This week Jill answers an FAQ the causes of flare-ups when you have kidney stones.
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Find more episodes of the Kidney Stone Diet Podcast here.
Who is Jill Harris?
Jill is a nurse and health coach that specializes in educating patients on kidney stone prevention. For more than 20 years she’s helped patients understand that kidney stones can be prevented with the right treatment plan. It’s one thing to be told to lower oxalate or drink more water, but HOW do you do it? That’s where she comes in. Through the educational resources at kidneystonediet.com, stone formers can learn everything they need to know to significantly lower new stone risk.
Who is Jeff Sarris?
Jeff’s co-founder of SPYR, a branding agency based out of Chicago, where he and his business partner Dave help awesome people like Jill create online platforms that make an impact. He’s also a certified health coach, Executive Producer of the Netflix documentary Minimalism, and host of the Starting Now podcast.
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Jeff Sarris: 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.
Jill Harris: And I’m Jill Harris, your kidney stone prevention nurse.
Jeff Sarris: Whatcha rollin’ around the apartment getting?
Jill Harris: So, you know I like thrift stores and, well, here’s what really happened–this was in the shot. I’m like, “What the hell is this, Jill? You got just a photograph on the floor.” So, this, Jeff, you see it?
Jeff Sarris: Uh huh, yeah!
Jill Harris: Do you see it?
Jeff Sarris: Yeah, I do.
Jill Harris: So, I went to the thrift store–I’m always scummin’ around the thrift store because, again, it’s like a treasure hunt. You never know what you’re going to find and that makes me so very happy. So, I saw this picture. It’s black and white. It was $8. And I’m like, “That is such a–it’s obviously from the ’50s because of what they’re wearing.” I’m like, “What is this? This kind of looks familiar.” I had a very familiar feeling about this photo. I was not born in the ’50s, even though I look it on most days. I was born in 1963.
But, anyway, so I took this home and I Googled who this was. I bought it and I didn’t care if it was famous or not. I just love the picture. And so what it was: it’s 1951 and it is a picture of two girls. They’re at the Old Town Art Fair in Old Town, Chicago. Yeah, and then I Googled the name and it’s a very famous–I ain’t gonna be on Roadhouse Antique show or whatever, that ain’t happening. But the photographer was Lee Balterman. So, I looked him up and I’m like “Look at that!” He was pretty famous in Chicago. So, anyway, that was just on my floor in our shot. And that’s the story about what the hell’s going on while I’m rolling around taking that away.
Jeff Sarris: And I feel like I need to note that my cat, Alpha, is on my lap right now. So just in case things look a little weird, and out of frame, it’s cause I have a kitty right here.
Jill Harris: Aww, a little ball of love. That’s what kittens are.
Jeff Sarris: Yeah, for sure. So, we are going to do another FAQ-type episode this week. And the question being: what foods cause flare-ups when you have kidney stones?
Can Kidney Stones Happen Overnight?
Jill Harris: So, again, you know, I’m not here to make friends. We know that. I’m going to say what I think. It doesn’t mean it’s right. I’m just saying what I think. So, I’ve had kidney stone patients definitely say to me, “When I eat boop, this happens. When I don’t drink enough, my kidneys hurt. When I eat too much of this, I feel it in my kidneys.” So people say that. I never disagree with that. Now, the question is what can flare kidney disease? So, not that I did this, but flare usually means you know, quickly. Poof! What’s gonna flare it up? What’s gonna bring it on? Like, if you eat too much tomato sauce. If my mother eats too much tomato sauce, she may have GERD that night. She’s not happy, okay? So that will bring it on, okay?
So I don’t think that anything brings on a kidney stone because you have to be doing something over time. People will go out to eat and they’ll be like, “Oh my God! What did I just do to myself?” Or they’ll have a sweet potato, “Oh my God, what did I just do to myself?” Stones don’t flare up. You’re not gonna get one. Just like you don’t flare up with weight gain. It may feel like it, but you don’t. You don’t gain a stone. You don’t gain 25 pounds overnight. You don’t do these things overnight. So, it’s a great question. And a lot of people do ask that, but nothing’s gonna flare up a stone because it’s over time–how we eat and drink over time will make a stone. Think months to a year, not a week, okay?
Now, what I began to say at the beginning of the video is this. Some people who have current stones–they’re just living their life and they know they have stones; they’re following the Kidney Stone Diet; they’re getting their fluids met; they’re living a healthy lifestyle; all foods within moderation, except spinach and almonds, but they have stones. Most of them will leave the Earth with the stones. And they don’t even grow when they follow the Kidney Stone Diet because they’re not getting bigger and they don’t move. So, they can leave the earth with them. It’s not a big deal. Of course, those stones can also leave at any time and then you know that happens.
But many patients have stones, they follow the Kidney Stone Diet, they get their fluids, all that, and they just have them. The good thing about having stones is, it keeps you compliant for the long haul, because you’re like, “Oh, my God, I haven’t had a lot of water in the last three days. I got those stones, I don’t want them to grow. Let’s make sure I get some water today.” Some people, though, will swear to God that if they have a little something, that’s going to bring on stone pain because they already have stones. A lot of people will say, “If I don’t hydrate, my kidneys tell me.” Is that true? Is that is that scientifically true that their kidneys hurt because they didn’t drink water? Or they had a raspberry? Or, or, or?
I don’t know. I don’t see any science that says that, but I do believe my patients. Not everything is written in gold. Not everything has been researched. First of all, it costs a lot of money to research, right? You have to know the researcher, know if they’re a good researcher, all kinds of stuff. But I do believe patients. I don’t think people make up pain, for the most part. There’s always somebody that has some emotional issues that could be making up stories. But in my experience, it’s rare. So, if somebody tells me that they’re feeling pain from an existing kidney stone, a lot of doctors will say, “That’s impossible. You can’t feel that.”
I beg to differ. I’ve heard too many people in 22 years tell me that they absolutely can feel stones, and they absolutely can feel their kidneys twinge or whatever, when they don’t drink enough water. So, I tend to believe my patients because why wouldn’t I? So there’s little variances of what the original question is. Is there food that will flare up kidney stones? No, it is what we do over time that will increase your risk to form new stones or make current stones grow. Does all that makes sense, Jeff?
Jeff Sarris: Yeah, absolutely! And I think with the flare-up, probably people are wondering, “Is there,” like you said, “something that will cause, like, pain because I have kidney stones?” But as you address–people do have sort of–there’s anecdotal evidence, but there isn’t anything really concrete that you can say. You can’t give, like, a list and be like, “Oh, X, Y, and Z are going to cause discomfort when you have kidney stones.”
Jill Harris: Right! And I have a lot of patients–so somebody could then throw back at me, “Oh, well, what are you gonna do? It’s all in their head because they know that they have stones, and they’re not drinking enough water. So they’re making up that pain.” Listen, most people are not in the business of making pain up. That’s number one. And number two, I am never going to doubt what another person says about what they’re feeling in their body just because I may not feel it in mine. So, I tend to really listen to my patients and I don’t poopoo anything they say because I’m not in your body. I can’t tell that, you know? So, I tend to believe people. Also, even if it was a little bit exaggerated–now, I’ll use me as an example, so I don’t get in trouble–because of my history with cancer and illness and all those things, sometimes I get a little bip of something I’m like, “Oh, hell no! Oh my god, I’m gonna have to call 911!” Because you have been sick before.
So, when you have had a history of being sick, any kind of bip that don’t feel good in your body, you may freak out a little bit because you know where that has led to you in the past. So it’s very scary. It’s not such a black and white issue. There’s many things going on. So, sometimes when I have a little something like you know, I wasn’t feeling very well yesterday. I had a fever, and I was like, “Okay, this is it.” I did my Hail Mary. “Hail Mary, full of grace….” You just think the worst, especially if you have had illness, whether that’s cancer, whether that’s kidney stones. No matter what it is, when you don’t feel right in your body, holy brigol, that’s scary.
So, I do not ever underestimate what a patient tells me or do I tell them that what they’re feeling is impossible. I absolutely don’t say that. But, at the same time, I say to myself when I start to go a little overboard because I get so afraid, I’m like, “Okay, sister. It’s a friggin’ fever. You need to take some Tylenol, and you need to come down. Oh, okay.” And I talk like that. Now, it really is to myself ’cause Luke ain’t here. So, now I really am a crazy old lady talking to herself.
And so I say to myself, “Okay, calm down. Pay attention. I’m not getting cancer because I have a fever.” You’re not getting a kidney stone because you ate one raspberry. You’re not getting a flare-up, most likely, out of any one food. But could you have a little feeling of something because you didn’t, you know, hydrate or something? If a patient tells me that I believe them. I just do. I mean, I’m not gonna argue that with somebody. I don’t have enough information since I’m not the one in their body. How could I know?
Jeff Sarris: Yeah, absolutely. And, again, how much water should someone be? How many fluids? should someone be consuming every day?
How Many Ounces of Fluid Should I Consume Per Day?
Jill Harris: Yeah, so on average, we want people–and I know people are annoyed when I say, “Okay, we care about the output, not so much the input.” “But, Jill, I want to know how much I need to drink in order to get that output.” The reason it’s not so clear-cut is because we all sweat, we all eat differently. You may eat a really high salt diet, so you’re going to need more fluids than me because you’re going to pee less. Whereas, I eat a really low-salt diet, so I drink and it comes right out of me because there’s not a lot of salt to hold it in. And I exaggerate, obviously, but if Jeff and I ate the same amount of–if he ate higher salt than I did, he’s probably gonna pee less than me.
So it makes a difference. Your diet, how much fruits and vegetables you eat. You may eat a lot of fruits and vegetables, then you’re going to pee more, too, because there’s fluid in your food. So, what we want you to do is pee 2 1/2 – 3 liters. Typically, 90 to 100 ounces produces that much, but you may be a small woman like me. I’m only five two, 120 pounds. So, you know, I may not need 100 ounces because I’m eating a high fruit and vegetable diet. That’s why that is always a little confusing to people. How do you know if you’re peeing enough? Because your urine pretty much looks like water coming out of you. That means you’re peeing enough. And if it doesn’t, drink up.
Jeff Sarris: Yeah. Actually, is there a sort of a–because we can tend to overdo things, of course, when we’re like, “Oh, we need more water?”–do you ever run into people who you need to sort of pull them back from too much?
Jill Harris: I mean, yes, I do, probably at least once a week. Common enough that at least once a week when I’m looking at their urine collection, I’m like, “Look, Betty, five liters of urine? You’re 4’11”? What the hell are you doing? How do you even have a life?” So, first of all, I ask the patient, “Is this real life, or is this you doing a urine collection? And you don’t want to catch whatfor from the doctor?” And, most of the time, they’re like, “Yeah, I just didn’t want to catch whatfor from the doctor. I don’t drink that much.” But then there are some people that are so anxious–not a judgement, a fact–about getting a new stone, that they are drinking so much water, now their blood sodium is really low, and they’ve got to be careful.
So I’ll tell patients, “You do not need to be peeing this much out. And I will tell them, “You’ve got to decrease your fluids.” Three liters? Great. Five liters? Absolutely not. It’s way too much. Now, of course, I never generically give out advice. I’m careful. I am a nurse. I don’t want to be liable for anything. If your doctor–which no doctor will tell somebody this, but I’m just saying–if your doctor said they want you to pee out five liters, then listen to them. That’s never been said, but I’m just, again, being careful because I have a nursing license. So, you do not need to be peeing out five liters of fluid. That’s much too much. I worry about patients like that for a few reasons: they’re not going to be able to do much in their life. They’re not going to eat a normal diet because they’re so full from drinking. And they may be losing all their electrolytes.
I mean it’s not good. So, you know, this is why we give precise goals because we know that people usually say “Well, she said this, so let’s do double.” Or, “She said go as low as this. so let’s go even lower.” There’s a reason for the goals were giving. Do not make them up by yourself. So, if we say 1500 milligrams of sodium, don’t go down to 300. I just had a patient today that said, “Well, I’m at 300.” “Well, what is the goal?” “Well, I know you say 1500, but I figured why not?” Well, that’s not enough sodium, you do need some sodium in your diet, okay? And then the other thing is when this patient, particularly, is lowering their sodium so much, they’re not eating enough and they’re underweight now.
So, there’s so much to this, and this is why we have so much misinformation about nutrition, why we have the obesity rate we do. There’s so much to this. It’s not as simple as people want to make it. And this is why we give all this free help out. Look, we could keep posting that on the kidneystonediet.com website, “Here’s the goals! Here are the goals!” But how are you going to make these goals? And, really, how do you flesh out each goal to incorporate it into your lifestyle? Because, guess what, Jeff and I work from home, we’re gonna have a different lifestyle than people who are going corporate every day, traveling back and forth, all the kinds of things that–office food all the time, which ain’t kale, it’s junk, especially this time of year in December.
So there’s a lot of things that we all have to navigate, some of us more or less than others. So it’s complicated, people. Getting your nutrition, getting a healthy lifestyle, and practicing that for the rest of your life, takes a minute to learn. And this is why Jeff and I and our other partner, Dave, give so much stuff out, so you can. If you can’t afford to work with me, there’s access to me and the things that Jeff and Dave and I do. The end.
Jeff Sarris: Yeah, and to get access directly to Jill, you can head over to kidneystonediet.com. And there is the Kidney Stone Prevention Course, but that includes the group calls, which that’s really the meat and potatoes of that. Like the course, you have all the knowledge we’re giving a lot–like we’re going through everything in the podcast here–so you can listen to episode after episode and get so much information, like the whole point is to give so much out for free. The beauty of the course, itself, is everything is there and you can access those videos whenever you want and then you have access to Jill in a group setting, where there’s other people who are sort of in the same boat with you. You’re all together discussing sort of where you’re at and Jill can help you along your journey.
Jill Harris: Jeff, those group calls–and I say this all the time, and for those of you who are in my group calls in the Kidney Stone Prevention Course, you know how much you mean to me–we have a ball. We laugh together, we cry together, we root each other on. It’s an accountability group for people because like I said–look, I don’t have to do that. I can give away those, you know, four hours worth of videos. You get them for a lifetime. You get to keep refreshing them. I could just give that out and sit back and spin around and go to the thrift store and look for more art and that’s what I could do. But I would not do that. I don’t do that.
Because there’s me telling you what the Kidney Stone Diet is and how you do it. Well, telling you what it is in the videos, but you come to the accountability calls–come and go as you please, they’re like office hours–and that is where you learn how. That is where you get the motivation to keep on trucking. That’s where you come and say, “Look, I’ve been doing so great. Now I’ve gained two more pounds.” A lot of people are in those group calls because they’re navigating weight loss as well. So those group calls, we are a tightknit community. We are family, dare I say. I think they would think that, too. We are family and we care about each other’s lives.
We care about keeping on even through the hard times. How do you do that? “Okay, I heard you said this, Jill, and now I got this. How am I going to navigate that?” Guys, the reason you’ve lost weight and gained it a million times is because you’re not learning how to make this your lifestyle. I could never in good conscience just give away those videos without coming to an accountability group and teaching you how to do it long-term for the long haul. That’s what this has to be about. Every disease should have that, some tele-visits the way we’re doing it here. Every disease should have it because it’s one thing to get a low, a high, or something’s out of whack. How are we going to fix it? How? And I’m going to be different than Jeff. Everyone’s different. So those accountability calls, that is worth everything.
Jeff Sarris: Yeah, and we haven’t talked about it in a while, but like you said every disease should have this type of service available. This is partially why you created all of this to begin with, from your experiences.
Jill Harris: Yes, because, again, you can give somebody a pamphlet in a friggin’ office, but then I think of things as a patient, as another human being. Actually, not of a patient. I’m not a nurse dealing with a patient. I’m a human dealing with another human that’s coming to me and saying, “Holy shit, I don’t know what to do. How am I supposed to do this?” And you sit down, and you talk to somebody. And more importantly, you listen to what their life is about, so then you can help them construct a diet that works for their life. You can’t tell them to do nothing that ain’t gonna work for them because then they can’t work the diet for the rest of their life. So, there has to be some kind of handholding here. There has to be in order to get it right. It can’t be: “This fixes everything.”
Again, this is why the Kidney Stone Diet is a set of goals. It does not tell you to get rid of a whole food group like carbs. That’s impossible, okay? For the two people it works for, God bless. Continue on. But for most people, it doesn’t. So, what we’re saying is here’s goals. Whether you’re a vegetarian, a vegan, a hoozy-boozy, whatever the hell you’re doing, fit it into these goals. If that’s the lifestyle that makes you happy, just fit it in these goals and you got it. Do you know how many vegans come to me and say, “Well, Jill, I thought I was the healthies this person I’ve ever met, and then I looked after making kidney stones–first of all, oxalate, who knew?–but second of all, as a vegan, I– vegetarians, too–I had no idea of the salt I was eating!”
Because a lot of vegetarians eat non-meat foods or, you know, the cheese and dairy substitutes, there’s so highly processed, there’s so much salt in those foods that they didn’t know. So until you look at the Kidney Stone Diet, which is the diet for anybody, forget about kidney stones. You want to lose weight? You want to lower your blood pressure?You want to get heart disease in check? All of these things are going to help. Low salt, low sugar; you’re gonna have to be eating healthier things. Get your portion size right. All of it! So, I get very passionate about this because people aren’t being done right, okay? We can’t just throw a pamphlet and say, “That’s it!” No, because there’s so much more to that. And you don’t know what you don’t know, okay? So, don’t get me started, Jeff, please don’t!
Jeff Sarris: No, but that was great because it is such a valuable service you have and just the resource–the site itself is such a valuable resource. You have everything to check those boxes of the things that people don’t know they don’t know. So, there is a free doctor’s visit document so you know the right questions to ask your doctor. And then you have the urine analysis, so you go through and help people understand the results of their urine collection. There’s so much there. If you’re dealing with with any of the things that we talk about on the show, definitely head over to kidneystonediet.com and check out everything that’s there.
And if you’re enjoying the show–if you’re watching on YouTube, we’d love if you subscribed, give us a little thumbs up, and leave a comment below because it really means a lot. It doesn’t cost anything. It just helps us reach more people and that helps us achieve our mission here, which is really just to help as many people as we possibly can reduce their risk for kidney stones. And yeah, if you have a question, we would love to hear from you. The number is 773-789-8763 and we will feature the question on a future episode. So, I think that’s about time to wrap up and I hate to wake him up, but I feel like I have to show little Alpha.
Jill Harris: Oh, yeah, you do! You have to show him! Come on, Alpha. Give him a big fat kiss!
Jeff Sarris: But, yeah, that’ll do it for this week and we will see you next time.
Jill Harris: Bye, guys!
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