[Script Info]
Title: 
[Events]
Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text
Dialogue: 0,0:00:08.24,0:00:12.67,Default,,0000,0000,0000,,The biggest kidney stone on record\Nweighed more than a kilogram
Dialogue: 0,0:00:12.67,0:00:16.76,Default,,0000,0000,0000,,and was 17 centimeters in diameter.
Dialogue: 0,0:00:16.76,0:00:20.64,Default,,0000,0000,0000,,The patient didn't actually\Nswallow a stone the size of a coconut.
Dialogue: 0,0:00:20.64,0:00:23.46,Default,,0000,0000,0000,,Kidney stones form inside the body,
Dialogue: 0,0:00:23.46,0:00:28.70,Default,,0000,0000,0000,,but unfortunately, they're extremely\Npainful to get out.
Dialogue: 0,0:00:28.70,0:00:33.24,Default,,0000,0000,0000,,A kidney stone is a hard mass\Nof crystals that can form in the kidneys,
Dialogue: 0,0:00:33.24,0:00:34.34,Default,,0000,0000,0000,,ureters,
Dialogue: 0,0:00:34.34,0:00:35.25,Default,,0000,0000,0000,,bladder,
Dialogue: 0,0:00:35.25,0:00:36.85,Default,,0000,0000,0000,,or urethra.
Dialogue: 0,0:00:36.85,0:00:39.60,Default,,0000,0000,0000,,Urine contains compounds \Nthat consist of calcium,
Dialogue: 0,0:00:39.60,0:00:40.48,Default,,0000,0000,0000,,sodium,
Dialogue: 0,0:00:40.48,0:00:41.39,Default,,0000,0000,0000,,potassium,
Dialogue: 0,0:00:41.39,0:00:42.41,Default,,0000,0000,0000,,oxalate,
Dialogue: 0,0:00:42.41,0:00:43.48,Default,,0000,0000,0000,,uric acid,
Dialogue: 0,0:00:43.48,0:00:45.49,Default,,0000,0000,0000,,and phosphate.
Dialogue: 0,0:00:45.49,0:00:48.33,Default,,0000,0000,0000,,If the levels of these particles\Nget too high,
Dialogue: 0,0:00:48.33,0:00:51.28,Default,,0000,0000,0000,,or if urine becomes too acidic\Nor basic,
Dialogue: 0,0:00:51.28,0:00:56.64,Default,,0000,0000,0000,,the particles can clump together\Nand crystallize.
Dialogue: 0,0:00:56.64,0:00:58.32,Default,,0000,0000,0000,,Unless the problem is addressed,
Dialogue: 0,0:00:58.32,0:01:03.91,Default,,0000,0000,0000,,the crystals will gradually grow\Nover a few weeks, months, or even years,
Dialogue: 0,0:01:03.91,0:01:08.12,Default,,0000,0000,0000,,forming a detectable stone.
Dialogue: 0,0:01:08.12,0:01:12.21,Default,,0000,0000,0000,,Calcium oxalate is the most common\Ntype of crystal to form this way,
Dialogue: 0,0:01:12.21,0:01:16.66,Default,,0000,0000,0000,,and accounts for about \N80% of kidney stones.
Dialogue: 0,0:01:16.66,0:01:21.94,Default,,0000,0000,0000,,Less common kidney stones are made\Nof calcium phosphate, or uric acid.
Dialogue: 0,0:01:21.94,0:01:23.78,Default,,0000,0000,0000,,A slightly different type of stone
Dialogue: 0,0:01:23.78,0:01:27.53,Default,,0000,0000,0000,,made of the minerals magnesium\Nammonium phosphate, or struvite,
Dialogue: 0,0:01:27.53,0:01:31.26,Default,,0000,0000,0000,,can be caused by bacterial infection.
Dialogue: 0,0:01:31.26,0:01:35.17,Default,,0000,0000,0000,,And even rarer stones can result\Nfrom genetic disorders
Dialogue: 0,0:01:35.17,0:01:38.49,Default,,0000,0000,0000,,or certain medications.
Dialogue: 0,0:01:38.49,0:01:44.10,Default,,0000,0000,0000,,A kidney stone can go undetected\Nuntil it starts to move.
Dialogue: 0,0:01:44.10,0:01:47.43,Default,,0000,0000,0000,,When a stone travels\Nthrough the kidney and into the ureter,
Dialogue: 0,0:01:47.43,0:01:52.47,Default,,0000,0000,0000,,its sharp edges scratch\Nthe walls of the urinary tract.
Dialogue: 0,0:01:52.47,0:01:57.48,Default,,0000,0000,0000,,Nerve endings embedded in this tissue\Ntransmit excruciating pain signals
Dialogue: 0,0:01:57.48,0:01:59.80,Default,,0000,0000,0000,,through the nervous system.
Dialogue: 0,0:01:59.80,0:02:04.14,Default,,0000,0000,0000,,And the scratches can send blood flowing\Ninto the urine.
Dialogue: 0,0:02:04.14,0:02:06.89,Default,,0000,0000,0000,,This can be accompanied \Nby symptoms of nausea,
Dialogue: 0,0:02:06.89,0:02:07.73,Default,,0000,0000,0000,,vomiting,
Dialogue: 0,0:02:07.73,0:02:11.14,Default,,0000,0000,0000,,and a burning sensation while urinating.
Dialogue: 0,0:02:11.14,0:02:14.59,Default,,0000,0000,0000,,If a stone gets big enough\Nto actually block the flow of urine,
Dialogue: 0,0:02:14.59,0:02:17.47,Default,,0000,0000,0000,,it can create an infection,\Nor back flow,
Dialogue: 0,0:02:17.47,0:02:21.25,Default,,0000,0000,0000,,and damage the kidneys themselves.
Dialogue: 0,0:02:21.25,0:02:24.12,Default,,0000,0000,0000,,But most kidney stones \Ndon't become this serious,
Dialogue: 0,0:02:24.12,0:02:27.35,Default,,0000,0000,0000,,or even require invasive treatment.
Dialogue: 0,0:02:27.35,0:02:30.16,Default,,0000,0000,0000,,Masses less than five millimeters\Nin diameter
Dialogue: 0,0:02:30.16,0:02:33.68,Default,,0000,0000,0000,,will usually pass out \Nof the body on their own.
Dialogue: 0,0:02:33.68,0:02:37.42,Default,,0000,0000,0000,,A doctor will often simply recommend\Ndrinking large amounts of water
Dialogue: 0,0:02:37.42,0:02:39.90,Default,,0000,0000,0000,,to help speed the process along,
Dialogue: 0,0:02:39.90,0:02:43.38,Default,,0000,0000,0000,,and maybe taking some pain killers.
Dialogue: 0,0:02:43.38,0:02:47.16,Default,,0000,0000,0000,,If the stone is slightly larger,\Nmedications like alpha blockers
Dialogue: 0,0:02:47.16,0:02:50.33,Default,,0000,0000,0000,,can help by relaxing the muscles\Nin the ureter
Dialogue: 0,0:02:50.33,0:02:54.13,Default,,0000,0000,0000,,and making it easier \Nfor the stone to get through.
Dialogue: 0,0:02:54.13,0:02:56.41,Default,,0000,0000,0000,,Another medication called\Npotassium citrate
Dialogue: 0,0:02:56.41,0:03:02.99,Default,,0000,0000,0000,,can help dissolve the stones by creating\Na less acidic urine.
Dialogue: 0,0:03:02.99,0:03:06.20,Default,,0000,0000,0000,,For medium-sized stones up to about\Nten millimeters,
Dialogue: 0,0:03:06.20,0:03:10.58,Default,,0000,0000,0000,,one option is pulverizing them\Nwith soundwaves.
Dialogue: 0,0:03:10.58,0:03:16.23,Default,,0000,0000,0000,,Extracorporeal shock wave lithotripsy\Nuses high-intensity pulses
Dialogue: 0,0:03:16.23,0:03:21.71,Default,,0000,0000,0000,,of focused ultrasonic energy\Naimed directly at the stone.
Dialogue: 0,0:03:21.71,0:03:25.37,Default,,0000,0000,0000,,The pulses create vibrations inside\Nthe stone itself
Dialogue: 0,0:03:25.37,0:03:29.15,Default,,0000,0000,0000,,and small bubbles jostle it.
Dialogue: 0,0:03:29.15,0:03:33.13,Default,,0000,0000,0000,,These combined forces crush the stone\Ninto smaller pieces
Dialogue: 0,0:03:33.13,0:03:37.39,Default,,0000,0000,0000,,that can pass out of the body more easily.
Dialogue: 0,0:03:37.39,0:03:40.11,Default,,0000,0000,0000,,But zapping a stone with sound\Ndoesn't work as well
Dialogue: 0,0:03:40.11,0:03:42.56,Default,,0000,0000,0000,,if it's simply too big.
Dialogue: 0,0:03:42.56,0:03:47.05,Default,,0000,0000,0000,,So sometimes, more invasive\Ntreatments are necessary.
Dialogue: 0,0:03:47.05,0:03:53.07,Default,,0000,0000,0000,,A rigid tube called a stent\Ncan be placed in the ureter to expand it.
Dialogue: 0,0:03:53.07,0:03:57.55,Default,,0000,0000,0000,,Optical fibers can deliver laser pulses\Nto break up the stone.
Dialogue: 0,0:03:57.55,0:04:00.98,Default,,0000,0000,0000,,Stones can also be surgically removed\Nthrough an incision
Dialogue: 0,0:04:00.98,0:04:04.49,Default,,0000,0000,0000,,in the patient's back or groin.
Dialogue: 0,0:04:04.49,0:04:07.90,Default,,0000,0000,0000,,What about just avoiding kidney stones\Nin the first place?
Dialogue: 0,0:04:07.90,0:04:09.82,Default,,0000,0000,0000,,For people prone to them,
Dialogue: 0,0:04:09.82,0:04:12.47,Default,,0000,0000,0000,,their doctor may recommend\Ndrinking plenty of water,
Dialogue: 0,0:04:12.47,0:04:15.65,Default,,0000,0000,0000,,which dilutes the calcium oxalate\Nand other compounds
Dialogue: 0,0:04:15.65,0:04:20.62,Default,,0000,0000,0000,,that eventually build up \Ninto painful stones.
Dialogue: 0,0:04:20.62,0:04:21.88,Default,,0000,0000,0000,,Foods like potato chips,
Dialogue: 0,0:04:21.88,0:04:22.93,Default,,0000,0000,0000,,spinach,
Dialogue: 0,0:04:22.93,0:04:23.74,Default,,0000,0000,0000,,rhubarb,
Dialogue: 0,0:04:23.74,0:04:26.28,Default,,0000,0000,0000,,and beets are high in oxalate,
Dialogue: 0,0:04:26.28,0:04:29.85,Default,,0000,0000,0000,,so doctors might advise limiting them.
Dialogue: 0,0:04:29.85,0:04:32.43,Default,,0000,0000,0000,,Even though calcium \Nis often found in stones,
Dialogue: 0,0:04:32.43,0:04:36.28,Default,,0000,0000,0000,,calcium in foods and beverages\Ncan actually help
Dialogue: 0,0:04:36.28,0:04:39.10,Default,,0000,0000,0000,,by binding to oxalate \Nin the digestive tract
Dialogue: 0,0:04:39.10,0:04:43.14,Default,,0000,0000,0000,,before it can be absorbed\Nand reach the kidneys.
Dialogue: 0,0:04:43.14,0:04:46.22,Default,,0000,0000,0000,,If you do end up with a kidney stone,\Nyou're not alone.
Dialogue: 0,0:04:46.22,0:04:48.91,Default,,0000,0000,0000,,Data suggests that rates are rising,
Dialogue: 0,0:04:48.91,0:04:52.85,Default,,0000,0000,0000,,but that world record probably\Nwon't be broken any time soon.