Post: #1

Hey gents, this isn't the most pleasant of topics but I'm hoping there are a few good MDs on the forum or perhaps somebody who has experienced something similar and could help me figure out what the heck is wrong with me.

Over the past few years or so I've had about 5 episodes of acute flank pain on my right side (under the ribs).

A couple of times it came with a fever that broke by morning and then I had some lingering flank pain that eventually just subsided on its own.

2 things that seem to bring this on are alcohol (even just a drink or two) and overtraining (I train jiu jitsu and lift weight virtually full time although I try to approach my training more intelligently and moderately than I used to).

This never used to be the case. I've trained hard for the last 8 years, and I don't drink much these days but if a glass of wine has my flank aching something's wrong.

Until now I've kind of written this problem off but on Monday I had an especially gnarly attack and woke up in the middle of the night wracked with flank pain and a fever. I made it through the night and then said enough is enough and went to the hospital in the morning.

Previously these episodes didn't result in me getting sick but this time I got a gnarly fever (38.8C) for about 3 days before it broke, and a nice little upper respiratory tract infection to boot. I think that's incidental despite the doctor's insistence on an x-ray and presumptive antibiotic treatment for pneumonia which I refused and which turned out to be unnecessary, big surprise.

Blood and urine tests were generally fine except for a very high creatinine level and a low GFR. Ultrasounded the abdomen, both kidneys, prostate, everything unremarkable.

I thought it might have been Rhabdomyolosis but it was ruled out because urine was clear and yellow.

I've got an appointment with a nephrologist next week and in the meantime I ordered a few diagnostics.

- A PCR assay on a urine sample to check for any STIs (in particular I'm worried about mycoplasmas)
- Semen culture

I also did some standard tests (HIV, Syph, hep B). Funny story: the hospital emailed me the Hep B results and I saw the word POSITIVE and freaked the fuck out. Once I chilled enough to Google everything I realized that I was positive for the Hep B surface antibody which just means you've been immunized and you're immune and can't get it or transmit it (oh yeah, I had this vaccine when I was a kid, duh!)

Man, on a side note, reading about hepatitis B, it's a fucked up virus with some serious complications for your liver. Nothing to play with. And it can be sexually transmitted. One of many scary reasons (including mycoplasmas which most of you guys have probably never even heard of) that I've long since turned in my team Raw Dog membership card.

Anyway, the reason I ordered the PCR is because the only thing I can think of that could possibly be a confounding factor is that at one point I had a mycoplasma infection (M. Genitalium) which I treated with antibiotics but it could have survived or I could have been reinfected.

I scoured the literature and there doesn't seem to be any documented connection between mycoplasmas and this flank pain issue. So it's a bit of a shot in the dark. But I'm going all out to fix this once and for all. To say nothing of the fact that kidney disease is generally considered to be irreversible and I'm 32 years old. Fuck that.

So guys, perhaps you can tell I'm a bit perturbed (I'm still recovering and I've been a weird, delirious state since Monday and finally am getting back to myself). But this forum has always been a haven and golden resource so I thought it's worth a shot.

Any clues you can offer will be most appreciated.

Post: #2

I don't have any medical background and this is purely speculative, but are you getting enough water? You mentioned that your urine was yellow - how coloured was it?

I know someone who was hospitalised earlier this year with acute kidney injury through dehydration; one of the signs of this is elevated creatinine in the blood. They put him on a drip and he was fine a couple of days later. Apparently this is more common than thought. He also had a fever, which was due to urinary tract infection.

Post: #3

You can regenerate even kidney damage with high-dosage orthomolecular medicine.

There were doctors who removed their patients from kidney transplant lists just by application of 20-30.000mg vitamin C as well as other nutrients.

http://www.doctoryourself.com/

Check out here - if interested, you might profit from reading a few of those books.

Orthomolecular doctors are spread out across the world and you will find some in every country, but their level of expertise will vary.

Your condition can be caused by a variety of factors. I would start out with full high dosage normal multivitamin-mineral regimen and then with meg-dosing of vitamin C. If you have no titration (no diarrhea reaction) after 10-15.000mg vitamin C, then you know that you have definitely a condition since your body requires far more vit. C than is necessary in a healthy state.

But this can be more complicated and you need a proper diagnosis of what your issue is.

http://www.doctoryourself.com/titration.html

Vitamin mega-therapies help with virus or bacteria, can repair organ damage, but if it's a fungus, an issue that requires surgery or a parasite, then it won't help - you need to poison those buggers and the conventional medicine is actually quite good at that.

Post: #4

Hi, abdominal pain in general is a tricky business and pinning down the cause can not always be straight forward as the differential diagnosis list is long.

Checking for STIs and seeing a doctor are both great ideas and that’s where I would have started too.

Top of my differential for fever and loin pain would be pyelonephritis - an infection usually not sexually transmitted, testing the urine for infection with a dip stix test and sending a urine sample would be a good start when you’re unwell and treating with antibiotics if required. (A visit to the GP would be the best way to do this).

Your doctor thought it could be pneumonia, this can often cause abdominal pain so isn’t as weird as I’m assuming you think? Also the antibiotics often cover more than one kind of infection. If you choose to not take antibiotics your body may well kill off the infection itself (If present) but on the other side you could get more sick. I’d be very careful when choosing to not follow the doctors advice, perhaps asking the doctor why or how they came to their diagnosis might help communication on both sides.

If I were you - if I had no further episodes I wouldn’t worry since you’ve done tests for STIs and ruled that out. If you have further episodes I would take advice from a doctor you trust.

It’s good to do your own research just be careful it’s not making you anxious or costing you lots of money on potentially unrequired tests.

Also, can’t believe they sent you the Hep B normal result in that format what the hell are they thinking???

Take care

Post: #5

(09-15-2018 08:28 PM)Heretohelp Wrote:  Hi, abdominal pain in general is a tricky business and pinning down the cause can not always be straight forward as the differential diagnosis list is long.

Checking for STIs and seeing a doctor are both great ideas and that’s where I would have started too.

Top of my differential for fever and loin pain would be pyelonephritis - an infection usually not sexually transmitted, testing the urine for infection with a dip stix test and sending a urine sample would be a good start when you’re unwell and treating with antibiotics if required. (A visit to the GP would be the best way to do this).

I ordered a PCR assay because I suspect mycoplasma. Results back this weekend.

Quote:Your doctor thought it could be pneumonia, this can often cause abdominal pain so isn’t as weird as I’m assuming you think?

True. But I've had this issue before unaccompanied by pneumonia or anything else, which leads me to believe that the upper respiratory tract infection is incidental and a result of lowered immunity.

Quote:Also the antibiotics often cover more than one kind of infection. If you choose to not take antibiotics your body may well kill off the infection itself (If present) but on the other side you could get more sick.

I'm aware of the trade off. Are you aware of how dangerous some routinely prescribed antibiotics are? The fluorquinolones for instance.

Most upper respiratory tract infections, including various types of pneumonia are self-limiting and require bed rest and a little patience.

Here in southeast asia there's a particularly bad situation with antibiotic resistant bacteria. I'm a young man and otherwise healthy. So I'll take antibiotics, but only as a last resort.

Quote:I’d be very careful when choosing to not follow the doctors advice, perhaps asking the doctor why or how they came to their diagnosis might help communication on both sides.

Appreciate the heads up but most of the doctors here are a small step above mentally retarded. There are a few notable exceptions.

I don't know if you've spent much time in Thailand but you can very quickly tell what kind of doctor (and person) you're dealing with here. If he's more concerned about trying to be your buddy and making stupid jokes than with getting to the heart of the matter you're dealing with a (probably) Thai trained doctor who hasn't been sufficiently exposed to Western medicine methodologies.

I'm telling this guy about my history of this exact issue and he's forcing a stupid smile and barely even concealing his absolute indifference to the data I was providing him as context for my arrival at the hospital. I'm not going to take the generic advice of a person like that unless it tallies with my own understanding of the situation and pros vs cons. And it didn't. And lo and behold I was right.

See, doctors don't pay any price for being wrong. They're completely indemnified. And here in Thailand they give out antibiotics like breath mints. So do pharmacists. And to whom are they accountable?

I went to the hospital last year with a furuncle that had gotten out of hand and required treatment and only when I insisted on a culture did they order one up for me. The antibiotic they prescribed for me turned out to be useless against the straight of staph I had. Hmm.

So there's a lot of people taking unnecessary and/or ineffective drugs and getting well in spite of them rather than because of them. And for those that don't get well but rather get worse, Somchai the doctor loses no sleep over it.

I consider doctors to be the gatekeepers of diagnostics I need and helpers with interpretation of the tests. I've been lucky in that a few doctors I've found have respect for their patients and the spirit of their profession (primum non nocere). But they are rare indeed.

Quote:If I were you - if I had no further episodes I wouldn’t worry since you’ve done tests for STIs and ruled that out. If you have further episodes I would take advice from a doctor you trust.

I've had about 5 episodes in several years. That's why I posted this thread.

Quote:It’s good to do your own research just be careful it’s not making you anxious or costing you lots of money on potentially unrequired tests.

Thanks. They're already into me for half a G but I'd pay that to take a piss in an American hospital so I can't really complain.

Quote:Also, can’t believe they sent you the Hep B normal result in that format what the hell are they thinking???

haha indeed.

Post: #6

I have felt pain as you describe. I would advise you to seek a good Urologist.
Best of luck to you.


Bobco

Post: #7

Cut back on the booze.

Fast or at least do intermitting fasting.

Drink a gallon of a water a day, distilled water is a good choice.

Cut back on the red meat.

I have similar issues with high creatinetine numbers.

Not to scare you, but Liver and Kidney are very serious organs and need to be taken care of. As you get older people tend to have problems develop in this area.

Post: #8

^^OP is only 32, an avid sportsman and non-drinker (or at least a moderate one)... For all we know, those symptoms like fever and abdominal pain are the same as a the ones of a gastroenteritis...which can be viral or bacterial...

Vincent, just get a doctor dyagnosis, and let us know how it went. All the advice here, even from an MD, whithout auscultation and examination is useless.

Post: #9

(09-15-2018 08:18 AM)VincentVinturi Wrote:  Hey gents, this isn't the most pleasant of topics but I'm hoping there are a few good MDs on the forum or perhaps somebody who has experienced something similar and could help me figure out what the heck is wrong with me.

Over the past few years or so I've had about 5 episodes of acute flank pain on my right side (under the ribs).

A couple of times it came with a fever that broke by morning and then I had some lingering flank pain that eventually just subsided on its own.

2 things that seem to bring this on are alcohol (even just a drink or two) and overtraining (I train jiu jitsu

Well there's your problem right there. You need to quit the BJJ and do Aikido. Let O Sensei's breakfalls massage the pain from your spirit!

Post: #10

Sounds like kidney stones to me. It's the only thing I can think of that can cause intermittent attacks of pain, is triggered by dehydration, and can cause kidney failure if it happens enough in the long term.

Your latest attack was probably triggered by taking over-the-counter fever medicines for your respiratory infection and fever. Most pain/fever medications are kidney toxic.

Cut out all bodybuilding supplements, herbs, vitamins, etc if you're taking anything. Something in your diet/supplements might be toxic to your kidneys.

Drink more water.

Get an ultrasound of your kidneys. You might have chronic stones if you have kidney failure (i.e. low eGFR, high Creatine) or at the very least find out what else is causing your kidney failure. You might end up needing a kidney biopsy.

Good luck.

Post: #11

Thanks gents.

All lab results came back fine, including Ultrasound which was unremarkable.

Creatinine fell back into normal range about 5 days after initial episode.

PCR analysis of urine revealed infection with Mycoplasma Hominis and Ureaplasma Urealyticum. This could very well explain acute kidney pain in the absence of any other issues. M. Hominis in particular is known to cause pyelonephritis (kidney infection).

Treating now with 1gm azithromycin plus 7 days of doxycycline (as M. hominis is resistant to macrolides of which azithromycin is one).

I also did a semen culture just in case and there is rare growth of staphylococcus epidermidis, which is considered a commensal organism and doesn't necessarily mean anything. Antibiotics should knock if out anyway.

Post: #12

Keep us posted. Do a culture two-three weeks afterwards to make sure it is all gone.

Post: #13

Sounds like very obvious kidney stones.

I'm not a doctor, but I've had what you're describing just further up around the liver, gallstones.

Otherwise, sounds exactly like it.