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Dr. Rick, MD
Dr. Rick, MD, Board Certified MD
Category: Medical
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Experience:  20+ years as a doctor. Internal Medicine Internship in NYC
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waking with quite severe right kidney pain

Customer Question

Hi there, for 3 months I am waking with quite severe right side kidney pain after 4 hours of sleep, occurring every night without fail. It is very painful and there is no way i can get back to sleep. It is only relieved by standing up and walking around and dissipates gradually over about 2 hours. Once it dissipates, I have virtually no pain, very minimal, until the process all happens again once I go to bed that night. It is gravity or positionally related. I have tried Ibuprofen and it does not give me relief. I have had a CT scan and was all clear. I have no pain urinating. I have recently suffered with gout and am taking Allopurinol which helps with the gout. It was in the morning that my uric acid levels were sky high. I would really appreciate any suggestions you may have as to cause and what investigations I should have. My GP does not have any idaes at this stage and as i live in a rural location a specialist appointment will be months away. I can't keep getting such reduced sleep as I just can't function. I also have hashimoto's ie hypothyroid, have had for 10 years or so. I have a recent osteopenia diagnosis as well. I have recent eczema-like rash on my neck. I have not had rashes or eczema before. Thanks for your assistance.
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. Rick, MD replied 1 year ago.
Hi. My name isXXXXX and I am online and available to help you today. Thank you for your patience.
Expert:  Dr. Rick, MD replied 1 year ago.
Has your GP considered doing an MRI?

Has an appointment already been scheduled to see a urologist?

Does this pain every occur at any other time?

Do you have any other symptoms?

This is not an answer, but an Information Request. I need this information to answer your question. Please reply, so I can answer your question. I look forward to helping you.
Customer: replied 1 year ago.
Hi Dr Rick,

As of yesterday, i am booked in for an ultrasound and also a voiding cystourethrogram. I have not had an MRI, would it be helpful? My GP has consulted with a Urologist who is happy to see me after results of these tests come back.

This pain does not really occur at other times. From waking the pain subsides quite quickly and within about 2 hours it is just about gone. In the past 12 months I have had gout, which became chronic in both hips of all places. In past 6 weeks have been taking Allopurinol and just in the last 10 days or so the pain is lifting. I do have hashimotos and I weigh 74kg, so am a bit overweight. The chronic gout resulted in steroid medication and not much exercise, not helping my weight. I have not drunk much alcohol for the past 7 years although I did drink more when younger.

I do need to urinate quite frequently and when I go the quantity is not really substantial. I have used valerian and doxylamine succinate to assist with sleep, which has been more difficult since hypothyroid.

I have recently developed an eczema like rash on my neck, and have no previous history of skin problems, not sure if related or just more inflammation! Thank you for your time.
Expert:  Dr. Rick, MD replied 1 year ago.
Renae,

I agree completely with the Urology consult, no matter what these test results show.

At this point, since you going to have the ultrasounds and voiding cystourethogram, I think it would be OK to hold off on getting an MRI.

After the Urologist examines you and reviews all the test results is he feels an MRI is indicated he can order one.

I have a suspicion that you may end up needing a kidney biopsy...but time will tell.

At this point I feel you are on the right track.

Does this make sense to you?

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you don’t feel that I have earned a “10” rating in all areas, please let me know what I can do to meet your expectations.

Thanks in advance,

Dr. Rick MD FACS
Customer: replied 1 year ago.


Thank you for your response it has been helpful. Just one quick question..... can I ask why you think a biopsy may be needed in the future?


 


I would like to know as I have really had to drive this a bit myself and insist on certain investigations. I do not want to waste time and perhaps end up with more, or potential, kidney damage. In our rural area it can be 6 weeks between available GP appointments and I would rather go in with more knowledge. I also work in health and my GP is very receptive to me doing a bit of research in the background (probably because she is so busy).


 


Thank you.


 

Expert:  Dr. Rick, MD replied 1 year ago.
There are many kidney problems, such as immune disorders, that do not show up on routine lab and urine testing. If a biopsy were done the pathologist would be able to see is there were any tissue changes that might explain your symptoms.

When you mentioned inflammation it made me think of these issues :)

Don't forget to mash the positive feedback button --the one labeled "excellent" is the most fun to push :)

Take care and have a good day.
Dr. Rick, MD, Board Certified MD
Category: Medical
Satisfied Customers: 8524
Experience: 20+ years as a doctor. Internal Medicine Internship in NYC
Dr. Rick, MD and 9 other Medical Specialists are ready to help you
Expert:  Dr. Rick, MD replied 1 year ago.
Renae,

I was just thinking about you and wondering what your ultrasound and voiding cystourethogram showed.

When will you be seen by the urologist?

I hope everything turns out OK.

Dr Rick MD FACS
Customer: replied 1 year ago.
Hi Dr Rick,

Have had both but no results yet. No Urologist appointment yet but if nothing shows on scans I will insist on it. Things happen slowly in the bush! Maybe it will be one of those things they can't explain. It just happens every night, it really hurts and disrupts sleep. It does not feel right and i have had nothing like this before. Is a deep ache, with waves of more acute pain. Thank you for your concern, I appreciate it.
Expert:  Dr. Rick, MD replied 1 year ago.
Renae,

I hope they figure it out soon as I'm sure it sucks to have your sleep messed up every night. :(

Don't forget to say "hi" to the Southern Cross for me :)

Take care, mate.

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Dr. Rick, MD
Dr. Rick, MD
Ophthalmologist & Retina Specialist
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20+ years as a doctor. Internal Medicine Internship in NYC