Questions about Rx's, Cystoscopy

[froelica]

Hello all-

I have not yet been diagnosed, but the cystoscopy is next week.

I have two questions-

1) When patients are prescribed Elavil, is it temporary or permanent? I don't know how antidepressants work in smaller doses, but I know that they can be tricky to get off of if prescribed for depression. I also don't know if the type of antidepressant Elavil is has any effect on that. I'm extremely wary of antidepressants (I have suffered from panic attacks and general anxiety disorder for 10 years now and have so far eluded them) and would not want to risk adding more cause for medical/mental concern.

2) My cystoscopy is next week. I've heard a lot of people talk about being put under general anesthesia for this, or even regional anesthesia. I think I remember my Uro saying I would only be under local anesthesia for the procedure. Is this odd? Am I going to be in more pain because of this? Has anybody out there had this procedure done under a LOCAL anesthetic?

Any help would be great! :)

[ICLori]

Hi, Froelica, and welcome! I'm sorry for the bladder problems you've been experiencing, but you've come to a wonderful place for support and for having questions answered!

I'm actually one of the people who have had a hydrodistention/cystoscopy under local anesthesia (Versed, in my case). My very first one, where I was diagnosed and where they took biopsies of my bladder (not a big deal, more like when they give you a Pap smear - just a gentle scraping of tissue really, heals very quickly) was just under local anesthesia.

I didn't have any problem at all under just the local anesthesia. I did not experience one moment of pain (that I remember) and I didn't feel pain either when I woke up. I think I was asleep during much of the procedure, or...it could be that because Versed is an amnesiac drug, I don't remember. I remember waking up once in the middle of it and seeing this angry red Mars-looking thing on the screen with a billion blood vessels running through it, like the nastiest looking bloodshot eye in the world. "Is that my bladder?" I remember asking one of the anesthesia nurses. "Yes, it is." He answered.

When I was wheeled into recovery, I remember that I did still have a catheter in, and I watched my urine drain into the bag. At first it was tinged with a drop of blood, from the biopsies, but after not very long, it became clear again. I was surprised at how quickly it healed up! I realized then that they must not have made any big cuts or anything like I was originally thinking they might. I was under this misguided notion that they were going to go in and remove a big chunk or two of my bladder, LOL!

I also had some experience with Elavil. Only limited, because it turned out that I was one of the unfortunate minority for whom Elavil did not work. (Studies show that Elavil does work for the majority of IC'ers to reduce pain, frequency and urgency, and to help promote restful sleep at night.)

My doctor told me that the doses used for pain relief were much, much, much smaller than those used for treating depression. At the extremely low doses used for pain relief, he said that you would not receive any antidepressant type benefits. You'd have to be taking - I don't remember how much, but it was some huge amount like ten times more than I was already taking or something - to begin to see antidepressant effects.

And, because only a small dose is used, there may not be much of a withdrawal. I withdrew cold turkey once from Paxil (eek!) and it wasn't fun...but I didn't experience anything like that at all when I stopped using Elavil. In fact I haven't heard anyone on the boards talk about withdrawal from Elavil being bad or anything. I'm not even sure it's ever come up - I don't remember it anyways - maybe someone will post who remembers more than I do.

Part of the reason we may not post often about withdrawal from Elavil, is because once a person gains relief from Elavil from the terrible symptoms of IC, they are reluctant to quit it. And their doctors are also reluctant to stop prescribing it.

This is because there is currently no cure for IC. It is a chronic incurable disease. All treatments are aimed only at relieving symptoms so that the person can have the best quality of life that can be achieved under the circumstances. They do not know what causes IC, nor do they know why one remedy works for one IC patient, but not another. There is much exciting research being done these days, however, after decades of IC being ignored, so I am very hopeful that we will soon understand what causes IC and perhaps even have a cure.

Oh, you are probably curious about the side effects of Elavil - well, sometimes the side effects are kind of a bummer. I have heard of people reporting feeling groggy in the mornings after they woke up (some people take their Elavil dose earlier in the evening rather than at bedtime to help with that) and some people report feeling more hunger/weight gain on Elavil. I have also heard of constipation being a potential side effect, and dry mouth. I wasn't on Elavil long, so I did experience pretty much every single one of these side effects. Others, who have been on Elavil much longer, have said that some of the side effects lessen in time.

Best of luck during your procedure, and I hope you get relief from your bladder problems soon. I hope that you are not diagnosed with IC - I hope it is something easily curable instead - but if you are, just come back here, and we'll do our best to help you learn to live well with this cantankerous disease. :)

Blessings,
Lori

[vm]

Is the cystoscopy just a cystoscopy or is it also a hydrodistension? Will you have it done in a hospital or in the doctor's office?

The people who use Elavil for IC generally take it for the long haul - it only works if it is in your system. I suppose some might take it only during flares, though. The dosage is usually very small compared with the dose taken for depression. I've gone off of it before (I'm on 25mg) and didn't have withdrawal symptoms.

When I started it I was drowsy for the first several days, but that went away. It does cause weight gain for some people - that didn't happen for me, but others have definitely had that as a concern.

Good luck with whatever you decide to do. :)

[TooYoung4IC]

Yes I had it two months ago. I fell asleep and didn't even know it. once i woke up it hurt really bad to pee for the first two days with blood i unrine but after that everything was fine except for the $10,000 bill!

[Mimi7]

Welcome to the group!
I had the cysto a number of years ago as a "surprise" office procedure without any anesthesia. I think I still harbor a little resentment to this day for the cavalier attitude of this particular urologist toward my pain. I think either of the two options you mentioned would be wonderful.

As far as the Elavil - I have been taking 10 mg in the evening for over 12 years for fibromyalgia. It actually helped my aches and pains and ability to reach restorative sleep. The only time I notice side effects (drowsiness) is when I take more than this dose. I am newly diagnosed with IC and was surprised to find that Elavil is helpful with that condition as well.

P.S. This time around I have a wonderful female urologist, and I am grateful for the compassionate care.

God bless! Mimi