Flank pain and dehydration

[ldchris777]

I should start off by saying that my health complications started 5 months ago.  I was waking up in the middle of the night with night sweats, confusion, and high blood pressure.  I went to the doctor and and he thought it might be anxiety. So he put me on clonazepam as needed.  I spent the next couple of months having those attacks less frequent with a healthy diet and proper exercise of running.  

One month ago I had severe pain radiating from my kidneys.  I have had kidney stones and cysts in the past so I immediately went to a high water/cranberry juice intake.  I took a urine test at the doctor and it showed that there was hematuria. At work my legs started to hurt and go numb.  The numbness went away and now I have muscle twinges.  I also have constipation.  I took an IVP and my kidneys looked fine. I took a blood tests and my levels were all fine. I still have flank pain, muscle twinges, off and on constipation, and still pee dark yellow in the mornings(one time cloudy). I drink lots  of water until my pee turns light yellow/clear.  At night I have to go pee like 3-4 times. (large amounts) I get dry mouth and have to start drinking water or I just feel terrible in the morning.

Last night I woke up with night sweats, flank pain, dry mouth, and had to pee three times in three hours.  I have stopped the clonazepam when I started getting kidney pain and decided to get on Budeprion XL thinking that this might all be mental.  I think there is something wrong but all the test show normal.  Should I see a Urologist for more tests, or will this eventually go away with massive amounts of water? The muscle twinging is annoying.  I am beyond frustrated and want to get back to my running without getting massive dry mouth afterward.

I have research most everything and would appreciate any help.

[el_em_en_oh]

I feel your pain my Texas Brother!

I've had kidney-stones for YEARS, so I know the IVP & CT drill very well.

I'm not sure about your Urologist specifically, but my Urologist has stopped with the IVP's w/contrast. Partly because my type of stones don't show up on X-ray, but partly because of what the contrast actually does to the kidney. Contrast is a liquid, liquid's are processed by the kidney, foreign substance in the kidney, could lead to kidney issues. So, my Urologist doesn't like IVP's w/contrast. But whatever...

Do you know what kind of stones you have (what's the chemical makeup)? Calcium, Calcium Oxalate, Uric Acid, Cystine? There are a few other types, but I listed the most common, with Cystine the least common of that bunch.

The reason I ask is this... I have Cystine stones exclusively, and unless you REALLY know what to look for on an x-ray (IVP w/contrast), you won't see them. They are quite literally, next to invisible. All the other types of stones show up quite well on an IVP (x-ray) and even better on a CT. Ask your Urologist if they sent your last stones to pathology, assuming you saved them and handed them over, of course!

[ldchris777]

I went to the urologist today and she thinks it might be tiny stones that wasn't picked up by the IVP. She pushed in where I told her the pressure was.  She said that is where the large intestine, appendix, and ureter are located. She wants to wait 4 weeks before we do more investigation. The dry mouth and constipation has stopped but my muscles are still twinging and the pressure is still there.

[Stephen Liroff, MD]

Your symptoms, unfortunately, do not point to a specific cause. With a normal IVP I think that  the problem is not urological. I do not know what blood tests you had that were normal, but I am concerned with your large water intake as you may have literally washed out some of your electrolytes and this may be why you have been having muscle spasms and tingling. Your awakening at night to urinate may simply be due to your large fluid intake. After you have been drinking large amounts for a while, for various reasons you crave water when you cut back, so  cut back slowly  to the volume that you are comfortable drinking. I think that you should return to your primary care physician or consider an internist in an academic medical center and possibly get an abdominal/pelvic CAT scan with oral and IV contrast.
Certainly, if nothing can be found then an emotional cause needs to be considered, but I am not sure that other causes have been completely ruled-out.
Good luck!
S.A.Liroff, M.D.