Kidney Problems

[tuky]

My sister-in-law seems to have a kidney problem.

She is in pain and goes through bad spells where she is hospitalised.

Unfortunately the hospital she goes to in Indo only ever give her some drugs that make her swelling worse.

Lately she has been tying off loose ends and apologising to everyone in her life for the wrongs she has done as she is preparing to die soon.

She is 19 years old.

Anyway, to cut a long story short, nobody is doing anything for her. Her brother took her to see a sensei who said she should just die so the family are doing nothing.

I want to get her to a real hospital and have her diagnosed and treated.

Would a Thai hospital be a good place to start? if so what one would I better off taking her to?

Malaysia?

I know it is her kidneys that are her problem, but she doesn't know what is wrong with them or anything.

What to do?

[bkkjames]

Well, in BKK BNH, Sametivej and Bumrungrad are international standard. Get here looked at - sounds like stones or something else.

[Sheryl]

It is impossible to tell from what you have written what the nature of her problem is. What hospital (s) has she been being treated in?

The hospitals mentioned above are all good options. A less expensive one would be Saint Louis

http://www.saintloui....php?dept_id=24

Large tertiary government hospitals like Chula or Siriraj also an option but would involve some red tape.

Wherever you go, need to have the records of her prior treatment and all test results so be sure to get these first, otherwise a lot of unnecessary repeat work and delays.

i could advise more if I had some idea what the nature of the problem is.

[tuky]

It is impossible to tell from what you have written what the nature of her problem is. What hospital (s) has she been being treated in?

The hospitals mentioned above are all good options. A less expensive one would be Saint Louis

http://www.saintloui....php?dept_id=24

Large tertiary government hospitals like Chula or Siriraj also an option but would involve some red tape.

Wherever you go, need to have the records of her prior treatment and all test results so be sure to get these first, otherwise a lot of unnecessary repeat work and delays.

i could advise more if I had some idea what the nature of the problem is.

Thanks Sheryl, I wish I knew too.

She has been treated (?) at AwalBros Hospital in Batam plus a government run hospital for the poor in South Sumatra. I don't think any diagnosis type work has been done I think they have just put her in a bed and given her drugs, I have no idea what the drugs are either but they do make her swell to twice her size.

The swelling is always from her hips on down, I have seen her ankles the same size as my calf. I guess this has been going for about 12 months.

Poor girl, I just hope to help her as she is miserable and has resigned herself to dying. I will try to get more info.

[Sheryl]

Oh, she's in Indonesia! That complicates things a bot as i don't know a thing about the public health system there, what it provides for and what it does not.

I suggest you ask speciifcally if she was told she needed dialysis. It may be that the this is not available free of charge in Indonesia, if so could explain why things are as they are. Unfortunately it is a costly thing to pay for privately, and a cost that goes on indefinitely unless a trabsplant is possible (all this assumes that btoh kidneys are in irreversible failure).

[Hairy]

Does she have sleep apnea, or is her sleep often disturbed?

[bangkokheat]

is your sister in law still having problems? I can help

[tuky]

Ok, just to follow up...

I am back at work in another country but my better half is with her now, so my understanding is still not quite clear as I am getting updates in Bahasa Indonesia.

Last Monday (on my way back here) I took her to Mount Elizabeth in Singapore where she has been hospitalised as an outpatient. ($10,000 so far but what is a life worth? ).

All manner of tests have been performed to find out what is wrong with her.

Firstly X-rays were taken, then lab tests on her blood and urine. These urine results came back showing an excess of protein and blood in her sample.

Next they (I think) injected a dye and MRI'd her kidneys, they also took a biopsy which the results are still pending.

So far the diagnosis is, and I am quoting what I have been told in Bahasa Indo that both kidneys are leaking, the drugs she has been taking from Indo doctors is 75% the cause of her problems according the Mount Liz doctor.

She has been having daily "injections" at the hospital, I can only assume this is for flushing the kidneys?

I am told after she is released today the treatments she has received is enough to get her through the next year taking the medicines they will prescribe.

Later today my better half will scan and email the doctors report in English so I will have a better understanding.

My thinking is the $10,000 I am paying now is worth it to get a proper diagnosis from a real hospital and from there we can then work out what to do for further treatment at a perhaps more sustainable cost.

I hope you don't mind if I pick everyones brain a little over the next however long.

She is such a lovely girl and so beautiful. Her family still think all she needs is a witch doctor and were unwilling to do anything more. I have a little trouble understanding that kind of thinking, for me the world is a better place with her in it so I will do all I can to make sure she is. It breaks my heart each day as she calls me, she is crying and can't stop thanking me. I am not in this for the thanks, I am in this because as I say the world is a better place with her in it. I am really looking forward to seeing her again soon, especially without her swollen legs (Ankle edema, is that correct?)

[Sheryl]

Yes, ankle edema.

"leaking kidneys" is not a diagnosis.

Sounds like renal (kidney) damage from nephrotoxic drugs but if so, question is, what was wrong with her that she took those drugs for to begin with?

I think wait till you have some report in English then post here.

Moutn Eliz is a good hospital.

[tuky]

Yes, ankle edema.

"leaking kidneys" is not a diagnosis.

Sounds like renal (kidney) damage from nephrotoxic drugs but if so, question is, what was wrong with her that she took those drugs for to begin with?

I think wait till you have some report in English then post here.

Moutn Eliz is a good hospital.

Ok, Apparently the The disease name is"membranous glomerulonephrttis"

The medicine they have prescribed is dhasolone5 mg,lasix 40mg, zantac 150mg,apo-k 600mg

This is all greek to me, Sheryl you have seen the report, does any of this make sense to you?

Is it just, for want of a better term, common place? or is this something devastating?

I am now totally confused.

Maybe there is a better place for me to ask my questions? if there is ongoing treatment required, and I am responsible to pay I want to learn more about this in the regard of finding the best place to get her help.

Mods I am sorry if this is out of line, life is more important than mere rules. As you know I used to be a mod, so I understand.

[Sheryl]

I've sent you a Pm as I need you to email me the report so I can view it in enlarged form.

Glomerulonephritis = inflammation of the glomeruli, the part of the kidneys that filter things out of the blood. Can have many causes and depending o nthe cause, prognosis varies from excellent to poor.

It can be due to nephorotoxic drugs but it cal also occur idiopathically (no apparent cause). Also often occurs following an untreated or incompletely treated streptococcal infection which may have bee =n a sore throat or skin infection. It is pretty common in SE Asia especially in children and teenagers. Treatment is aimed at the underlying cause, if known, and at alleviating the inflammation, usually through the use of steroids which is what they appear to have done in her case.

Dhasolone = prednisolone, a steroid. Be sure to follow instructions exactly as it should not be stopped abruptly.

Lasix is a duiuretic, to help the body rid itself of excess accumulated fluid.

The zantac is to guard against gastric ulcers which can be a side effect of prednisolone. The apo-K is a potassium supplement which replaces the potassium lost in the urine as an effect of the lasix.

She should have a follow uop appointment scheduled fairly soon an d I would expect the lasix not to be needed for long. the prednisolone may need to be taken for a while and when it is stopped, it needs to be stopped gradually under medical supervision. Not unusual to relapse while the prednisolone is being tapered off. If that happens, treatement is restarted at high doses of prednisolone and then gradually reduced etc.

I'll provide morei nfo once I've read the reports, as I wasn't able to enlarge them to a readable font.

[FBN]

Made some inquiries in Indonesia and these 2 physicians seem to be the local experts in this:

Option 1.

Prof Jose Rosma, at RS Medistra Jakarta.

Hosp phone: +62 21 5210200.

Option 2.

Dr Widodo Suprapto, at RS Pondok Indah Jakarta.

Hosp phone: +62 21 7657525

Best...

[phuturatica]

As someone who also has kidney problems... I fully sympathise and hope she gets better soon!