The roller coaster treatment for kidney stones

My husband has been treated for kidney stones many times over the last 50 years. No matter the method--and they have varied--it’s always a very painful business. One thing he’s never tried was the roller coaster treatment. But it works!

A doctor was inspired to study the roller coaster treatment after seeing multiple patients who had passed kidney stones after riding roller coasters at amusement parks. One patient passed kidney stones after each of three consecutive rides on the Big Thunder Mountain Railroad roller coaster at Disney World in Florida. (Apparently bungee jumping can have the same effect.)

To test the effect of a roller coaster, the scientists created a 3-D model of the ureter, bladder, and other appropriate parts and filled them with urine and kidney stones (calcium oxalate), then took the simulator off to Disney World and the Big Thunder Mountain roller coaster. (The journal article notes that “care was taken to protect and preserve the enjoyment of the other guests at the park.”) The stones were shaken loose! 

The scientists’ conclusion was that moderate-intensity, rattling coasters can be effective at dislodging little kidney stones (five millimeters or less in diameter) from the outer ducts of the kidney and propelling them toward the ureter (the tube that connects the bladder to the kidneys). “The idea is to displace these little stones before they become big stones and cause a lot of pain and suffering,” said David Wartinger, a professor emeritus at Michigan State University who was an author of the study.

More than 300,000 Americans seek emergency care for kidney stones a year, mostly because of severe pain from having a large kidney stone stuck in their ureter. By this time, it’s too late. You’ve got to ride the roller coaster prophylactically, that is, before you’re having the painful symptoms. If you’re a kidney stone sufferer, perhaps a yearly ride on a roller coaster would be just the thing. Shake those stones down before they get too big. Oh…and choose a seat in the back where it’s bumpier.

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A pharmacist responds to my blog post

My friend Donna passed along my blog post, “Pity the poor pharmacist,” to a retired pharmacist friend of hers. He was self-employed and never worked for a chain, but still found that his work could be stressful. Here’s his response (slightly edited):

“The pharmacy that I loved and trained for was not the same pharmacy I retired from 50 years later. I was very fortunate to have started as a delivery boy when I was 12 years old and continued working at the same pharmacy until I went away to UC at 19. During that time I learned a lot about pharmacy and pharmacists and had a fair idea what I could expect when I became one. The thing that I learned the most completely was that pharmacists are dealing with sick people. Most of them are nice and thankful for your help but some of them are real SOB’s and it is hard to tell if it is from their illness or if they were born that way. Either way, my job was to take care of them and this is where I got my satisfaction.

I have to admit that pharmacy has become harder and more stressful over time and less enjoyable. Most of these changes have come about not by pharmacists or other members of the health professions but by outsiders. The chain stores have their corporate chain of command responding to the shareholders who really don’t care about the individual pharmacist as long as he or she shows up for work and gets the job done.  

Most problems are caused by non-medical people controlling the money for third party payments. They were and probably still are a bunch of non-caring idiots placed in a position of power in a job they know nothing about. They caused me more grief in trying to get the medication to the patient but equally in my case being a store owner getting payment for prescriptions filled in a timely enough way that I wouldn’t go broke filling more prescriptions. I could write a whole book on the unfairness of their payment plans. They are the reason I would never go back into pharmacy. Not because I don’t like it; I love pharmacy, but the stress of not getting payments in a timely way so that I didn’t have to borrow money from the bank to pay the bills I had accrued filling prescriptions for their clients.  Now that is stressful!”

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.

Medicine in the wake of Kavanaugh

As a result of the Kavanaugh hearings, a primary care physician who practices in a women’s health group has been inundated with patients whose memories of abuse have been brought to the surface. “Stories of struggle and abuse, of trauma inflicted by people with power, have permeated my sessions with patients over the past couple of weeks,” she writes in the New England Journal of Medicine. “Today, it was my third patient of the morning: a woman with a history of childhood sexual abuse and an abusive marriage. She shared with me her distress, her escalating nightmares and flashbacks over the past week. She held out her left arm to me, where for the first time since her adolescence she had started cutting herself.”

The doctor says that her “…patients’ experiences reflect the prevalence of trauma in our country: more than one third of U.S. women have been the victim of contact sexual violence at some time in their lives.” She recognizes that health care services themselves, “with an inherent power differential between patient and physician” can also be re-traumatizing for survivors.

Sitting with these patients day after day has taken a toll on the doctor herself. “It can use up my emotional resources and leave not a lot of room for my family, friends, and community.” Doctors such as this one experience vicarious trauma, which she says can lead to compassion fatigue and burnout. Nevertheless, she is part of a movement to educate health care providers about the growing field of trauma-informed care which includes such principles as safety, peer support, empowerment, and trustworthiness. We are talking here of caring for patients whose past experiences may have left them unable to tolerate Pap smears. One example of trauma-informed care is simply asking the patient whether she prefers to have the door open or closed while waiting for the doctor.

Let's hope the medical profession is paying attention.

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.

Heart palpitations

For a year or so, I’d been having episodes wherein my heart would pound after I’d lie down—as on the couch or in yoga class. The pounding would stop after a few minutes. I’d have these episodes two or three times a week. I was mildly concerned about this, thinking that the old ticker was starting to go.

A few months ago, on the night before we were to leave on a road trip, I’d gone to sleep and was awakened with my heart pounding like never before. I waited for it to stop, but after an hour of pounding, I decided maybe this was something serious. I woke my husband and we went to the emergency room. By the time we got there, it had stopped. Nevertheless, I had an electrocardiogram (EKG)—the test that uses electrode patches on various places on your skin to test your heart rhythm, blood flow, and whatnot. The results showed that my heart was fine.  

I was told that my problem was heart palpitations. Heart palpitations! I thought that was what Victorian women had when overcome with emotions. Like the vapors. I asked the doc what the deal was. He said, “Oh, some people just have these.” Basically, it’s caused by surges in adrenaline that affect your heart’s electric impulses. You might get these from coffee, stress or panic attacks. But from lying down in yoga class? Lying on the couch to read? Waking me after I’ve gone to sleep?

Anyhow, on the one hand, I felt embarrassed at having gone to the emergency room for heart palpitations. On the other hand, now I know not to be concerned about these episodes—should I ever have more. Oddly, it’s been several months since my ER visit and I’ve not had another episode. Maybe the last one jiggered the reset button on my heart.

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.