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Thread: Chronic Infection or Pain

  1. #1

    Question Chronic Infection or Pain

    For almost 10 months now I've been on and off IV therapy for chronic UTI/kidney infections. The Result of which has led me to increased pain medication and in general my pain management has been very poor. The majority of the pain resides in my kidney area, bladder and then there's some there is neuro pain in both legs.

    I finally succumbed and began Fentanyl patches with hydrocodone a month ago. The past few days I started to have increased pain and fatigue. These patches have been ok at best- they fall off, withdrawal symptoms, some relief back to withdrawal symptoms. I would not recommend them.

    Currently, my recent urine result says that I have a low white blood cell count but I'm in extreme pain (7/9-10) and have extreme Fatigue and mental cloudiness, which i usually use as my rulers of infection. The question is if an infection can be present even with low white blood cell count in the urine? If this post is confusing, it is because I am really struggling with mental clarity.

    If not then, it has to be the meds combined with pain. I'm reaching out to physicians? But I don't expect quick answers and I've learned by now that your visit and doesn't solve much for people with spinal cord injury.

  2. #2
    Have you been evaluated by an infectious disease physician, not just a urologist, for your infection issues? Have you ruled out stones, prostatitis, hydronephrosis, or diverticuli in your urinary tract as a source of these infections? How do you manage your bladder?

    Generally we would not treat or even call it a UTI for a person with SCI who does not have fever, chills, and elevated white count in their blood (not the urine). Fatigue and cloudy thinking can go with an infection, but can also be caused by many of the medications used for pain, including opioids, synthetic opioids, and antiseizure drugs like Tegretol, Neurontin, or Lyrica.

    Infections are notorious for increasing the severity of neuropathic pain, but you may need to see a pain specialist to work on getting appropriate management of your pain at this point. Fentanyl patches will stay on better if you secure them with a piece of transparent dressing (like Tegaderm).


  3. #3
    Thank you for your helpful and thorough response.

    I have been in communication with an ID physician and will see him tomorrow. I will bring the post in the information that you supplied with me. Thank you for this, I've seen urologists in other specialists and none of them have brought up or explained all of this in succinct manner.

    I have been tested for stones with an MRI but tomorrow will ask for an ultrasound.
    I've also ruled out prostastis with a blood test in the past.

    I have constant chills, but slight fever.

    I'm about 70% certain that there's some sort of infection. I can't keep my eyes open for more than one hour, extreme nerve and general musculoskeletal pain – I have not change any medications within the last three weeks and this mental fog has brought with it hallucinations another mental abnormalities that for me usually accompany some sort of UTI. Sorting out whether it is urinary I guess is going to be the challenge. Thank you again

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