Trip To Er- Kinda Graphic Details

[Michelle F.]

It's been a while since I've been on, but I am not sure where else to turn. You all have helped me so much in the past, I wanted to come here and see if anyone has experienced anything like this.

Almost 48 hours ago, I awakened from sleep with sudden SEVERE lower abdominal pain (cramping?) and extreme thirst. I went to the toilet and had a little diarrhea and urinated. Then, my hands started itching like crazy and turning red quickly! Other body parts started to itch a lot: feet, inside my mouth and my genitals. I felt like I was in the transition (most painful) part of childbirth. The itching and red hands stopped within about 30 minutes.

My dh got me to the ER within about an hour, so the doctors didn't see my hands and other itching areas. Lower abdomen was tender. The doctor ordered a urine test. When I was getting the sample, I could see a lot of debris in the urine and it was concentrated. I patted dry and had thick discharge and light to medium bleeding vaginally, but don't think it got in the cup....not sure. The results were "a few bacteria, red blood cells, white blood cells". His dx was UTI, possibly kidney stone. The intense pain subsided within 2-2 1/2 hours. I do not believe I am/was pregnant. Don't know if he did pg. test.

The first UTI I had was last year about this time and now I always have some RBC in my urine. Don't know why and urologist said not to worry about it.

I emailed my dysauto dr. who is a cardiologist, but she is out for the week. The nurse will call me, but I am at a loss for what this sounds like. This was my first trip to the ER, since my NCS dx and I was uncertain of how to handle it. My bp was 109/70, so that was good. I am on Metoprolol. No fever.

I am a 43 yo female. Does anything come to mind?

Thank you,

Michelle

[Michelle F.]

Oh, I also barely remained conscious through the itching and painful episode before I got to the hospital. I don't think it was from the pain, but one of the NCS episodes. Kind of felt like I did right before I passed out on the tilt table.

[persephone]

This definitely sounds like a large kidney stone == especiallly the debris

[potsgirl]

I had a small kidney stone a couple of years ago, and the pain came on very quickly, and was almost unbearable. I was crying so hard I could barely speak. I couldn't stand up or walk, and I had to call the ambulance since I was alone. Didn't they check you for kidney stones? If not, they were irresponsible. I would get in to see a nephrologist as soon as possible to get an ultrasound done of your pelvic region. Or go back to the hospital. I've done that a time or two when I've been in great pain and no one could get me in for a couple of weeks. Please check it out soon, and good luck!

Peace,

jana

[shoe]

Oh, my... I haven't had something like that go on personally, I feel for you. I've had UTIs and kidney infections in the past -- no stones, but the UTIs were painful enough on their own (and my cousin had a few stones where he passed out when peeing). Not sure about the itching, but I'd wonder if the combination of a urinary tract infection/stone and the inflammation and havoc they wreak combined with the "usual" (ironic word to use here) dysautonomia stuff might make what would seem unrelated/unusual combinations of symptoms pop up. Thinking back, I once had a kidney infection -- I didn't have much pain (so I didn't recognize it as such) but when I got to the doctor and he started the exam his face lost all color, he pulled some blood and got a urine sample, and said depending I was either going home with heavy duty antibiotics or I'd be headed to the hospital and worked up to possibly be put on the liver transplant list (fortunately it was antibiotics, and fortunately, I felt way too sick to really get alarmed by the liver failure possibility). So I guess these things can have weird referred seemingly unrelated presentations?

I hope that whatever it is calms down, gets figured out, and stays well away from here on out. Wishing you well.

[Michelle F.]

Thank you for your responses. No, they didn't check my kidneys or do any blood work. It has now been a little over three days and I still feel like something is going on; 3rd day on Cipro (antibiotic). There is less debris in my urine. I am very thirsty. No matter how much water I drink, it feels like it goes straight through me. My urine is less concentrated after I have had a glass of water. But, when I wake up in the morning, after urinating all night, there is not much urine and it is very concentrated. Why is my body not holding onto the water I drink. Are my kidneys being overworked?....leaving me with rbc in the urine? I do think I have a uti, but I'm just not sure about the kidney stones? Would I have vaginal bleeding with those?

I am waiting on a call from my dysauto. doctor (cardiologist).

Thanks again.

[dsdmom]

I can understand you wanting your cardiologist's input since you have NCS but I wouldn't wait to hear from your caridologist about this since it's certainly not in his/her realm. At least call your pcp in the meantime.

[Michelle F.]

I think I will try to see my pcp tomorrow. I didn't have a good day. It isn't that I really want my cardiologist's opinion, but I want my dysauto. doctor's opinion...she happens to be a cardiologist, if that makes sense. She works at a Dysautonomia Center. None of my other doctors seem to understand my condition....not the gyno, uro or pcp really. But, my pcp tries, so I think that's a good idea. Thank you.

[Michelle F.]

Over the past couple of days, I have scheduled appointments with my urologist and my gynecologist (ultrasound first) for this coming Thursday (6/25). This will give me time to finish the round of antibiotics and be off of them for about 5 days.

Thinking back to the severity of the pain with this event, I recall I was wallowing in the bathtub, sloshing water out by the gallons according to my husband. I was not really aware of what I was doing because of the pain. He gave me a large glass of ice water because I was soooo thirsty. I was shaking so badly (I presume with pain) that I spilled almost the entire contents on me in the bathtub. Didn't phase me a bit!! At the time I remember thinking...."that should hurt"...but it was the least of my concerns.

Both the uro and gyne offices seemed irritated and shocked that the ER had not done an x-ray (don't know of what) or an ultrasound....but had only done a urinalysis.

Thanks everyone for your input and advice. I'm going to go to someone.

[flop]

Hi Michelle,

some kidney stones show up on Xrays. They do what is called a KUB (kidneys, ureters, bladder) - essentially lower abdomen and pelvis looking for bright white spots that may be a calcified kidney stone.

Here is a picture of a KUB showing a kidney stone (white blob on the left side of the picture)

Another type of x-ray that can be done is an IVU if they think that a stone is actually blocking off one ureter (ongoing severe pain and back-pressure on the kidney). The intra-venous urethrogram (IVU) is essentially a KUB x-ray then they give you an injection into a vein of something that when it is passed by the kidneys shows up as white on the x-ray. They then take a series of x-rays to see how the dye flows from the kidneys down into the bladder.

This is a picture of a normal IVU x-ray.

Flop

[Michelle F.]

Flop- Thanks so much for taking the time to post those very interesting pictures! I guess when I hear "x-ray", I think "bones". Last year I had recurring UTI's, with no prior history. A test was done that used dye (don't remember what it was called), but since they called it by it's more specific name, I didn't think of it as an "x-ray". Nothing was found and the urologist doubted that I had in fact had infections. He believed the specimens may have been tainted at the lab or my PCP's office. I had symptoms though..that's why I went in the first place. He did do a cystoscopy which revealed nothing unusual. He did say that I have some blood (not visible to the naked eye) in my urine and that some people just have that.

Surely, whatever test they should have done....or will do, will look at the complete urinary tract though.

Thanks so much. Very interesting and informative. I appreciate any thoughts and information you have to offer.

Michelle F.

[Michelle F.]

Today was a day of follow-up doctor visits after my initial ER trip. The doctor in the ER didn't tell me to follow-up, I just did. Anyway, I am glad I did.

After seeing my urologist and gynecologist; and having a pelvic ultrasound, a renal ultrasound and a KUB x-ray, the apparent cause of my excruciating pain and odd reaction to it was a ruptured ovarian cyst. The cyst is still there and measures 2 cm. Because it is irregular in shape, the gynecologist believes it ruptured, giving it some relief. She will do another pelvic ultrasound in 6 weeks to be sure it is resolving itself...which is what she expects. She also said every person's body is different and that she suspects that the symptoms I had with my hands, feet, etc. were my bodies reaction to the severe pain.

She let me know that I should have had an ultrasound or x-ray in the ER and that is not normal....she was not happy with the way I was not checked out more thoroughly. BTW, I didn't go to the hospital where she works, but a smaller one. I just didn't think I could handle the extra few minutes to get to the big hospital.....because of the pain. I will know better next time.

Also, the urologist said my urine was clean as a whistle.

Thanks everyone for your help!

Michelle F.