每当母亲节来临，我们都会买康乃馨送给妈妈，感谢她的爱护和表达母爱的温馨。
当晚的天气超好，一点都不会热闷。而且我们坐的位子很靠近在隔壁唱歌的乐队，所以，在用餐之余，也可以一边欣赏美丽的歌曲。
那晚唱的都是比较抒情的怀旧英文歌曲，感觉很休闲。
蛮喜欢Winter Warmers的食物和饮料，原因他们往往都喜欢用上花的料理。再加上店铺的布置都比较英式，碎花窗帘和英式茶几，感觉好“公主”。哈哈！
嘻嘻！很美吧？
This drawing was captured by camera. The original colour should be darker, but I have no idea why the tone is lighter when upload to computer.
This one was scanned by company scanner. It is brighter than the original or the one captured by camera.
当瑾还是个小婴儿时，璇才那么一岁。这张相片时我当年帮她们拍下的。好可爱吧！
还记得她们小时候，爸妈要去工作，我们就得照顾她们。其中包括帮她们冲凉、换衣、吃饭、教她们做功课等等，都由我或妹妹一手包办！(所以吗，我可看过她们的“裸体”喔！)嘻嘻嘻！又注意：璇，对不起哦！由于你晚上没和我一起睡，所以没有受到特别的“待遇”！但是！如果你要的话，我现在也可以讲“小白兔与萝卜”的故事给你听！唱歌也没问题！哈哈哈哈！好吧？那你等我多两个星期回去吧！
那时候，家乡没有什么娱乐。唯有陪她们“看了又看”卡通片和教育片。看到我都可以把剧情背得滚瓜烂熟。记得当时她俩最爱看“小飞象” 、“比诺丘” 、“啊哟哟老师”等等。（我想当时看了有超过整百遍吧？）
自从我毕业后，由于要在KL读书做工，便很少和她们相处。现在，她们也已经“亭亭玉立”了。（虽然不是很美！哈哈！没有啦！又是开玩笑的，好不好？）
希望她们可以活得更好，努力读书，为将来做好打算。加油吧！我的好妹妹们！
Well, at least now I can draw or paint something when I feel bored or when I do not feel like to write. Picture speaks a thousand words, doesn't it? (Yes, I like to write, to draw and to take pictures! DSLR, your day will come! Just not now! Hehe!)
I like the purplish feel of that night, felt so "romantic" though the environment was quite noisy. :P
这是她画的。（我的因为送了给她，所以没有办法拿到公司扫描进电脑。）
This dairy was bought when I was shifted to KL in year 1996 (or 1997?)
But nowadays, I rarely have time to write a diary "with pen" for a long time since I have started blogging online.
Reading again on what I wrote in the dairy, it made me remember of my old days. There were sweet and bitter carried along the journey. I am not sure if it was due to the aging concern, I hardly recall some of the details I wrote in the dairy but it did happen in my old time.
I like to write when I feel depressed or down. May be in the other way, is to release my depression and also for self-motivation.
Therefore, I was grieved when I read through the diary last night. All the life stories written were filled with tears and sorrow. Anyhow, I think this is good. As least I know I have been doing it well to walked through the hard time and I am still alive now.
I took up a pen and wrote a short diary last night. A page with words and another page I drew a picture.
No doubt that life is difficult and I am trying to do it well. Just sometimes, even you are trying to be good, the good way doesn't always come to you.
"Life is like a boucing ball, it bounces up and down. Catch tight when it falls, and look up when it bounces. When you are at the bottom, it also is the time it will bounce back to the air. When you are at the top, be prepared when it could be falling anytime."
Am I at the bottom of my life yet? Because I am looking forward a rebounce. Hmm...
Urolithiasis is the medical term used to describe stones occurring in the urinary tract. Other frequently used terms are urinary tract stone disease and nephrolithiasis. Doctors also use terms that describe the location of the stone in the urinary tract. For example, a ureteral stone—or ureterolithiasis—is a kidney stone found in the ureter. To keep things simple, the general term kidney stones is used throughout this fact sheet.
High-oxalate foods—higher to lower
- rhubarb
- spinach
- beets
- swiss chard
- wheat germ
- soybean crackers
- peanuts
- okra
- chocolate
- black Indian tea
- sweet potatoes
Foods that have medium amounts of oxalate may be eaten in limited amounts.
Medium-oxalate foods—higher to lower
- grits
- grapes
- celery
- green pepper
- red raspberries
- fruit cake
- strawberries
- marmalade
- liver
What are the symptoms of kidney stones?
Kidney stones often do not cause any symptoms. Usually, the first symptom of a kidney stone is extreme pain, which begins suddenly when a stone moves in the urinary tract and blocks the flow of urine. Typically, a person feels a sharp, cramping pain in the back and side in the area of the kidney or in the lower abdomen. Sometimes nausea and vomiting occur. Later, pain may spread to the groin.
If the stone is too large to pass easily, pain continues as the muscles in the wall of the narrow ureter try to squeeze the stone into the bladder. As the stone moves and the body tries to push it out, blood may appear in the urine, making the urine pink. As the stone moves down the ureter, closer to the bladder, a person may feel the need to urinate more often or feel a burning sensation during urination.
If fever and chills accompany any of these symptoms, an infection may be present. In this case, a person should contact a doctor immediately.
How are kidney stones diagnosed?
Sometimes “silent” stones—those that do not cause symptoms—are found on x rays taken during a general health exam. If the stones are small, they will often pass out of the body unnoticed. Often, kidney stones are found on an x ray or ultrasound taken of someone who complains of blood in the urine or sudden pain. These diagnostic images give the doctor valuable information about the stone’s size and location. Blood and urine tests help detect any abnormal substance that might promote stone formation.
The doctor may decide to scan the urinary system using a special test called a computerized tomography (CT) scan or an intravenous pyelogram (IVP). The results of all these tests help determine the proper treatment.
Preventing Kidney Stones
person who has had more than one kidney stone may be likely to form another; so, if possible, prevention is important. To help determine their cause, the doctor will order laboratory tests, including urine and blood tests. The doctor will also ask about the patient’s medical history, occupation, and eating habits. If a stone has been removed, or if the patient has passed a stone and saved it, a stone analysis by the laboratory may help the doctor in planning treatment.
The doctor may ask the patient to collect urine for 24 hours after a stone has passed or been removed. For a 24-hour urine collection, the patient is given a large container, which is to be refrigerated between trips to the bathroom. The collection is used to measure urine volume and levels of acidity, calcium, sodium, uric acid, oxalate, citrate, and creatinine—a product of muscle metabolism. The doctor will use this information to determine the cause of the stone. A second 24-hour urine collection may be needed to determine whether the prescribed treatment is working.
How are kidney stones treated?
Fortunately, surgery is not usually necessary. Most kidney stones can pass through the urinary system with plenty of water—2 to 3 quarts a day—to help move the stone along. Often, the patient can stay home during this process, drinking fluids and taking pain medication as needed. The doctor usually asks the patient to save the passed stone(s) for testing. It can be caught in a cup or tea strainer used only for this purpose.
Lifestyle Changes
A simple and most important lifestyle change to prevent stones is to drink more liquids—water is best. Someone who tends to form stones should try to drink enough liquids throughout the day to produce at least 2 quarts of urine in every 24-hour period.
In the past, people who form calcium stones were told to avoid dairy products and other foods with high calcium content. Recent studies have shown that foods high in calcium, including dairy products, may help prevent calcium stones. Taking calcium in pill form, however, may increase the risk of developing stones.
Patients may be told to avoid food with added vitamin D and certain types of antacids that have a calcium base. Someone who has highly acidic urine may need to eat less meat, fish, and poultry. These foods increase the amount of acid in the urine.
To prevent cystine stones, a person should drink enough water each day to dilute the concentration of cystine that escapes into the urine, which may be difficult. More than a gallon of water may be needed every 24 hours, and a third of that must be drunk during the night.
Medical Therapy
A doctor may prescribe certain medications to help prevent calcium and uric acid stones. These medicines control the amount of acid or alkali in the urine, key factors in crystal formation. The medicine allopurinol may also be useful in some cases of hyperuricosuria.
Doctors usually try to control hypercalciuria, and thus prevent calcium stones, by prescribing certain diuretics, such as hydrochlorothiazide. These medicines decrease the amount of calcium released by the kidneys into the urine by favoring calcium retention in bone. They work best when sodium intake is low.
Rarely, patients with hypercalciuria are given the medicine sodium cellulose phosphate, which binds calcium in the intestines and prevents it from leaking into the urine.
If cystine stones cannot be controlled by drinking more fluids, a doctor may prescribe medicines such as Thiola and Cuprimine, which help reduce the amount of cystine in the urine.
For struvite stones that have been totally removed, the first line of prevention is to keep the urine free of bacteria that can cause infection. A patient’s urine will be tested regularly to ensure no bacteria are present.
If struvite stones cannot be removed, a doctor may prescribe a medicine called acetohydroxamic acid (AHA). AHA is used with long-term antibiotic medicines to prevent the infection that leads to stone growth.
People with hyperparathyroidism sometimes develop calcium stones. Treatment in these cases is usually surgery to remove the parathyroid glands, which are located in the neck. In most cases, only one of the glands is enlarged. Removing the glands cures the patient’s problem with hyperparathyroidism and kidney stones.
Surgical Treatment
Surgery may be needed to remove a kidney stone if it
- does not pass after a reasonable period of time and causes constant pain
- is too large to pass on its own or is caught in a difficult place
- blocks the flow of urine
- causes an ongoing urinary tract infection
- damages kidney tissue or causes constant bleeding
- has grown larger, as seen on follow-up x rays
Until 20 years ago, open surgery was necessary to remove a stone. The surgery required a recovery time of 4 to 6 weeks. Today, treatment for these stones is greatly improved, and many options do not require major open surgery and can be performed in an outpatient setting.
Extracorporeal Shock Wave Lithotripsy. Extracorporeal shock wave lithotripsy (ESWL) is the most frequently used procedure for the treatment of kidney stones. In ESWL, shock waves that are created outside the body travel through the skin and body tissues until they hit the denser stones. The stones break down into small particles and are easily passed through the urinary tract in the urine.
Several types of ESWL devices exist. Most devices use either x rays or ultrasound to help the surgeon pinpoint the stone during treatment. For most types of ESWL procedures, anesthesia is needed.
In many cases, ESWL may be done on an outpatient basis. Recovery time is relatively short, and most people can resume normal activities in a few days.
Complications may occur with ESWL. Some patients have blood in their urine for a few days after treatment. Bruising and minor discomfort in the back or abdomen from the shock waves can occur. To reduce the risk of complications, doctors usually tell patients to avoid taking aspirin and other medicines that affect blood clotting for several weeks before treatment.
Sometimes, the shattered stone particles cause minor blockage as they pass through the urinary tract and cause discomfort. In some cases, the doctor will insert a small tube called a stent through the bladder into the ureter to help the fragments pass. Sometimes the stone is not completely shattered with one treatment, and additional treatments may be needed.
As with any interventional, surgical procedure, potential risks and complications should be discussed with the doctor before making a treatment decision.
Percutaneous Nephrolithotomy. Sometimes a procedure called percutaneous nephrolithotomy is recommended to remove a stone. This treatment is often used when the stone is quite large or in a location that does not allow effective use of ESWL.
In this procedure, the surgeon makes a tiny incision in the back and creates a tunnel directly into the kidney. Using an instrument called a nephroscope, the surgeon locates and removes the stone. For large stones, some type of energy probe—ultrasonic or electrohydraulic—may be needed to break the stone into small pieces. Often, patients stay in the hospital for several days and may have a small tube called a nephrostomy tube left in the kidney during the healing process.
One advantage of percutaneous nephrolithotomy is that the surgeon can remove some of the stone fragments directly instead of relying solely on their natural passage from the kidney.
Ureteroscopic Stone Removal. Although some stones in the ureters can be treated with ESWL, ureteroscopy may be needed for mid- and lower-ureter stones. No incision is made in this procedure. Instead, the surgeon passes a small fiberoptic instrument called a ureteroscope through the urethra and bladder into the ureter. The surgeon then locates the stone and either removes it with a cage-like device or shatters it with a special instrument that produces a form of shock wave. A small tube or stent may be left in the ureter for a few days to help urine flow. Before fiber optics made ureteroscopy possible, physicians used a similar “blind basket” extraction method. But this technique is rarely used now because of the higher risks of damage to the ureters.
Hope through Research
The Division of Kidney, Urologic, and Hematologic Diseases of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) funds research on the causes, treatments, and prevention of kidney stones. The NIDDK is part of the National Institutes of Health in Bethesda, MD.
New medicines and the growing field of lithotripsy have greatly improved the treatment of kidney stones. Still, NIDDK researchers and grantees seek to answer questions such as
- Why do some people continue to have painful stones?
- How can doctors predict, or screen, those at risk for getting stones?
- What are the long-term effects of lithotripsy?
- Do genes play a role in stone formation?
- What is the natural substance(s) found in urine that blocks stone formation?
Researchers are also developing new medicines with fewer side effects.
Points to Remember
- A person with a family history of stones or a personal history of more than one stone may be more likely to develop more stones.
- A good first step to prevent the formation of any type of stone is to drink plenty of liquids—water is best.
- Someone who is at risk for developing stones may need certain blood and urine tests to determine which factors can best be altered to reduce that risk.
- Some people will need medicines to prevent stones from forming.
- People with chronic urinary tract infections and stones will often need a stone removed if the doctor determines that the stone is causing the infection. Patients must receive careful follow-up to be sure that the infection has cleared.
Source: http://kidney.niddk.nih.gov/Kudiseases/pubs/stonesadults/
