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Kidney stone procedure "has the potential to be game changing"
- donatj 3y agoOh nice. I had to have mine lasered and it was a big ordeal with tubes being placed ahead of time and later removed over as many appointment.
- anonymousiam 3y agoHad my latest one lasered a few months ago. It all went well, except for the annoying stent that had to be removed a month later. IMHO, the laser approach to removing the stone (by obliterating it) is safer for the kidneys.
- apetresc 3y ago> It will also give astronauts the go ahead they need from NASA to travel to Mars. Wait, what? Everything else was worked out, but NASA just went "hold on, we can't go to Mars just yet until we figure out what to do if an astronaut gets kidney stones on the way"? Did the writer just throw this in to make the procedure seem more hip and exciting?
- chmod775 3y agoIt's a real issue in space: > Because space travel makes astronauts prone to kidney stones due, in part to bone demineralization from weightlessness, they are at increased risk. The NASA evidence base and publications note that astronauts have had more than 30 instances of kidney stones within two years of space travel. Medical assistance is a formidable challenge for those orbiting this planet or heading to other solar system destinations. https://newsroom.uw.edu/news/keeping-kidney-stones-bay-during-space-flights https://newsroom.uw.edu/news/keeping-kidney-stones-bay-durin...
- Andrex 3y agoI'm not even sure a free trip to space would be worth a kidney stone, personally.
- bastardoperator 3y agoYeah, hard pass for me, no pun intended.
- throwanem 3y agoI mean if it was only blocking a ureter for ten minutes tops, then sure? Compared to what hydronephrosis feels like, merely voiding one isn't so much of a much, really.
- Firmwarrior 3y agoHaha, wow, what a fun discovery Personally, I don't even like roller coasters.. I'd probably take a kidney stone to avoid having to go to space I'm sure I'll end up there sooner or later though, that's where all the jobs are going to be
- jwestbury 3y agoChronic stone former here, and I can confirm this. That said, I did have a stone large enough to get stuck in the urethra -- not the ureter. The doctor was quite impressed. Unfortunately, I passed it in a public toilet shortly after leaving the doctor, so I wasn't able to capture and measure it. At any rate, hydronephrosis is the real thing to fear in most cases.
- at_a_remove 3y agoThe article has a bit in it "This technology is also making it possible for astronauts to travel to Mars, since astronauts are at a greater risk for developing kidney stones during space travel." And then a hyperlink to more information.
- aristus 3y agoAs I understand it, it was not literally the last thing holding back. But NASA worries about everything and we have centuries of examples of remote missions failing because of medical problems that could not be solved in the field. Billions of dollars, tens of years, and a ship full of lives can't be risked on a 3mm pebble if it can possibly be prevented.
- hanniabu 3y ago> we have centuries of examples of remote missions failing decades*
- ToValueFunfetti 3y agoDepends on how broadly you define "remote missions"
- kstrauser 3y agoI assume they’re including sailing ships dealing with scurvy, and things like that. We haven’t been in space very long, but we’re a species of explorers.
- morkalork 3y agoThe Franklin Expedition of 1845 comes to mind. There were even theories about new-ish technology (tinned food) accidentally poisoning the crew with lead.
- letmevoteplease 3y agoNASA currently considers kidney stones an unacceptable risk for a Mars mission that requires mitigation.[1] There are also about 10 other risks requiring mitigation, though.[1] [1] https://humanresearchroadmap.nasa.gov/Risks/risk.aspx?i=81 https://humanresearchroadmap.nasa.gov/Risks/risk.aspx?i=81 [2] https://humanresearchroadmap.nasa.gov/Risks/ https://humanresearchroadmap.nasa.gov/Risks/
- ghufran_syed 3y agoNASA saying there is a “research gap” and that it “needs mitigation” is very different from it being an “unacceptable risk” which implies that no mission can happen until it happens. if there was a ship ready to go with a hab and propellant for the return trip sitting on mars, I can guarantee they would take the very next transfer window, kidney stone risk notwithstanding- particularly if the chinese or russians were about to do so and might get there first!
- hypercube33 3y agoI mean I just watched a bunch of documentaries about Challenger and Columbia...you're damn right they would rubber stamp it.
- bumby 3y agoWhat’s your definition of rubber stamping? Usually it means approving without any consideration. In both of those cases, there was a lot of deliberation. Their end conclusion may have been wrong, but it’s really quite different than “rubber stamping”
- bumby 3y agoAccording to the method by which NASA measures risk, it is indeed an "unacceptable risk". The red 4x4 "LxC" box stands for "likelihood x consequence". So they consider it a high likelihood and a severe consequence. It's red because that puts it in the unacceptable category. If you look at the medical risk matrix it puts the likelihood between 60% - 80% and consequence at "loss time injury or illness per OSHA criteria" On a score of 1 (least risky) to 25 (most risky), a 4x4 scores 22. Now to your point about "guaranteeing" they would still go, they are allowed to waive these risks through a formal process. It tends to make managers squeamish though, because nobody wants to be the person who's signature is attached to a known risk that eventually causes a mishap. https://www.nasa.gov/wp-content/uploads/2015/10/s3001_guidelines_for_risk_management_-_ver_g_-_10-25-2017.pdf https://www.nasa.gov/wp-content/uploads/2015/10/s3001_guidel...
- add-sub-mul-div 3y ago[flagged]
- apetresc 3y agoI did read; I saw the additional sentence that, yes, astronauts are at increased risk of kidney stones. I get that. My surprise comes from the fact that a trip to Mars is already incredibly risky and any astronaut signing up likely is at peace with never coming home. I would think "painful kidney stones" or "non-ideal kidney stone treatment" is far enough down the list of potential concerns for such an astronaut that it wouldn't block NASA from giving "the go ahead they need to travel to Mars", which is what the article says. Like, I get that NASA funds all sorts of things like this. I just can't quite believe that this is considered a showstopper. Like the famous apocryphal anecdote about needing to develop a zero-gravity pen before the moon mission; I'd have been equally surprised, even knowing that story, to hear that NASA wouldn't have launched the moon mission until they figured the pen out.
- add-sub-mul-div 3y agoSure, but none of that surprise warrants accusing the writer of anything like you did. It's not an article about the space program. It mentions the relevance to the space program and links to more information about it.
- felixgallo 3y agowhether or not the astronaut is willing to take the risk, kidney stones can be so painful that someone suffering from them could potentially jeopardize the mission from incapacity or increased risk of making a mistake. Even if the astronaut were personally signed up for a suicide mission, there's a lot of incredibly expensive and difficult science and exploration to be done.
- jawns 3y agoI know the Internet cloak of anonymity makes us feel comfortable saying things we wouldn't feel comfortable saying face-to-face to a colleague, but HN tries to promote civility in our comments, and yours demonstrates a lack of it. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
- joduplessis 3y agoNot to the moon or the space station, but to Mars. Yes, next stop is Mars folks.
- user568439 3y agoNice, but why this website trues to download a file automatically to my phone?
- CodesInChaos 3y agoDoesn't happen for me, but I'd guess it's a wrong mime-type on an ad-iframe.
- soco 3y agoDid you have the patience to wait for "saving preferences"? I gave up at around 74% whatever that means.
- nharada 3y agoYeah it takes time to "save preferences" if you don't give it maximum permissions.
- cromulent 3y agoI’m used to accepting cookies, but after the download I checked the list of “required cookies”. Insane. I clicked on one privacy policy and was met with the same download and required cookies in order to read it.
- Ecco 3y agoThe UW announcement is from 2022. I wonder why that article is posted now. https://newsroom.uw.edu/news/ultrasound-promises-relief-those-kidney-stones https://newsroom.uw.edu/news/ultrasound-promises-relief-thos...
- xezzed 3y agoWell, isn't it called 'lithotripsy' and exists for quite a time?
- apendleton 3y agoThis is "burst wave lithotripsy," compared to the somewhat-similar existing "shock wave lithotripsy." The new iteration apparently works more quickly and causes less pain, so can be performed while the patient is awake rather than requiring general anesthesia, which would make it practical to do it in, say, an ER or regular doctor's office. See https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10117400/#sec2title https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10117400/#sec2t... for a comparison of the mechanisms.
- __xor_eax_eax 3y ago> Ureteroscopy is another minimally invasive way to treat stones but often requires a temporary stent, which can be quite uncomfortable. "The ways we have to currently treat stones have some downsides," he said. "Most involve anesthesia." In contrast to the shock waves used in ESWL, the BWL procedure uses "short harmonic bursts" of ultrasound energy, potentially enabling the stones to be broken up in a shorter procedure without the need for sedation or anesthesia. Pre-clinical studies supported the effectiveness of BWL in breaking experimental stones of varying size and composition, the study noted.
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- vondur 3y agoOoh, this sounds good. I've had kidney stones a couple of times. It was not very fun.
- 8f2ab37a-ed6c 3y agoIs this available anywhere outside of UW?
- Giorgi 3y agoUltrasonic bursts? Is not that quite an old tech for stones?
- lunarimiso 3y agoI just, 2 days ago, starting to experience slight discomfort in the liver/kidney area. The feeling was very similar to how it was with my gallbladder. At least until it was removed. I am totally a ticking time bomb. So, yes.. please bring on even better treatments.
- justanotheratom 3y agojust FYI, AFAIK, kidney stone pain is sudden and unbearable, when the stone starts moving out of the kidney. Slight discomfort may not be a sign of kidney stone.
- powersurge360 3y agoChronic stone former here, requiring surgical intervention a few times a year. It definitely can be sudden and debilitating but for most of my teenage years I had mistaken the pain for ‘sleeping wrong’. Sometimes when I would bend over and then stand it would feel like someone had stapled my back together at the bend and I had to rip it out. It hurt, but not anything like what I expected. A couple of years later I wound up having a few stones that had grown to larger than an inch. If you have unusual and unexpected pain it’s definitely worth getting checked out. I didn’t have health insurance at the time and since the pain was intermittent I never suspected anything serious and just chalked it up to sleeping in a poor posture or maybe not getting enough exercise to be limber. It almost killed me!
- westurner 3y ago> Still being run through clinical trials at UW Medicine, the procedure called _ burst wave lithotripsy _ uses an ultrasound wand and soundwaves to break apart the kidney stone > Ultrasonic propulsion is then used to move the stone fragments out, potentially giving patients relief in 10 minutes or less (Edit) "Fragmentation of Stones by Burst Wave Lithotripsy in the First 19 Humans" (2022) https://www.auajournals.org/doi/abs/10.1097/JU.0000000000002446 https://www.auajournals.org/doi/abs/10.1097/JU.0000000000002... gscholar citations: https://scholar.google.com/scholar?cites=4452238185664707620&as_sdt=5,43&sciodt=0,43&hl=en https://scholar.google.com/scholar?cites=4452238185664707620... Lithotripsy: https://en.wikipedia.org/wiki/Lithotripsy https://en.wikipedia.org/wiki/Lithotripsy EWST: Extracorporeal shockwave therapy: https://en.wikipedia.org/wiki/Extracorporeal_shockwave_therapy https://en.wikipedia.org/wiki/Extracorporeal_shockwave_thera... Could NIRS help with this targeted ultrasound procedure, too? "Ultrasound-activated chemotherapy advances therapeutic potential in deep tumours" (2023) https://news.ycombinator.com/item?id=37885774#37885798 https://news.ycombinator.com/item?id=37885774#37885798 : > NIRS Near-Infrared Spectroscopy does not require contrast FWIU?
- westurner 3y agoOn reading brains with light, https://news.ycombinator.com/item?id=28399099#28400060 https://news.ycombinator.com/item?id=28399099#28400060 : > What about with realtime NIRS with an (inverse?) scattering matrix? FWIU Openwater's technology portfolio includes targeted ultrasound with e.g. NIRS and LSI/LSCI: https://www.openwater.health/technology https://www.openwater.health/technology One of their demo videos explains how inverting the scattering caused by the occluding body yields the mass-density at least (?). [Radio]Spectroscopy and quantum crystallography may have additional insight for tissue identification with low-cost NIRS sensor data? Open fNIRS: https://openfnirs.org/ https://openfnirs.org/ "Quantum light sees quantum sound: phonon/photon correlations" (2023) https://news.ycombinator.com/item?id=37793765 https://news.ycombinator.com/item?id=37793765 ; the photonic channel actually embeds the phononic field
- anonymousiam 3y agoI've had conventional lithotripsy a few times, and I now have CKD. I have none of the typical CKD risk factors, and I suspect that the ultrasonic energy caused some damage. Unfortunately there is no way to know.
- jjeaff 3y agoit could just be the stress that having kidney stones put on your kidneys in addition to the stress the ultrasonic waves impart. but also, probably the worst part of lithotripsy is that they usually use a strong x-ray to see what they are doing live. if they are slow in completing the procedure, you can end up being exposed to quite a lot of radiation.
- RCitronsBroker 3y agoit may be good to know that we aren’t talking about an entirely new process, shock(!) wave lithotripsy has been around for quite some time now. The "game-changer" is the introduction of burst wave lithotripsy, which apparently is less painful and thus possible to go through without general anaesthisia, which, don’t get me wrong, is definitely an improvement. But I’m not sure I’d call it a game changer. I’m not convinced it’s entirely painless as it’s still the same "crush and drive out via ultrasound" idea. Combine this with the fact that just existing is excruciating with stones, i don’t see a way around opioid analgesia. Additionally, the game hasn’t changed in the regard of the human pelvis being great at keeping out ultrasound, so if your stones are out of reach that way, you’re SOL.
- misja111 3y agoShock or burst wave lithotripsy is not new either, but it is being improved all the time. So I guess that's what this article is about, just another recent improvement.
- indigomm 3y agoI've had lithotripsy and it certainly wasn't done under general anaesthetic. They just gave me painkillers and the procedure was fine. I was in and out very quickly - something like an hour or so.
- misja111 3y agoI must be missing something. This kind of treatment is called lithotripsy and it is used already since the 80's. What is new here?
- xutopia 3y agoBurst waves rather than one signal.
- jl2718 3y agoBreakthrough? You could buy these machines on Alibaba years ago marketed for this purpose. I assume this means there was a cottage industry of private kidney stone treatment in Asia.
- bawana 3y agoI wonder if it helps impotence as ESWL seems to have been used iin this regard as well.https://healthcare.utah.edu/mens-health/conditions/erectile-dysfunction/shockwave-therapy#:~:text=During%20the%20treatment%2C%20a%20small,which%20is%20essential%20for%20erections https://healthcare.utah.edu/mens-health/conditions/erectile-....
- anotheraccount9 3y ago'Breakthrough'
- UberFly 3y agoThey've been blasting with sound waves for a while. "Ultrasonic propulsion" though, that sounds cool.
- oldbbsnickname 3y agoI have 19 mm left and 14 mm right stones that I generally don't notice and don't have any pain. ESWL seemed like a scam because there was no redness on back tissue and not a single grain or fragment was passed. I wonder if they set the machine to a high enough power or if they skipped the actual procedure while I was anesthetized. I'm wondering if BWL would be any better where ESWL fails.
- RobRivera 3y agoKidney stone breakthrough...hehehe thats funny. [Best read in Norm MacDonald's Burt Reynolds' voice]
- mechhacker 3y agoI've broken bones, including a leg, and a kidney stone was the most painful thing I've experienced. It was so painful it resulted in a blackout as it was moving through my innards and getting to my bladder. Anything to save myself from that non-invasively would be welcome. Thankfully, they have not returned as I think I know what triggers them for me.
- anderber 3y agoMay I ask what triggered them for you? As someone prone to them, I'm curious if I'm doing everything possible to avoid these nasty things.
- kabouseng 3y agoVitamin fizzy / soluble pills can cause it for some people.
- mechhacker 3y agoI narrowed it down to grapefruit. At least that's what I suspect. I avoid them now.
- xxpor 3y agograpefruits should usually help, as they're high in citric acid.
- 131012 3y agomost citrus fruits help to reduce kidney stones, but not grapefruit. grapefruit has different weird interaction with medication and does increase risk of kidney stones, contrary to other citrus fruits. https://www.webmd.com/diet/foods-high-in-oxalates https://www.webmd.com/diet/foods-high-in-oxalates
- xxpor 3y agoI don't know what to believe any more because that article says kale is a low oxalate food, but https://blog.swedish.org/swedish-blog/kale-causes-kidney-stones-seriously https://blog.swedish.org/swedish-blog/kale-causes-kidney-sto... says the opposite (and was on the list I got at discharge)
- galkk 3y agoHope that the ticking bomb in my right kidney (that was found during CT scan when the stone from my left kidney was coming out) can wait for the next year. In all seriousness the article doesn't have anything about general availability and cost, alas. How soon it can be offered at your typical hospital instead of vicodin and lots of water?
- xxpor 3y agoI was asked if I wanted to sign up in 2020, and said yes. No word back from the team though :(. I ended up getting the normal EWST, at UW Medicine. I had a stone kicking around for 2 years that would cause pain off and on. Went to normal primary care, but they had no idea. We thought it was a gastro issue, since it felt like constipation (or so I thought). The problem was I was always fine when I actually went to see the doc. Until I finally went to the ER and they ordered a simple x-ray and found it :/