ASK THE DOCTOR: Leave kidney stones alone
By Dr. JIM MITTERANDO
For The Patriot Ledger

Q. I have two 1-centimeter kidney stones in my left kidney. My doctor wants to put in a stent and then break them up with lithotripsy (ultrasound waves). I have read horror stories about the stent pain. Why can't I wait until I have symptoms of a problem before I go through a month of pain? The only signs of a problem are blood cells in the urine.

A. If you are not having any pain and those stones are not obstructing the kidney then you might not need to treat them. In other words, ‘‘don't fix it, unless it's broken.'' These large kidney stones are often incidentally found on an X-ray or ultrasound in people without any symptoms.

Your doctor may want to break up the stones if you have had painful stones in the past and are worried about these stones causing an obstruction. You can ask your doctor what is the chance that the stones will remain in place versus moving and causing symptoms. You can also get a second opinion from another urologist or advice from a nephrologist (kidney specialist) who is a medical doctor and not a surgeon. Certainly, this not an emergency since you are not having symptoms and you have normal kidney function so take you time in reaching a decision.

Q. My husband and I have had bad nocturnal leg cramps for two nights. Normally, we don't have such problems. We have had some work done on the house due to moisture problems and some resulting painting. Can these cause leg cramps?

A. I cannot think of any environmental causes of legs cramps or any common problem that would cause you both to have night leg cramps at the same time other than, possibly, stress or recent physical exertion. Make sure you stretch at night and that you are also well hydrated.

Q. I recently had a MRI of my elbow. It was uncomfortable and painful. I could not tolerate it and stay still. They could not get a good picture and I will have to come back for another one. What can I do?

A. MRIs can be stressful and claustrophobic. They do not cause pain. If you are claustrophobic, you can ask your doctor to take a mild sedative like valium one hour before the procedure, which will make it a lot easier to tolerate and stay still. Someone will have to drive you to and from the MRI since you cannot drive that after taking a sedative. If you have a painful condition or injury, you may consider taking pain medication before the MRI. For people with severe claustrophobia, there are also ‘‘open'' MRIs that are not fully enclosed.

Dr. Jim Mitterando is a family doctor at Cohasset Family Practice and a staff member at South Shore Hospital in Weymouth.

Readers should send questions to: Ask the Doctor, The Patriot Ledger, P.O. Box 699159, Quincy, MA 02269-9159, or by E-mail to his attention at features@ledger.com.Questions of general interest will be answered in this column. The information in this column is not intended to diagnose individual conditions, and individual replies are not possible. Readers should see their own doctors about specific problems.

Copyright 2005 The Patriot Ledger
Transmitted Tuesday, July 05, 2005