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Dr. Hive- bladder infection question (possibly tmi) (Updated)


Mergath
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Update #36

 

 

 

My dd is absolutely miserable, and I'm not sure what to do. :(

 

Wednesday she started having symptoms of what seems like a bladder infection.  She couldn't be away from the toilet for more than thirty seconds because she felt like she had to pee constantly, though she says it doesn't actually hurt to pee.  Her temp was up over 100 and her face was flushed bright red, which only happens when she's sick.  We bought cranberry juice and had her drink a ton of that along with lots of water, and finally bought a package of pull-ups so she could leave the toilet.  At this point she'd been in there for hours, and we knew she wasn't going to sleep if she thought she was going to pee in her bed.  She's really sensitive about that kind of stuff.  What worried me was that despite how much she was drinking, hardly any actual pee was coming out.

 

Yesterday after she got up she still wasn't any better, so I brought her into the walk-in at our clinic, thinking it was a pretty clear UTI.  She gave a urine sample, and when we got in to see the doctor- not our normal one- he told us that there's some bacteria in her urine, but not enough, so despite all her symptoms he wasn't going to prescribe anything, and we should give it a week. (!!!) He checked her and said he couldn't see any irritation or anything, so it wasn't any kind of external irritation causing it.

 

Well, dd is still miserable today.  She spent half the morning in the bathroom sobbing.  We've still been giving her a lot to drink, but even though she's been on the toilet forever, she's hardly making any urine.  She had a bm and peed a small amount at one point, and it smelled like something had died.  It was seriously a horrible, horrible smell.  Her temp is back up over a hundred, higher than yesterday, and her face is so red she looks sunburned.

 

I have a call in to our normal doctor to see what he says, but haven't heard back yet.

 

Any ideas as to what could be wrong?  I don't see how it couldn't be a UTI.  There's no way I'm going to let her sit like this for a week to see if it just goes away on its own.  I'd appreciate any thoughts.

 

Thanks!

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It could be bladder inflammation, not due to infection.  It could be a reaction to something in her diet, especially artificial sweeteners.  She needs to see a urologist or at least a more proactive doctor quickly.  There are meds to help reduce the inflammation, and then of course the root cause needs to be found and addressed. 

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I'd probably just take her straight to the doctor's office and demand that she be seen today, even if you have to sit and wait for a while.

 

I wouldn't let this wait until Monday, because it could be a kidney infection. (I hope not!)

 

Whatever the case, she needs medication, and she may also need to have her bladder drained if she's drinking a lot but isn't able to pee it out.

 

I feel so sorry for her! :grouphug:

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It could be bladder inflammation, not due to infection.  It could be a reaction to something in her diet, especially artificial sweeteners.  She needs to see a urologist or at least a more proactive doctor quickly.  There are meds to help reduce the inflammation, and then of course the root cause needs to be found and addressed. 

 

Would that cause her temp to go up?  That's what was making me think there has to be some kind of infection somewhere.

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Has she been drinking/eating anything unusual?  I have urinary symptoms from Aspartame/Nutrasweet.  Took me nine months to work out that it wasn't a recurrent urinary infection.

 

L

 

Nope, not that I can think of.  I get horrible headaches from artificial sweeteners, so I'm a nut about making sure we avoid them.

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She could have a stone and be partially blocked, a kidney infection, etc. Those stupid strips they use in the office are notoriously inaccurate. Also, no more cranberry...the acidity can make it burn worse. In fact, it could be causing a lot of the pain. (ask me how I know!) There is over the counter medication to make the pain go away, but she needs the problem treated. 

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That dr is an idiot. I would call UC back and see if a different dr can look at her file and call in a rx. Cystex has always been helpful for managing my symptoms, but it doesn't fix the source problem.

 

Poor girl!

 

I'm hoping our regular doc will do that without making us go in again.  Dd is so uncomfortable she's been waddling like a duck when she's away from the toilet. :(

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My last bladder infection did not show up in the urine sample. I had to have a clean catch retrieved with a catheter (sorry if TMI) and I had blood in my urine. With all of your DD other symptoms the DR. should have prescribed medicine (IMO).   :grouphug:  :grouphug:  :grouphug:  for you and your girl!

 

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She could have a stone and be partially blocked, a kidney infection, etc. Those stupid strips they use in the office are notoriously inaccurate. Also, no more cranberry...the acidity can make it burn worse. In fact, it could be causing a lot of the pain. (ask me how I know!) There is over the counter medication to make the pain go away, but she needs the problem treated. 

 

Good to know about the cranberry juice, thanks.  I've always been told it can clear out a uti, it's hard to know what's accurate and what's a myth.  We'll stick to water today.

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I agree with Cat. Take her straight to the doctor (looking at your signature - she's Kindergarten age?) or ER. Hope she feels better sooner than soon!

 

Yup, she's five.  I'm going to give our doc another hour to call back, and then I'm just going to bring her back in.  Our car died and we're getting by with a bike/trailer combo at the moment while we set aside money for a new car, so actually going in to the clinic is a fairly long and uncomfortable ordeal for her.  Hoping to avoid it if I can. :(

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Yup, she's five. I'm going to give our doc another hour to call back, and then I'm just going to bring her back in. Our car died and we're getting by with a bike/trailer combo at the moment while we set aside money for a new car, so actually going in to the clinic is a fairly long and uncomfortable ordeal for her. Hoping to avoid it if I can. :(

Could you call a taxi to take you to the clinic and arrange to call them to pick you up when you're ready to go back home?

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I would take her to the ER. There are going to have better diagnostics to figure this out. If she's not producing very much urine, and it's foul smelling, plus a fever, that's a big concern. Hopefully just some dehydration and a simple infection that can be easily treated. I would really encourage the ER with those symptoms since you've already tried the office route. Poor baby! 

 

ETA: I agree with a PP when they mention a catheter to collect the urine. I would trust an ER with this sterile procedure over an office that may not be able to do it, or not do it often enough to trust the technique. Good luck and hope it's nothing! 

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I also had bad bladder reactions to cranberry juice. It was solved by drinking something alkaline, miso soup.

 

But in this case, I'd want to rule out a kidney infection. I'd think about going somewhere where you could get a blood draw right away. Perhaps the ER. It sounds extreme but she seems miserable and you're upset, and I think it's worth getting to the bottom of it.

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I would take her to the ER. There are going to have better diagnostics to figure this out. If she's not producing very much urine, and it's foul smelling, plus a fever, that's a big concern. Hopefully just some dehydration and a simple infection that can be easily treated. I would really encourage the ER with those symptoms since you've already tried the office route. Poor baby!

 

ETA: I agree with a PP when they mention a catheter to collect the urine. I would trust an ER with this sterile procedure over an office that may not be able to do it, or not do it often enough to trust the technique. Good luck and hope it's nothing!

I was the one who suggested that they might need to use a catheter, but I hadn't thought of the ER being far more experienced and probably more sterile -- I change my vote from doctor to ER.

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I've always had good luck with cranberry juice clearing up utis. I don't usually run a fever with a uti. (unless it goes into a kidney infection.)   healthfood type stores sell supplements that are just the active ingredient.

 

one thing to keep in mind - it is possible to so irritate things by consuming stuff that is acidic that it can be very painful, but there is no infection.   then drinking baking soda water will return the ph closer to normal.   my gyn had me do that after a culture came out negative.

 

I had a kidney infection once, i ran a fever and was exhausted (but thought it was because of other things).  I didn't have many symptoms typical of a uti.  that requires antibiotics, and just to rule it out should be seen asap.

 

eta: it sounds like she could have a kidney infection - go find another dr and get her seen.  if she's been doing the cranberry - that could easily have taken care of any infection in her bladder, so not much would be found.  but if it had already started up towards her kidneys, cranberry wouldn't stop that.

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ER.

 

I just got done with bladder spasms that made me feel like I had to go all the time.  It was not a UTI.  Cranberry juice made it worse.  (Cranberry juice is great for an actual UTI but not for other things.)  I had a kidney stone as well as some other problems.  The fact that she cannot urinate despite drinking is concerning to me.  

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I'd either take her to the ER go all Momma Bear on them until she is seen and treated.  Tell them how long she has suffered and that the first doc at Clinic X blew her off and will be reported. File a report on the first doctor.  Totally unacceptable.

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Given what you have described I would probably take her to the ED.   If you had a pediatrician who was trusted and very competent, I might try to go that route initially, just because they knew her, but it sounds like you've already had a bad experience there and I question if she may need tests/treatments not usually available in offices.  The reason I usually start with our kids' pediatrician is because she is amazing, they aren't scared of her, and she has admitting privileges so if something is needed that is beyond the office she can admit and get it done in the hospital.  Even so, we've still gone through the ED, and then had her admit them after that, when they've been really sick and we've been wary about that and or them waiting until her office is open.

 

I'm not sure what the other doctor means by "some bacteria but not enough" because urine should be sterile.  I wonder if what he is trying to communicate (poorly I acknowledge) is that his UA showed some trace white cells and no nitrates and he is suspecting it isn't infected. I would probably lean that way as well with a clean catch sample from a five year old as well.  But I would send the culture just to be sure I'm right and not missing the UTI and if I didn't think the UTI explained her symptoms I would be looking for another explanation. Did they send a culture from where you took her yesterday?  Urine cultures are often finalized in 24 hours, especially if they are negative, so you might have some information there.   

 

If she isn't able to void then that is an at least urgent, if not emergent, problem.  The suggestions that it may be an obstructing stone are certainly possible.  You can also have obstruction from other causes, like infection, inflammation, tumors, clots, etc. All of these are less likely, but not impossible, in five year olds without other medical issues. You can also have urinary retention due to underlying neurologic disorders and as a side effect of medications.  Untreated urinary retention can cause renal failure so it is important to act in a timely fashion to relieve the obstruction and prevent this. 

 

Finally, although this is a rather atypical presentation (and you would expect to see glucose in the urine) make sure that they check a glucose (and ideally a BMP for a serum CO2) to make sure that this isn't early Diabetes. 

 

Good Luck!  I hope she feels better soon!

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Oh, the poor baby!!  :(   Hoping you are already on your way to or at the doctor's office or ER with her. 

 

I always have UTI-like symptoms with a kidney stone (constant urgency, but no pain with urination).  They don't cause fevers for me, though. 

 

I hope you don't mind me saying that you and your daughter have been in my thoughts and prayers all afternoon (I didn't have a chance to post earlier).  Hoping that you will get some answers today and that your daughter will feel better soon.  :grouphug: :grouphug: :grouphug:

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Would that cause her temp to go up?  That's what was making me think there has to be some kind of infection somewhere.

Yes, when the temp goes up, that means there is infection. My temp always goes up when I get a kidney infection. Poor baby, give her a hug for me!

 

I totally competent GP can be clueless about pediatric conditions and presentations, so please try to get her seen be her pediatrician or the er. I know you are doing this... :)

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I'm not usually sexist about things like this, but am I the only one who wasn't surprised that it was a male doctor who told Mergath to wait a week? :glare:

 

Because I don't think there is a female doctor on the planet who would send another female home with a possible urinary infection and tell her to wait it out. :eek:

 

UTIs are so painful!!! What kind of idiot adopts a wait and see attitude toward a UTI??? It had to be obvious that the little girl was in a lot of pain. :angry:

 

I'm still worried that it might be a kidney infection, though, but I hope it's just a minor UTI. Hopefully, Mergath is at the doctor's office or the ER right now, getting some answers -- and some fast-acting medication for her little girl.

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Hi everyone!  Sorry to keep you waiting, and thank you so much for your concern and good wishes.  Yes, we were at the clinic.  I figured we'd start there, since the clinic and the hospital are next door to each other and it would be easy to go on over to the ER if the clinic blew us off or something.

 

I told the clinic I wanted to see a different doctor, so they had us see a nurse practitioner who was on call (and who was lovely and wonderful).  She seemed much more concerned than that last douche-canoe we saw yesterday, and said that dd needs to be on antibiotics, especially with the weekend coming up so we didn't end up in the ER with worsening symptoms and a giant bill.  She did a more thorough exam, and said she didn't think it was her kidneys, since she didn't seem to have any pain there, but to keep an eye on it and let her know if anything gets worse or changes.

 

So we have a weeks worth of antibiotics, and hopefully dd will start feeling better soon.

 

Thanks again everyone, I really appreciate it! 

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Glad you found someone to really listen to you.  A basic screening urine test can come back negative but then a longer one can test more and might have been positive.  Glad she got the meds.  She should start feeling much better within 24 hours or so.

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I'm so glad you were able to get your dd in to see someone better this time around and that you were able to get some medicine for her. I'm relieved to hear that it doesn't sound like a kidney infection.

 

I hope she starts feeling better very soon! :grouphug:

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Has she been drinking/eating anything unusual?  I have urinary symptoms from Aspartame/Nutrasweet.  Took me nine months to work out that it wasn't a recurrent urinary infection.

 

ETA: but that doesn't fit with the fever.....

 

L

 

This is what I had - severe inflammation due to aspartame.  Infection did not show up in urine test results.  However I did also have a kidney infection, from the whole urinary tract being messed up, and a fever from that....but that did not show up in the urine sample, (while a blood test did show elevated white count), and the infection was not the cause of the bladder inflammation.  A more proactive doctor would cover all the bases, instead of quickly dismissing the symptoms just because a urine sample didn't easily show infection or explain the inflammation. 

 

Just read update - excellent !  I hope she feels better quickly. 

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I was hospitalized by a kidney infection last fall. It started as a fairly mild UTI (really, I've had much worse) and progressed quickly. I never felt the back/kidney pain that you're supposed to feel. It was bad before I knew what it was. I couldn't regulate my body temp by the time I went to the ER. I'd never been hospitalized for illness so I was in serious denial. I wouldn't play with this. At the very least they should have given her some pain relief! Even if it's just an irritated urethra aggravated by the juice, she needs some relief to rest and heal.

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Did anyone check her ears? My DD used to get really severe UTI symptoms with ear infections. It sounds bizarre to me, but the Dr said it is fairly common.

 

The CNP checked her ears today, I'm guessing that was why.  No ear infection, thank goodness.

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Please send an update when you can. Hopefully, she's already feeling a bit better by now and can have a relaxing weekend recovering.

 

Unfortunately with antibiotics it takes a few days to feel better. I was hoping she would get 2 prescriptions, one to make her healthy and one to make her feel better, but at least she's getting proper treatment. I assume she'll feel better by Monday.

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Did anyone check her ears? My DD used to get really severe UTI symptoms with ear infections. It sounds bizarre to me, but the Dr said it is fairly common.

2dd had a sinus infection when she was three - and even being completely dependably trained, lost continence.  wierd, but that's what happened.

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