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Wednesday, April 23, 2014
A Lot of Blood in Urine
I have been having a lot of blood in my urine, and want to know what to do about it. I have type II Diabetes. About 3 months ago I felt sick like I did before I had an angioplasty & had 2 stents implanted in my neck & heart. 2 months ago I started taking 20mg Lantus Solostar insulin at night. I am trying to lose weight. 3 months ago to avoid plateauing I stepped up my tri weekly work outs at the gym (I am @40 lbs overweight & my weight has been increasing since I started going to the gym @ 1 year ago). I take a lot of pills each night & I take them with different juices alphabetically. Yes, I`m OCD. That`s like OCD but the letters are in the right order! Just before I started bleeding I was drinking cranberry juice which is what I initially attributed the urine color to. My urine progressively got darker, so I stopped the cranberry juice & went to water. About a week later my urine color progressively started changing to florescent yellow where it is normally just yellow tinted. I then went to my GP who also treats me for the diabetes & the 2 stents. My GP sent me to a urologist who ordered a CT scan. I went to the appointment to discuss the results of the CT. Instead, as soon as I walk in, I am greeted with a permission slip for Cysto--something or other which, I was told, involves running a orthoscope (?) up my penis. This before the CT`s even been looked at. I said I wasn`t doing any more tests until I got the results of the last test. I was told I could "call" the triage nurse later that day which I did. After much delay, I was told I had a blockage in my "ureter" & I needed surgery right away. I asked what the blockage was but never got a direct answer. About 20 years ago I had kidney stones. Went to the hospital. Got pain pills antibiotics & something to dissolve the stones. At that time they said that if that didn`t work, they`d sit me in a tub & bombard me with ultrasound waves & that would break them up. THEN if that didn`t work they would have to do surgery. I don`t trust this urologist but after the urine went to the bright yellow (before I went to the urologist) I started doing an abreviated walk at home & started doing the push ups & pullups again. I`ve been urinating solid red since. I have finally found health insurance (because of the preexisting conditions) but it won`t take effect until September 1. What can I do in the meantime? I am taking the antibiotics the urologist gave me script for & drinking lots of water, not exercizing & getting fatter every day. I am a 59 year old male. What can I do?
It is worrisome that you are urinating blood and apparently have no pain. In this case, kidney stones or infection are unlikely to be the cause of the blood, and a tumor is more likely. It is too bad that the urologist did not sit down with you and go over the CT scan, but since he asked you to sign for a cystoscopy and told you that you had a blocked ureter (the tube that connects the kidney to the bladder), I have to assume that he saw something abnormal on the CT scan, perhaps a narrowing of the ureter causing urine to back up behind the blockage. While such a blockage may be caused by a stone or even scar tissue, the blood in your urine is a very worrisome sign and suggests that a tumor is high on the list of possibilities. I would see the urologist again and have him show you the CT scan and go over it with you. Explain your financial situation and see if he has a recommendation of how to proceed. Although September 1 is barely a month away, perhaps there are other tests that could be run in the meantime in preparation for the cystoscopy, which it is advisable for you to have (it is done under anesthesia, with a slender, flexible tube with a light on the end that can be used to examine both the bladder and the ureters to determine the source of bleeding). Good luck to you.
Mildred Lam, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University