Interstitial cystitis or kidney issues?

Patient

Q: I have been having trouble with my bladder for years including close to 30 bladder infections. Some of which weren't officially diagnosed due to taking urinary pain relief medicine affecting dip stick tests. Four months ago I was told I probably have interstitial cystitis at a local free clinic. Not having health insurance I have taken preventative measures that seem to have worked. I don't drink caffeine or acidic juices, I try to drink tons of water. About 3 days ago I woke to extremely painful UTI symptoms. I took an at home test strip it was very dark for leukocytes but no nitrates. Yesterday I took 1 gram of azithromycin thinking I must have some kind of infection. There was clearly some blood in my urine also it seemed my stream was affected, it did not have the "force" it usually does, it seemed like it was just falling out. I took some urinary pain relief tablets last night and early this morning so I could not tell if there was more blood in my urine.I am still feeling pain but only in my bladder, not my back. I also appear to have slight edema in my stomach and hands which concerns me. I have no fever. I am concerned something is happening with my kidneys and am wondering if there are any at home tests I can do to determine if my kidneys are working properly or if this is just a crazy bout of interstitial cystitis or bladder stones. No health insurance makes things exceedingly difficult. Any advice or thoughts would be greatly appreciated.

Doctor

A:   From your symptoms it seems that you may be having another episode of UTI or an acute episode of Renal stones. It is difficult to tell as symptoms for these are almost similar . The dipstick you performed shows leukocytes which is typical of a uti. There is no home test that you can do to check the functioning of the kidneys for that we need your urine and we need to check the levels of creatinine and urea in your blood. This can only be done is specialised labs. Inorder to deal with this episode you should drink more fluids, cranberry juice has been proven to some extent to prevent further infections of the urinary tract. Simple other measures like voiding before and after sexual intercourse, and wiping the genital area from front to back is also helpful in preventing further episodes. If this continues I advice you to see a physician and I understand that you are without health insurance but that will be needed as more tests may be needed to be carried out.

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