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Urology (Expert Forum)
Chronic Kidney Stone Pain
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
Chronic Kidney Stone Pain
by Bombie, Nov 10, 2006 12:00AM
Dear Dr,
I come to you as a last resort and for an unbiased opinion. I have followed with a nephrologist for three years and a urologist 1 year prior to that. I am a 33 year old (otherwise healthy) woman who passes kidney stones very frequently (at least 1-2 month). I have had the whole sha-bang work up, IVPs, CT, and 24 Hr. urines. I am currently prescribed HCTZ 50mg and Urocit-K 4xday.(I will be honest, I have not been taking the Urocit for about a month because I just feel nothing has been helping). Since October 15 of this year, I have been to the hospital four times. Only to be treated like I was a drug seeker or hospital shopper. Can anyone imagine how this must feel. Being a former hospice nurse and charge nurse for Long term care facility, I never made any of my patients feel that way. The CT scans now read two 2mm stones in the right calyces and one stone left kidney superiorly. The also found that I had a 3.8 cyst on Right ovary which led to an overnight admission on 10-31-06. My question is...Do dormant kidney stones cause chronic pain? I constantly have pain in my right flank area. My history of passing kidney stones starts four years ago with passing 21 while pregnant. I have since passed many more, but decided (for my own mental health) to quit counting. I would estimate approximately 50. I also currently take a strong pain medicine Norco about 4 times a day which does relieve the pain with no "Woo-Woo" side effects. Being a former nurse, I do know dependence and addiction can occur, but at this point, I don't care. I just want the relief. My nephrologist recently sent me to a pain clinic because he literally said he "wanted to cover his a..". The one doctor I have put all my faith in for three years justs wants to cover his hiney for prescribing narcotic pain medicine. The doctor at the pain clinic immediately told me there was nothing he could do for kidney pain. So, here I am, losing my faith in the medical profession, having constant pain, being treated like a drug seeker, and my spirit is broken. This consumes me and my family. Where do I go from here? Is taking pain medicine on a routine basis okay? Are the health care professionals ,who so snidely look at me, justified in saying that I should not have pain unless a stone is moving through my ureter? My next appointment with my nephrologist is December 6. Any advise? Thank you so much for your time.
Sincerely,
Angie (Bombie)
I come to you as a last resort and for an unbiased opinion. I have followed with a nephrologist for three years and a urologist 1 year prior to that. I am a 33 year old (otherwise healthy) woman who passes kidney stones very frequently (at least 1-2 month). I have had the whole sha-bang work up, IVPs, CT, and 24 Hr. urines. I am currently prescribed HCTZ 50mg and Urocit-K 4xday.(I will be honest, I have not been taking the Urocit for about a month because I just feel nothing has been helping). Since October 15 of this year, I have been to the hospital four times. Only to be treated like I was a drug seeker or hospital shopper. Can anyone imagine how this must feel. Being a former hospice nurse and charge nurse for Long term care facility, I never made any of my patients feel that way. The CT scans now read two 2mm stones in the right calyces and one stone left kidney superiorly. The also found that I had a 3.8 cyst on Right ovary which led to an overnight admission on 10-31-06. My question is...Do dormant kidney stones cause chronic pain? I constantly have pain in my right flank area. My history of passing kidney stones starts four years ago with passing 21 while pregnant. I have since passed many more, but decided (for my own mental health) to quit counting. I would estimate approximately 50. I also currently take a strong pain medicine Norco about 4 times a day which does relieve the pain with no "Woo-Woo" side effects. Being a former nurse, I do know dependence and addiction can occur, but at this point, I don't care. I just want the relief. My nephrologist recently sent me to a pain clinic because he literally said he "wanted to cover his a..". The one doctor I have put all my faith in for three years justs wants to cover his hiney for prescribing narcotic pain medicine. The doctor at the pain clinic immediately told me there was nothing he could do for kidney pain. So, here I am, losing my faith in the medical profession, having constant pain, being treated like a drug seeker, and my spirit is broken. This consumes me and my family. Where do I go from here? Is taking pain medicine on a routine basis okay? Are the health care professionals ,who so snidely look at me, justified in saying that I should not have pain unless a stone is moving through my ureter? My next appointment with my nephrologist is December 6. Any advise? Thank you so much for your time.
Sincerely,
Angie (Bombie)
Doctor's Answer
by Kevin Pho, MD, Nov 11, 2006 12:00AM
, Nov 11, 2006 12:00AM
This sounds like a difficult situation - as you have been appropriately evaluated with many tests, and treated preventively with things like HCTZ and Urocit-K.
At this point, I agree with a referral to a pain management specialist. Not just for liability purposes, but they are familiar with other pain management options such as a morphine pump and other options that may not be available to a PCP or urologist.
If there is appropriate pain management, this will result in less trips to the emergency room. However, this requires the services of a dedicated pain management specialist. Another pain management option can be sought if the first one isn't satisfactory.
This option 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_
At this point, I agree with a referral to a pain management specialist. Not just for liability purposes, but they are familiar with other pain management options such as a morphine pump and other options that may not be available to a PCP or urologist.
If there is appropriate pain management, this will result in less trips to the emergency room. However, this requires the services of a dedicated pain management specialist. Another pain management option can be sought if the first one isn't satisfactory.
This option 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_
Member Comments
by exusafflyer, Nov 13, 2006 12:00AM
To: Kidney Stones
0
by fergus, Dec 20, 2006 12:00AM
To: Kidney Stones
0
by princesskroll, Jan 03, 2007 12:00AM
To: Kidney Stones
0
