There are a few things in life you can always count on: the grass is green, the sky is blue, the subway is delayed for what seems like an eternity, and five-time Olympic gold medalist Simone Biles is a verified badass. This weekend, Biles took her reputation a step further and competed in the World Artistic Gymnastic Championships—just a day after being diagnosed with a kidney stone.
On Friday, Biles tweeted that she was hospitalized with a kidney stone a day before the world championships in Doha, Qatar. “Nothing like a late night ER visit less than 24 hrs before world championships,” she wrote, alongside photos of herself in what appears to be a hospital. “This kidney stone can wait…. doing it for my team! I’ll be gucci girls!”
Later, Biles tweeted to a fan that she hasn’t had the stone removed yet. “Just got the diagnosis and information about it,” she added. “We will deal with it after world championships! fingers crossed it stays okay!!!”
Ultimately, Biles qualified for every event—despite the previous night's excitement. She came in first in the all-around, floor exercise, vault, and balance beam, USA Today reports. And she came in second in the uneven bars.
The symptoms of a kidney stone are usually painful and hard to miss—but not always.
Kidney stones are crystalized mineral and salt deposits that form when your urine becomes concentrated, the Mayo Clinic explains, which may be a result of dehydration, a high-protein diet, a urinary tract infection, or a chronic underlying health condition (such as a thyroid issue).
They can affect any part of your urinary tract—from the kidneys to the bladder. And when they do form, many people experience a very specific type of pain: It's usually severe pain in your side and back below the ribs. The pain might radiate from your lower abdomen and groin, come in waves, or come when you pee. And, along with the pain, you might have odd colored pee (red, pink, brown, or cloudy), a persistent feeling like you need to pee, frequent peeing, nausea, or vomiting, the Mayo Clinic says.
“They can be excruciatingly painful,” S. Adam Ramin, M.D., a urologist at Cedars Sinai Medical Center and medical director of Urology Cancer Specialists in Los Angeles, tells SELF. “I’ve even heard the pain of passing a kidney stone compared to the pain of childbirth.”
However, Dr. Ramin says, not all patients experience the same level of pain, and sometimes kidney stones don't cause any pain. The type and intensity of pain you feel depends on the size of the stone and where it’s located, Edward Schaeffer, M.D., Ph.D., chair of the Department of Urology at Northwestern Medicine, tells SELF. For instance, if it’s still in your kidney, you’ll probably have dull, insistent upper back pain, or sharp intermittent pain, he says. If the stone has moved into your ureter, which is the tube that connects your kidney to your bladder, it can block your ureter from draining urine. “That causes this intense, extreme, labor-like pain,” Dr. Schaeffer says. “That will make people fall over in pain. It’s pretty intense stuff.”
Any unexplained extreme pain definitely warrants a trip to the ER. But if you, like Biles, are diagnosed with a kidney stone, you may not need immediate treatment.
The pain alone may be enough to send you to the ER. But if you have any other symptoms—such as the aforementioned nausea, vomiting, or blood in your urine—you’ll definitely want to get checked out because these can all be a sign of an infection, Dr. Schaeffer says.
Once your doctors have determined that you have a kidney stone (through an imaging test, such as a CT scan), the next steps depend on how you’re doing, where the stone is located, and how big it is, Dr. Ramin says. If the stone is small and making its way through the ureter, your doctor may just want to put you on "observation" while it passes, Dr. Schaeffer says. But if it's causing a lot of pain, is on the larger side, or is blocking the ureter, your doctor will want to take action. “Observation is definitely a treatment option that we use if the stone is small and it’s moving down through the ureter,” Dr. Schaeffer says. However, if the stone is causing a lot of pain, it’s bigger, or it’s blocking your ureter, doctors will want to treat it.
Treatment might involve a procedure called extracorporeal shock wave lithotripsy (ESWL), which is when sound waves are used to try to break up the stone. Or, your doctor may use a thin, lighted tube inserted through your urethra and bladder to try to snare the stone or break it into pieces that will pass out through your urine, Phillip Mucksavage, M.D., assistant professor of clinical urology in surgery at Penn Medicine, tells SELF. Or, if the stone is especially large, you may need surgery.
But don't be surprised if you are sent home with your kidney stone to chill, Dr. Mucksavage says. “It depends a little bit on the stone, but not everyone needs to be treated,” he says. “It’s very common to go home and try to wait it out if the stone is smaller and the pain is well controlled.”
In that kind of situation, doctors generally recommend taking over-the-counter pain medication and drinking plenty of water to try to flush out the stone, Dr. Schaeffer says. The patient is usually urged to follow up with a urologist in a week or two, and to go back to the ER if they develop a fever, their pain gets significantly worse, or they’re not able to keep food or liquids down, Dr. Mucksavage says.
So, luckily, most people are able to recover from a kidney stone without extensive treatment. But very few of us go on to absolutely crush a routine on the uneven bars less than 24 hours later.