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Pain due to poly cystic kidney disease - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Very Good Posted in: Kidney Conditions
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2380 Questions
User :   Hello

I tried to sign in again , but seems something wrong..
Doctor :   Hi
User :   Hello
User :   Hi Dr.
User :   Are you there ?
User :   Now I can see my typing
Doctor :   Ok.
Doctor :  
I need few more details before giving my suggestion.
User :   Ok Dr. What exactly do u wnat to ask about ?
Doctor :  
May i know where exactly is the pain?
User :   Yes on the left flank
Doctor :  
Ok.
User :   and sometimes on the left loin
Doctor :  
Is the pain spasmodic or just a ache?
User :   Dull aching and sometimes throbbing
Doctor :   Does he have any problem in urination?
Doctor :  
I mean any pain/burning senation
Doctor :  
while passing urine?
User :   mostly no problem but he had one attack of fran hematuria few weeks back
User :   frank
Doctor :   Ok.
User :   yes one more thing
Doctor :  
Has he seen a doctor for this?
User :   he sometimes has pain in the scrotum
User :   yes he did
Doctor :  
And what did they suggest?
User :   And he asked a friend of his
User :   and he suggested to do seomthing called " 24 hours urine for stone "
Doctor :   Ok
User :   but we dont have this facility as we are living
Doctor :   Ok.
Doctor :  
I shall brief you the best way so that you can understand.
User :   Ok
Doctor :  
The pain in PCKD is due to four reasons
User :   By the wayI can understand any medicalterms as I am a doctor
User :   gynecologist
User :   ok
Doctor :   Ok.
Doctor :  
Then i shall be brief.
User :   ok
Doctor :  
The pain could be because of the enlargement of the cyst causing pressure effects
Doctor :  
or due to rupture of the cyst
Doctor :  
or due to infection
Doctor :  
or due to a kidney stone as rightly suggested by your friend.
Doctor :  
The reason for the present pain has to be confirmed before the treatment.
Doctor :   Have you followed.
User :   yes
User :   What do u suggest ?
Doctor :   I suggest you to get a CTscan of the abdomen with the urine test,
User :   What urine test Routie one ?
User :   routine ?
Doctor :   Yes.
Doctor :  
routine will do.
User :   He did a recent CAt scan and urine
User :   like 2 -3 weeks back
User :   do u want him to repeat them again ?
Doctor :  
May i know the reports of these?
User :   yes urine was free
User :   no pus cells no crystals
User :   RBCs were there but low count
User :   10-15 /HPF
Doctor :   Ok.
Doctor :  
And the scan?
User :   CAT scan--> big cyst in the right kidney
User :   and left has many small ones
User :   if you want the detials I can see you agin online to get the details
User :   I mean the report becuase I dont remember figures
User :   or numbers
Doctor :   It would be better if you can send us the reports of both the scan.
User :   how can I send you the report Dr.?
User :   Scanned one ?on your e-mail ?
Doctor :  
I mean a comparison is needed to see if there is any enlargement.
Doctor :  
Yes you can scan the reports and mail to us.
User :   You mean the first and the second CAT scan ?
Doctor :  
the id would be YYYY@YYYY
Doctor :  
Yes.
User :   By your name Dr.Ayman ?
Doctor :   You just have to mail to us.
User :   ok doctor
Doctor :   we shall be able to answer you better after going through the reports.
Doctor :  
Now presently i shall suggest you few measures for the pain relief now.
User :   ok
Doctor :   Since paracetamol is not helping his pain relief you need to try higher pain killers like opioid analgesics.
Doctor :  
And since these are prescription medications they need prescription for these.
Doctor :  
Pregabalin as two disadvantages.
Doctor :  
1. Being it is neprotoxic
Doctor :  
2. It is not useful in acute pain scenario.
Doctor :  
And hence i would suggest you to with hold the use of pregabalin.
Doctor :  
Have you followed?
Doctor :  
Apart from these
User :   yes
Doctor :  
Ice massages. hot water bags may help in pain control.
Doctor :  
Advise him for bed rest.
User :   Hot water bags every day ?
User :   ok
User :   you mean on the side of pain and he should be rested in bed
Doctor :  
As movements of the abdomen may cause increase in the pain if the pain are secondary to pressure effects.
Doctor :  
The other treatment strategies we shall discuss through mail.
User :   How foments for howmany minutes ?
User :   ok so for the time being i have to try the hot water bags until I send you send u CAT scan
Doctor :   The opioids will give him enough relief from the pain.
Doctor :  
Fomentation is only for support.
User :   But how about the addiction and tolerance ?
Doctor :  
You can try these every 4th or 6th hourly.
User :   ok
Doctor :  
As i said the opioids are only temporary relief of pain
Doctor :   It is not a life time treatment presently
User :   which type do you suggest ?
Doctor :   I am mentioning this only because you are a doctor.
User :   ok Dr. thank you very much
Doctor :   You can try tramadol in the begining.
User :   I am just very worried about him
User :   ok
Doctor :  
You also need to the side effects of these
Doctor :  
So i would suggest you not to use it liberally.
User :   ok
User :   How frequent ?
Doctor :  
Under supervision would be better.
Doctor :   Tramadol is given twice a day.
User :   ok
Doctor :   I am repeating that it is a supervision drug.
Doctor :   So need to take atmost care when administering these.
Doctor :  
Do you have any other query?
Doctor :  
Are you there?
Doctor :  
Are you there?
Doctor :  
Are you there?
Doctor :  
I have to close the window as you are not responding. Please chat with our doctors 24/7 for medical queries.
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