My dear one had his follow-up appointment with his surgeon yesterday following the removal of his stone. Analysis suggests that it was a calcium oxalate stone, with some magnesium as well, which is the standard type. He was given a sheet of dietary guidelines to help prevent future stones.
First, remember how I mentioned that he was getting so much sleep now that he didn’t have pain? Well, with the amount of fluid he’s to be getting every day (3 litres), he’s up at night for other reasons.
On the diet front….
Calcium: post-surgery, he realized that he was not bothered by what he thought was lactose intolerance anymore and had been enjoying café au lait in the mornings and ice cream after dinner. Hah! He has to keep his calcium intake to 500 mg per day, or about 1.5 cups of milk-equivalent. He could switch back to soy milk, but….oops….soy in on the verboten list (see below). Knowing Z, he’ll stick to cheese and drop all other forms of calcium.
Oxalate rich foods: this is so funny. I mean, all the things that he’s been eating as part of the Mediterranean diet seem to be limited. For example, he takes 3/4 cup greek-style yogurt with a handful of walnuts and raisins in his lunch every day. Yogurt? calcium =>limited. Walnuts (in fact, all nuts)? oxalate =>limited.
What else is on the oxalate list? beets, beans (he heats up cans of mixed beans for lunch), parsley (tabouleh????), celery, okra, sweet potato, dark greens (spinach, kale, chard, endive, etc), strawberries, tea (TEA????), marmalade, chocoate, cocoa, nuts, wheat germ, cola, tofu.
Animal protein: He is to eat less meat, poultry and fish, with special emphasis on avoiding the following foods that increase uric acid: organ meats, goose and partridge, anchovies & fish roe, game meats, rabbit, sardines, herring, mussels, scallops. This is so depressing. We eat anchovies. We love sardines and mussels, and had been eating lots of the former for fish oils.
Sodium: reduce it.
Fibre: increase it, particularly using rice bran and wheat bran as they bind to calcium.
Supplements: NO Vitamin D, Calcium, or Vitamin C supplements, or fish oil.
It’s going to take me a while to figure out some new meal plans to avoid or reduce our intake of oxalates. I’m already a fairly low sodium cook, and now that he’s giving up nuts, that will be reduced even further. But I’ll have to re-evaluate our vegetable purchases, and forget about anchovies on pizza, those great packs of mussels from Costco, and the multi-can packs of sardines we go through every month. We’ll have to keep tabs on the amount of protein he consumes because so many good sources are limited due to either calcium, oxalate, or uric acid issues. Pleasures? I don’t see coffee, beer, wine or other alcohol on the list. Most fruit seems okay.