When is blood in urine considered "er" type visitation?(its the weekend and my urologist on vacation).

 

Question. When is bladder dysfunction worthy of being treated "emergent" enough that an E.R. visit is not "abusing" the E.R.? ========== My Dr. On vacation until September 18th ("figures") correct? *sigh* ==========

History-I'm a 47-year old white male. Beginning in January 2016...I noticed I was infrequently/frequently "voiding" urine.

Aka..I would have abnormal amount of urges for urination..but more often than not wouldn't void. .aka..probably 8-10+ times day sitting at desk...feel need to go

However would only void..maybe 2x a day Each "void" being a "relatively"(to myself) a normal amount.'eh a "cup or two"....

========== I Started to have many frequent night time wake ups (sometimes every hour on hour it "seemed like"). But unable to void....

FFW to early 2017 (March)--I had a CT scan looking for Thyroid problems. The results of that exam indicated (good news--no cancer--bad news "distended bladder"). ==========

June (week 3) 2017 I Visited a "Chief" Urologist..only able to void around 200cc's on my own..but had over 600cc's in bladder..(tech sonogrammed me)...thus Dr. diagnosed "by definition" distended bladder.

That time had just over 600cc in bladder...

Here is where "bizzare" parts occur.. my questions... ============ Course Urologist ordered a  Urodynamics exam  Follow up Cystoscopy.

Urodynamics (August 15 2017) Cystoscopy (August 21 2017) Urologist also prescribed Flomax. ============

Strange #1: For the "first script" filled. My flow came back more powerful than ever. I jokingly say "like a firehose"---very "powerful" stream.. (end June- through July).....

*BUT THEN* Flowmax stopped working .(aka I reverted back to voiding 2-ish times per day..like before meds..(end July into August 2017). ============

I showed up to Urodynamics (August 15) I "self voided" again about 200cc's

*HOWEVER* THE TWO RN'S doing test WERE *SHOCKED* (to the point of almist "canceling" my exam..called MD he said "no continue"

Urodynamic test of course they cath'd me..

I "self voided" 200cc's They removed 3550 (Not a typo over 3.5 LITERS) sitting in bladder with *ZERO* urge to "go"

Dr. As said, no continue......exam...

Of course I flat out "flunked" them putting 1000cc's back in..not even a remote feeling of "need to go"(*ha* American medicine..RN said..tell me when you first feel the "urge"...then tell me when it gets so bad if you were in a car at a red light you would be looking for a tree to "desperately" go). *guffaw*

Flunked..nothing....no feeling...

They cath'd again removing the 1000cc's I was given *ZERO* instructions (other than handed an 8oz bottle of water).. "Be sure to drink this so you don't get dehydrated"

I asked..should I be doing anything before my Dr. follow up next Monday? RN said no.

============ Problem #1-showed up...more "hyper vigilant" monitoring... Urodynamic..was a Tuesday... I noticed Wednesday..no voiding.... I noticed Thursday..no voiding.. I noticed Friday no voiding.....

Friday p.m. voided "a cup or two"--'eh maybe 16oz..... Saturday woke up with back pain/kidney pain..only "irritating" not "painful".. Saturday P.M. was closer to a "4" on pain..and 7 just "annoying".. aka feeling like laying on pile of rocks "discomfort" laying on sofa watching college Football...

I tossed around "maybe" E.R... But figured since my Cystoscopy was Monday at 10 a.m. would wait. Finally Sat night "voided" what I deemed "normal" 3-4 "cups"

============  Cystoscopy (Monday August 21 2017) show up for exam. Dr. Took *MAYBE* 60-SECS for procedure (45-seconds more close).

In exam room, advised "your bladder muscle not working"--heard him tell nurse after clothes back on send him to my office.

In office, he said he felt it was Neurological..sending me to Neurologic exam (Earliest is Nov. 3rd). ============ Dr. Advised in interim, starting me on Self Cath ("Lofric Intermittent") 4x day.

Told me go this xyz room assistant will teach you self cath..... ============ .I "warned" girl..listen, I haven't pee'd fully in week....You better have extra bottle avail...she of course didn't listen..

Sure enough....I "eliminated" about 3,500cc's again (aka fully filled up 3-1000cc jugs...and 1/2 a 4th.....the type "jug" on gets in hospital...when bed ridden.."yiu know"..

============

August 22 2017--was called by Nurse, told urine sample showed UTI..given  14-day supply of Nitrofurantoin to take. Couse that supply ended on  September 5th...

*NEW PROBLEMS* ============ Recent symptoms developed.. Week 1 (ending SATURDAY September 9 2017).. Very Low level pain in back/side (aka can tell eminating from kidneys) Some radom pelvic pain....more annoyance.than "true disconfort").More Pelvic than Kidney...

Week 2(ending SATURDAY September 16 2017)..Pain worse..but not "bad" aka "when" feeling pain.."discomfort" about a 7.."pain" about a 5..no real "pelvic" week 2) ============ What's changed? Blood now in Urine... (while on UTI med only once a *very,very* faint punk hue).

Starting last night..Friday September 15th my last (cath dependent) elimination..had blood in pee....but very minimal..one "void" my urine was a "very dark cloudy brown" at 2nd to last before night time...(aka 6pm ish cath)

My 11pm ish cath...Last before bed..had a "very low" tint of pink to it...... ============ Awoke this a.m..Saturday September 16th.(bizzare for recent feeling) actually had the muscle(?).. "urge feeling" to pee..can't pee without cath right now...

My 5:30 a.m. elimination...much more "muddy brown"....

Again "urge to go" around 8 a.m. (*zero* liquid consumption)---The pink hue came back..

AGAIN "urge to pee"--can't without cath..NOW (after having two 16oz bottle water) 9:30 AM..*VERY RED*

============

MY DELIMA? BY "PURE COINCIDENCE"--happen to do a follow up "introduction" to the Well Plan,RN,Lofric Rep".

Told her the "can't pee" story above how I was debating going..

I asked.."what's the qualifier I should go to E R. Since of course the cath is voiding for me..

She immediately daid "A Fever"(no mention of blood) and she knew had former UTI treatment...

============ Thus..what's an emergency her? Or "justifiable" going to E.R. would not be "abuse"..

It's 10 a.m. I last cath'd at 9:30 blood red after 32oz if drinking water...

My Dr. Out of town until Monday September 18th..thus calling Office for med needs won't help..he's not there..

As I type this on phone...I have no pain...don't (feeling head) have temperature...

Should I head to E.R. Wait until monday Take over the counter meds? (assume a *NO GO* is *NOT* aspirin, since that complicates blood clotting).

If over the counter Tylenol?(acetaminophen)?

My biggest concern..since I'm already "abnomal" age having these problems (aka Dr. Said.."youre too young to be having these issues..rold Lofric rep rhat she said "Yes, I did notice 47-years old, that's young".

Advice?