Jeff Bezos, the founder of Amazon was forced to abandon his yacht during vacationing in Barbados and was flown to the US for treatment.
Dr. Alex Shteynshlyuger a urologist specializing in kidney stone treatment and prevention says that up to 50% of men and women with one kidney stone will have a kidney stone recurrence. We do not know whether Jeff Bezos has history of kidney stones in the past but certainly for patients with history of kidney stones, routine care is important.
Kidney stones can be very painful, often compared to childbirth without an epidural block. In fact commercial airlines require pilots to be ‘stone-free’ in order to pilot aircraft.
Kidney stones can be detected using ultrasound or CT scan before they cause symptoms. Current recommendation is to break stones greater than 5 mm as they are less likely to pass without causing symptoms.
“Treatment of kidney stones involves very sophisticated technology and high skill level that may not be available during travel to countries or locations with less access to highly trained urologists.” states Dr. Shteynshlyuger, “I typically recommend to patients with history of kidney stones who travel a lot to have close surveillance for kidney stone recurrence and treatment while in the US.”
If this is Jeff Bezos first stone, depending on location, stone size and whether there is any evidence of infection, there are 3 options available to Mr. Bezos according to Dr. Alex: (1) try to pass the kidney stones if his pain is well controlled, the kidney stone is relatively small in the lower ureter and there is no evidence of infection; in this case Dr. Shteynshlyuger would prescribe him pain medications and a medication such as Flomax that has been shown to accelerate stone passage as well as improve the chance that it will pass. (2) ESWL lithotripsy or (3) ureteral stent insertion with possible ureteroscopy and laser lithotripsy.
“Many stones are preventable with proper urological care” says Dr. Shteynshlyuger.
Dr. Alex would recommend that Mr. Bezos have a thorough evaluation by a urologist who specializes in kidney stone prevention and treatment. At a minimum he should have a thorough history, CT scan and blood work that includes Creatinine level, calcium and uric acid level. If he has multiple or recurrent stones he should have 24 hour urine collection.