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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor
Category: Medical
Satisfied Customers: 40150
Experience:  MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
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I had sudden on set pain mid lower back out of nowhere. I

Customer Question

I had sudden on set pain mid lower back out of nowhere. I urinated shortly after and my urine had numerous black fleets in it. I went to lay dow, as my mid low back now all the way across @ rt ground pain. I urinated again, to get even more black fleets Ben before! I took it w me to the ER & the Er dr has never heard of this. Nor has my Pcp. I’m perplexed, as I have notice a few fleets before, but really wasn’t sure it came from me & didn’t see cause for concern. It hasn’t happened again & I feel my dr thinks I’m nuts. I was recently DX with SIADH, we don’t know from what. I have been increasingly unwell for some time. Severe e hustion, weakness, confusion & fell like Im going to drop. Any small task wipes me out. Can you share your knowlage. I feel like something serious is going on & my dr seems to be dismissive. Help!
Submitted: 4 months ago.
Category: Medical
Expert:  Dr. Arun Phophalia replied 4 months ago.

Welcome to Just Answer.
Answers here are for education and information.
I will respond shortly with an answer or further information request.

Expert:  Dr. Arun Phophalia replied 4 months ago.

What did your urine exam show?

What are your age and gender?

Customer: replied 4 months ago.
Everything was normal on urine test, yet dr couldn’t explain black flecks. I don’t know if lab looked at them, as a regular urinalysis. I am female & 54 ( I had a hysterectomy at age 21).
Expert:  Dr. Arun Phophalia replied 4 months ago.

Thanks for the additional information. I am writing the answer for you and will get back to you in 4-5 minutes. If you get a phone call request, you may ignore it as that is an automated site trigger. Thank you.

Expert:  Dr. Arun Phophalia replied 4 months ago.

The most likely explanation for black fleets is tiny concretions of calcium magnesium oxalates. Your doctor should order a 24 hours urine for evaluation of;

total oxalates.

total calcium

total citrates.

These tell if there is the tendency to form, the stones or tiny concretions.

A urine culture should also be ordered, if not already done with a CT scan (IV contrast).

Please feel free for your follow up questions.

I would be happy to assist you further if you need any more information.

Thanks for using Just Answer.

Customer: replied 4 months ago.
A CT ways done without vontrast in ER, “ no stones”. Would the contrast have shown more? The urine test you referred to, can it be fine or conclusive without the flecks( like Coffe grounds kind of).
Expert:  Dr. Arun Phophalia replied 4 months ago.

A contrast CT is far better to assess the cause.

A urine culture test may be done without flecks too.

It is privilege assisting you.

Customer: replied 4 months ago.
Thank you. Couldn’t or shouldn’t a culture have been done in ER? Also, why would contrast have help give more information? I know report mentioned “limited” without contrast. I don’t always understand what is really meant by these things. Thank you
Expert:  Dr. Arun Phophalia replied 4 months ago.

You are very welcome.

It is difficult to say why ER physician did not order the culture test. Usually, it is done for any urinary abnormality.

The IV contrast is the best way to depict the kidneys and their functions.

Wishing you a speedy resolution.

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Expert:  Dr. Arun Phophalia replied 4 months ago.

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