Is blood in your urine cause for concern?

blood_urine

Oh, yes!  This was my very first indication that I had kidney cancer.  Here’s part of my story…

From https://cushingsbios.com/2016/05/09/maryo-10-years-cancer-free/

April 28 2006 I picked up my husband for a biopsy and took him to an outpatient surgical center. While I was there waiting for the biopsy to be completed, I started noticing blood in my urine and major abdominal cramps. I left messages for several of my doctors on what I should do. I finally decided to see my PCP after I got my husband home.
When Tom was done with his testing, his doctor took one look at me and asked if I wanted an ambulance. I said no, that I thought I could make it to the emergency room ok – Tom couldn’t drive because of the anesthesia they had given him. I barely made it to the ER and left the car with Tom to park. Tom’s doctor followed us to the ER and became my new doctor.

 

The News Item that inspired this post:

The sight of blood in your urine is enough to make anyone panic. It doesn’t always indicate a serious problem, but it’s important you get it checked out with your doctor.

Blood in the urine is known as hematuria. There are two forms of hematuria:

Gross hematuria – This is when you can see blood in the urine. The urine may look pink, red, or cola-colored due to the presence of red blood cells (RBCs). Most of the time, other than the change in appearance in urine, most people do not have other symptoms.

Microscopic hematuria – This is when you cannot see blood in the urine but it can be detected when examined under a microscope. Most people with microscopic hematuria have no symptoms.

Causes of blood in the urine:
When a person has hematuria, the kidneys or other parts of the urinary tract allow blood cells to leak into the urine. Anyone, including children, can be at risk for blood in the urine, and it can occur as a result of many common conditions. Some of those include:

Menstruation
Vigorous or strenuous exercise
Sexual activity
Urinary tract infection
Kidney infection
Kidney or bladder stones
Injury
Family history of kidney disease

More serious problems that could be causing blood in your urine might be:

Kidney or bladder cancer
Polycystic kidney disease
Irritation or swelling in the kidney, prostate in men, or another part of the urinary tract
Blood clots
Sickle cell disease
Enlarged prostate
Medications – the anti-cancer drug cyclophosphamide (Cytoxan) and penicillin can cause urinary bleeding.

Diagnosing hematuria
Hematuria is diagnosed with a urine sample called a urinalysis. The urine sample is collected in a special container at a doctor’s office and usually tested in a lab for analysis. The lab technician places a strip of chemically treated paper called a dipstick in the urine. If RBCs are present, patches on the dipstick change color. When RBCs are noted, then the urine is further examined under a microscope to make the diagnosis of hematuria.

Depending on the circumstances, the doctor may order further testing such as a urinalysis, blood test, biopsy, cystoscopy, or a kidney imaging test.

Treating hematuria
Hematuria is treated by addressing its underlying cause. If no serious health problem is detected, no treatment may be necessary. If your hematuria is caused by a urinary tract infection, it will be treated with antibiotics. A urinalysis should be repeated within 6 weeks after antibiotic treatment ends to be sure the infection is gone.
Dr. Samadi is a board-certified urologic oncologist trained in open and traditional and laparoscopic surgery and is an expert in robotic prostate surgery. He is chairman of urology, chief of robotic surgery at Lenox Hill Hospital and professor of urology at Hofstra North Shore-LIJ School of Medicine. He is a medical correspondent for the Fox News Channel’s Medical A-Team and the chief medical correspondent for am970 in New York City. Learn more at roboticoncology.com. Visit Dr. Samadi’s blog at SamadiMD.com. Follow Dr. Samadi on Twitter and Facebook.

Read more at http://www.foxnews.com/health/2016/06/23/is-blood-in-your-urine-cause-for-concern.html

 

Bee’s Knees

bees-knees

 

No, I don’t think bees have knees but I do – and one of them was hurting a lot.  Mine started, I think, the day after DH’s heart attack – January 28, 2013.

Fast forward to January 2016.

I fell in the bathroom in the middle of the night and hit my left knee on the tub. I used a brace for a few days and it seemed better.

Around January 27-28, I was in Walmart and had to get a produce bag that was way over my head.  I had to stand on tiptoe…and my knee felt like something ripped.  Thankfully, I had a cart available to use as a temporary crutch.

Got home, used the brace, took Tylenol but the pain got worse.

Thursday, I drove home from choir at church.  My car is a manual so the act of using the clutch, extending my foot that way, made everything worse again.

Friday, we went to the Limp-In Clinic in Greenbriar.   That doctor was going to prescribe Cortef or NSAIDs but I couldn’t take either due to my history of Cushing’s (Cortef) and kidney cancer (NSAIDs).  He prescribed Vicodin and sent me for an x-ray.

January 31, I got very itchy, presumably from Vicodin so I stopped that and started taking Benadryl for the itchiness.

February 2, I went back to the clinic for the results of x-rays and  I mentioned the itchiness.  Since I have very limited meds available to me, he recommended an Orthopedist.  I called him when I got home and he didn’t take my insurance.  I tried another doctor who supposedly took my insurance but they didn’t.

February 7, I really needed the sleep so I took half a Vicodin.  No pain and no itching.  HOORAY!

LCL-tearFebruary 8, I saw my regular doctor.   She thinks it’s a possible “lateral collateral ligament vs meniscus tear”.  https://www.nlm.nih.gov/medlineplus/ency/article/001079.htm

I was surprised that she thought my knee was swollen but one of my therapists showed me later that it was.

She referred me to Physical Therapy (PT) and prescribed Ultram http://www.drugs.com/ultram.html.  As of this writing, I haven’t used that yet.

February 11, 8:30 am  My first appointment with PT.  Since my blood pressure was high, we mostly did assessments.  I had a main therapist and a student. They had to use 3 types of BP machine to do this.

I bent my knee and they took measurements with a caliper.  I lay on my front and they manipulated my knee to see what happened. They also concluded that it was a lateral collateral ligament.

A suggestion – to rest my foot on the walker without the brace and see if gravity helps my knee straighten out.

After this, there was more pain than before but I know this is the right thing to do.

February 13.  My leg feels a bit better.  I had the brace off last night and almost straightened my knee out.

Somewhere in this period, I learned how to manually move my knee cap (patella) around.  I saw my day 1 therapist again and he said my knee was angry.  Swollen, angry, whatever.  I just want a normal non-hurting knee!

One of the therapists had me doing a stretching exercise and my hip was out of kilter (everything is attached!) since I’ve been walking with my knee bent.  So she manipulated that back into alignment.

vastus-medFebruary 22, A new-to-me therapist had me do an exercise with a basketball under my knee, pointing my toe to the left.  I didn’t remember doing that before but she said I had.  Hmmm…

That hurt too much so we moved to a foam roll under my knee.  It was still uncomfortable but I did it, a bit too much, apparently.

Turns out this exercise hurt my “VMO”, which is short for Vastus Medialis Oblique.

“This is the most important quad muscle and arguably the most responsible muscle for knee stability. The VMO’s main function is to control knee extension…” Read more at  http://sportskneetherapy.com/the-best-vmo-exercises/

February 25,  My VMO pain still hurt.  I told my regular therapist about it and she worked on it some.  She concurred that my knee was swollen.

February 26,  I went all day with no brace at all!!  A bit of pain but manageable.

Today is February 28 and I haven’t worn the brace since the 27th. I still need assistance to get up from sitting but I can see huge improvement.

I still have 6 more PT sessions, finishing on March 16, but I’m really impressed with what they’ve done for me.  I still have twinges of pain and I don’t plan on stepping on tiptoe anytime soon but I can tell I’m on the right track.

If there are any significant changes (I sure hope not!), I’ll post an update.  When I’m done – and have approval – I intend to keep exercising, walking, climbing stairs, riding the bike.  I never, ever want to go through this kind of pain again.

I’ve learned a lot from PT – lots of new exercises, stretching, how to move manually my knee cap, all kinds of muscle names, that the lateral collateral ligament is attached to my ankle, that ice is better than heat for this kind of thing.

 

no-pain

 

 

 

 

 

Other Stuff, Part 4: Fire Ants

WayBack Machine

 

This one is from the WayBack machine.

I’m trying to work out the year – we bought our first time share while I was being diagnosed with Cushing’s so this was some time after 1987.  We never stayed in that time share, just used it for trade.  This particular year, we’d traded for a place in Arkansas (not too exciting, but drivable from home) but they had a fire so they offered us a 3-bedroom house in Hilton Head instead.  Of course, we accepted that offer!

We located a kennel fairly nearby to leave our dog.  We were so sure she’d love the ocean just like the dogs on TV do, running and playing in the water. She was a retriever so she could swim out and fetch frisbees and such.  HA!

We packed up the dog and our stuff and made the long drive down to South Carolina.  We dropped her off at the kennel and found our home for the next week.  Absolutely beautiful, on a little lagoon, in the middle of a golf course community. Our son had the upstairs all to himself and he loved that.

Our lagoon had an alligator and one day the young boy next door was out on the porch.  We could see the alligator eyes watching him…and waiting.  Luckily, nothing happened!

We took the dog out of the kennel and onto the beach and all those years of instincts failed her.  When a wave came in, she tried to bite it – and swallowed.  She was – ahem – sick as a dog for the rest of the trip.  So much for running and playing in the waves.

When our son got out of the water, we realized that he had some sting marks on his leg.  Most likely from a jelly fish someone said.  Great!

Our house had come with bikes and we used them to ride all over the golf course and out into Hilton Head sometimes.  This evening, we were riding along the street and there was a red light.  We stopped and I put my foot down on the pavement.  Naturally, I was wearing sandals.  Naturally, I’d stepped into a fire ant nest.

The rest of the trip was awful. Burning, itching, pain.  The ant bites seemed like they were increasing in number, not getting better.

It was the end of the week, so we headed home.  I was in misery all the way.

First off, I saw my PCP who prescribed something for me.  I think it might have been an antibiotic but I can’t remember.  I woke up that night, red, itchy, broken out in hives.

About 3AM, DH took me to the ER – I was having an allergic reaction to the meds.  Great!  They pumped me full of epinephrine and I started to get better.

The next morning I was back at the PCP for another drug.  I took that for one dose and had the worst nightmares of my life.  I went back to the PCP the next day and he said that no one had reported nightmares from that drug and I told him to alert whoever – one person had had them.

And I got another drug.  This one finally worked and the ant bites and the infection that they’d caused finally started going away.

Will I ever go back to Hilton Head?  I don’t know.  I do know I won’t ride a bicycle wearing sandals at dusk.  That’s for sure!

Monday – Four Weeks Post-Op

This is the first of the timeline posts that I’m actually writing more or less as they happen!

day-mon

Last Monday, Feb 18 was the first visit with the cardiologist.  Getting there was a bit of a problem but the appointment itself went smoothly.

We got into the inner sanctum and a very nice nurse named Lisa took down DH’s info.  It worked out well that we hadn’t finished all the paperwork since she had lots of info fron the hospital, anyway.

She took DH’s blood pressure and oxygen levels (both good), then took the bags of meds and vitamins away for cataloging.

The doctor came in and asked some of the same questions as everyone else about how he was eating, sleeping, exercise, swelling, pain.  He listened to DH’s heart and lungs and everything sounded good.  He checked the legs for swelling…none.

We made 2 more appointments – one for a low-stress treadmill next week and one with him for three months out.  There’s also bloodwork to be done before the treadmill. After passing the treadmill test, DH can start rehab.  Yea!

When we got home, there was a call from the PCP’s lab.  DH called back but had just missed them.

day-tues
DH slept in the bed and out of the recliner for several hours last night.  Another step forward!

DH finally got through to the PCP’s lab and the cholesterol numbers were excellent.  Hooray!  Other numbers such as liver enzymes were good, too.

day-wed
DH did some work today, with several naps in between. I got the car taken care of. He got the disher unloaded and reloaded – with resting afterwards.

He decided to start off the night sleeping in bed and made it until about 4:00 am. He said that there was no pain but he would be more comfortable in the recliner.
day-thurs
DH spent most of the morning working (at home) on a proposal, then most of the afternoon napping.  Most of the pain seems gone – hooray! Evening there was a short meeting with a nap before and after.  Then, dinner and another nap before bed.

He started out for about an hour in bed, then back to the recliner for the rest of the night.

He doesn’t seem to cough nearly as much. Hooray!

day-fri

Friday through Sunday – lots of napping, trying to sleep or nap in the bed but usually winding up in the recliner.

day-sun

 

It was a nice day so we took the dog outside for a very short walk…followed by more napping.  DH is looking forward to the treadmill test on Wednesday so he can start the rehab soon.

Monday – 3 Weeks Post-op

I’ve decided to do a sort of timeline in case anyone is interested.  This is all from memory so future posts should be more accurate.

Week Zero, January 28, 2013 was the actual CABG surgery.  The hospital experience  can be found here.

DH came home on Thursday of that week and the first visiting nurse arrived on Saturday. Luckily, DS was able to stay until Sunday and he was a big help.

DH wasn’t allowed to lift any more than 5 pounds, so couldn’t raise himself out of bed.  He slept on a recliner in the living room and either DS or I slept on the sofa in case he needed any meds or help during the night.

Week One, February 4, 2013, one week from surgery.

The visiting nurse came twice and is pleased with wound healing.  Blood pressure is sometimes low.  The nurse thought he should have more fluids.  One lobe of the lung isn’t working to capacity and she wants more use of the incentive spirometers.  DH has two types from the hospital – the traditional one and one that our dog thinks looks like a dog toy that she should have.

incentive spirometer

Week Two, February 11, 2013 two weeks from surgery.  DH continues to lose weight.  He’s still sleeping in the recliner and I’m still on the sofa but there is much less getting up at night.

The Oxycodone is down to half pills much less often than prescribed.

The first (and only) visit to the surgeon’s office this week.  We saw her nurse practitioner who was very impressed with how DH is doing as was his PCP.  The nurse practitioner was so pleased, she said we don’t have to go back unless there are any problems.

The PCP ran blood tests, glucose, liver enzymes, cholesterol and others.

We saw the visiting nurse twice.  She thought DH was doing so well that she discharged him on Thursday.

DH made a few phone calls this week, worked a little, had a visitor on Sunday.

Week Three, February 18, 2013, three weeks from surgery

DH slept in the bed for half the night last night and seems to be doing ok.  He still took a half Oxycodone this morning.

We see the cardiologist this afternoon.  That report will be in the Week Four post. I imagine that we’ll be talking about rehab at this appointment.

Weeks Four and Beyond will have their own posts.