Acute urinary retention & have just come out of hospital!

[Athena]

What an incredible last 24 hours have been. I woke up yesterday morning with a full bladder but was completely unable to empty it. I ended up in ER and they gave me a drug called Flomax to hopefully enable me to urinate. That didn't work & by the time they finally inserted a catheter in the afternoon, I had almost a litre of urine in the bladder & was in considerable distress & pain! Pelvic scans and xrays were done & the the good news is that my serum creatinine levels were unchanged (even slightly lower) & it would seem that no tumours, cancers, stones or any obvious obstructions like vaginal prolapse were discovered. BUT, I do have severe constipation (fecal loading in entire colon), which now seems like to be the likely cause. No UTI was found & some moderate level of hydronephrosis was seen (but they told me that's normal in the circumstances & not a danger - I certainly hope so!). Apart from that there is only gyno issues that I have (fibroids, benign ovarian cysts) remaining as possibilities but this does not look like the likely cause.

I am going to a uro-gynecology clinic on an outpatient basis in 2 days time to have the bladder catheter removed & to see if I can void on my own. In the meantime, I am needing to take some laxatives (Movicol & Coloxyl + Senna).

I've been living with chronic constipation for a few years now but have always thought it is benign & a 'new normal'. I am unsure about relying on laxatives. My gynecologist told me that an enema would be the better option. But am still waiting to hear from my Nephrologist.

Has anyone experienced anything like this before?

As I am a long-term diabetic I am worried about any autonomic nerve damage, as I do tend to a certain degree of difficulty passing urine occasionally (which I have accepted as a new normal in addition to the tendency towards constipation). Perhaps I may need to see a neurologist?

Praying for a easily treatable condition & for no kidney damage/trauma in the ensuring investigations. Including no infection developing while having this catheter in. 

[kickingandscreaming]

Sorry, Athena.  Sounds like a not fun adventure in the medical-industrial complex.  I hope you have some good answers coming your way.  Take good care.

[Athena]

Thanks K&S. Huge medical-industrial complexes is a very good description. I spent the whole morning, afternoon & night in the emergency dept and feel like I've come back from a war zone. My experience however was largely positive (in spite of the huge wait & delay in emptying my overloaded bladder). I hope there has not been any irreversible damage to the bladder and also kidneys. The business of physical survival in probably nowhere more overwhelming than when finding oneself trapped in a large hospital ER dept.

[Athena]

Well I now have diarrhoea. It's not at a very severe level but it is still diarrhoea. I've stopped taking my ACE inhibitor (as my Neph told me that in times of illness, to stop taking this one in order to "allow the kidneys too work better"). I have taken laxatives a few times over the last few weeks but have certainly have to stop taking them, as I now have the opposite problem. My PCP is away on holidays, my Neph is back next week ... Do I just hold on or do I go to another PCP?

I now have a bloating/swollen abdomen, mild nausea episodes, reduced appetite and sometimes after eating, just feel a bit weird - almost like abdominal pain.

I've just read that people with CKD should be very alert to any potential dehydration issues.

[kickingandscreaming]

CKD People with UTI and other urinary issues should be very alert to the possibility of it causing further kidney damage.  I would get it checked out by whatever medical help you can get.

[Michelle2016]

If I were you, I will go ER directly. You will have all of the tests (include lab work for blood, urine, feces, CT scan or X-Ray) done there and ER doctor visit. But you have to pay ER co-payment.

Good luck.

[Charlie B53]

Diabetus is a terrible disease in that it damages so many nerves necessary to function.  There are so many nerves in the groin that become damaged, sexual nerves usually go first, becoming numb, a loss of feeling and desire simply doesn't work.  Urination and bowel control can be affected.

You have got to be absolitely Religious as to testing and adjusting your insulin and diet to keep sugars very well control to minimize any firther nerve damage.


Diet, constipation is often a result of processed flour and progressed grains.  While difficult to do, limiting daily intake of these and increasing daily intake of vegetables and fruits can make a huge difference in regulating intestinal activity.  Whole grains, oatmeal can be used effectively when accompanied with sufficient volumes of water.  You cannot allow these grains to become dry.

[Athena]

If I were you, I will go ER directly. You will have all of the tests (include lab work for blood, urine, feces, CT scan or X-Ray) done there and ER doctor visit. But you have to pay ER co-payment.

Good luck.

That is what I wish I had the courage to do! But being in ER is easily one of the most traumatic experiences on the face of the earth. And wandering in on your own there without any personal support of any kind can be downright dangerous (eg getting an infection, being subjected to a medical mistake).

I have made an appt with my alternative PCP tomorrow. She's very nice mature woman but I don't find that she understands CKD very well.

The best thing would be to go back to ER but I am still traumatised by the earlier ER visit. 

The diarrhoea & other symptoms seems better today. I think I eat out too much - this might be a protracted food poisoning or bacterial infection thing.

[Athena]

CKD People with UTI and other urinary issues should be very alert to the possibility of it causing further kidney damage.  I would get it checked out by whatever medical help you can get.

I have been checked for an UTI after the ER visit & after the catheter was removed & it was negative. So I thankfully haven't been worrying about an UTI.

[cassandra]

How are you today Athena? Any improvement?

Love, luck, strength, Cas

[Athena]

Hi Cas,
Yes, today there seems to be a considerable improvement. Thank you for asking, you are very kind. I think I'm just going to have to go to a gastroenterologist and go through that colonoscopy & telescope down the gullet affair. I have a colonoscopy 13 years ago & it was perfect. I'm already wondering whether all of this can be done without any damage to the kidneys.

[Michelle2016]

For diarrhea, try to avoid ice water and spicy food. They will irritate the GI system. Ginger tea is good to GI system. You are right. Try to avoid eating out because you don't know if it is well cooked.

Again, make sure to good hand hygen at anytimes before touching the food. This is one of my new year resolutions.

Good luck.

[Charlie B53]

Regularly eating out may be hazardous to your digestion in that most everything is saturated with added Salt, Butter, and possibly unknown spices.  Any of which can be cause for a sensitive digestive system and cause a problem.

My Wife has this problem.  She rarely cooks herself, and because I still have not learned to cook 'smaller' she prefers to eat out.  Then suffers the diarrhea shortly after.   It is just terrible.

[Athena]

Thanks Michelle and Charlie for your replies about eating out. I've always had a good digestive system, it seems and have only ever had one bout of food poisoning within the last few years (minced chicken pattie!). I do feel nervous about eating out so much - I do try to make good choices whenever I do.

[Athena]

Saw my GP today & was given a referral to get another abdominal X-ray done. She examined me by feeling my abdomen & thinks that I still have a constipated colon (which ER identified through their scans). Once the abdominal xray is done - then based on that result we will either do a stool sample test or we many not need to. Stool test will identify if I've picked up a 'stomach bug'. So just some more running around organising and participating in more medical stuff. I also regret that I didn't push for a urine UTI test to be done in her office - any CKD patient needs to be tested for that, regardless of whether they have any noticeable symptoms or not. I also feel that I should do the stool test at once so that we can rule that out earlier rather than later. I see her in 2 weeks. I pray that this horrible diarrhoea will just go away in the meantime.

One comment I may make about the 'system' is - imagine how much money any government would save if the fragmentalisation of any medical health concern was seriously addressed & reduced! We'd save money on unnecessary duplication of tests, overservicing and unnecessary delays in identifying issues in patients. Just my little rant for today.

[smartcookie]

I know you are having trouble with diarrhea now, but when taking laxatives, make sure your blood test are okay.  Laxatives can decrease the amount of nutrition you absorb from your food.  I am sorry you are going through so much pain!  Praying the diarrhea stops soon!

[Athena]

I know you are having trouble with diarrhea now, but when taking laxatives, make sure your blood test are okay.  Laxatives can decrease the amount of nutrition you absorb from your food.  I am sorry you are going through so much pain!  Praying the diarrhea stops soon!

Thank you Smartcookie for that. I have been wondering what impact laxatives may actually have on a CKD patient. They tried to tell me in the hospital that the laxative I was given 'just goes straight to the bowel' & won't affect me. But that just didn't sound all that plausible for some reason. My gynecologist has told me the laxative is 'positively dangerous' & has advised me to take a simple enema that I can buy at the pharmacy ...

[Charlie B53]

Breakfast of oatmeal and an increase in daily diet to include raw cruciferious (Sp?) veggies like broccoli and cauliflower PLUS a couple of servings of fruits can make a marked improvement in bowel function.  The fiber plus the natural waters will help soften the matter and also the fiber will 'scrape' the lining of the intestines and bowel, keeping it healthier than those that omit so much fiber.

Laxatives such as those little gel caps shouldn't hurt, but I wouldn't use much of the stronger types.  Fiber supplements shouldn't hurt as long as sufficient fluid is included.  With our fluid restrictions I would shie away for those powders.  Instead be looking for those additional fruits and veggies to do the job more naturally.

[Athena]

Thanks Charlie for your last post. I believe I eat a fairly good diet each day, I eat salads and fruit every day as well as wholemeal or rye bread. I drink according to my thirst - as I am prone to sweating attacks that have nothing to do with the weather, I do need to drink more water than before, it seems.

I am starting to suspect that it may be my blood pressure meds, in particular the calcium channel blocker, Amlodopine. I remember when I started BP meds a few years ago that that was when my tendency towards constipation started. I also take an ACE inhibitor.

I'm stuffed if it is one or both of the BP meds - because there's no other alternative.

A radical option - but one that isn't feasible for any kidney patient - is to take a one of those bowel pre-operative prep solutions (they come in enema format & can clean everything out within 2-5 minutes apparently). But it is contraindicated in renal impairment as well as those taking calcium channel blockers. Sodlum, phosphate & calcium electrolyte levels can be severely affected by this dangerous substance.

[Athena]

I've recently seen a gastroenterologist for my ongoing constipation & laxative-induced diarrhoea problems. Wanted to do a colonoscopy but because of concerns I had raised about the impact this would have on my kidneys, I've been give 2 choices, either an abdominal CT scan (with oral contrast dye, not IV) or an abdominal MRI scan. Apparently the oral contrast would make it safe as it would not go to the kidneys (I really do question this).

As far as I'm concerned - the only option is a MRI, as there is no radiation, sedation nor anything to take orally. It is apparently just as safe as having an ultrasound. Is this correct?

I would appreciate any advice anyone can give me.

[smartcookie]

Anything you drink goes to the kidneys, so I am not sure why he thinks oral dye would not.  I would be very skeptical of this and ask your nephrologist for his/her opinion.  MRI's are very safe.  Just don't wear any metal and let them know if you have metal inside you. 

[Athena]

Anything you drink goes to the kidneys, so I am not sure why he thinks oral dye would not.  I would be very skeptical of this and ask your nephrologist for his/her opinion.  MRI's are very safe.  Just don't wear any metal and let them know if you have metal inside you.

Agreed, on the oral contrast! Swallowing & drinking anything means that our liver & kidneys need to process whatever it is that we've ingested. It's not rocket science. I will ask my nephrologist about this. But whatever his answer is on this, I just know that I am not going to agree to a CT scan because of the high levels of radiation exposure. I've already had 3 pelvic X-rays since this ordeal started in Dec 2016. How much radiation do they think any single person can take?

Thanks for your advice Smartcookie.

[smartcookie]

I had x-rays monthly on my back after back surgery for about 4 months. I think you will be okay with that.  X-rays are pretty low radiation. 

[Charlie B53]

A radical option - but one that isn't feasible for any kidney patient - is to take a one of those bowel pre-operative prep solutions (they come in enema format & can clean everything out within 2-5 minutes apparently). But it is contraindicated in renal impairment as well as those taking calcium channel blockers. Sodlum, phosphate & calcium electrolyte levels can be severely affected by this dangerous substance.

I wasn't aware of this!

The VA uses something called Go-Lytely.  They send me a gallon jug with almost a quart of powder in at.  Just add water and stir.

YUCK!

And we are supposed to 'Pass' the whole gallon.  YUCK!

I used lemonade instead of water.  It made it much more tolerable.

That's been well over ten years ago already.  Dr noticed and has put in the referral to make me do it again.

YUCK!

Last inspection the Attending Dr told my Wife that I am a Perfect A-Hole.

She already knew that.

[Athena]

Errr .. Charlie, what was this for? Were you blocked & they wanted to unclog you or was this in preparation for some surgical procedure?

You want to be careful with this as this really can cause severe dehydration and associated electrolyte disturbances. I don't know the exact substance you referred to but I pray that it's not the regular sodium phosphates that are given to anyone who needs to have surgery of some kind where the bowels need to be empty.