So on thanksgiving day I noticed something was wrong. It burned when I peed, My urine smelled like fish (<-TMI part) and most noticibly I had to go to the bathroom probably every 10 minutes or so). This coupled with back pain and a general crappy feeling caused my wife to call her mother (her mother is an RN). Dr. MIL said it might be a kidney infection and if it was still bad in the morning I should get to a doctor. Well we did a little research and my syptoms matched up exactly with a kidney infection and off to the ER we went. While there I was diagonosed with pyelonephritis, they gave me Levaquin, Pyradine and Vicodin for the pain along with a script for each one. The expierence left me with a bunch of questions. First the doctor said it was very odd for someone (esp a male) to have a kidney infection at 24 with no history of any problems before (in fact he said it’s so odd he wasn’t totally sure that’s what it was, until of course the UA came back from the lab a little while later). Why is that? What caused it? How do I prevent it? Could it have been from sitting in a hot tub/whirlpool the day before (public one at an indoor water park?) Second. He gave me both Levaquin and Pyradine. To the best of my knowledge, they are both antibiotics, why does he use both? Do they attack different things? Why is the pyradine only for two days? Also, is one of them known to cause headaches? I’ve had a pounding headache since I started taking them that tylenol can’t touch. Luckily I’ve been diagnosed with migranes, so I have imitrex that can take care of it in a pinch if need be, (otherwise the Vicodin keeps it in check) and I’m used to having headaches for days on end, so it may just be a coincidence.
Lastly and somewhat unrelated. Why do opiate analgesics mess with my ears? When ever I take Vicodin, Tylenol 3 etc… I get this wierd thing that when someone is talking to me it’s almost like pressure is building up in my ears, the louder they talk the more it seems to build up and it makes it harder for me to hear (everything sounds all muffled). People don’t seem to understand when I say “Talk quiter I can’t hear you…No no no, really the louder you talk the less I can understand you. Talk quiter”
Wait, one more, the big one. What can I expect from all this? Is this something that’s likely to be recurring? I have a follow up with my GP on Monday. The ER doc said the GP will probably order an ultrasound (I can handle that) to check for stones, although he said my symptoms don’t match those for stones (Thank Og), and a VCUG. From what I’ve read about that, it doesn’t sound like much fun, anybody have an expiernce with those. I’m really not looking foward to that, but I’ll just keep telling myself that it seems to be something they normally do on little kids, surely I can handle it. Do they have a virtual one yet? I know the hospitals in my area do virtual colonoscopies, do they do virtual VCUGs?
Wow lots of questions. Anybody have any answers?
Kidney infections in male children are uncommon. In adults, not that uncommon. In the catheterized elderly male, kidney infections are even more frequent.
At 24, kidney infections are not common, nor that unusual. Infections are usually caused by gram negative bacteria. E.coli is a common cause. Folks who don’t wipe “front to back”, shower after sex, utilize hot tubs, require a catheter, have pelvic surgery, etc. are more susceptible to urinary tract infections. These may have few symptoms and turn into a kidney infection – odds are you had a UTI first. The difference between a kidney infection and a UTI is severity of symptoms – back pain, vomiting, fever (hypothermia in infants), etc.
Levaquin is an antibiotic, and a fairly expensive one. If I am sure you have a UTI, I would prescribe generic Septra (or Macrodantin if you have a sulfa allergy). The doctor should have done a rectal exam (!!) to rule out prostatitis. If you refuse this, then there is a role for Levaquin or ciprofloxacin.
Pyridium is a pain killer, probably the same as your pyradine. I tend to use it only if requested, it can cause other problems – but lots of folks swear by it and if they want something “that has worked in the past”, I would often give it to them.
Vicodan is also a pain killer. I tend to prefer Toradol (found to be as effective) or Naprosyn; but sometimes I will use narcotics if the pain is severe. If the pain is severe or there are plenty of red blood cells (and thus I have reason to suspect a stone), I would get an ultrasound or IVP – not using VCUGs much myself (nor heard of virtual VCUGs). If symptoms are severe, I would admit you to hospital for intravenous antibiotics and pain control.
A pyelonephritis infection by itself can cause headaches – and some headaches can cause ear symptoms. Some medicines are “ototoxic” (most popularly ASA and gentamycin). You might well have a sinus or ear infection in addition to your UTI, and this should also have been ruled out.
This case can also illustrate differences in health care systems. If you have a “mild to moderate” kidney infection (diagnosed from your urinalysis, white blood cell count and most importantly, your symptoms) , the symptoms might well disappear after three days of Septra (costing the pharmacist under twenty-five cents). If this is the case, you may well not need an ultrasound nor a VCUG if stones are thought to be unlikely. Such tests add a great deal to the costs of a medical system while providing only the illusion of better care. That being said, kidney infections can be very serious and can require hospitalization and testing. This illustrates flaws in accepting internet medical advice, as well as the dangers of the need to practice “cover your ass” medicine in a society too prone to sue.
I think you answered the bulk of the questions. I should mention that the ear thing has nothing to do with an ear infefction etc… It’s been something that’s always happened to me with opiate Rx’s. I always assumed it had something to do with the fact that I was a little spaced out from the meds. Well, I guess we’ll see what happens when I see the doc on Monday, not looking foward to it. I had my first dose of drugs on thursday, I finish up the Pyradine in a few hours and I still have 8 days of Levaquin left and I can say I do feel ALOT better then I did on Thursday. The ER doc did say that it likely wasn’t stones, so maybe if I’m lucky the doc will make me pee in a cup, maybe take some blood and send me on my way.
My husband had pyelonephritis about 12 years ago. His case was bad enough to keep in the hospital for 5 days.
The good news is that it has not recurred since, although due to other medical problems he is at high risk for both bladder and kidney infections. So if you take care of yourself this may be the only time you have to go through this.
Some people are more prone to these infections than others - if you feel it would be reassuring, speak to a urologist about means of lowering your risk of these infections, and how to spot early symptoms of trouble so you can be treated before you get the serious problems. Certainly, making sure you drink adequate fluids every day is important for maximum kidney function. And in the future you might want to be careful since certain medications can have a negative impact on kidney function and you may need to be watched more closely than usual for side effects if you need to take such medications.
But only a real-life doctor (which I am not) can really give you the advice you need. If you aren’t satisfied with the current doc(s), seek a second opinion.