It’s Not Apple Juice

Those of you who have been reading my posts since the early days may recall that I had an argument with my kidneys around the end of 2013, which resulted in my receiving one of the worst presents ever–and I couldn’t even exchange it for something more pleasant.

I didn’t mention my second kidney stone a couple of months ago because, unlike the first, it passed relatively easily, and because I couldn’t think of anything amusing to say about it. Let’s be real: nobody wants to read depressing blog posts about stabbing pains in the abdomen. But funny posts about pain? Oh, yeah.

One kidney stone is no fun, and it’s the joy that keeps on keeping on. If you have one, the odds are good that you’ll have more. You can make dietary changes to reduce the chances of recurrence, but as my experience shows, you can’t reduce them to zero.

Of course, the more you know about what’s going on in your innards, the better you can craft your approach. Last time around, my dietary changes were based primarily on the type of stone. This time we’re also taking a closer look at what my kidneys are doing. This is not, fortunately, an invasive procedure. It is, however, amusingly perverse. Allow me to introduce you to the dubious joys of the 24 Hour Urine Collection.

The tools are simple: an orange jug with a capacity of four liters, two little cups with screwtops (they look a lot like a little kid’s sippy cup, only without the drinking spout), and a ziplock bag prominently marked “BIOHAZARD”.

Step One: Clear enough space in the refrigerator to hold the jug. Clear some extra space while you’re at it. Unless you’re a heck of a lot more comfortable with your own waste products than I am, you don’t want anything else in the fridge touching that jug.

Step Two: Choose a day when you’re not going anywhere to do the test. You do not want to carry this bright orange jug around with you. Did I mention that it’s bright orange? Hard to miss, and while it’s a great conversation starter, those aren’t the kind of conversations most of us want to have.

Step Three: Begin collecting with your second trip to the bathroom of the day. Those of us with convex excretory apparatus are lucky: we can pee directly into the jug, as long as we’re careful not to touch the sides of the opening with our gear*. Women, as I understand it, get to pee into a cup and then pour the contents into the jug. Don’t forget that the first thing your physician tells you to do to reduce the risk of kidney stones is to drink lots of water–a minimum of two liters a day. Those cups are tiny and fill up quickly. You do the math; I suggest wearing gloves.

* Officially, avoiding contact is to prevent the microorganisms that live on the outside of your spout from contaminating the specimen. The real reason is that touching your equipment to a piece of plastic chilled to just above freezing temperature is an experience you want to avoid. Especially at three in the morning, after you’ve crawled out of a nice warm bed.

Step Four: Continue filling the jug. Bring the jug along on every trip to the bathroom. Miss one and you’ll need to get a fresh jug and start all over.

Step Five: Collection concludes with your first trip to the bathroom the next morning. So now, roughly twenty-four hours after you started, you’ve got a bright orange jug of urine. Congratulations!

Step Six: Now you get to mix the sample thoroughly. Close the lid of the jug. Tightly. No, tighter. Got a large wrench handy? Use it. Now shake the jug as hard as you can. Try not to think about the lid popping off. You twisted it tightly, right? If you’ve been drinking enough to satisfy your doctor, the four liter jug will be at least three-quarters full. That’s fairly heavy. Better give it a couple more shakes to be sure it’s well mixed. Unless you’re going to do this regularly, it’s probably not worth investing in one of those shakers the hardware store uses for mixing paint.

Step Seven: Take the two lidded cup. Pull open the pour spout and fill both cups. Put the lids on and put both cups in the BIOHAZARD bag.

Step Eight: Discard the rest of the urine. Yes, all your hard work collecting your pee will literally go down the drain. Look at the empty jug. It does not say “BIOHAZARD”. Only the samples in the sippy cups are a public health menace, it seems.

Step Nine: Take the sippy cups to the lab. I asked the technician what I should do with the jug. “Oh, you can just toss it out,” she said. “I know,” I replied. “But does it go in the garbage or the recycling bin?” She froze, her expression completely blank. Clearly this is not a question she gets every day. Or, in all likelihood, ever. Finally, she shook her head. “Just toss it out.”

Step Ten: Examine the jug closely. I couldn’t find a recycling indicator on it. If you find that ecologically unsatisfying, you might consider washing it well and using it to make lemonade. You might. I put it in the garbage can.

10 thoughts on “It’s Not Apple Juice

  1. Very well written and funny as always, but my brain hooked on to “kidney” and “procedure” and couldn’t stop. I’ve been nail-biting a lot lately over family illness, and now I’ve started on my toes. Best of luck, Casey–I hope the procedure finds nothing and that Maggie is watchful of the beverage section in the fridge.


    • Thanks. It’s not so much a question of finding something or not, just a matter of fine-tuning my diet to minimize the particular load on my kidneys that results in stones forming. In that sense, finding nothing would be a BadThing(tm).

      That said, I hope you’re washing your feet before biting your toes–or toenails (the phrasing was a little ambiguous).


  2. I almost clicked the “Like” button, but thought that was needlessly cruel at your expense as I didn’t like that you went through it, but I’m delighted that you shared it with us. Did the instructions you received begin, “Dear Patient, Urine for some fun today!” ? Because really there’s nothing wrong with a little urinary humor.

    I’m going to go hug my kidneys now and thank them for their continued good service. And, I hope you get some helpful information from your micturition marathon. (I have waited more than a decade to use “micturition” in a sentence, as it is one of the coolest words learned in massage school … so thank you for letting me have this moment.)

    I hope you feel better! (And, I hope you scrubbed out the fridge with bleach.) 🙂

    Liked by 1 person

    • Feel free to like the laughs while deploring the necessity that provoked them. No, the instructions were depressingly boring. You’d think they’d figure that peeple going through this could use a little humor.

      Bleach and food don’t mix well. Now fire, on the other hand… Just because those kitchen blowtorches are intended for caramelizing the top of creme brulee doesn’t mean you can’t use them for fridge sterilization!


  3. Yeah, collecting various excretia is an interesting topic. Happily, we don’t have to do it often, although I have an uncomfortable feeling that there are people who… Well, let’s just leave that there. Kaiser occasionally asks me for a feces sample, sending a little kit that, surprisingly, makes the whole thing pretty simple once you get past the “eeewww” factor. Then, there were the samples I had to submit after my vasectomy. To this day, small, screw-top jars bring up strange, seemingly inappropriate feelings, for some reason. Hello? Where did everybody go?


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