Case Cluster #1: Urinary Tract InfectionPresentation: We have seen an upsurge in urinary tract infections this week. Symptoms can include burning, frequency, urgency, low midline abdominal pressure, fever or chills.
Course and treatment: UTI can be very dangerous when untreated and no delay should occur in seeing your doctor. Cranberry juice and the over the counter drug that turns urine orange called pyridium are not a substitute for proper antibiotic treatment by a doctor. Untreated UTI can result in death.
Epidemiology: UTI is more common in women due to the proximity of anus and urethra. It is also more common with certain sexual practices and techniques and poor hygiene and immunocompromising diseases like diabetes.
Prevention: Proper hygiene such as wiping front to back, urinating after intimate relations and not holding urine but rather urinating frequently all reduce frequency of UTI. Also vigorous hydration can decrease incidence by keeping the pipes clean. Controlling diseases that cause immunocompromise such as diabetes can reduce UTI.
Case Cluster #2: PainPresentation: We are seeing a large upsurge in patients complaining of pain. From back pain to muscle pain to joint pain, all categories of pain are increased in the patient population.
Course and treatment: Depending on the origin of the pain there are various modalities that can be of help including hot pax or cold pax, massage, Jacuzzi, gentle stretching exercise, acupuncture, physical therapy, epidural shots, holistic remedies and oral pain meds among others.
Epidemiology: Dr. Arian blames the rash of pain complaints on 2 primary things. First, changes in weather especially with low pressure systems increase pain. Pain is also affected by mental health and in this time with anxiety rates peaking and woes in the socioeconomic milieu, pain complaints are more frequent.
Prevention: Regular exercise and good nutrition remain the best ways to prevent pain.
Case Cluster #3: Kidney StonesPresentation: We have seen several cases of kidney stones this week. They presented with back pain usually one sided left or right, that wrapped around the flank to the abdomen and headed toward the groin. Blood in the urine was sometimes seen. Patients were unable to hold still and moved and wiggled as the pain ensued. Pain was accompanied by severe nausea and anorexia.
Course and treatment: All the renal stones we saw this week passed into the urine without assistance followed by rapid relief of severe pain and gradual relief of the remaining pain. Because renal stones can mimic other serious intrabdominal processes and blockages of the ureteral tract can endanger the kidney, an advanced imaging study such as CT scan or ultrasound is usually obtained. Treatment usually consists of hydration, pain control and straining urine to capture the stone for analysis.
Epidemiology: Dehydration, certain metabolic abnormalities such as hypercalcemia and hyperuricemia can predispose to renal stone formation. Because the weather is warm and folks are still on winter hydration patterns, renal stone diagnoses are up.
Prevention: Hydration hydration hydration!!! Also have a standard metabolic panel drawn by your doctor yearly to see if you are at risk for stone formation.