Do I need annual urine collections?

The following is designed to entertain and inform, not provide medical advice. Always consult your doctor before starting a new 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. Summertime, summertime, loving the summer!

Oh, yeah. We hit the beach the other day, which was really fun. Amara and I did.

It's always, always nice to enjoy the Chicago summers. I don't know, I love them. I just love them.

I mean, Chicago summers, I mean, people are like, "Why do you still live in Chicago, Jill? The winters are terrible." But, man, we really enjoy the heck out of our summers here in Chicago because we know the days are limited. So, that's the one great thing about life.

You can have this, you know, maybe a bad period coming, but typically, when the good comes, you just so love it up extra because you know it's fleeting. That's what I love about life. It's just a mix of all of it.

And, you know, you would never appreciate the beach if we had it every day. I know that you, because you like warm weather, would be like, "Oh, no, girl, I would always appreciate it."

No, but you make a really good point. Like we're going to savor it more because we know that it's fleeting. But along the lines of just living life to the fullest, too, just whatever that means for each of us, those reminders help.

Like having the seasons here helps to be like, "Oh, no, this is— I only have so many more summers." Like it's just not to be morbid, but that's just how it is for all of us. We all have a different number ahead of us. We don't know the exact number, but yeah, trying to live as much as we can in the moment and being present and experiencing life is so important.

So, I think that's a really good point as far as, you know, if you look at your life, and I'll be 60 in October. And if you look at your life and you're like, realistically, active, like an active life, I probably have, you know, if I'm lucky, especially with all my cancer junk, but if I'm lucky, 20 summers left, right?

And again, I know people are like, "Oh, it's so depressing!" It's not! It's amazing that you get to really think about this if you take the opportunity to do it and think, with luck, I have 20 summers left. I've had 60 of them, right?

I've had 60 of them, and now I have 20 left. That's not a lot. And we all know that's going to go fast.

So, that doesn't depress me. And listener or viewer, I hope it doesn't depress you, either. It's just reality.

It's just reality and it's okay. And some of us will have a lot less cuz they're not going to be 60, they're going to be 85, right? So, maybe you have a couple summers left.

Maybe 10, you don't know. We don't know. You could be 20 and only have one summer left, you don't know.

And so, with that, I mean, Jeff and I talk about these kinds of things because you should sometimes pause and think about it because how do you want to spend your life? Are you in the job that you want to be? "Well, Jill, I got to pay the bills.

You just want me to quit my job?" No, I didn't say that. But are you spending most of your day with happiness? Are you feeling fulfilled or are you feeling drained?

So, Jeff and I like to talk about these things because I really don't know what else we would be thinking about. And like I said, I mean, we all have bills, you have a family to take care of, all of it. I'm just simply saying think about these kinds of things.

Think about them. Just think about it. It's grounding.

It helps you put your priorities in place, so you can get rid of the stupid things that you're focusing on that really are not going to matter to overall life happiness or fulfillment. And I think, Jeff, one of the reasons that we work for ourselves and, you know, we've worked really hard to get to this place in our lives where we can work for ourselves, it's always a risk to do that, people.

I mean, it's so risky. You don't know, so we've both been there. We understand that.

But if you work really hard, typically, you can figure it out and then, if you're lucky enough, make it work. And it's really amazing. But, you know, you have to stop and be reflective and think about things.

Are you happy? Are you fulfilled? What do you want that you're not getting?

It could be really simple things, right? More peace, more downtime. I'm often talking to people in the accountability calls, which is part of the Kidney Stone Prevention Course, about how long do you want to be a martyr?

How long do you want to say, " if I don't do it, nobody will." Or how long are you going to put your own health at risk in order to take care of everybody else? And by the way, I'll specifically tell this to women cuz women tend to be more like this, you know, if you don't take care of yourself, you are not emotionally equipped to take care of other people.

And also, pay attention to how you're taking care of them. I know if I don't take care of myself, I can't be there 100% for other people, and I'm just crabbier, bitchy, and not kind. And so doesn't it make more sense to be taking care of oneself so they can show up more for other people?

Meaning, not more, but in a better way, cuz what's the point of showing up for somebody when you're bitter and resentful? So, again, women specifically have a really hard time trying to carve some time out for themselves. And if they don't do it, they're not helping anybody like they think they are.

And the world is harder. So, I think women— and again, I know I'm being a little sexist here, but in my experience, women feel so guilty about finding me-myself time, and I really want to push back with that. You must find it.

You must find it so then you can show up in life a happier, more joyful you, more fulfilled, less resentful, not being a martyr anymore. This is really important. And the older we get, the more we see that.

But if I can get the younger people now to start recognizing that, they don't have to go through middle age just trying to figure it out. And, you know, by the time you're in a rocking chair, you're like, "Oh, now I get it." Yeah, I mean, no! Let's get on this kind of stuff now, right?

Yeah, absolutely, and it's fine to—

I don't know what we're talking about! I don't know. I don't know.

Well, I just wanted to say real quick about priorities, you mentioned, and like finding our priorities, not someone else's. That's so important to recognize that just because— again, we're not saying someone should quit their job, but are you in that job because you want to be there or maybe because parents or peers or something?

Like really figuring out what it is, what your priorities are that mean something to you and are going to give you the life you want to lead, your one life. You're the only one living this life. Everyone else has their own.

So it's like, so important.

Jeff, so important. Yeah, I mean, right. How many people— I'll talk to people on the phone, "Well, Jill, I like bologna sandwiches on Wonder Bread." Well, Frank, I don't know why, Frank.

"Well, because, Frank, what'd your mother pack you when you were little? Bologna sandwiches on Wonder Bread." So that's what Frank eats at 72 years old. We need to check ourselves.

Is that what you want to eat, Frank? "I don't even know what bologna is, Jill. What the hell is it?" I don't know, Frank, I have no idea, but you need to stop eating it.

It's too salty! "All right, let me think about something else." But what I'm saying, right, Jeff is 100% right. Are you living your best life or are you living your mother's best life, or your father's best life, or your husband's, what he expects you to do, or your wife's, what she expects you to do?

Are you living your life for yourself, first, and then you figure out everybody else? Because you can't be your best person unless you're coming from the best place possible. And again, days throw different things at you, folks.

I'm not saying life is grand every single day, of course it's not. But you should be building your own belief systems, your own values, and from that comes nothing but goodness. Honestly, it really does, right?

Yeah, and I hear someone saying, "Oh, but that's selfish. I don't want to be selfish." But a little bit of selfish is— oh, I think my camera's just going again. But a little bit—

I can see you.

So, a little bit of selfish actually can be powerful and a valuable thing. It doesn't sound good because we think selfish is a bad thing, and it can be. But also just recognizing the importance of taking care of oneself.

But actually before we go too far on this, should we go into the voicemail for this week, do you think?

Yes! Yes, let's go to the voicemail.

Because yeah, we could talk about this stuff forever.

Yeah, we could. Go ahead, let's go to the voicemail.

Hey, Jill. This is Pam from Ohio, and I have a question about following up long term with your urologist. In my case, I saw a urologist, not a nephrologist, but either way.

So, it's been four years, almost, since my one and only stone episode and my surgeries and what not. And initially, I had surgeries, I had an X-ray, I had a 24-hour urine, had another X-ray, 24-hour urine. This went on, right, for a little while.

I've had a total of three 24-hour urines. I recently, a few months ago, messaged my doctor in the portal to say, "Hey, can you order me another Litholink kit?" And, he wouldn't do it because I hadn't seen him in person in a certain amount of time. So, I haven't done it again, yet.

My question to you is: does this need to be a forever thing for everyone? And I know you might be hesitant to answer that, but I guess, you know, my question, I guess, is I don't want to identify for the rest of my life as, "Oh, I'm a stoner, so I need to forever and ever get an X-ray every single year and check my urine every single year." The anxiety that surrounds those events is high.

As you know, I'm sure you know with your cancer history, anytime you're going for testing, it creates a lot of anxiety, "What are they going to find?" And I just wonder if there's for someone like myself who the diet is just now how I eat, period, it's just my life, nothing's changed, do I need to continue doing that for the next 40 years?

Or does there come a point where you can stop? I don't know if I'm wording this. I'm going to erase this and start again.

Yeah, I mean, I think that was a great question.

It is a great question. I can see the camera, Jeff, or something, your lens, so I don't know if you can see that.

Yeah, so that won't be on this end when I reconnect this, but yeah, that's just you.

Okay. Okay. Let me talk to Pam.

Pam, it's a great question, and you worded it just fine. So, I'm going to make it a smaller question. Pam wants to know, "Jill, I don't want to have to think about getting kidney stones for the rest of my life.

I don't even want to think about identifying as a kidney stone former. Do I have to do these tests every year? And I asked the doctor for it, but he wants my butt in the office, and I don't want to deal with any of this." Makes sense.

She suffers anxiety from it. I get it. And she says, because I know Pam from the Facebook group, she's like, "I know you know, Sissy, because of your cancer scans." Every time I have to go in for some kind of checkup to check my cancer, you know, if I'm still in remission, I have a lot of anxiety about it, quite frankly.

Of course! You don't know if you're going to be rediagnosed yet again with another tumor. Did they find something?

And so, Pam's saying, you know, "I'd rather just put this out of my mind." Now, I know Pam well. And you could say, "Well, she's going to put it out of her mind. She's going to start eating all kinds of junk again." You don't know Pam.

You don't know Pam. Pam ain't going to eat no junk. So, recognize, folks, that I know who I'm talking to because Pam has been a Facebook member, a Kidney Stone Prevention Course person, I know Pam, okay?

So, I know Pam is not going to slip up on her diet or I'm pretty sure. Now, the gold standard of urine collections, when you are diagnosed with a kidney stone, the doctor should order you a 24-hour urine collection. Actually, the gold standard should be a two-day, a 48-hour urine collection, because you want to do a 48-hour urine collection and mimic a weekday versus a weekend or a working day versus a non-working day, so you can see the average of your diet.

Okay? Then you meet with the doctor and go over the 48-hour urine collection results. Hopefully, you met with me first, so you know how to facilitate that office visit.

The doctor will put you on a treatment plan. After that, the doctor should order, at the time of that visit, the doctor should say, "Okay, do your treatment plan and in six to eight weeks, I want you to do a 24-hour urine collection, a one-day test to see how that treatment plan is working for you, or do we need to tweak something?" If that follow-up urine collection comes back fine, then the patient is told, "See you in a year." Every year thereafter, gold standard, you do a 24-hour urine collection.

You may get another medical condition. You may start changing— not you, Pam, but one, you may start changing your diet. I've had this with a lot of patients.

"Jill, I haven't had no stone in 20 years." But then I got boo-boo, and then I started changing my diet and I didn't realize I was bringing back these high-oxalate foods and then I stopped getting calcium because, blah. You'd be surprised, folks. And so then they do make another stone.

Now, so the gold standard is you do yearly 24-hour urine collections. That's what gold standard is. But I also listen to my patients.

So, the doctor's saying, "You ain't getting nothing until you come and get an office visit with me. I'm not just going to order tests for the rest of my life for you. We got to talk, maybe he wants to do imaging." So, as a patient myself with imaging, every time we get imaging, you know, you get some radiation.

CTs nowadays are a lot less radiation than it used to be, but, you know, it's still something, right? So Pam is probably thinking, "I don't want to have to get X-rays every year if I don't need them, and I certainly don't want to get 24-hour urine collections if I don't need them." But how do you know you don't need them if you don't take them?

So, and she also doesn't want to identify as a stone former, which I totally understand. But you definitely don't want to get another stone. So, if something's going on, at least you're on top of it every year.

Now, you can talk to the doctor at the office visit and say, "Listen, if I'm not having symptoms, though, do I have to have the X-ray?" That's plausible, right? That's plausible. And now remember, and Pam was also very conscientious and she said, "Well, you may not want to answer this, because everybody might be a little bit different." Now, Pam, her history is she had one stone, I think it was four years ago.

So the doctor's like, "Whatever, it ain't that big of a deal," okay? As opposed to Cindy Sue, who has 25 stones a year. That doctor will be following up every year, I can assure you.

So, Pam, it's a complicated thing. She's not a chronic stone former. So her question is, "Can I actually not do this crap, Jill?

Cuz I'd rather not. It causes me anxiety." Every time I get a scan, I'm caused anxiety. I am re-traumatized by all the illness I've been through and I'm again, I'm not being dramatic.

There are days I'm like, "Damn, I've been through so much. It's been so much." And I really don't like thinking about it cuz it wears on me. It's been a lot.

And I have bowel issues to this day because I don't have a rectum, just a tiny bit left, I only have half a colon, so I'm not normal, like I can't just go out to eat and you know, I can't travel a lot cuz I'm always anxious about it. So, man, I understand. And I understand, we call it in the cancer world, "scanxiety." Every time we have to have a scan, because it brings back all this stuff.

And I don't think cancer is any different than kidney stones. Any illness will bring up trauma. And so we have to recognize that.

But how I look at it, Pam, is if I don't know, I think that would cause me more anxiety. And knowing you, dear friend, I think it might cause you a little bit more anxiety as well, not knowing and not being sure. So, I guess I would look at it like I look at my stuff.

Both options suck. I don't want to have to go in for another CT scan. I've had 50 of them.

You know, so many colonoscopies. I can't even tell you the testing I've had, the surgeries I've had, all the things I've had. So, it causes me just to go to my primary office visit every year, it causes me anxiety, just cuz it brings old stuff back.

So, I'm saying all that about me because I want you and everybody— Pam, I know you know, but I want the audience to understand, I understand where she's coming from, because I understand. But it doesn't stop me from getting my scans, because I'd be more anxious not knowing. So, you know, I fall under the umbrella as you should get your 24-hour urine collection every year, and I would say that to any stone former.

Now, and also, what I say, my advice would be, I also recognize everyone here is grown. And so you will make your own decisions. So, I'm not the end-all-be-all of what you should do.

I'm just giving you— I can't tell you how many times I've said to a healthcare professional, "What would you do?" "Well, I don't want to tell you what I would do, cuz I don't want to—" I tell people what I would do. I think it's helpful as a patient. I would get the 24-hour urine collection cuz even though it's nerve-wracking, not knowing, for me, is worse.

So, that's where I fall under it. So, but the ask, you're going to have to have an office visit, if that's what the man wants, you can ask, "Can I do it by Zoom?" He may want the X-ray. You could push back on the X-ray, Pam, and say, "You know, I do want the urine collection.

I'm a little nervous about getting the X-ray radiation or whatever. Do you really feel I need the X-ray? I'll come into the office and get the urine collection or can we do a Zoom call, but could I bypass the X-ray?" Maybe that, Pam.

Try that, see if that gets you anywhere.

Yeah, that's great. It's problem solving, finding the solution that'll fit best.

And that's what I do all day long with patients. It's not just a "here's the answer." We got to talk about each patient, because I know Pam and I know her history. This would be different and— well, it wouldn't be different advice, because I would tell anybody to get their annuals done.

But I will say this: I understand where Pam's coming from, because she's not a chronic stone former, she's very compliant with the diet, you know, the point is everybody needs to be heard and seen and listened to, because everybody's situation is a little bit different. And then, also, folks, we have the emotional side of being sick.

And that is something I'm always very interested in because I understand it. I have a lot of empathy for it. I really feel that deeply when my patients come to me and say, "This is what I'm emotionally going through.

I know it sounds silly." And I'm like, "No, it don't. I understand." And so, the bonding I get with my patients, I mean, it's one of my greatest gifts of this world. So, you know, that's one of the greatest things about me going through that sickness, all the things I've learned, but also the way I can bond with my patients.

I always did, cuz I'm a people person, but in a whole new way, with total empathy, not just sympathy, it's total empathy now, so I really get it. I just get it and it's very valuable to me. And I also, people are like, "Did we ask her any of this?

Shut up, people, I'm telling you anyway." So, even in my patient calls and with my students, I get the same support and love that they get from me. It's very it's a very equal relationship, and I love that, you know. It's very valuable to talk to people who understand also what you're going through.

It's a wonderful thing.

Yeah, absolutely, and being able to find the bright side in the cancer, in the stones, and everything, I think is a really valuable way to look at it.

Yeah. Yes, absolutely. All kinds of life lessons being sick.

I mean, that is the one, you know, I was talking I did some kind of Instagram or Tik-pic, whatever the hell I was doing, and I was talking about— I don't know about that second one. I don't know what I was doing! I was doing something and I was just like, you know, I just watched my son go to prom, and I didn't think that would ever happen for me cuz I had an 18% survival rate.

So, it's things like that when you get super sick, sickness teaches you to live more in the moment, and to appreciate all those, you know, "Oh, my kid's just going to prom" moments. I mean, of course, that's always special for every parent, but for a parent that thought she wasn't going to be here, well, it's over the moon exciting, right?

And it just keeps you in the moment and keeps you filled with, you know, thankfulness and gratitude. So, you know, it's the gift that keeps on giving if we can look at sickness in a different way, if we get over the hump once we get over all the hurdles of it and you let the dust settle and you start feeling better, then you're like, "Shit, man, I learned a lot of stuff from that." You know, it's amazing.

Yeah, absolutely. Well, yeah, I mean, thanks, Pam, for the question. I think that was a great one to be able to touch on.

And for everyone else who has a question out there, again, that number is 773-789-8763. And we haven't really talked about it, but this is a hard left turn, but we do have the Kidney Stone Diet Safe Smoothies ebook. We haven't really talked about that much.

I threw it up on the screen right now. That is I mean, all the photos are just so enticing, just in my opinion. I just I love everything you did, everything you put together, it's so beautiful.

Oh, thank you.

Yeah, and that ebook is available for purchase, but it also is included when you are a Kidney Stone Prevention Course member. So, whether you're already subscribed, have been subscribed, or want to now, you immediately get access to that right in your dashboard. Just kidneystonediet.com/dashboard, you'll see a little link there and you can click through and download, print, whatever you want to do, keep it on your phone, whatever works best for you.

But, yeah, I think that's just one more piece of the puzzle in figuring out how to how to live your best life with kidney stones and avoiding future ones.

Yeah, people love the I've made some kick-ass smoothies. That was a labor of love, that book, I will tell you. There's 25 Kidney Stone Diet-friendly smoothies and we categorize them as calcium-rich—there's lots of non-dairy choices, you don't have to use dairy—so, calcium-rich smoothies, calorie-conscious smoothies for people who don't want 300-calorie smoothies, and protein-packed smoothies.

So, an amazing variety, delicious, cuz I had to eat all of them, people. And believe me, I'd make one smoothie 27 times to get it perfectly. So, they're really good and very nutritious and yeah, that was a labor of love and they are beautiful.

Smoothies are easy to make beautiful because it's so colorful, right? So, it was a lot of fun doing that. And right now with the course being on sale as of this airing, it's $40 off, plus now you're getting 10 bucks cuz the smoothie book is $9.95, so it's $50 off on the Kidney Stone Prevention Course, people.

I'm giving that away. Jeff and I are giving that course away right now. So it's a little harder times post-COVID.

We know people are struggling, so, but we will take it off soon enough, so take advantage of that right now. And if you had the course prior, 10 years 5 years ago, 3 years ago, well, less than 5 years ago, you'll get it's in your dashboard. We gave it to everybody who's ever taken the course, cuz that's how we roll here at kidneystonediet.com, people.

So, anybody who's ever taken the course, you don't have to re-buy it, obviously. It's in your member dashboard for free, so please enjoy it. Lots of great recipes, super delicious smoothies, I enjoyed them, I'll tell you that.

Yeah, so if you haven't been back to the website in a while, definitely head to kidneystonediet.com, log in, check out your dashboard, and you'll see everything. Also, meal plans, there's the snacks ebook, not to dive into that as well, but yeah, we've just we're trying to give you as much as we possibly can to help you along your journey, whether that's through the email newsletter, the podcast, all of the freebies that are there that can help you each and every day.

Yep. And one more thing, we're trying to get 10,000 subscribers, so if you could press that red button, that would be really awesome, because we're slowly getting there, but we really— it's just one click, people, it doesn't do anything for you, but it gets us higher rankings on YouTube so people can find us more and YouTube will show our video so people can get free information on kidney stone prevention.

So, please check the red box, and if you do, that says subscribe, please write in the comments so I can thank you personally for doing that for us. We would appreciate it.

So, thanks again, and we will see you all next time.

Thanks, Pam!

Bye.

Bye. Bye-bye.