Kidney stones become soldiers’ silent enemy

BALAD AIR BASE, IRAQ – Army Sgt. John Jimison first felt the pain in his side while driving a military truck on a mission.

He felt it for the second time the next day, only this time it hurt much worse.

“When I stepped down, I had leg pain and one side just went numb,” said Jimison, 28, a soldier with 1st Battalion, 101 Aviation. out of Fort Campbell, Ky.

Jimison soon discovered that he’d become a casualty of an increasing medical problem in Iraq, one that has nothing to do with insurgents or improvised explosive devices. Large numbers of soldiers are developing kidney stones, more so than in prior conflicts, and the U.S. military is trying to determine why.

The problem has become so prevalent that the Air Force Theater Hospital at Balad, the major trauma center for soldiers wounded in Iraq, was equipped in January with a $120,000 surgical laser and 24-hour urine test kits that measure minerals and chemicals in the body.

That means soldiers can be treated immediately without having to be shipped to a military hospital in Germany, which was the only option in the past. Since the Germany medical center often floods with serious combat injuries, soldiers with kidney stones had to wait weeks in throbbing pain and away from their units.

“This is the first time ever in the history of war that we have been able to treat kidney stones in this fashion,” said Lt. Col. Jay Bishoff, the Air Force urologist in Balad who requested the surgical equipment for Iraq.

“It’s never been treated in theater before.”

The military has no hard numbers yet on how many soldiers have been afflicted, but Bishoff, who himself has had kidney stones, estimates that at least three hospital beds a day are filled with kidney stone patients. The hospital has 40 standard beds and 18 intensive care beds.

The exact reasons for the trend are undetermined, although Bishoff said there are several likely contributors. There are 17 types of kidney stones and 24 metabolic reasons why the body develops them, he said.

One likely factor in Iraq is the hot and dry weather, which causes dehydration, especially when soldiers are wearing 50 pounds of body armor for protection. Soldiers also tend to dehydrate themselves to avoid having to urinate while on patrol or on a convoy, which leaves them vulnerable to attack, Bishoff said.

Also, military diets are high in protein, which could be a culprit adding to the problem, he said.

Some also suspect that the water in Iraq might be a contributor.

Kidney stones primarily develop in men, although a few women get them. They more likely affect those serving in the Army infantry or Marines, Bishoff said. It takes a minimum of 90 days for a kidney stone to form.

Bishoff said the urine test kits help soldiers learn what personally could be putting them at risk and will help the military spot any trends, which might lead to the issuance of supplements or pills to prevent kidney stones. The urine tests are sent to a private lab for results.

“We want to see the factors that can help guys prevent stones while they are here,” Bishoff said.

Some soldiers have a predisposition to stones that is exacerbated in Iraq. Spc. John Callahan, 41, of Massachussetts, was at the hospital waiting to pass his kidney stone, in smaller pieces, after the doctor blasted it with the surgical laser.

He came in for treatment after awaking in the middle of the night with a sharp pain. But he’s been through the pain before, having his first episode in 1991. “I went through four weeks of complete hell,” Callahan said.

Many don’t realize how costly it can be to military operations when a soldier goes down from a kidney stone. Bishoff said he recently treated a Navy SEAL who was on a special operation when he collapsed in pain from a stone. He said the military operation had to be scrapped.

Many patients mistake the pain of kidney stones for symptoms of cancer, Bishoff said.

About 65 percent of patients in the theater hospital are treated for noncombat-related injuries, including medical conditions such as kidney stones and sports injuries.

McChord mission

Reporter Scott Gutierrez accompanied airmen from McChord Air Force Base on their mission to deliver equipment and troops to and from Iraq.