### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
6 weeks ago I was diagnosed with a kidney infection. I had a shot of rocephin and oral bactrim . Everything seemed to clear up. Then 2 weeks ago I came down with a cold/virus. I had some stomach upset and associated it with drainage until 5 days ago when I started chilling and having back pain . I went to an urgent care facility where they did a dipstick urinalysis . It came back normal. However, every day since, I have progressively felt worse. I have no appetite , intermittent severe back pain (like someone punched me), nausea, chills/sweats but no fever. I used an OTC UTI test strip that came back negative on nitrites and positive (trace) on leukocytes the first time and both negative the second. I still feel absolutely miserable. I did notice tonight 2 times tiny black specks in my urine. I ve not noticed this ever before. I know I need to see a dr and have an appointment set up already, but I have no insurance and am afraid that they will order multiple tests and it turn up I m just paranoid. (not that I m imagining the pain because I ve even lost weight from it, but that I m over analyzing every symptom .) are these symptoms to be concerned about?

### output:

Dear Madam/ Sir, thanks for your question. I must assure you that your concerns are well justified, and you ought to keep your appointment with the doctor. Your symptoms could well be due to pyelonephritis (infection of the kidney). Unfortunately you will need to undergo urine culture, ultrasound of kidneys and some blood tests at the very least. I can understand your predicament since you donor have insurance cover, but if you donor get it sorted now the medical expenses of complications will only be higher! Good luck. RB