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Comment by nrau | Hacker News Reader

I got my first and so far only (fingers crossed!) kidney stone five years ago. At that time I started drinking lemon juice with hot water to start each day before consuming anything else, and it has so far kept any recurrence of kidney stones away. I really do believe the lemon juice has been key for me in this regard, and it is in any case a very healthy thing to do daily anyways (known and practiced by other cultures around the world).

Most folks who have kidney stones get them again and again, and anything that can help prevent this very painful event is critical. For anyone who does unfortunately experience kidney stones I highly recommend you try this option.

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You're going to erode your teeth enamel like that. Hot water has nothing to do with it. Timing has nothing to do with it. Citrate and water increase; oxalate, protein, and cola decrease are generally important. Also, being endocrinologically stable is important.

See a urologist because they form silently again and again. Unless you have x-ray vision, it's impossible to know their status.

>You're going to erode your teeth enamel like that.

Honestly, this gets repeated a lot, but I've yet to see literature that shows this is true. It is true that you can show erosion under ridiculous conditions that don't mirror the real world like immersing loose teeth in acidic beverages for days. But I've yet to find evidence that drinking unsweetened acidic beverages like carbonated water or water with a little lemon juice has any meaningful impact on tooth decay. Over and over again the actual epidemiology shows an association between sugar / processed carbohydrates and tooth decay.

I've had a couple over the last few years. I've also started throwing lemon juice in my water bottle whenever I refill it. My urologist also suggested apple cider vinegar, I try to take a bit of that every day too (usually hot). It can help dissolve stones.

I personally don't find them particularly 'painful' more like profoundly uncomfortable. I find that I constantly am in a cycle of sitting for a few minutes then pacing around then maybe try and lay down, rinse repeat. A little heating pad time on my kidneys seems to make it less of a problem.

I’d say in your case your stones probably haven’t been that big. My stones were the worst experience of my life - only IV morphine helped. And even that made the pain just tolerable. Horrible!

I do identify with the constant uncomfortableness though.

I don't think size has much to do with it, or at least there is no deterministic correlation to pain. Mine, just removed, was only 3-4mm, but it caused immense pain. The pain was 11/10, such that I cried and vomited from the pain, and the pain pushed through toradol, hydrocodone, and oxycodone. The second hydrocodone IV juice I got was described as 10x more potent than morphine. On my second ER visit in just two days, I had to have a stent installed until the stone could be removed because my kidney was doing poorly. The stone still hadn't passed after a month.

The shape of the stone and size of the ureter have an effect as well. I think the main thing on pain is: is the stone blocking urine. If yes, then you will experience pain that you didn't think existed. And if things stay that way, you risk kidney failure, infection, and/or sepsis.

The insane-o pain comes not from the stone itself but from the stone causing urine to backup which causes the kidney to expand in its casing. I had more discomfort from the stent than I did pain from the stone while I had both, but the stent kept the insane-o pain and my kidney from failing since it kept urine flowing.

I literally cannot describe the pain I had when the stone first entered my ureter. It was existential pain, my back and abdomen muscles locked up and felt like they were dying and turning into stone, and the nausea was unbearable. The best analogy I can come up with is that it felt like someone was taking a screwdriver and stabbing me in the side all the way to my spine without it piercing, and then some, all the while having the worst stomach ache, immense pressure to void, etc. And I don't think that even gets to it.

That sounds horrible, something I don’t ever want to experience. I’m sorry you had to go through that, you’ve just convinced me to start including more lemon juice in my diet.

Yea, 0/10, would not recommend. Lol. Even dealing with the stent for four weeks was unpleasant. Everything's out now, and I'm so much better now. I think even just a lot water is supposed to help since it decreases concentrates.

Was your pain acute? I get a stone in my right kidney every 5 to 7 years. My pain is usually very acute. I like to describe it as somebody slamming a large needle into my abdomen. Think Uma Thurman in Pulp Fiction.

These days my regimen is to avoid caffeine. I don't know if it's working, I had a year long relapse during COVID as caffeine free coke became unavailable.

I'm due for my next one.

The pain was beyond acute. When it first occurred I was sitting on the couch. I went from being perfectly normal, to being slightly uncomfortable, to thinking I had a back or stomach cramp, to thinking I needed to use the restroom, to thinking I needed to go to urgent care, to knowing I needed to go to the emergency room all in about 5-10 minutes. But at times, the pain was so radiating that I thought my abdomen would explode. I honestly thought I would die any minute.

I've been caffeine free since 2020, stopping it due to severe anxiety during that whole debacle of a year. I have been dealing with acid reflux in the prior months, and I have a suspicion my stone was caused by low water intake and Tums. Hopefully the stone analysis correlates with that because it would be an easy fix. I'm certainly increasing my water intake now and staying completely away from Tums.

I hope to everything this is my only experience. It was my first stone, and I hope my last.

Sounds like me. I occasionally get heartburn and worry that the Tums are a contributing factor but they are the only thing that provides consistent and immediate relief.

Stay hydrated and good luck!

Ouch, I had my first one a few weeks ago, 4mm too and this hits home.

3 days before the acute crisis which led me, vomitting with pain, to the ER, the symptoms were weird and not easily attributable to a kidney stone: a few drops of pink urine at first, discomfort more than pain, mostly in the morning after peeing, then almost ok for the rest of the day.

The ct scan showed swelling of the kidney. When I finally ejected the stone (more like peeing black sand) 6 days later, I lost ~2kg over the next 24h.

The medicine that helped with the pain was ketoprofene (and antispasmodics) but 2 doses a day were clearly not enough to cover 24h :(

didn't know about lemon though...

I think when they saw them on the scan (they were very obvious) they said they were around 4-5mm.. I assume thats on the smallish side?

Though kidney stones are the most horrible experience of my life time (worse than being shot), you should take care of your bones as well.

Some studies linked high consumption of apple vinegar with early osteoporosis.

How much lemon juice? Like the juice of one whole lemon, or what?

Doesn't matter. Don't do this. Take citrate as a supplement.

Increasing citric acid intake does seem to be helpful, at least for calcium oxalate stones (one of the more command kinds).

I've had more than a few stones over the past couple decades, and when I finally got myself in to see a urologist, that was one of her primary recommendations.

That, along with some other treatment, seems to have helped considerably (only one non-trivial stone in the last ~12mo & the few others were barely noticeable).

I'm tempted to start taking a tablespoon or two of lemon juice in my morning orange juice - should be pleasant enough, as I like tart flavors anyway.

...maybe not that tart, though.

In fairness, I keep the stuff around mainly for cocktails, but if Kingsley Amis is any example, having one of those every morning will certainly cause me many more problems than it's at all likely to solve.

Why hot water specifically? That sounds like the worst kind of lemonade.

It's actually very nice and refreshing. I've done this too at times for unrelated reasons. It feels "healthy".

Think of it like a lemon tea. You can in fact get lemon flavoured tea (e.g. lemon and ginger).

In my experience, it isn't perceived as bitter/sour as it feels in cold water.

Hmm, I’ll go ahead and assume that consuming the lemon juice in a cocktail (e.g. a Sidecar) negates the benefits.

Do you think squeezing some lemon juice into, say, a morning tea, like maybe a Yerba Mate, would cover the requirement here?

Drink terere instead

Did you have the kidney stones removed the first time round?

Fortunately I passed the stone in about 5 days. That's the best possible outcome as painful as that can be. I started the lemon juice about 3 days into the event and I do think it helped already in making the stone a bit smaller and getting it out of my body.

I opted for surgery on my 2nd stone and it was a terrible mistake IMHO I should have tried to let it pass. The first was painful but not THAT bad. Worst experience I've ever had.

Now when I get a tinge of pain I immediately take Chanca Piedra and it seems to have helped for past few years, no reoccurrence, but could just be anecdotal & conicendental.

What procedure, and what was a mistake about it? I've had to have a 5mm stone removed endoscopically, and that didn't seem to do me any harm, although I was anesthetized for the procedure - if that's the difference, then say no more, as I'm sure it would have been fairly agonizing if I'd been aware of what was going on at the time.

FYI I replied about the particulars of the surgery here https://news.ycombinator.com/item?id=35036735 . I post this because I don't think you would get notified otherwise.

It was super painful!

> Worst experience I've ever had.

wait... did you... have a surgery without anesthesia or something??

They consider it a surgery, but it’s not unlike a colonoscopy where there is no investing, just instruments entering orifices.

I’ve had two ureteroscopies while awake without any kind of anesthetic. It’s likely the worst experience I’ve had another human inflict on me. You’re in a very vulnerable position, it’s very painful, and it induces the sensation of urinating uncontrollably.

After my first, the doc decided he might as well do a prostate exam as well. I went in not knowing either was going to happen. I was shaken for about a week afterwards.

s/investing/incision

Autocorrect!

> two ureteroscopies while awake without any kind of anesthetic. It’s likely the worst experience I’ve had another human inflict on me

well, that makes me feel good, because there were trace amounts of urine in my blood not long ago and they wanted to do one of those to me, but instead I got a second opinion and test done and the trace blood had disappeared, so hopefully I dodged that bullet. it sounds terrifying

FYI I replied about the particulars of the surgery here https://news.ycombinator.com/item?id=35036735 . I post this because I don't think you would get notified otherwise.

It was nothing like a colonoscopy!

Oh no, I was fully asleep. I remember nothing of the surgery.

The bad experience was after I woke up. The pain was excruciating. They had first tried to zap it with ultrasound but it didn't work. Then they went in and did some kind of scraping of the urethra. I know this because there was a descent amount of discharge that I can only describe as skin scrapings. It was insanely painful to pass each of these and I think it was that painful because it was passing them through the raw skin that was scraped off itself (within the urethra).

To alleviate the pain I was put on some kind of opioid pain meds for 2.5 weeks that had an insidious effect on my personality. During that time I was (without realizing it) a total unhinged ass it had a terrible effect on my working and personal relationships.

Beforehand I asked the Dr. do I need the surgery? He said "Well we don't really know. You haven't passed it yet (2 weeks) and the only way we can be absolutely sure is with with surgery." There was no real explanation about the tradeoffs of how painful scrapings etc would be.

After the fact, the cynic in me wondered, was this guy gaming the system by tipping the scales in favor of surgery (since he was the one to do the surgery in private US medical healthcare system). FYI It was a 4-5mm stone.

Is blowing them up using ultrasound not an option where you’re from? Surgery sounds horrible. Would have probably also opted for passing the stones if that was an alternative… Also the procedure is pretty sci-fi - https://www.hopkinsmedicine.org/health/treatment-tests-and-t...

I asked about this after I passed my first stone (went to my gp, they gave me flomax and a painkiller, the later of which I really only used to help me sleep, I didn't find the stone particularly 'painful' just very uncomfortable). My urologist said they really only use ultrasound for stones they consider large.

TIL - I must’ve had huge ones then .

Maybe smaller stones don’t show up on the scans and there’s a much larger risk of collateral damage.

Kidney stones are the worst things I’ve ever experienced in my life. I wouldn’t wish it on my worst enemy. Ugh.

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