Seek out a knowledgeable physician to determine the origin and cause of your pain.
KIDNEY CYSTS
KIDNEY STONES
SURGERY PAIN
LIVER CYST PAIN
BACK - JOINT PAIN
TOOTH PAIN
HEADACHE
CHRONIC PAIN
CHEST PAIN

KIDNEY CYSTS This pain can become chronic requiring narcotics. For a review of some causes of PKD pain click here. The source for kidney pain can include but is not limited to the following:

KIDNEY STONE Your doctor can determine if you have a kidney stone an ultrasound study or CT scan. He might ask that you strain your urine through a filter to catch any possible gravel. This will give a clue as to what type of kidney stone you are forming. This knowledge can aide in the prevention of future stone formation. Shohl's solution or potassium citrate is an old time remedy for kidney stones. Pain relief will need to be given immediately, usually in the form of narcotics. If your urine is too acid you will need to maintain a constant alkaline pH, increase water intake, and eliminate too many proteins. Urocit K and polycitra syrup are two forms of potassium citrate a strong alkalizer. These medications are useful for preventing future kidney stones. A high salt diet increases the amount of calcium excreted in the urine. This too promotes the formation of calcium stones. Avoid caffeine. Two (2) separate studies found caffeine and protein to be a primary factor in the chances of developing more kidney stones. If you have an oxalate stone, your doctor may suggest you avoid high oxalate foods such as spinach, rhubarb, beets, strawberries, wheat bran, nuts and nut butters. Here is an oxalate food list and another oxalate food list. Naturopathically it is recommended that one, alternate freshly squeezed apple juice with freshly squeezed lemon juice each hour.

KIDNEY STONE ARTICLES
Nephrolithiasis treatment improved with magnesium and potassium citrate
Nephrolithiasis trial with potassium citrate
Potassium Citrate kidney stone trial
Potassium Citrate polycitra - K prescribing information
Potassium Citrate bio of G. Tanner and publications
Potassium Citrate Urocit dose chemical structure
Potassium Citrate Urocit contraindications
Potassium Citrate Reoccurrence of kidney stone diminished by potassium citrate
Caffeine causes an increase in kidney stone formation
Low Oxalate Diet
A study from Italy was done to determine the correct diet for chronic kidney stone formers. Participants wanted to prevent future kidney stones. Each participant drank 3 liters of water daily. Their daily protein intake was determined by laboratory testing. The hypothesis was would dietary calcium cause an increase in kidney stone formation? It was determined that dietary calcium was not the culprit. It was eating too much protein. It was thought that dietary calcium might precipitate kidney stone formation. Participants used the same guidelines. Participants gladly cut back on their protein intake to assure no further kidney stones.

SURGERY PAIN For post surgical pain relief, An indwelling epidural catheter is sometimes left in place for 3 days following surgery. This results in a totally numb feeling from the lower abdomen to the tops of the thighs. Sometimes narcotic pain medication can bring on extreme nausea.

LIVER CYST PAIN About 8% of individuals with cystic livers go on to develop severe polycystic liver disease. Pain is the most common symptom from polycystic liver disease PLD. According to a polycystic liver disease PLD review from Alberta Canada 1990 - 2002
36.6% experienced pain
9.6% had difficulty breathing
9.6% restricted mobility
45% restricted mobility with hepatomegaly
62.3% female
37.7% male
71.7% had PKD
The mean age at diagnosis 56.4 years
We are a very stoic group of individuals and often wait until there is a low level of chronic pain before seeking help. Should the pain become chronic requiring opiods, fentanyl patches, vicodin, oxycodone compounds to allow us to function on a daily basis, there is a procedure available called a Splanchnic denervation of T10 -T12. This is done laparoscopically, performed by a thoracic surgeon and available at many centers throughout the world. Some individuals have been helped by this procedure.
Here is a short listing of various reasons for experiencing liver pain:

BURST CYST If there has been a rupture of a liver cyst, there are specific imaging studies to determine this. A burst cyst requires rest to enable the body to fully heal.
CYST INFECTION If it is determined that there is an infection within a liver cyst, these are very difficult to diagnose and treat. An infected cyst can be very unresponsive to antibiotics. It is difficult to penetrate the liver cyst walls with antibiotics and treatment usually has to be repeated every 6 weeks with multiple sessions. Tagged white blood cells along with imaging, are used to determine which liver cyst is infected. Once the infected cyst is isolated, sometimes antibiotic is directly delivered to this target cyst.
LIVER TOXINS If the cause of liver pain has been to an exposure to a liver toxin such as bleach, try a heating pad, hot lemon juice , saffron tea, saffron thistles, milk thistle plus (milk thistle, artichoke and turmeric capsules) and cabbage juice. This usually gets the pain to subside. Careful with cabbage juice and any cruciform vegetables such as broccoli, rutabagas, cabbage, brussel sprouts, cauliflower if you have difficulties with your thyroid.
FOOD If it is something I have eaten that is causing bloating and distension, I avoid yeast, wheat, sugars, alcohols, and more until I can isolate the offending food and then I avoid it. I take lemon juice with hot water with tupelo honey until the pain subsides. I eat small amounts of food or I stop with all food and just sip lemon water for an afternoon. Caffeine, chocolate, fine French wine, soy, wheat, yeasted products, cheese, ale, beer, sugar, pastry, baked goods, fish oil, salmon, and flaxseed have all caused my liver to severely ache. Proteins especially animal proteins cause an increase of secretin.This adds to the expansion of liver cysts and to the growing discomfort.
To read more try: Liver avoids, liver diet, liver lecture, liver treatment, liver hormones, liver nexium, liver hot flashes, liver black cohosh, a story of an individual with liver cysts, our stories, liver and false estrogen, liver and phthalates in cosmetics-shampoo- creams, and liver transplant.
GALLSTONES Sometimes we can develop gallstones. Oftentimes the pain of PLD overlaps and mimics gallbladder pain. The pains from a cystic liver can intensify and be mistaken for gallbladder pain. If a doctor should recommend gallbladder surgery for you, get a second opinion or see if you might be a candidate for a liver resection, a liver transplant or a TAE. The gallbladder is removed with both a liver transplant and a liver resection. These procedures can be curative for PLD. To read more about liver treatment, click here.
According to the following articles laparoscopic liver deroofing requires repeated surgeries and ultimately either a liver resection or liver transplant to reduce the mass effect of extensive cystic liver disease.
LIVER CYST PAIN   Is there anything to do to ease the pain when my liver hurts? It is not a burst cyst; it just hurts especially when I take a deep breath or cough or sneeze.
Pain is the most reported symptom from liver cysts. Pain when you take a deep breath can be from one or several liver cysts near your diaphragm expanding and filling with fluid. To ease these pains I usually try:                                                             
1. Lemon juice recipe
2. Saffron tea recipe
3. Heating pad
4. Milk Thistle Plus (milk thistle, turmeric, artichoke)
5. Organic Turmeric capsules
6. Avoid sweets, yeast, sugar, alcohol, chemicals, bleach
Is there a pain center for cystic organ pain?
Yes there are several PKD centers throughout the USA. One is at the Cleveland Clinic. Another is at the Mayo Clinic in Rochester Minnesota. I mention liver cysts alongside kidney cysts as most, if not all the research for polycystic liver disease has come through polycystic kidney disease centers. The ARPKD animal models are similar for testing treatments for Polycystic Liver Disease.
Why are aspirin, NSAIDs, phenacetin, tylenol and other over the counter pain medicine harmful?
Individuals with cystic organs should avoid these if possible. These can cause kidneys to fail even in people without kidney disease. It is the long term continuous use of these products which causes kidney problems. The rare use of these medications for a limited time is probably all right under your doctor's advice. The latest FDA warning is for all individuals to limit simultaneously taking full strength aspirin in conjunction with ibuprofen. Patients who are using ibuprofen for pain relief should do so at least 30 minutes after immediate-release aspirin taken for cardioprotective or stroke-protection or at least eight hours before taking immediate-release aspirin. Ibuprofen taken this way, the FDA said, does not appear to interfere with aspirin's antiplatelet effect. We with PKD should not take either of this OTC over the counter medications as the harmful effect upon both kidneys and liver is over a lifetime.
Are there any other things which might help with pain?                                                                                                      
Pineapple is a strong anti-inflammatory. When I slipped in the ice one frosty winter I began with pineapple juice, then pineapple smoothies, frozen pineapple sorbet, and by morning the pain had disappeared. Lemon juice diluted in warm water gives me relief from headaches, from muscle aches, from kidney pain and liver pain. When I have drunk any citrus, I will wait twenty minutes before having something else, otherwise I get a bit of indigestion. Each morning I juice two lemons. For my husband I give him the juice of half a lemon mixed with one teaspoon of tupelo honey diluted in a cup of water. Stir with a small wire whip. He loves this. Papaya is high in papain, which helps dissolve proteins, high in natural anti-inflammatories which helps to relieve low back pain. Apple juice alternating with lemon juice is said to help with the pain of passing kidney stones. It is very alkalizing. Saffron tea one teaspoon in a cup of water allow it to reduce down to 1/2 cup has really helped me with liver pain.Milk thistle (silymarin) is a good herb for liver pain.
Cabbage juice with almonds stimulates endorphins of the brain and causes a release of natural morphine to help with pain. It also returns gray hair to its natural color and prevents future graying hair. Heating pad. I lay or sit with heating pad over the area sipping my lemon tea. I have the type of heating that gets hotter and hotter as long as you continually hold the button. It gives off a moist heat. Wonderful for relieving pain of aching kidneys, liver or muscles. Email with any questions.                                Discuss the above suggestions with your physician:
If the pain does not lessen with two lemons juiced three times a day, then try saffron tea, lie down with a heating pad (Try a moist heat pad known as a theromopore - while you continue to depress the button it gets hotter and hotter. Once you let go of the button it cools down). If after trying these and the pain is still there, try milk thistle plus - 2 capsules three times a day and start with organic turmeric capsules as well. Now is the time for the detective to come out and to discover what foods or chemicals may have triggered these pains as well as exposure to estrogen and false estrogen. Avoiding yeast, breads and baked goods along with concentrated sugars, soy, will help alleviate bloating. These foods can turn into alcohols when ingested and cause an increase in bloating and pain from liver cysts. For a more complete list of things useful and those to avoid try here.
ARTICLES LIVER CYST PAIN
Deroofing UK liver cyst experience.
Laparoscopic deroofing Colorado symptomatic relief liver cysts was undertaken in eight patients, with one conversion to open technique because of bleeding from a superficial hepatic vein.
Laparoscopic deroofing Hungary 2006 Laparoscopic deroofing was indicated when a single liver cyst was larger than 5 cm (the general size of liver cysts was 6.9 cm) and caused complaints of pain and was in a superficial position.
Laparoscopic deroofing Mexico 2004 laparoscopic deroofing is reserved for type I polycystic liver disease. There are no prospective randomized studies that show benefits of laparoscopic over open surgery.
Laparoscopic deroofing Greece 2005 Despite the reported morbidity, aggressive and meticulous deroofing of type II polycystic liver disease is possible.
Laparoscopic deroofing Poland 2001 Fenestration (deroofing) with excision of the liver cyst wall is increasing.
Open deroofing Poland 2001 Open surgery is safe and effective for symptomatic liver cyst and complication rate is low. Deroofing 2000 Albert Einstein Med Ctr USA For simple liver cysts, percutaneous aspiration invariably leads to recurrence; laparoscopic deroofing is usually curative.
Deroofing Edinburg Scotland 1998 no symptomatic recurrences after 14 hepatic resections liver cysts.
Liver Treatments
Liver Transplant
Liver Resection
Liver Laparoscopic Procedures
Liver TAE                                                                                                                                                                  

JOINT PAIN BACK PAIN
Sometimes our cystic organs become enlarged. that it is like caring around 40 pound sack of rice or potatoes. This creates a strain on the back, the rib bones, the hips and more. For this some have tried the services of a chiropractor. If you can find one that uses the strain counter strain technique, this is very good. A few have been taught a series of exercise so this can be prevented. .For back pain most of us do not take aspirin, tylenol, NSAIDs, ibuprofen or other over the counter non-steroidal anti-inflammatories. Some have found cherries, papaya, and pineapple helpful - all strong anti inflammatories. Bromelain is the pill form made from pineapple and papaya (contains papain).                                                                                                                                        

                                                                     
JOINT PAIN - GREAT TOE PAIN
Individuals with PKD have elevations of body acids, especially urinary uric acid. PLD 'rs often have elevated uric acid levels from the liver's inability to metabolize body acids. This sometimes manifests as gouty arthritis, or pain in the great toe. The pain is from uric acid crystals trapped within the joint. Sometimes I get great toe pain. I have found that by avoiding raw spinach (high in oxalates) and the nightshade plants (tomatoes, potatoes, eggplant, peppers, tobacco and belladonna) these joints do not ache. If the toe does act up, I take foods which help to lower uric acid, i.e. ten cherries a day, nettles, artichokes, a shot of wheat grass juice, or I chew on a few sprigs of parsley. Nettle juice lowers uric acid, is a great alkalizer, however it is also high in potassium. A few drops of non alcoholic nettle extract in a cup of warm water seem to help relieve great toe aches. Cherries, ten a day, helps with arthritis pain by lowering uric acid. A rheumatologist told me, he investigated all the different foods that seemed to help arthritis and the one that was really helpful were cherries. Attempting to maintain a constant relative alkalinity helps to diminish body pains from cystic organ disease. This can be accomplished through diet and lifestyle and by supplementing occasionally with potent alkalizers such as potassium citrate or sodium citrate. Citrate alkalizers are preferable to KCL (potassium chloride) or sodium bicarbonate. See the page on Potassium Citrate for more information.
JOINT PAIN - ARTHRITIS
I drink the juice of two freshly squeezed lemons each morning and I have the juice from about a two inch wedge of a cabbage juiced with 5 almonds. If this does not relieve the pain, then I start with 10 cherries (I must confess I have sometimes eaten maraschino cherries if I cannot get frozen or fresh) and this did make the joint pain go away but by morning, I had a migraine headache from the sugars and dye in the maraschino cherries. If I am traveling, I might stop in a jamba juice bar and get a one ounce shot of wheat grass followed by a bite into an orange slice.                                                                                     

TOOTH PAIN Plain darvon or propoxyphene for pain relief after a tooth extraction and a root canal might be preferable to tylenol or Ibuprofen or aspirin or NSAIDs. If one can tolerate plain codeine this too can be helpful but constipating.
TYLENOL ARTICLES Paracetamol (acetaminophen)
acetaminophen-induced liver toxicity in rats
kidney function in elderly
Combination analgesic-induced kidney disease: the Australian experience.

HEADACHE If you have a history of aneurysms in your family, and you experience the worst headache you have ever had, call your doctor and get an MRI of the brain to determine if you might have an aneurysm. See imaging for more information. Prior to surgery, this was a part of my surgical workup. I have a family history of aneurysms.
This is not the usual headache, however. The usual headaches I get occur when I have eaten chocolate. This triggers a migraine and it occurs not immediately but 3 - 4 days later and it is usually a whooper of a headache. Once I sense this headache coming on, I start right away drinking freshly squeezed lemon juice until the headache abates. Imitrex, a medication to relieve migraines, decreases the blood flow to the kidneys and is to be avoided with PKD.

CHRONIC CYSTIC PAIN - CLINICAL TRIALS
Dr. Marie Hogan at the Mayo Clinic in Rochester Minnesota USA is conducting a clinical trial titled ADPKD Pain Study. This utilizes an interventional procedure known as - Videothracoscopic Splanchnicectomy (VSPL) similar to Videothoracoscopic splanchnicectomy done for pancreatitis pain.
Status: Currently Recruiting - Enrollment goal: 20
Description: To evaluate the effectiveness of VSLP procedure for pain management in patients with ADPKD
Contact: Beth B. Bjornson at 507-255-7768 or bjornson.beth@mayo.edu

Splanchnic Diagram of Nerves

KIDNEY CYST DEROOFING for pain relief.is another surgical procedure done for pain relief. There are a handful of surgeons throughout the USA who perform DEROOFING laparoscopic surgery of polycystic kidney cysts and polycystic liver cysts. There are dedicated operating suites for this. Deroofing is solely for pain relief. It does not make kidney functioning worse nor does it make it better. It does not affect liver functioning. Of those that are helped with their pain, almost all eventually have to repeat the procedure. One individual noted that her liver cysts came back with a vengeance. She experienced no pain relief. The amount of pain has nothing to do with cyst size or numbers of cysts. Decompressing the cyst and relieving the pressure on other organs does not always stop the pain. The response is very unique with each individual. Dr. J F Valente uses laparoscopic denervation of the kidney to relive chronic pain. He also has techniques to de-roof cysts for pain relief done laparoscopically. Dr Valente is at the Cleveland Clinic. Sometimes laparoscopic surgery is used to remove cystic kidneys provided their size is small enough to allow this. Another laparoscopic surgeon is Dr. Ralph Clayman at University of Irvine California. Commonly the native kidneys are left in place. Surgeons may wait 6 months before removing the native cystic kidneys. Natives are not always removed. They are removed for uncontrolled high blood pressure, chronic infections, and shear mass of the cystic organs. See dialysis and transplant for more information.                                                                                                                                                                 

CHEST PAIN - HEART ATTACK WARNING SIGNS Some heart attacks are sudden and intense — the "movie heart attack," where no one doubts what's happening. But most heart attacks start slowly, with mild pain or discomfort. Often people affected aren't sure what's wrong and wait too long before getting help. Here are signs that can mean a heart attack is happening: Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
Shortness of breath. May occur with or without chest discomfort.
Other signs: These may include breaking out in a cold sweat, nausea or lightheadedness
As with men, women's most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting, and back or jaw pain.If you have chest discomfort, especially with one or more of the other signs, don't wait longer than a few minutes (no more than 5) before calling for help. Take an aspirin right away and Call 9-1-1... Get to a hospital right away. Heart Attack Warning Signs
CHEST PAIN - STROKE WARNING SIGNS
Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
Sudden confusion, trouble speaking or understanding
Sudden trouble seeing in one or both eyes
Sudden trouble walking, dizziness, loss of balance or coordination
Sudden, severe headache with no known cause.
If you or someone with you has one or more of these signs, don't delay! Immediately call 9-1-1 or the emergency medical services (EMS) number so an ambulance (ideally with advanced life support) can be sent for you. Also, check the time so you'll know when the first symptoms appeared. It's very important to take immediate action. If given within three hours of the start of symptoms, a clot-busting drug can reduce long-term disability for the most common type of stroke.
A FEW PAIN RELIEF ARTICLES
Deroofing 2003 UCI California. Cyst decortication of 29 polycystic kidney patients One patient had greater than 20% increase in creatinine clearance; six patients had worsening hypertension. Every detectable cyst within 2 mm of the renal surface was treated. About half of the patients noted a 50% decrease in their pain.
Laparoscopic renal denervation for intractable ADPKD-related pain John F. Valente
Chronic pain may require opiods or fentanyl patch or vicodin just to enable us to perform the activities of daily living. There are two (2) surgical procedures to help us with chronic pain from cystic organs - PKD and PLD. Both are done laparoscopically.
Renal nerve denervation first done by John F. Valente MD now in Cleveland Ohio. Renal denervation is performed by laparoscopic surgeon, probably a transplant surgeon or a urologist.
Splanchnic denervation of T10 - T12 for intractable abdominal (PKD) pain. This is performed by a Cardio-Thoracic laparoscopic surgeon. It has been performed in South Africa, the UK, Germany and the USA.
Pain Laparoscopic fenestration R Clayman MD - 29 ADPKD patients with debilitating pain, underwent 35 extensive laparoscopic cyst decortication procedures.  The average follow up was 32 months. Half of the patients at 2 years noted 50% improvement in pain. Renal function remained largely unchanged over the 3-year follow-up period with one patient had greater than 20% decrease in creatinine clearance.
Pain Laparoscopic denervation by John F Valente MD
Pain Laparoscopic denervation by Chang
Pain Management Torres MD
Pain GAIT study osteoarthritis knee pain
Pain Chondroitin GAIT study knee pain
Splanchnic denervation of T10 -T12
Splanchnic denervation India
Splanchnic pain South Africa
Splanchnic pain UK
Pain deroofing Sultan Qaboos University
Pain Laparoscopic nephrectomy 35 pages
Pain China laparoscopic fenestration cysts
Pain Cyst aspiration fenestration recur 75%
Pain Ethanol Hepatic Cysts alt Liver Tx

Pain TYLENOL ARTICLES Paracetamol (acetaminophen)
Pain acetaminophen-induced liver toxicity in rats
Pain tylenol on kidney function in elderly
Pain Combination analgesic-induced kidney disease: the Australian experience
Pain treatment with both liver and kidney disease
Pain Gabapentin in patients with the pruritus

last updated Wednesday, December 17, 2008 12:22 PM