Acute urinary retention or poor kidneys? Emergency Room time?

[RightSide]

Hi all,

I'm a newbie dialysis patient as of this coming Tuesday:  GFR 13, BUN 100, symptoms of moderate-to-severe uremia, bone pains, itching, tingling, insomnia, mental fog, etc..  I got my kidney failure from a badly enlarged prostate--"hydronephrosis from chronic urinary retention," I think my PCP called it.

I'm been fighting a urinary tract infection these last couple of days.  The nurse told me to drink LOTS and LOTS of water, so I did. (Yes, she knows about my kidney failure but she told me to do it anyway.)  But tonight, I find myself unable to pee at all--and I'm getting VERY bloated and overweight.

So I figured I was going into acute urinary retention.  So I catheterized myself as the nurse taught me:  I inserted the so-called "intermittent" catheter through my penis into my bladder to get the urine out every couple hours.  BUT very little urine is coming out through the urinary catheter either!!!  The catheter can't find much urine inside my bladder!  I don't understand it.  Where is all the water I've been drinking going???

I thought a GFR of 13 only meant the kidneys can't filter out urea and toxins.  Does GFR 13 mean they can't even filter out water either???  Will the water come out overnight if I stop drinking anymore?

I apologize in advance if I sound really stupid about this, but I'm wondering if I should just go to the ER.   

[Rerun]

Get to an ER right now.  Your kidneys have obviously failed.  If no urine is coming out and your are drinking tons of water it is saturating your tissue and probably your lungs and heart.  I would stop drinking until you get checked out.  They can insert an emergency catheter and get you dialyzed and get some of that fluid off.

Just my opinion.  God Bless and good luck.                     

[monrein]

Rerun is absolutely right.  You should go to the ER , Rightside.  Immediately

[okarol]

If there is fluid in your bladder the catheter should work if it's inserted properly. Either way, you need to be seen. I would page my doctor or the one on call and have them call ahead to the ER, if it were me.

[Romona]

Please go soon. The build up can cause serious problems. It may lead to congestive heart failure.

[G-Ma]

ER now.

[JerseyGirl]

I hope RightSide took our advice and made a visit to the ER...agree with all our posters - get thee to Emergencee!

[Rerun]

His post was at 10:22 and mine was at 10:36.  I noticed after my post that he was no longer online.  I don't think he read it.  I hope someone took him to ER.  This is why it is important to email your personal information to the Admin folkes.  They can contact you or a loved one in an emergency.       http://ihatedialysis.com/forum/index.php?topic=356.0

                                                                     

[RightSide]

I did NOT go to the ER.  I'm trying to hold out till Tuesday AM when I go to the hospital to have the dialysis catheter inserted.

I've been to doctors and ERs so many times since I was diagnosed with ESRD that they're going to start to think I'm a hypochondriac or a lunatic.  If I go running to the ER because I can't pee, they're going to diagnose me with panic disorder and lock me up under guard. 

That actually happened to me with a hospital that shall remain nameless. When this whole business first started, I showed up in their ER looking worried and nervous that I couldn't pee.  Their diagnosis was "mental illness" and they locked me in a room under guard and called a psychiatrist to interview me and kept me under guard all night.  They never examined my bladder or urethra.  They never tested my renal function.

I will NEVER go through a humiliation like that again.  I'm not insane, I really have a badly enlarged prostate and a bladder infection.  And my BUN is really, really on the high side of 100!!!  Yes, I appeared worried and nervous, but it was 3 AM in the middle of the night and I thought it was serious.  All the parents were there with their sick kids and yes, the parents were laughing and playing and trying to distract the kids.  Everybody else seemed to be having a grand time--except me.

I did frequent catheterizations over the night, and enough urine came out overnight that I'm not so bloated anymore.

I'm going to try to hold out just a couple more days.  Risk is what life is all about.

[okarol]

Good luck. I hope you have a friend or family member who can check in with you. Uremia can make your thinking process get confused, in my opinion.

[G-Ma]

Somtimes you have to bite the bullet and stand your ground.  When I took my hubby to the hosp the last time the Male RN on duty after midnight told the Dr it was stupid to come to ER because the patient was intoxicated..my youngest son and I both heard it and when I got done with the Dr, Robert finally let him touch hubby..by this time Robert was holding hubby in his arms and begging him to hang on..his organs were failing.  We never saw the nurse again...Dr had another nurse stay with us the next two days, all the way with a morphine drip in attendance.  Do you want me to call your ER?  I really think you should not wait until Tuesday.  My nurse always tells me no matter how little you go...she knows I probably won't but if I feel I should I know I can.
Ann

[monrein]

Rightside, you have left me feeling quite confused, a little frustrated and very worried.  In your first post you described your situation and asked if we thought you should go to the ER.  Several of us said yes we thought you should because this is a serious illness and it can and does kill people, sometimes quite suddenly.

Now most of us here have been to ER far more times than we have wanted to and we completely understand that it's never something any of us wants to do.  Now tonight you tell us about a dreadful sounding previous visit to ER, that sounds like you could have sued the hospital if you'd had a mind to.  I understand your reluctance to go but your symptoms  are serious and by waiting you could in fact be doing some damage to your body that you may regret later.

I'm completely baffled about why you're "holding out" for three more days.  Obviously you wouldn't be going back to the hospital that was so humiliating so you should be able to reasonably expect better treatment.
As for your point about risk being what life is all about, that's true, but this kind of reckless risk is russian roulette, high stakes, life or death kind of risk.  Even skydivers use parachutes to increase their odds against the known risks.  As kidney patients, going to the hospital when we're having serious symptoms, is our parachute.  If you need dialysis NOW and hold off too long, you could die.

No one can make you go.  You must of course make your own decisions.  However, it really sounds as if you're not thinking too clearly about how serious this is and Karol is right that severe uremia clouds our thinking.  I've been wacky out of it more than once and actually incapable of making any decisions at all, let alone a good one.

You'll probably ignore what I'm going to say next, but, I repeat....GO TO THE HOSPITAL.   

[kitkatz]

I agree with Monrein.

Go get seen soon.

This disease is a butt buster and can kill you quickly!

[Joe Paul]

Rightside, you have left me feeling quite confused, a little frustrated and very worried.  In your first post you described your situation and asked if we thought you should go to the ER.  Several of us said yes we thought you should because this is a serious illness and it can and does kill people, sometimes quite suddenly.

Now most of us here have been to ER far more times than we have wanted to and we completely understand that it's never something any of us wants to do.  Now tonight you tell us about a dreadful sounding previous visit to ER, that sounds like you could have sued the hospital if you'd had a mind to.  I understand your reluctance to go but your symptoms  are serious and by waiting you could in fact be doing some damage to your body that you may regret later.

I'm completely baffled about why you're "holding out" for three more days.  Obviously you wouldn't be going back to the hospital that was so humiliating so you should be able to reasonably expect better treatment.
As for your point about risk being what life is all about, that's true, but this kind of reckless risk is russian roulette, high stakes, life or death kind of risk.  Even skydivers use parachutes to increase their odds against the known risks.  As kidney patients, going to the hospital when we're having serious symptoms, is our parachute.  If you need dialysis NOW and hold off too long, you could die.

No one can make you go.  You must of course make your own decisions.  However, it really sounds as if you're not thinking too clearly about how serious this is and Karol is right that severe uremia clouds our thinking.  I've been wacky out of it more than once and actually incapable of making any decisions at all, let alone a good one.

You'll probably ignore what I'm going to say next, but, I repeat....GO TO THE HOSPITAL.   

Well said, I agree 100%

[graftgurl]

Rightside, you definitely have some very serious issues going on. You state in your original post that your kidney failure is due to an enlarged prostate and urinary retention. If you are having trouble obtaining urine when you catheterize yourself, your prostate could be more enlarged. Continuing with the intermittent catheterization is only putting you more at risk for introducing infection, and that is the last thing you need at this point.  If you are bloated as you say in your post and gaining weight that quickly then it is most likely kidney failure. You know in your experience with uremia so far that the mental fog and confusion can alter your ability to make sound decisions. You are not able to be objective in this instance and It stands to reason that is what is going on now. As Monrein so adequately put it "...your symptoms  are serious and by waiting you could in fact be doing some damage to your body that you may regret later...If you need dialysis NOW and hold off too long, you could die."

Is your previous treatment in the ER that ended in you being under locked guard truly worth losing your life over?

Please go to the hospital.

[Ken Shelmerdine]

Please take the addvice we are all giving you Rightside. It is possible that your cather is not working properly because your prostate is so enlarged. Are your legs ankles wrists and hands very swelled up? if so you are most certainly hugely uremic. Get it seen to NOW!!!!

[BRANDY]

Rightside-- I am not on dialysis but your message is very alarming  you ask for advice  you should take everyones advice and go straight to the ER room  you know in your mind that everyone is right.  You dont have to put up with incompeteant nurses.  If you dont want a specific nurse   ask or demand another  .  You sound as tho  your situation is vey serious   please go