18 mos flank pain/occas hematuria/malaise/fatigue

[fixmypain]

I am 51 year old male. I had three episodes of kidney stones beginning Oct 04.Since that time have constant right flank pain (never going away); frequently severe requiring demerol or even morphine.Pain feels like stone ripping out my flank area. The pain gets so bad when it becomes severe that it suddenly hits and causes me to break out in a sweat, turn pale as a ghost, and buckle down to my knees. I am active. I work part time in Dr.'s office, I am a Firefighter/Paramedic, love to work in my yard on 10.5 acres, I do some woodworking, and help my wife at craft shows. I can't do woodworking anymore due to pain and pain meds. I have had CT Scans, MRI's, cystoscopes/stents, ultrasounds, retrograde and kidney biopsy all with negative results. One doc dx flank hematuria syndrome which women had! Bull **** dx of exclusion. Tired of being on pain meds. Can't take much more pain. Prior to this I was active. Last week I urinated at 9:30 one morning and did not go again. Went to hospital with 1300 cc of bloody urine returning. Came home at 3:30 AM. Woke my wife up at 8AM with chills. Don't remember anything after that. My wife said she tried taking my temp but I could not stay awake for it. Temp 102.7 axillary. she called ambulance. Before I got there I became unresponsive, diaphoretic, my lips, face and hands were becoming dark. The paramedics had to put me on oxygen. The doctors treated me for pyleonephritis. The pain was severe for about a week. I came home with the same pain and nausea; no change after antibiotics. Just now getting a little strength back; the pain is just dropping to a 6 out 10 on a pain scale. I can't take another episode like this one. I take a vitamin every day, Glucophage twice a day, a Baby ASA every day, Verapamil SA once a day, Avapro 300 mg once a day. None of these seem to have the side effects that I am experiencing.
Someone please help me!

[Kevin Pho, MD]

Difficult case.  With the studies you have mentioned, many of the urological possibilies have been exhausted.  

If the stones are calcium stones, you can consider medications like thiazide diuretics to help prevent formation.

If the tests continue to be non-revealing (i.e. you've been to a second urological opinion), referral to a pain clinic can be considered.  A proper long-acting, supervised, narcotic regmien can be considered to help manage the chronic pain.  

You can also look outside of the GU system - i.e. GI causes (i.e. IBS) or musculoskeletal causes can also lead to similar symptoms.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_

[jakesma]

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