Leave No Stone Unturned – Understanding Kidney Stones

Senior man with bad back

Are you one in 11? About one in every 11 people in the United States will get a kidney stone in their lifetime – and if you are male, obese or have diabetes, the chances are even higher.

Kidney stones are hard collections of salt and minerals that form inside the kidney and can travel to other parts of the urinary tract. Stones vary in size and form when too much of certain minerals accumulate in your urine. When you aren’t well-hydrated, your urine becomes more concentrated with higher levels of certain minerals, making it more likely a kidney stone will form.

Unfortunately, kidney stones are typically very painful. Most stones will pass on their own, but some require a procedure to break up or remove stones.

Signs and symptoms of kidney stones:

  • Pain in the back, belly or side
  • Pain or burning during urination
  • Urgent need to go to the bathroom
  • Blood in the urine
  • Cloudy or smelly urine
  • Going a small amount at a time
  • Nausea and vomiting
  • Fever and chills

Prevent kidney stones

  • Dehydration increases the risk of kidney stones. Be sure to drink lots of water, especially when engaging in exercise or activities that cause a lot of sweating.
  • Reduce the amount of sodium in your diet, including processed foods, canned soup, canned vegetables, lunch meat and condiments.
  • Eat calcium-rich foods, such as low-fat milk, low-fat cheese or low-fat yogurt.
  • Talk to your doctor to better understand your risk for kidney stones and what you can do to prevent them.

Struggling with kidney stones? A urologist specializes in diseases of the male and female urinary tracts, which includes the kidneys. Find a St. Joe’s urologist to discuss ways to reduce your risk for kidney stones or treat an existing stone or concern.

Citrus and Beet Salad

Serves 2

Ingredients

  • Mixed greens
  • 1 grapefruit
  • 2 oranges
  • 1-2 medium beets, peeled and roasted
  • 1 tablespoon orange zest
  • 2 tablespoons orange juice
  • 2 tablespoons olive oil
  • ¼ cup white wine vinegar

Directions

  1. Wash and lay out all ingredients.
  2. Begin by peeling citrus fruits and removing all the white pith. Slice fruit into round ½ inch thick pieces. Arrange flat on plate.
  3. Next slice roasted and peeled beets into ½ inch think circles and arrange on top of fruit.
  4. Top with mixed greens to add color.
  5. Mix zest, juice, vinegar, and oil to combine for a dressing. Drizzle on fruit and beets and serve.

Ready to take the next step?

Our Lifestyle Medicine team is here to support you on your journey to better health. Connect with one of our Board-Certified Lifestyle Medicine Specialists today.

Marinated Mushrooms and Beans

Serves 2

Ingredients

  • 1 carton of cremini mushrooms
  • 1 can butter beans, rinsed
  • ½ bunch parsley, chopped
  • 2-4 sprigs fresh rosemary
  • 2 roasted red peppers
  • ½ red onion
  • Salt and pepper to taste
  • 2 tablespoons olive oil
  • ¼ cup white whine vinegar

Directions

  1. Wash and lay out all ingredients.
  2. Rinse and drain beans and add to a bowl.
  3. Dice onion and red peppers and add to mix.
  4. Mince herbs and garlic and add with salt and pepper.
  5. Finally quarter mushrooms and add to bowl and combine.
  6. Top with oil and vinegar and let sit for 1 hour or more.
  7. Serve with whole grain bread or store for up to one week.

Ready to take the next step?

Our Lifestyle Medicine team is here to support you on your journey to better health. Connect with one of our Board-Certified Lifestyle Medicine Specialists today.

Kids and the COVID-19 Vaccine: What Parents Should Know

Pfizer Vaccine Approved for Children Ages 5-11

The COVID-19 vaccine is now available to children ages 5 to 11, however, supplies and availability are extremely limited at this time.  More information will be coming soon on how parents can schedule their child’s COVID-19 vaccine through IHA. 

On November 2, the Pfizer COVID-19 vaccine was authorized for emergency use for children ages 5-11. It is a 2-dose series taken three weeks apart. Each dose will be 1/3 the dosage of the adolescent/adult vaccine.  

St. Joe’s has been vaccinating children ages 12 and up since May of 2021, and we have confidence that the Pfizer COVID-19 vaccine is safe and effective for our patients. As of October 2021, more than 11.1 million adolescents have been vaccinated against COVID-19 with the Pfizer COVID-19 vaccine nationwide.

Here’s what you should know about the vaccine, the possible of side effects, and the benefits of getting your child vaccinated.

+ It is 90-100% effective in clinical trials
+ There were no severe cases of COVID-19 in clinical trials
+ The vaccine works against Delta and other known variants.

Frequently Asked Questions

Should I worry the vaccine is too “new”? No.
As of October 2021, more than 6.63 billion doses of the COVID-19 vaccine have been given worldwide, with more than 416 million doses in the United States. For adolescents alone, over 11 million doses of COVID-19 vaccine tell us that this vaccine is no longer “new.” Scientists and pediatricians feel confident in the safety of the COVID-19 vaccine. Waiting puts you at higher risk for infection and illness.

The vaccine got to us fast due to: 

The vaccine research for mRNA started in 1961 and, in the last decade specifically, was focused on SARS.

  • mRNA research started in 1961 and, in the last decade specifically, was focused on SARS.
  • The vaccine was released more quickly thank other vaccines because the production started before the clinical trials. This was due to the urgency of the pandemic, which provide funding and resources to speed development.
  • Due to high disease rates in our communities during vaccine development, we didn’t have to wait for a minimum number of cases for clinical trials.

Will we need booster shots every year? We don’t know yet.
It depends on how many people get vaccinated and if the virus continues to spread and change. As the population becomes vaccinated, we reduce the spread of the virus, which helps to prevent it from continuing to change. We won’t need boosters if we are reducing and eliminating variants of COVID-19.

Does it affect puberty or fertility? No.

Based on our knowledge of mRNA, we are confident that the COVID-19 vaccine will not have long-term effects on puberty or fertility. mRNA cannot integrate with DNA or alter cells. 

  • Vaccine ingredients are cleared from the body quickly. mRNA is fragile and breaks down within 72 hours after injection. Ingredients do not linger in the body. 
  • Thousands upon thousands have gotten pregnant after receiving the COVID-19 vaccine. 
  • mRNA vaccine is not made up of COVID-19. It is only the protein. 
  • There are reports of menstrual cycle changes after the COVID-19 vaccine. This is due to the body mounting an immune response and a temporary side effect, like a fever. 

What are the most common side effects for kids? They can vary but are minimal.

  • Side effects that have been reported are mild to moderate such as fever, fatigue, headache, chills, diarrhea, or muscle aches.
  • More kids reported side effects with the second dose compared to the first dose.
  • Rare side effects can happen, such as swollen lymph nodes or skin sensitivity, but these are not long-term and resolved in most cases in a few days. 

How do we know about long term side effects? Decades of research.

Based on our knowledge of mRNA and the human body, we don’t expect long-term side effects since it breaks down in the body in 72 hours.  

  • As will all vaccines, including the COVID-19 mRNA vaccines, concerning side effects have all occurred within 6-8 weeks after injection. Vaccine development is based on decades of research. Scientists have done a rigorous review of all available data before approving for children. Our history of science tells us that if there are no side effects in those first few weeks, we are confident that concerns that arise with any patient decades later are unlikely to be related to any vaccine.  
  • mRNA cannot be converted to or inserted into DNA. It’s not scientifically possible. 

How common is Myocarditis for children after vaccination? Extremely rare.

​​​​​​Myocarditis means “inflammation of the heart muscle. This can happen due to the robust immune response the vaccine can have on your body.

  • It is very rare. We expect 26 cases of myocarditis per 1 million doses given. That’s 0.0026%.
  • Symptom of myocarditis is most commonly chest pain or difficulty breathing and usually happens within the first week after injection. 
  • Adolescents who have had this rare side effect are monitored closely. Most make a full recovery in 3-4 weeks by using anti-inflammatory medications like ibuprofen.
  • No kids have died of myocarditis after the COVID-19 vaccine.
  • Myocarditis can also happen if you get the actual COVID-19 virus. In those cases, unfortunately, the myocarditis is more common, more severe, and last long-term.

My child had COVID. Do they need the vaccine? Yes.

  • We know that “natural immunity” can be high at first. However, protection can drop off quickly or change based on circulating variants.
  • Getting a vaccine, even for those who have already had COVID-19, strengthens your immune response.
  • If you had COVID-19 once, it is possible to get a different strain again. The immune response after infection is not as focused. Evidence shows the vaccines protect you longer and for all the variants to date.
  • Most importantly, the vaccine gives protection and prevents hospitalization for several of the COVID variants. 
  • Your child can get the COVID-19 vaccine once they are out of quarantine. There is no “waiting period,” as another strain may come, and the vaccine will protect from getting hospitalized. 

Can kids become very sick with COVID? Yes.

COVID-19 disease in kids can range from no symptoms to severe illness. 

  • As of October 2021, over 6.3 million COVID-19 pediatric cases have been reported.
  • Only 43% of kids under 12 have natural immunity.
  • 30% of hospitalizations for kids with COVID-19 hadno underlying medical conditionsAs of October 2021, there were 5,217 MIS-C cases linked to COVID-19 in kids. This multi-organ system effect makes children extremely ill and requires hospitalization, often in the ICU. 
  • Long COVID, or lingering COVID-19 symptoms, can lead to learning problems, heart problems, exercise fatigue with sports, and respiratory issues. This has been reported in about 8% of children who have had COVID-19. 
  • Since the pandemic began, over 600 pediatric deaths due to COVID-19 have been reported. It is now a top 10 cause of death for kids in the United States. 

What are the ingredients? Put simply, it’s fat, salt, electrolytes and sugar.  

  • Lipids: This “fatty layer” protects the delicate mRNA so it has time to work before getting chopped up. Polyethylene glycol (PEG), the most famous lipid, is also the main ingredient in MiraLAX (which you know about if your child has ever been constipated).
  • Potassium chloride, monobasic potassium phosphate, sodium chloride, and dibasic sodium phosphate dihydrate and sucrose: These fancy names are just salt, some electrolytes, and sugar. These ingredients help keep the vaccine stable and are natural preservatives.

Is there less quarantine from school, sports, or activities if vaccinated? Yes.

  • This pandemic has been traumatizing, especially for children. Their lives were abruptly disrupted in March 2020, and their mental and physical health has suffered. Anxiety and depression rates are up. 
  • Based on the State of Michigan’s current guidelines, students who are vaccinated and exposed to COVID-19 can remain in school and wear a mask.  
  • We know that less quarantining will only benefit all children.

From Numbness and Pain to Relief

It started with numbness in his hands and feet and then progressed to lower back pressure. It was April of 2021 and Derik, 37, was already receiving treatment for the numbness but needed a solution for the constant back pain.  A resident of Waterford, MI, Derik reached out to the Spine Nurse Navigator at St. Joe’s Oakland for help. Nurse Navigator Larissa scheduled Derik for an appointment with board-certified neurosurgeon, Dr. Todd Francis.

Dr. Francis ordered an MRI of Derik’s spine which helped to diagnose mild to moderate cervical spine stenosis. His medical recommendation was surgery to improve the numbness and back pressure. In May, Derik had an anterior cervical discectomy and fusion. The surgery was successful, and Derik was discharged the following day. By July, Derik was feeling very well and was pleased with the outcome of the surgery. He’s seen significant improvement in his walking and stability.

“Recovery is going great and I’m happy with my results. The numbness in my hands has improved. I was impressed with the speedy process and enjoyed connecting with my nurse navigator the whole time.”

Derik, 37, Back Pain Patient

St. Joe’s Spine Program is comprised of a multidisciplinary team of physicians and clinicians whose goal is to help patients return to normal function by providing both non-surgical and surgical solutions to simple and complex spine conditions. Our spine surgeons, physical medicine doctors, and pain specialists work together to find the best solution for your back and neck pain. Our Spine Nurse Navigators are here to help guide you through the process from beginning to end.

Ready to take the next step in back health?

Connect with one of our Spine Nurse Navigators today to discuss your spine and neck pain treatment options.

Exercises to Improve Posture and Reduce Pain

Back or neck pain can be debilitating and interfere with your quality of life.  Here are seven exercises to improve your standing posture and reduce pain:

  1. Walk three to five times per week for 15-60 minutes.
  2. Act like there is a string pulling the top of your head up, making you as tall as possible.
  3. Maintain a good forward curvature in your lower back.
  4. Find your lumbar neutral position by moving through flattening and arching your back and try to find the midpoint of the motion. Finding this midway position should decrease your pain in standing.
  5. Use a small box to put one foot up on and then switch every 5-10 minutes.
  6. Wear supportive and well-cushioned shoes or boots.
  7. Shift your weight from one foot to the other frequently.

Ready to take the next step?

Connect with one of our Spine Nurse Navigators today to discuss your spine and neck pain options.

Wild Rice and Lentil Stuffed Acorn Squash

Serves 2

Ingredients

  • 1.5 cups of a wild rice and brown rice blend
  • 1 carton of cremini mushrooms
  • 3 cups vegetable broth
  • 2 tablespoons soy sauce  
  • 3 cloves of garlic
  • 1 yellow onion
  • 3 medium celery stalks
  • 2 bell peppers
  • 1 cup brown lentils
  • 1 acorn squash
  • 2 tablespoons olive oil
  • Salt to taste

Directions

  1. Begin by washing all ingredients. Preheat oven to 375 degrees.  
  2. Slice the acorn squash in half and remove seeds. Brush the acorn squash with olive oil to coat.
  3. Add a pinch of salt and pepper to the squash and place face up on a baking tray. Bake at 375 degrees for 30-40 minutes.
  4. Mice garlic and dice onion. Set aside and let sit for 15 minutes.
  5. Dice celery and peppers and slice mushrooms. Set aside.
  6. Rinse rice and lentils. Set aside.
  7. In a slow cooker, large stock pot, or Instant Pot, add garlic, onion, celery, peppers, mushrooms, rice and lentils. Add in remaining seasonings. Mix well and cook for 2 hours (slow cooker), 1 hour (large stock pot), or 30 minutes (Instant Pot) respectively.
  8. When the acorn squash is fork tender and rice is cooked through, plate by filling the center of the squash with ¾ cup of the rice and vegetable mixture.

Ready to take the next step?

Our Lifestyle Medicine team is here to support you on your journey to better health. Connect with one of our Board-Certified Lifestyle Medicine Specialists today.

Tailgating Recipes

Fresh Corn & Avocado Dip

I alter my sister’s dip recipe by adding finely chopped jalapeno for a little heat. It’s a different way of serving corn as a dip that can be made ahead of time and refrigerated until serving. — Pat Roberts, Thornton, Ontario

Total: 20 min.

Yield:4 cups

Ingredients

2 cups fresh or frozen corn, thawed

1 medium ripe avocado, peeled and diced

1 small peach, peeled and chopped

1 small sweet red pepper, chopped

1 small red onion, chopped

2 tablespoons olive oil

2 tablespoons white wine vinegar

1 tablespoon lime juice

1-1/2 teaspoons ground cumin

1 teaspoon minced fresh oregano

1 garlic clove, crushed

Salt and pepper to taste

1 minced and seeded jalapeno pepper, optional

baked tortilla chips

Directions

1.Combine first 11 ingredients; add salt and pepper and, if desired, jalapeno. Serve with tortilla chips.

Nutrition Facts

1/4 cup (calculated without chips): 52 calories, 3g fat (0 saturated fat), 0 cholesterol,

4mg sodium, 6g carbohydrate (2g sugars, 1g fiber), 1g protein. Diabetic Exchanges: 1/2 starch, 1/2 fat.

Slow-Cooker Buffalo Chicken Dip

This healthy copycat recipe for classic Buffalo dip cooks in your slow cooker for an easy, hands-off appetizer you can keep warm for the whole game, party or any casual gathering. Serve with carrot sticks, celery sticks and tortilla chips for dipping.Carolyn Casner

Active: 15 mins

Total: 3 hrs 15 mins

Servings: 16

Ingredients

1 cup low-sodium chicken broth

1 large onion, chopped

1 large jalapeño pepper, finely chopped

1 pound boneless, skinless chicken breasts, trimmed

8 ounces reduced-fat cream cheese

1/4 cup crumbled blue cheese, plus more for garnish

3 tablespoons hot sauce, preferably Frank’s RedHot

Sliced scallions for garnish

Directions

Combine broth, onion and jalapeño in a 4- to 5-quart slow cooker. Place chicken on top. Cover and cook on High for 2 1/2 hours. Transfer the chicken to a plate and shred with 2 forks. Cover to keep warm.

Nutrition Facts

Serving Size: 1/4 Cup Each Per Serving: 86 calories; protein 8.6g; carbohydrates 2.2g; dietary fiber 0.2g; sugars 1g; fat 4.7g; saturated fat 2.4g; cholesterol 32.8mg; vitamin a iu 212.9IU; vitamin c 1.8mg; folate 7.3mcg; calcium 32.4mg; iron 0.2mg; magnesium 11.1mg; potassium 155.5mg; sodium 183.7mg. Exchanges: 1 Fat, 1 Lean Protein

https://www.eatingwell.com/recipe/256971/slow-cooker-buffalo-chicken-dip/

Sweet Potato Skins with Guacamole

Top crispy sweet potato skins with guacamole for a healthy take on classic potato skins in this easy crowd-pleasing recipe. — Devon O’Brien

Active: 25 mins

Total: 2 hrs

Servings: 8

Ingredients Potato Skins

4 small sweet potatoes

1 tablespoon extra-virgin olive oil

1/8 teaspoon kosher salt

1/2 cup shredded Cheddar cheese

Ingredients Guacamole & Toppings

1 ripe avocado

1 tablespoon lime juice

1 clove garlic, minced

1/8 teaspoon salt

1/4 cup chopped tomato

2 tablespoons minced red onion

chopped cilantro for garnish

Directions

Step 1 Preheat oven to 400 degrees F.

Step 2 Tightly wrap sweet potatoes in foil and place on a baking sheet. Roast until very tender, 50 minutes to 1 hour. Carefully unwrap and set aside to cool.

Step 3 Line a baking sheet with parchment paper.

Step 4 Cut the potatoes in half lengthwise and scoop out the flesh, leaving a 1/4-inch border (save the scooped-out flesh for another use). Place the sweet potato halves skin-side up on the prepared baking sheet. Brush with oil and sprinkle with kosher salt. Bake until browned and crisp, 20 to 30 minutes.

Step 5 Cut each skin in half widthwise and return to the baking sheet, skin-side down. Sprinkle each with 1 tablespoon Cheddar. Return to the oven and bake until the cheese is melted, 8 to 10 minutes.

Step 6 Meanwhile, make the guacamole: Mash avocado in a medium bowl. Stir in lime juice, garlic and salt.

Step 7 Top each sweet potato skin with guacamole, tomato, onion and cilantro, if desired.

Nutrition Facts

Serving Size: 2 Potato Skins Each Per Serving: 117 calories; protein 3g; carbohydrates 9.7g; dietary fiber 2.9g; sugars 2.6g;fat 7.9g; saturated fat 2.2g; cholesterol 7.2mg; vitamin a iu6369.8IU; vitamin c 10.5mg; folate 25.6mcg; calcium 65.1mg;iron 0.4mg; magnesium 19mg; potassium 301.5mg; sodium113.2mg; thiamin 0.1mg. Exchanges: 1 Fat, 1/2 High-Fat Protein, 1/2 Starch

https://www.eatingwell.com/recipe/256970/sweet-potato-skins-with-guacamole/?printview

Ginger Chicken Kabobs

Active: 25 mins

Total: 2 hrs 35 mins

Servings: 4

Ingredients

1 pound skinless, boneless chicken breast halves, cut into 1-inch pieces

2 tablespoons finely snipped fresh cilantro

1 tablespoon grated fresh ginger

2 cloves garlic, minced

1 fresh serrano pepper, seeded and finely chopped

1 teaspoon cooking oil

1/2 teaspoon ground coriander

1/2 teaspoon ground cumin

1/4 teaspoon salt

1/4 teaspoon garam masala (Optional)

1/8 teaspoon ground nutmeg

1 cup fresh pineapple cubes

1/2 medium red sweet pepper, cut into 1-inch pieces

1/2 medium green sweet pepper, cut into 1-inch pieces

Directions

Step 1 Place chicken in a large resealable plastic bag set in a shallow dish. Add cilantro, ginger, garlic, serrano pepper, oil, coriander, cumin, salt, garam masala (if desired) and nutmeg to bag. Seal bag. Turn and press bag to coat chicken. Chill for at least 2 hours or up to 6 hours.

Step 2 On eight 10- to 12-inch skewers, alternately thread the chicken, pineapple, red sweet pepper, and green sweet pepper, leaving a 1/4-inch space between pieces.

Step 3 Place kabobs on the rack of an uncovered grill directly over medium coals. Grill for 8 to 12 minutes or until chicken is no longer pink, turning occasionally to brown evenly.

Tips Handling Chile Peppers

Because chile peppers contain volatile oils that can burn your skin and eyes, avoid direct contact with them as much as possible. When working with chile peppers, wear plastic or rubber gloves. If your bare hands do touch the peppers, wash your hands and nails well with soap and warm water.

Variation Tips

Variation: Broiler Directions: Preheat broiler. Place kabobs on the unheated rack of a broiler pan. Broil 4 to 5 inches from the heat for 8 to 12 minutes or until chicken is no longer pink, turning occasionally to brown evenly.

Nutrition Facts

Serving Size: 2 Skewers Per Serving: 169 calories; protein 26.9g;carbohydrates 7.9g; dietary fiber 1.4g; sugars 5.1g; fat 2.8g;saturated fat 0.5g; cholesterol 65.8mg; vitamin a iu 1143.5IU;vitamin c 61mg; folate 28.4mcg; calcium 27.9mg; iron 1.2mg;magnesium 42.1mg; potassium 422.9mg; sodium 222.8mg.Exchanges: 3 1/2 Lean Protein, 1/2 Fat, 1/2 Other Carbohydrate

https://www.eatingwell.com/recipe/264026/ginger-chicken-kabobs/?printview

Fresh Corn & Avocado Dip

When to Seek Care for Back and Neck Pain

The U.S. Center for Disease Control recently reported that lower back pain is the leading cause of pain.  Americans spend at least $50 billion each year on back pain.

Back Pain: Acute or Chronic?

Spine issues typically fall into two categories; acute and chronic. Acute pain is considered a new pain occurrence with typically no previously known issues. Often a combination of icing, heat and stretching aids a quick recovery.

Chronic back pain is pain that has been ongoing for weeks, months or even years.  You may have self-treated with a combination of rest, over the counter medications or chiropractic care.  Prolonged rest is no longer a recommended treatment so if your pain persists, a good first step is to talk to your doctor.

When to Get Help

Regardless if the pain is acute or chronic, if you experience any of the following signs and symptoms you should contact your doctor immediately:

  • Constant or intense back pain, especially at night or when you lie down.
  • Pain spreads down one or both legs, especially if the pain extends below your knee.
  • Weakness, numbness or tingling in one or both legs.
  • Occurs with unintended weight loss.
  • Occurs with swelling or redness on your back.

Always seek emergency care if back pain occurs after a high-impact car accident, fall or sports injury; causes new bowel or bladder control issues; or occurs with a fever.

Don’t allow back or neck pain to keep you from the things you love.  St. Joe’s offers a comprehensive Spine Program providing both non-surgical and surgical spine solutions.  Our highly skilled care team includes board certified, fellowship trained doctors and surgeons, as well as a nurse navigator who will help guide you every step of the way.

By: Ahmad Issawi, MD, Board Certified Neurological Surgeon

Ready to Get Back to Your Life?

Schedule an appointment with one of our back pain specialist today.