Oxalate stones LONG
I had a long bout with these stones which required laser surgery on the stone (1.6 cm) and yes, that is the correct size of the stone. Which required OR for it getting stuck in my uretor so off to OR for stent placement, back to OR for Laser to break up and catch and remove what he could and then another OR visit to get the remainder of the stone. Stent in for 9 weeks. Don't know if anyone has ever had one of these stones or a stent but no fun, really !!!
Any way though I would pass on some information from Dr. K I received after my yearly labs which shows I am making more of the suckers. Yea me.........
Review of your lab results identified a Calcium Oxalate Crystals in your urine. We would like to make sure that you are taking your multivitamins, supplements and Calcium as recommended.
Information on Calcium, Oxalate and The Duodenal Switch Operation:What you should know...
Oxalate (water soluble) is a byproduct of vitamin C metabolism. Ordinarily the oxalate formed in the lumen of the bowel will bind to the Calcium that is also present in the lumen of the bowel and forms a crystal that cannot be absorbed thru the large bowel. These crystals are then excreted in the stool. A pre- op patient who forms Calcium oxalate kidney stone should avoid Vitamin C and increase Water intake.
Post-Op DS patient:
A DS patient has less fat absorption. As the fat enters the colon it changes to Fatty acid. The Calcium present in the lumen of the bowel is picked up by the Fatty acids and the complex of Calcium-Fatty acid is dumped into the stool and excreted. There-by limiting the amount of Calcium available for absorption to the serum to be used in maintaining bone structure, blood clotting, normal cardiac & skeletal muscle contraction, nerve function, & enzyme cofactor.
This leaves the Oxalate in the soluble forming the lumen that is absorbed from the lumen of the bowel and enters the blood and when in the circulation gets to the kidneys and forms the insoluble Calcium Oxalate crystals and stones.
Conclusion:
A post-op DS patient who has formed Calcium-Oxalate kidney stones in the past or has a Urine Analysis that shows high number of Calcium-Oxalate Crystals SHOULD increase the volume of fluid intake and NOT reduce the Calcium intake as a first measure.
Calcium restriction – NOT recommended because;
1) Cutting down on calcium increases the risk of stone formation - Most calcium in the diet remains in the gut where it binds to oxalate from food and the liver. The bound oxalate cannot be absorbed and is excreted. This means it never enters the bloodstream or the kidneys and never causes stones.
2) Calcium is an essential nutrient - A low calcium diet can lead to osteoporosis, a crippling bone disease. In some cases increased calcium intake may be in order.
3) Oxalate restriction Is Recommended – Oxalate is common in foods, and it is not difficult to consume a large amount of oxalate within an otherwise healthy diet. This can increase the risk of developing stones. Below is a list of common foods high in oxalate. Unfortunately there may be some of your favorites below.
Foods high in oxalate that should be avoided-limited: chocolate, tea - including herbal teas, raspberries, strawberries, soy sauce, baked beans, peanuts and pecans, beer, juices made from berries
Urinary oxalate may play an even more important role than urinary calcium in the process of stone formation because saturation of urine with calcium oxalate increases more rapidly with increases in oxalate concentration than increases in calcium concentration.
Low Calcium Oxalate (Kidney Stone) Diet Persons prone to forming calcium oxalate stones should cut back on: Apples, asparagus, beer, beets berries, (e.g., cranberries, strawberries), black pepper, broccoli, cheese, chocolate, cocoa, coffee, cola drinks, collards, figs, grapes, ice cream, milk, oranges, parsley, peanut butter, pineapples, spinach, Swiss chard, rhubarb, tea, turnips, vitamin C, yogurt.
More importantly should increase liquid intake (not beer!). Drinking Lemon Aide will help to reduce the risk of Kidney Stones.
Please note that the above outline description is not valid for patients who may have other reasons for forming kidney stones (tumors involving the breast, lung, thyroid or parathyroid glands, etc.) Also please remember that patients should consult their surgeon or primary care physician before making any changes to our daily vitamins, minerals (calcium) and supplements intake.
So, I have upped my Calcium to four times a day and cut back/out a lot of the foods. Vitamin C is gone because I switched to Proferrin ES so I don't need to take it with the iron. I used to live on yogurt, cheese, apples, oranges occasionally, heavy on the black pepper, tea, diet soda, milk, and cheese. I know it says avoid or limit, but if any of you have ever had kidney stones I think you would avoid too.
Any and all comments/suggestions will be helpful.
Thanks in advance,
Terry
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Terry
I am coming to the conclusion that I need a surgery that does not affect the absorption of nutrition, sticking to a "restrictive only" option. I am investigating VSG/Sleeve for this reason. I have already begun a calorie-restricted well balanced nutritional plan and can already feel that my urine is getting more acidic by the day. Don't know what will happen, but I have no choice but to go forward. I can deal with periodic stone surgeries okay, but I'm worried about long-term kidney damage.
