I need some advice - please help

[Guest]

It has been 23 months since my prostate cancer surgery and I always have some small amount of blood in my urine. The urologist says that I probably always will. You can't always see it but the tests will detect it. I have had several kidney stones. One scared me because it did not hurt just bright red blood. The worst part was that I was in the hall of the hospital swapping jokes with a urologist just before going into the rest room. I came running out asking everyone, "Where did Dr. Stewart go?" The ones who had seen him said that he went out to the parking lot heading home. I went to a Doc-in-the-box clinic that our hospital ran and the doc there said to go home and he would try to schedule an X-ray for the moring but it was too late that day. I don't take warfarin and it was still pretty scary but now I live with it just like you guys do with your valves.

 

[bvdr]

Ann, how is your brother doing?

 

[hensylee]

our doctor's nurse called me yesterday afternoon and said nothing but blood was found in his urine - no infections or anything else, but the doctor rxed Septra to be on the safe side. The 'home' nurse called me, too - said she had called cardio's office and told them what she had done and was waiting for a call back - she stated Richard doesn't need the Septra but she has to give it because our local dr had rxed it. (I thought it was a good idea, myself). The assisted living home called me again today - she had talked to the cardio who told her to put him back on his usual dosage of coumadin (which she had done) and I am to get him tested in 10 days.

I am not altogether comfortable with this nurse. She is used to working in hospitals, not nursing facilities. There are separate licensings and laws governing each and she is still learning which is which. She seems competent, but she can't go changing things that are ordered, however Richard's urine is clear now and we may never know exactly what it was. Maybe she did the right thing. Mayhap it was the coumadin. We will wait for further developments and if none occur, all to the good. For now, anyway.

Thank you all for your help. I really did need it. Might need it again.

 

[Guest]

Adding Septra to warfarin calls for an INR on Monday. I have seen some spectacular rises in the INR from this. Many doctors are not aware of this - like a cardiologist- because they rarely (if ever) prescribe it.

 

[DrAllan]

I have several thoughts regarding your brother?s therapy. First, giving him an antibiotic for hematuria is inappropriate. If there is no pus or white cells in his urine, then there is no infection and no reason to give antibiotic. True, it appears that the gold standard fro determining infection, a urine culture has not been done, again another reason for not giving antibiotic. For continued bleeding over the time course you have described demands a work up for the cause of bleeding. Unfortunately, a recurrent kidney tumor is more likely than stones as the cause at this time. Start with a CT scan of the kidneys and bladder. A negative study does not rule out tumor, but a positive one points in the right direction.

My opinion of a doctor that treats a non-proven infection is less than sterling.

Best to you