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Microcyn Bladder Treatment (An Open Letter to Dr. Young)

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    Originally posted by SweetStem View Post
    GJ

    I started thinking about your question : " Are you sure you don't have a UTI?" I don't have any of the symptoms i've had in the past like chills, extreme burning (just a little discomfort), fever, achyness , but then your comment about not necessarily having the classic symptoms made me wonder.

    I went and gave the lab a sample on Friday and they called me today and said i was positive for E coli and that it's sensitive to most common antibiotics so they prescribed bactrim.

    They kept the discussion brief but i'm curious how they know when its an infection and when its a colonization. Could my bladder be super-colonized?

    It actually makes sense to me that it is a UTI just based on the extreme leakage and some soreness, but that probably means that i've had this going on for at least a year. Is that possible?

    Also wanted to let you know that i started VVF again. Used it with 180 to 240 cc saline for 3 days and noticed increased soreness again so i quit, again.

    I'm wondering though if the soreness is more a manifestation of the UTI and some kind of interaction with the VVF, and if you think i should try VVF midway through this course of bactrim?

    Thanks for asking the right question,

    Philip
    I'm not sure I quite understand who prescribed Bactrim for your e.coli urinary tract infection (UTI). It really isn't the lab's responsibility to prescribe medications. The lab reports results to your physician on the basis of the antibiotic to which the bacteria causing the UTI was most sensitive. In people with spinal cord injury (neurogenic bladder), it is not uncommon for a physician to treat a UTI at 50,000 CFU (colonizing forming units) as opposed to treating a UTI in the able bodied population at 100,000 CFU. That is why it is important to have a physician who is familiar with spinal cord injury and neurogenic bladders to analyze the data and prescribe antibiotics from experience.

    Once again, please understand, Vetericyn is not an antibiotic. It works best if used on a daily basis to prevent bladder colonization and UTI. Once you are having symptoms, Vetericyn is not going to cure the UTI, except in very rare situations where the individual is using big volumes of Vetericyn instillations every 2-3 hours round the clock until the urine seems to clear. There are some members here, for whom that works, but they are rare individuals and should not be considered the model for use.

    What is important to remember is that neurogenic bladders change over time. What was once your norm, may not be anymore. Things do change.

    There is no harm in using Vetericyn staring about midway through the course of antibiotics you are taking. But, in your situation, you have not found a level of using Vetericyn that seems to work for you without causing some irritation and sensitivity. I really don't have any other advise about how you find your comfortable level of use of Vetericyn, except to experiment, given parameters we have previously discussed.

    All the best,
    GJ

    Comment


      Sorry about the confusion. I should clarify that the lab sent the results to my urologist and his office called me with the recommendation and prescription for bactrim.

      You raise another interesting issue: I'm not sure how competent my urologist is in terms of dealing with neurogenic bladders. He's a friendly guy and seems generally knowledgeable so i've stayed with him for about 10 years, but he hasn't given me some of the relevant advice i'm getting on this forum. I don't mean VVF as i expect that is off his, and most urologists, radar but just advice about anticholinergics and expecting changes in my urinary function over time.

      I've been on the bactrim for about 2 days but still have leakage and occasional mild soreness. Probably too early to tell, but i'm "worried" that you are probably right and the leakage may be due to a new normal and not a mild infection. Crap.

      I'll keep you posted.

      Comment


        Can anyone here tell me how a woman would go about flushing the urethra with vvf before cathing.
        I know bob has talked about men doing that. I've tried putting the cath in a little ways and squirting some in the end of cath with a syringe. But will no work. Is there a trick for us women. Or are we just out of luck with the urethral flush
        Thanks

        Comment


          Originally posted by Kat0465 View Post
          Can anyone here tell me how a woman would go about flushing the urethra with vvf before cathing.
          I know bob has talked about men doing that. I've tried putting the cath in a little ways and squirting some in the end of cath with a syringe. But will no work. Is there a trick for us women. Or are we just out of luck with the urethral flush
          Thanks
          Sorry. I don't have any suggestions for you. May be you could ask your urologist or search on the internet. You might find something on forums that discuss interstitial cystitis, urinary retention, bladder distention, or obstruction.

          All the best,
          GJ

          Comment


            Not a medical expert, but not sure it's possible / practical due to the fact that women have such a short urethra, which is going to make it difficult to have the cath inserted exactly the right distance... As I understand the measurements involved, there really isn't anything to flush - if you clean the outside surface you are basically getting the sphincter muscle with the bladder right on the other side of it.

            Guys have a MUCH longer urinary tract, so there is a lot more distance for bugs to hide in, so flushing is more of an option for us... (also why UTI's are much more common for AB women since the length gives guys some protection)

            ex-Gooserider
            T-5 ASIA-B para, currently working on building own power chair, as being in a manual is an EXTRA handicap.

            Comment


              You might try what I have been doing. I spray the catheter itself with it, coating it really well and insert into the urethra. I figure doing it this way, I am coating the urethra as I insert it . So far it's worked well :-) if you spray it into the catheter, you are missing the urethra because the tube is covering it. Hope this works for you. I do this daily a few times by alternating my catheters through out the day, such as one lofric prelubed, then the next one a regular silicone sprayed with the vet instead of using lube,I substitute the lube with vet. The I do the next with the prelubed, next after that sprayed one with vet and so on and so on ;-)
              BobbieLee
              SCI from L5 to S2-S3, complete Cauda Equina Syndrome , symptoms from waist to feet, as well and as far up to the stomach. Spinal cord surgery for removal of tumor Jan 2009

              Comment


                Yea, I figured there wasent a good way to flush the urethra I used hydrophyllic caths. And spray everyone with vetracyin.
                I'm on my last few days of abx and decided to start flush with vetracyin, just to get a jump on any thing left. And after I flushed 60cc the next cath, was yukky cloudy urine. It has been crystal clear for days cause of abx. Could the vvf just be killing off bugs the abx is missing?? I'm so confused, but don't want to give up on vvf yet. Any help???

                Comment


                  Originally posted by Kat0465 View Post
                  Yea, I figured there wasent a good way to flush the urethra I used hydrophyllic caths. And spray everyone with vetracyin.
                  I'm on my last few days of abx and decided to start flush with vetracyin, just to get a jump on any thing left. And after I flushed 60cc the next cath, was yukky cloudy urine. It has been crystal clear for days cause of abx. Could the vvf just be killing off bugs the abx is missing?? I'm so confused, but don't want to give up on vvf yet. Any help???
                  Was the antibiotic used prescribed from a urinalysis (UA) and culture & sensitivity (C&S)? If so, was the most effective antibiotic indicated prescribed? Was the antibiotic prescribed for 10-14 days?

                  Sometimes, especially if the most effective antibiotic isn't used, the bacteria can overwhelm the effectiveness of the antibiotic. It may have been coincidence that the bacteria was no longer able to fend off the bacteria and you instilled Vetericyn. Finish the course of antibiotics, continue to instill Vetericyn or not as you choose. After you have finished the antibiotics, get another C&S to make sure that not bacteria is lingering. When you cath a specimen for the C&S, make sure the urine is not mixed with retained Vetericyn.

                  All the best,
                  GJ

                  Comment


                    Yes, they did a c and s told me it would take a week to come back, in the mean time he put me on suprax
                    Then I call Thursday to see what the culture showed. She tells me it takes 2 weeks!! I haveva feeling my culture was not sent off until the next week. I'm really upset with this uro, as he's giving me no hope for much. Now it's a holiday, he won't be in office this week at all, and I'm stuck. So praying the vetracyin and the few abx I have left will hold out till I get some freakin answers.
                    Thanks for your help.
                    Kathy

                    Comment


                      Originally posted by Sunnydayz View Post
                      You might try what I have been doing. I spray the catheter itself with it, coating it really well and insert into the urethra. I figure doing it this way, I am coating the urethra as I insert it . So far it's worked well :-) if you spray it into the catheter, you are missing the urethra because the tube is covering it. Hope this works for you. I do this daily a few times by alternating my catheters through out the day, such as one lofric prelubed, then the next one a regular silicone sprayed with the vet instead of using lube,I substitute the lube with vet. The I do the next with the prelubed, next after that sprayed one with vet and so on and so on ;-)
                      Thanks for the advice sunny, I spray my hydrophyllic caths with vvf. The i use it as a peri wash.got a feeling there's a bug hiding way up in kidneys or ureter somewhere :/

                      Comment


                        Originally posted by Kat0465 View Post
                        Yes, they did a c and s told me it would take a week to come back, in the mean time he put me on suprax
                        Then I call Thursday to see what the culture showed. She tells me it takes 2 weeks!! I haveva feeling my culture was not sent off until the next week. I'm really upset with this uro, as he's giving me no hope for much. Now it's a holiday, he won't be in office this week at all, and I'm stuck. So praying the vetracyin and the few abx I have left will hold out till I get some freakin answers.
                        Thanks for your help.
                        Kathy
                        It should take only 3-5 days to get a result from a culture and sensitivity if the specimen is sent immediately for analysis. If your urologist is holding on to a urine specimen before it is sent to a laboratory, you have got to question how the specimen has been handled before it got to a lab for testing. Was the specimen under refrigeration the entire time, at room temperature, what??? It sounds to me that you were put on a broad spectrum antibiotic, but not necessarily the most effective antibiotic and you may be experiencing a break through infection.

                        I urge you to be proactive about your urinary tract infections. Request copies of the results of the culture and sensitivity tests, keep a log of the type of bacteria that have caused urinary tract infections and the most effective antibiotics and the results you have experienced on each antibiotic per infection. In this way, you will have information to question the kinds of treatment that are prescribed.

                        All the best,
                        GJ

                        Comment


                          I agree with GJ, I have never had a CS take over 3 days and I myself immediately wondered how accurate the results would be, waiting so long to culture. Is there any way you can see a different uro ? It just sounds like this one is not really on top of things.
                          BobbieLee
                          SCI from L5 to S2-S3, complete Cauda Equina Syndrome , symptoms from waist to feet, as well and as far up to the stomach. Spinal cord surgery for removal of tumor Jan 2009

                          Comment


                            I called his nurse last night, she said it had been refrigerated before being sent off. And it's not unusual for 2 weeks. I disagree. She Said if it dosent culture anything it comes back sooner. So mine must be growing some bad stuff.
                            She is supposed to call tomorrow if it ones in. The sad thing is not many good urns around here :/

                            Comment


                              In the 4 1/2 years since my SCI, I have never had a CS take a week, much less two. I think if its going to grow, it will do it in the regular amount of time a CS normally takes, and I would not think 2 weeks is going to make it grow anything else that would not have grown in the first 3 to 5 days. Plus if you have an infection, waiting 2 weeks could possibly put you at risk of damage to your system, by not being treated properly as soon as possible. If they give you an AB that is not very effective, it could either make the infection harder to treat and you could become resistant to that AB, if the culture eventually comes back only to find that one does not work on that particular infection. That's one of the biggest dangers for us SCI patients, is running out go AB's that work for us. I know this from experience, as I am resistant or allergic to all but 3 pill form ab's. so my usual treatments for infection usually end up being treated by IV.

                              Here is another thought, is there a good infectious disease doc in your area? That is usually who I go see when infection comes on. My uro agrees with me going there first because he knows that my infectious disease dr knows more about infection then he does :-) it might be something to look into fr when you need treatment for infection, and because that's all they do, they would probably get your culture done much quicker. Hope this helps :-)
                              BobbieLee
                              SCI from L5 to S2-S3, complete Cauda Equina Syndrome , symptoms from waist to feet, as well and as far up to the stomach. Spinal cord surgery for removal of tumor Jan 2009

                              Comment


                                We agree week at most for cs. We have a hard time getting homehealth nurses to treat samples with the care that they should.
                                Try to give them ice and most time don't want it. Always worried if sample gets compromized?
                                We sometimes consider taking sample to doctor office so we know it will be taken care of.
                                Wanted to ask for some thoughts on possible cause of yeast infection. Maym has not been on antibiotics for 4 months cause that vvf/ns has been doing its job. We use 15vvf/15ns at night and that keeps urine clean. Maym has suprapubic for about nine years so bladder must be real small. When we push vvf/ns nightly she most always overflows out natural path due to a very weak meatus,hope i spelled that right, at about 15cc than we push the rest. Hold treatment last about 5 minutes.
                                We now have this yeast infection and trying to figure out why? Do any of you think that the overflow into vagina is killing normal flora in vagina? Started last night we cut back to 15cc of mix in am and 15cc in p.m. So we don't get overflow. So far so good.
                                Diflucan three days helped but rash heating back up so we took another diflucan today. Maybe since we are preventing overflow we can turn it around. Going to doctor tomorrow for regular checkup so we will talk to him about it also. Most of time all of you make more sense than these doctors. Anyway we trust your opinions and would like you thought. Thanks maym husband

                                Comment

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