Kidney issues and diving

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Maine Diver

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Messages
197
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Location
Central MA
# of dives
200 - 499
Monday I had a sudden, severe onset of pain in my kidney, vomitting, and painful urination. I had a CAT scan with no contrast looking for kidney stones that showed no stones but "something". Yesterday the urologist ordered another CAT scan with contrast as he thinks the something could be a blood clot or an infection. He started me on Cipro for 10 days. He said my blood work showed left shifting. I am leaving for Bonaire in 9 days. Will any of this prevent me from diving?
 
It's way too early to know. An uncomplicated urinary tract infection should be cleared up within 10 days, but if there is something abnormal on the CT scan, that needs to be sorted out. A kidney abscess would require more treatment.
 
.... He said my blood work showed left shifting. ....


Just an fyi:

A "left shift" refers to a higher than normal count of immature forms of a certain class of white-blood cells called neutrophils. A left shift first of all suggests that your body is increasing production to clear the presence of abnormal or damaged cells, substances, tissue.

The term "left" simply came from the format of lab reports; new immature cell counts on the left, older mature counts on the right -- at least, that's the usual story. A related term sometimes heard is "bands" which refers to the elongated, band-like appearence of the young cell nucleus. OTOH, "right shift" and "segs" are terms used for older nuclei which have morphed into a multiply segmented, pinched, or lobular appearence. A marked right shift suggests a drop in cell production or a sluggish elimination of them; e.g. allergies, cancer, liver disease, vitamins/drugs, and some blood disorders.
 
Go back to the doctor, or to an ER!
 
Ditto what TSandM said.

I am leaving for Bonaire in 9 days. Will any of this prevent me from diving?

It well might. If it does, and you have a DAN Preferred Plan or similar, don't forget to use it.

Best of luck and please keep the board posted.

DocVikingo
 
Update and question. I am feeling much better after a week on the Cipro. I still don't have a CAT scan scheduled. The insurance company must pre-approve it. The doc's office called and said they had approval for the kindey scan but the doc wants an abdominal scan as well. What is the difference?

Thanks,
 
The first CT scan was almost certainly what's called "CT-KUB" (CT of kidney, ureters, and bladder) which is a quick look for stones or blockages. Although quicker, an ultrasound look is less sensitive, especially when a suspected stone may still be moving (in the ureters from kidneys to bladder) as is often the case with abrupt new onset of pain. The planned second CT scan with contrast (called an "CT-IVP" or CT intravenous pyelogram) can detect stones not seen in a regular CT. It's also used to look for a pouch ("renal diverticulum") inside the kidney itself where products can gather and stagnate to create stones or infections. Because the kidneys can react (spasm) to the injected contrast material (newer dyes reduce this), some prior blood work (esp. creatinine) is needed to evaluate their condition.

The abdominal CT provides a wider look at organs and spaces beyond the KUB; from about mid-ribcage down to about the hip joints. Besides the major organs and vessels, abdominal lymph nodes can also be evaluated; these are involved with the immune response to infection, cancer, etc. Also, there is a phenomenon known as "referred pain" where the reported site of the pain is not the site of the actual problem*. Suspected stone pain may actually be a problem, for example, of a stomach ulcer, or gall bladder (cholecystitis), or intestinal problem (diverticulitis). An abdominal CT should help consideration of such possibilities.

*The most well-known example of referred pain is the left-arm pain sometimes accompanying a heart attack.
 
The first CT scan was almost certainly what's called "CT-KUB" (CT of kidney, ureters, and bladder) which is a quick look for stones or blockages. Although quicker, an ultrasound look is less sensitive, especially when a suspected stone may still be moving (in the ureters from kidneys to bladder) as is often the case with abrupt new onset of pain. The planned second CT scan with contrast (called an "CT-IVP" or CT intravenous pyelogram) can detect stones not seen in a regular CT. It's also used to look for a pouch ("renal diverticulum") inside the kidney itself where products can gather and stagnate to create stones or infections. Because the kidneys can react (spasm) to the injected contrast material (newer dyes reduce this), some prior blood work (esp. creatinine) is needed to evaluate their condition.

The abdominal CT provides a wider look at organs and spaces beyond the KUB; from about mid-ribcage down to about the hip joints. Besides the major organs and vessels, abdominal lymph nodes can also be evaluated; these are involved with the immune response to infection, cancer, etc. Also, there is a phenomenon known as "referred pain" where the reported site of the pain is not the site of the actual problem*. Suspected stone pain may actually be a problem, for example, of a stomach ulcer, or gall bladder (cholecystitis), or intestinal problem (diverticulitis). An abdominal CT should help consideration of such possibilities.

*The most well-known example of referred pain is the left-arm pain sometimes accompanying a heart attack.

Thank you for the info. I just don't understand why it takes so long to get the approval.
 
The simple answer: Medicine is a business and the reimbursement process is the absolute monster. If you want to light off just about any doc, ask about reimbursements, ICD, CPT, and HCPCS codes.

But you will get the care you need; one way or another.....
 
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