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Having pain in joints, abdominal discomfort and swelling. History of kidney stones. Had surgery for bladder stones & kidney stones. Guide?

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My daughter, 35,has a history of Kidney stones caused by high calcium. Has had major surgery for bladder stones & kidney stones unable to be helped by simple lithotripsy. She has pain currently again, Blood work came back with WBC-11.4 platelets -578 her CA+-10.3 all other labs were within normal limits. She suffers from severe pain in joints, has abdominal discomfort with swelling even when drinking water. She is obese and tries to eat healthy. What do you think should be done as she gets sick more often than she is well(her job is social worker for Homebound/ disabled). Now (Adult protective services)- recent? Please advise.
Posted Wed, 26 Jun 2013 in Kidney Conditions
Answered by Dr. Ravi Bansal 10 hours later

your daughter has recurrent kidney stones. We have to answer the following questions-

1. How many stones are present now, where are they present, and what can be done for them? - For this i need to know the latest report of ultrasound or ct scan imaging. Kindly provide a copy of the report. lithotripsy converts one large stone into many small stones. If they do not come out in short span of time they can cause pain and grow into many larger stones. Endourological procedures like URS and PCNL can remove all stones.

2. Why are the stones forming? the factors include metabolic causes in atleast 50% PATIENTS. you have mentioned serum calcium of 10.3, it is high. you need to see iPTH levels to rule out hyperparathyroidism. General metabolic work up should include-- tests for urine infection, 24 hours urine for calcium , phosphorus, uric acid and oxalates. serum samples for calcium , phosphorus and uric acid. Renal function tests including creatinine, sodium and potassium.
If There is structural problem in the urinary tract it can also predispose to stone formation.

3. Joint pains and swelling will not occur due to stones. they show that there may be some metabolic disease affecting bones also.

4. For pain management- you can take tramadol, paracitamol under guidance of your physician.

We should not get disheartened and try to find answers scientifically.

If you have any of the above reports please post.

best wishes.
Above answer was peer-reviewed by
Follow-up: Having pain in joints, abdominal discomfort and swelling. History of kidney stones. Had surgery for bladder stones & kidney stones. Guide? 5 hours later
Her urine tests UA & culture have come back neg!
Her history of pain, headaches, depression, basically constant feelings of ill health, the doctors could never pin point anything.
I too am concerned re: parathyroid tumor? As she has every symptom that would point to.
What specific tests does she need to rule this out? She goes to her Primary Physician today, but alas has been under the care of for 7 years.
Lives in A very poor Qualified MD area.
I am a retired ER/ Nurse Anesthetist, but live across the country.
Please help me help her! XXXXXXX
Answered by Dr. Ravi Bansal 1 hour later

To confirm hyperparathyroidism , serum iPTH levels should be done. (Parathyroid hormone levels). It is a simple blood test and you can get the report in one day.

We have to cover all aspects of the disease as I have enumerated before. Kindly discuss on these aspects with your treating doctor.

If you have any specific test results kindly inform. In any case I would be interested to know the patient follow up .

Hope it helps.
Above answer was peer-reviewed by
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