Urinary Tract Infection
Early Sunday morning, I woke up shivering. It was not the air conditioner. I knew what it was as I had sort of anticipated it. Chills are the first and unmistakable sign of a urinary tract infection (UTI). It was around 4.00am then. I know for sure because I turned on the television to watch the AXN channel.
I must have caught it during the urodynamics study. It is not an uncommon occurrence after this procedure. No matter how sterile the gears were, somehow somewhere during the process, something was bound to be contaminated and the contaminant introduced into my urinary tract.
In the afternoon, I took two Panadol Actifast tablets and the fever or chills has not recurred since. My urine has been cloudy for the past two mornings though. It clears up as the day progresses. I have been drinking water a lot to flush out whatever that is still inside. I have also been drinking cranberry juice.
I know I should be seeing a doctor for this. UTI in people with kidney disease is no small matter. The infection may just wipe out the little that is left of the renal function that I still have. Tomorrow. I will make it a point to see a doctor if the urine is still cloudy tomorrow. For now, all I want to do is to lie down and go back to sleep.
First Urodynamics Study
For all the years that I have been living with spinal cord and chronic renal failure, I have not had a urodynamics study done to determine the pressure in my bladder. This test is needed to determine whether the pressure in the bladder will cause a reflux and further damage to the kidneys.
I had one done at SJMC last Saturday for once and for all as to see if the pressure in my bladder is the cause of my renal failure and whether I need further treatment. I have been waiting to get it done at UMMC but two appointments were cancelled. The first time was because the urologist was away and the second because the urodynamics clinic was under renovation.
All garbed up at SJMC waiting for the urodynamics study to commence.
Photo by Wuan.
There is usually a six-month waiting period at UMMC but it would have been done free of charge there as I hold the Kad Orang Kurang Upaya from the Department of Social Welfare Malaysia. It costs RM1,500 at SJMC. Another urodynamics study was schduled for mid-June at UMMC but I thought I better get it done first at SJMC just in case the one at UMMC gets cancelled again.
The procedure was not as embarrassing as I had anticipated. The technician was very patient in explaining the entire procedure and made me feel at ease even though I was bare-bottomed throughout. A thin tube was inserted through the urethra into the bladder and another into the rectum. The tubes were connected to a device that fills up the bladder with saline at a pre-determined rates – 30ml/min and 15ml/min, measured the pressure in the bladder as it filled up until urine started to leak.
The equipment used for the urodynamics study.
Photo by Wuan.
Another device was placed right below my seat to measure the amount of urine that leaked. After that, the residual urine in the bladder was sucked out with a syringe and measured. The results showed that the presurre in my bladder is normal until the volume is around 300ml where the pressure rises to slightly more than 50cmH2O and the fluid started to leak. The leaked volume was around 100ml while residual volume was around 200ml.
According to the urologist, as long as I keep up with my three hourly intermittent catheterisation programme, it should not be a cause for concern as reflected by the results. No further treatment or medication is necessary. He recommended that I get the urodynamics study done every two years. He also checked the lump in my scrotum which has gotten smaller after a two-week course of antibiotics. I am to go back to see him in two months to get the lump checked again.
Tags: bladder pressure, cefuroxime, epididymitis, lump in scrotum, neurogenic bladder, urodynamics, Zinnat
All Is Not Well With My Kidneys
Wuan took me to UMMC for my scheduled medical check-up today. The blood test revealed that my serum creatinine has hit the roof again – 289umol/l. This is the highest level yet. and is an indication that something is not right. I had to see the dietician to review my low-protein diet again. I have been stuffing myself with rice to appease the hunger pangs during meals. My allowable daily rice quota is one bowl but I have consistently blew it by adding another bowl into each meal. Rice contains protein. This I have to replace with fruits from now on. Fruits too contain protein but in lower amounts than rice.
In addition to Detrusitol for my overactive bladder, and Lactulose and Dulcolax for my bowel management, Dr. Chung, the doctor on duty, also prescribed calcium (calcium lactate), iron (ferrous fumarate) and folic acid tablets. According to him, after so many years of not walking, my bones would have become osteoporotic. The fact that I have not been keepng to my standing exercises aggravated the condition. The calcium supplement was to reduce the osteoporosis. The iron and folic acid tablets were to replace the Sangobion that I have been taking for aneamia. He also wrote a referral for me to see a urologist to perform a urodynamic test to determine the pressure in my bladder. Looks like I have to go back for a series of tests and to collect my medication on a regular basis from now on. That I have to do nonetheless in order to maintain the health of my kidneys and other complications associated with spinal cord injury.
Tags: Detrusitol 2mg tablet, Sangobion, Tolterodine 2mg, urodynamics