, "I really don't know much about kidney stones." I can't tell you how many patients have wasted their time with that.

Finding a Nephrologist Specializing in Stones

So, do your due diligence, and always remember that each of these doctors specialize in certain things. Like Dr. Coe is not doing dialysis.

He knows about it for sure. And he's not doing CKD. He knows about it for sure.

But his specialty is kidney stones. So, there are plenty of nephrologists that really dig kidney stones and they know exactly how to help you. Look in their bio when you're online, type nephrologist that cares about kidney stones, look in their bio and see what they specialize in, what their areas of concern are for you.

If it's not listed because it's a tiny, little practice maybe, when you call to make an appointment, you ask the person who picks up the phone or ask to speak to the nurse. You're better off probably asking the front desk, "Hey, I want a doctor that specializes in kidney stones. Who do you got?" Okay, so that's super important not to waste your time and your copay money.

Again, I'm a patient. I know about this. So, you really want to pay attention to that.

So, to wrap this up, it's really quite easy. Well, when you know what it all is. A urologist, if you're making stones, everyone should have a very good surgeon.

That is your urologist. If your urologist, your surgeon, is not able to help your complex kidney stone case, please ask for a referral from that urologist, say, "Hey, Doc, I need I'm going to need help here. Can you refer me out to a nephrologist?" Or if you feel a little, you know, you know, he's trying to help you, the you're the urologist, but you're like, "Oh, I feel a little shy about saying I got to go somewhere else because you're not doing it for me," then ask friends, ask, as everybody knows a kidney stone former, look on the internet, somebody next to close to you, a nephrologist near you that specializes in kidney stones, okay?

And so, that's how you begin this. But most of you will not need both. Most of you won't.

Most of my patients, the thousands and thousands and thousands that I've had over the years do not have both. Some do, most don't. I hope that helps figure it out, cuz it's it is complicated.

It is. And also, we always have to think about it. I know when I'm sick, I ain't thinking straight, and I know a lot of stuff about healthcare, and I'm a nurse.

So, you would think, "Oh, Jill, she's got it." But when you're anxious and you're sick, all rationale goes out the window. It's just really scary. So, pay attention to this video, do what I'm saying, and you'll get the right help at the right time.

I hope it I hope this helps. Did it make sense, Jeff, to a lay person?

Oh, yeah, for sure. And it's so important because getting the best doctor's visit possible is what we want. We don't want to be bouncing doctor to doctor to doctor cuz we're at the wrong spot.

So, I think that's so helpful. And also, that's why you also have the resource on the site to have a better doctor's visit, where you can just download this PDF, and it'll explain everything you need to know to make sure you have the best appointment possible before you even get there.

Yes, that article yeah, that article is called "13 Critical Questions to Ask at Your First Doctor's Appointment" or something like that, folks. Go to kidneysitonediet.com and put that in the search bar, and you'll find it. But, yeah, you it's really important.

We have so little time with doctors. We really want to navigate those appointments well. And that's why we have the urine analysis consult.

I can't tell you, that's a very valuable service and well worth the price. When you're prepped for your doctor office visit, you're going to get a better treatment plan, you're going to get better time with the doctor, you're going to get more attention. When you seem ready and eager, you get more help, folks, typically, okay?

So, that's really important, too. Check out the urine analysis consult. It's well worth its price.

I will tell you that. It's a very valuable service.

Absolutely. So, you can find that and everything else at kidneysitonediet.com. And I think we'll wrap there for this week.

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Bye, everybody. Thank you!