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Having Kidney Pain. Follicular And Large Cell B Lymphoma Treated. Urgent Consultation Necessary?

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Posted on Wed, 21 Aug 2013
Question: Dear Dr. Galera, Many thanks for your help. The day before yesterday I felt very unwell on waking (sudden onset). I was in bed all day, not well enough to get up. Acute left kidney pain and tonsillitis which started that day too. No exudate, but inflamed tonsils. No nausea, but no appetite. Urine clear, no frequency, no pain urinating. I had chills all day. It was 25C and I had a blanket on all day. In the evening I took my axillary temp and it was 37.4. After 500mg Aspirin the chills stopped and I felt better. Yesterday, all day there were no chills, I ate fruit throughout the day, so some appetite, but the kidney and throat pain remained. I spent yesterday in bed. Today, i have just woken up. I feel a lot better in myself, and the kidney pain is less (VAS of 1, 5 before). Both my oncologist and general doctor are on holiday and I dont really feel up to waiting 3-4 hours in a casualty dept if there is no acute risk to the kidney. All of this is very similar to the episode last year, except that then I had nausea too, and no throat problems. Many thanks for your help and your time.
doctor
Answered by Dr. Rene Gerard Cruz Galera Jr (10 hours later)
Hi XXXX! Thank you for getting back to me. I am glad that you feel better and the pain has improved.

I still advise that you see a general physician at least so that the appropriate antibiotics can be prescribed if tests deemed that you do have infections again - both on your tonsils and the left kidney. It is possible that you only have tonsilitis and a left kidney stone but an infection almost always comes with kidney stones because these change or obstruct urine flow.

I have to emphasize that you have to take care of kidney infections - I have had some patients who just ignored their symptoms of pyelonephritis and ended up in chronic renal failure requiring dialysis at least 4 times a month. I don't want you to reach that stage as it is very costly, riddled with a lot of possible complications, and, most of all, irreversible.

In the meantime, continue with your good personal hygiene, drink lots of fluids (fresh ginger tea really helps a lot with the pain of the sore throat - it stings at the first cup but improves afterwards), try and eat a balanced diet.

I hope I was able to answer your questions. If you have any further queries, please do not hesitate to ask.

I wish you the best of health!


Dr. Galera
Above answer was peer-reviewed by : Dr. Shanthi.E
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Follow up: Dr. Rene Gerard Cruz Galera Jr (9 hours later)
Dear Dr Galera,
Many thanks for your help and attention. I followed your advice and managed to see a replacement doctor today. Diagnosis of pyelonephritis and 14 days antibiotics. We both think that the tonsillitis is due to my general diminished health caused by the UTI. As this is the second pyelonephritis in 9 months with no dysuria or frequency, but a very dirty dipstick test, my own personal opinion is that the chemo has caused an insensibility of the urinary tract which means I dont feel the cystitis symptoms before they ascend (I am a nurse with 30 years experience). Thank you once again. I will give you positive feedback. Yours, XXXX
doctor
Answered by Dr. Rene Gerard Cruz Galera Jr (18 minutes later)
Hi XXXX,

Thank you for the update and I am really, really glad that you saw a GP today and that you are now receiving the appropriate antibiotics.

Yes, it is quite possible that this is an unfortunate consequence of chemo. Practicing good hygiene and drinking plenty of fluids are very important to you now. When your GP/Oncologist comes back, ask if you need to take some prophylaxis antibiotics once in a while so that you can clear any developing infections early.

Thank you also for a very touching feedback, I appreciate it from the bottom of my heart.

I wish you all the best! You know how to reach me if you have any questions.


Sincerely,

Dr Galera
Above answer was peer-reviewed by : Dr. Vasanth
doctor
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Follow up: Dr. Rene Gerard Cruz Galera Jr (13 hours later)
Thanks a lot! Once again I will follow your advice.
doctor
Answered by Dr. Rene Gerard Cruz Galera Jr (1 minute later)
You are very much welcome!


Best,

Dr. Galera
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Rene Gerard Cruz Galera Jr

General & Family Physician

Practicing since :2009

Answered : 93 Questions

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Having Kidney Pain. Follicular And Large Cell B Lymphoma Treated. Urgent Consultation Necessary?

Hi XXXX! Thank you for getting back to me. I am glad that you feel better and the pain has improved.

I still advise that you see a general physician at least so that the appropriate antibiotics can be prescribed if tests deemed that you do have infections again - both on your tonsils and the left kidney. It is possible that you only have tonsilitis and a left kidney stone but an infection almost always comes with kidney stones because these change or obstruct urine flow.

I have to emphasize that you have to take care of kidney infections - I have had some patients who just ignored their symptoms of pyelonephritis and ended up in chronic renal failure requiring dialysis at least 4 times a month. I don't want you to reach that stage as it is very costly, riddled with a lot of possible complications, and, most of all, irreversible.

In the meantime, continue with your good personal hygiene, drink lots of fluids (fresh ginger tea really helps a lot with the pain of the sore throat - it stings at the first cup but improves afterwards), try and eat a balanced diet.

I hope I was able to answer your questions. If you have any further queries, please do not hesitate to ask.

I wish you the best of health!


Dr. Galera