I have a kidney stone, now what?

In this conversation, Jeff Sarris and Jill Harris discuss the complexities of dealing with kidney stones, including what to do when diagnosed, how to navigate doctor visits, the importance of diet, and making informed decisions about surgery. Jill shares her extensive experience as a nurse and emphasizes the need for patient education and compliance with dietary changes to manage kidney stones effectively.

Takeaways

• People often feel frantic when they have kidney stones.
• Jill helps patients understand their urine collection results.
• Dietary changes can significantly impact kidney stone management.
• Patients should ask their doctors about the best course of action for their stones.
• Living with kidney stones can provide motivation for dietary compliance.
• Surgery decisions should be made based on individual anxiety and stone location.
• Patients often feel lost when making decisions about their health.
• The kidney stone diet promotes overall health, not just stone prevention.
• Compliance with dietary recommendations can lead to improved health outcomes.
• Understanding one’s own health is crucial for making informed decisions.

00:00 Introduction to Kidney Stones
00:45 Understanding Urine Collection and Diet
02:41 Navigating Doctor’s Advice on Kidney Stones
07:10 The Role of Current Stones in Compliance
09:26 The Kidney Stone Diet and Its Benefits

Jeff Sarris (00:00)
So I have a kidney stone. Now what?

This is the moment. This is the moment when we want to know the answers. So there’s a kidney stone. I have a kidney stone or multiple stones. What do I do?

Jill (00:17)
What do you do? Well, you’re sad. I know that. People are frantic when they—so here’s a common scenario. Somebody calls me, they have a urine collection. I’m helping them understand it so they can have a better doctor office visits. That’s one of my best services, honestly, getting a consult with me. Well, Jill, you’re not a doctor. I know I’m not a doctor, but believe me, I’m very well versed.

A lot of doctors send patients to me because I’m very good at reading those urine collection results. I’m not diagnosing anybody and I’m not telling them, you need this, you need that. I’m talking to them about diet and how it will help. But I’m educating them so they can really be productive during their doctor office visits. Because many people tell me, look, I went in there, they didn’t tell me anything, Jill, drink more water.

When I look at the urine collection, holy brujo, is there a lot of stuff that needs to be changed? And guess what? It’s just healthy diet changes, right? So, yeah. Yes, I am a nurse, yes. Yes.

Jeff Sarris (01:17)
And I just want to jump in real quick. You said you’re not a doctor, but you are a nurse since 1998 and recording this in 2025. So what is that? 27 years of being a nurse, working with tens of thousands of patients at this point. So you, this isn’t coming out of, out of nowhere. You’re not making up any of this. This is through practice of working with people over years and from through your mentor, Dr. Fred Coe.

Jill (01:25)
Yep. Yes. Well, with our friend Dr. Coe, I mean, you can find him at kidneystones.uchicago.edu and that’s where all the science lives. And not just his science, it’s science from all the doctors who are researchers, the leading researchers in the world on kidney stone prevention. So I’m the communicator of it all and he’s the science guy. And so many, many, many, many, many years ago, he taught me how to read these urine collections. So I’m very well versed because I’ve had an excellent mentor.

And now with all these years of experience, I just look at them and I know exactly what’s going on. And so I’m able to tell the patient, go talk to your doctor about this. Okay, so now, I forgot what we were talking about. Somebody has a current stone. You can see guys, it’s not like we prepare for this. He just says the topic and I go on it. So that’s the great thing about having that experience. You don’t have to do a lot of research into this. Okay.

So somebody is calling me. Jill, here’s my urine collection. Help me. Okay. And by the way, Jill, because I take an extensive medical history, I have current stones. I’m petrified of them getting bigger. Whatever you tell me, I’m going to do it. Because they don’t want them to get bigger. Because hopefully those stones can pass. Here’s the scenarios in which you guys who have current stones need to know. Number one, these are things to ask the doctor.

Because you will also say, Jill, what should I do? Should I have a surgery? Should I get rid of it? Should I wait? What should I do? So I go through this with the patient. Ask your doctor. Your doctor knows best upon the lobe. The doctor knows where the stone is. And if it’s easy to take out, he may say or she may say, look, it’s in the lower pole. So we’re just going to watch it and wait.

And so if you have a kidney like this, I can’t make it, but and it’s it and your stone is in the lower pole and your urine is up here, it has to go against gravity. If you’re listening on Spotify or Apple, Booboo Kitty or whatever, you’re not, I’m doing a picture of a kidney. But here’s your ureter up here. If your stone is in the lower pole down here, it has to go against gravity to come out. So a lot of doctors will say we ain’t touching that lower pole kidney stone, we’re just going to do imaging every six months or a year to make sure it’s not getting too big. Fine. There’s that scenario.

The other scenario is I have a current stone embedded in the meat in my kidney. I just had that kind of patient today and the doctor is like, we got to just watch that and make sure it doesn’t grow because that’s a very tricky surgery. They don’t want to cut into the meat of your kidney. Then there’s other stones, which is many of you. You just have little tiny stones all over and you know, typically under five millimeters they pass. Typically.

In that scenario, people come to me and say, what should I do, Jill? On one hand, I don’t want to ever think about a stone again. I want to be stone free. And they will ask me, should I have the surgery? Or they’ll say, should I just wait for them to pass? What would you do, Jill? Because I’m traveling, Jill. I got this. I’m worried about it so much. I’m anxious. I don’t want these stones in me. So I talk to the patient and I say this.

If you’re somebody who’s gonna worry about those stones, I’m not judging, I’m asking you. If you’re somebody who’s gonna worry about them and they’re gonna drive you nuts and you’re gonna be afraid to travel, you’re not gonna go on a plane again and all the things, I would talk to the doctor and ask him or her, Doc, I’d like to get them taken out. What do you think about that? Or if you’re somebody that’s like, hell no, I’m not having no surgery if I don’t need it, you can opt to leave them in.

But I would again, your urologists, may not be great with diet, but they know what’s going on in your kidney. And that’s where they’re 100% excellent. And they’ll say, look, that stone, I’m not touching. This stone, let’s take it out. If it’s going to make you anxious, let’s get rid of it. So your doctor really will know what to do. So people will say, well, my doctor gave me the choice. So I’m telling you how to talk to the doctor about that.

Because a lot of patients get upset, Jill, what the hell do I know? I don’t know what I should do. So think about it how you feel about it. If it’s something that you don’t want to think about ever again and get rid of it, have the surgery. If you’re like, well, I don’t care if it ain’t going to move. But see, there’s no guarantee that that puppy won’t move is the problem. So a lot of people don’t like living with that anxiety. So but a lot of people don’t want a stent in a surgery. So they will take their chance and they will just, you know, not do the surgery and just whenever it moves it moves. Many of you will leave this earth with stones in you. They may never move. You don’t know. Okay.

Here’s, I never tell what a patient, I never tell a patient what to do. I just explain to them all of this so then they can make a good decision. It’s important that a patient understands all the things to make a good decision. I’m a patient myself with all my cancer stuff and so I really understand some of the decisions I had to make going through my cancer journey. What I’m saying from a patient’s perspective, because I’m also a patient, I was thrown, but with my cancer stuff, lots of times doctors will say, well, what do you want to do? I don’t know. I’m a patient and even though I’m a nurse I wasn’t well versed with cancer stuff. I know kidney stones, so I didn’t know what to do so I had to really dig deep and just go with my gut with some things and God bless my doctors say I’m a unicorn because I should not be here with my stage 4 cancer anyway I digress as usual.

Jeff Sarris (07:49)
You do.

Jill (07:58)
Okay so so the only reason that I like when you guys still have a stone inside of you is because I will call that a negative motivator. Meaning, on the days where you’re going off the rails with diet, you may do it a couple days, but then one day you wake up and say, my God, I do have this stone. I don’t want it to get bigger. Let me get back on track. So a lot of people will say that the current stones they hold provide them with accountability because they don’t want them to get bigger. And I still have people send me Christmas cards from decades ago saying, Jill, they’re still there. They haven’t grown. Doing great. Nothing makes me happier.

Now, could those stones from years ago all of a sudden dislodge? 100%. They can, but they haven’t. And it keeps people compliant. And why I want people compliant is number one, I don’t want you to get bigger stones or more stones. Because these surgeries that you have, another patient today had a, has lost kidney function in her left kidney because she’s had so many surgeries. Those surgeries are not for the faint of heart as you all know. And you have instruments and blasting and all this. Eventually it will erode kidney function. It can. Which will cause CKD, chronic kidney disease, high blood pressure, all kinds of stuff. And again, if your kidney’s not happy, your heart ain’t either. These things go hand in hand. So we want to pay attention to all that.

But the other reason I like when you have current stones, like I said, it keeps you compliant to the Kidney Stone Diet. And the kidney stone diet is just a bunch of healthy goals for almost any disease. Lowering sodium, not overeating candy and cakes and cookies. Have some, get right back on track. Getting enough fluids, getting your calcium needs met to lower oxalate and help your bone health. Not overeating meat, eating moderate amounts of meat. And then of course, lowering oxalate if you need to do that and that’s your problem. So it’s just a healthy diet.

So it makes me very happy that people are compliant with it because I can’t tell you how many people say, I’ve lowered my dose of metformin. I was pre-diabetic, now I’m not. I’ve lost 150 pounds. Believe it or not, 150 pounds. I am off my blood pressure medications. So some of you can not only prevent kidney stones, but you can help your other disease states simply because you’re eating better. It’s not a miracle. The kidney stone diet is not miraculous. And I’m not a saint. People will say, my God, she’s such a saint. I’m not. I’m talking. You’re doing. And when you do, when you take action, you get results. So I mean, I’m just giving you information. You got to do it.

And the whole reason I’m successful is because my patients and students work harder than anybody I know. And that’s what gives me success. If they didn’t work hard, everybody would be still making stones. And I wouldn’t be successful. So you guys do the work and you take it seriously. And then you reap the benefits of all of this. So it’s super important. If you have current stones, please adhere to the diet. You can at least keep them from growing bigger. You can decide, have that conversation with your doctor depending upon if you’re overly anxious about having current stones, are they something that you should get rid of or would you just like the wait and watch approach?

Many people decide to do that and because they know that they’re being surveilled, going under surveillance with imaging and stuff, they really tend to be more compliant with the diet. So I think it’s, you know, it has its advantages, but you’ve got to know what you can live with and make that decision with your doctor on what you should do with your current stones, okay?

Jeff Sarris (12:11)
Sure. Yeah. And if you’re ready to take your health into your own hands, go to kidneystonediet.com where you can find all of the free resources plus everything premium, working with Jill directly, the all access pass that includes meal plans and the prevention course and group calls and all of the things that will help keep you on track and prevent your stones from growing or from creating future stones. So I think with that, we’ll wrap and we’ll see you next week.

Jill (12:35)
Yes. Everybody have a great day.