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View Full Version : IC, PFD, VV or Something Else? Extreme Newbie with Lots of Questions


mello64
01-02-2009, 12:04 PM
Hi, this is my first post here. I've been reading, researching and lurking here for about a month though, and I'm so impressed with the amount of knowledge, optimism and compassion you all have!

I have so many questions and no diagnosis as yet. My regular OB's partner, whom I had not seen before an emergency visit for a UTI at Thanksgiving, through out "It could be Interstitial Cystitis" with a shrug as he left the room, after saying the culture came back negative for UTI. He said to keep taking Cystex & Azo if that helps, and if it doesn't go away after awhile they'd send me to a Urologist.

Well, it's been awhile, and it hasn't gone away, so I'm ready to call for an appointment with my regular OB and see what she thinks. In the meantime, I'm hoping some of you can give me some input.

Here's my (long) story, followed by my many questions...

2008 April: UTI symptoms most likely triggered by daily jogging, (noticed incontinence with jogging, and started kegels & tightening muscles while running/walking to compensate). Didn’t go away with usual methods. Didn’t go away with 3 rounds of antibiotics (Cipro, Bactrim & Septra).
Discovered Cystex and Azo/Uristat (pyridium) to mask the symptoms. Went away after about 4-5 weeks, while on vacation.
Diagnosed at same time with extreme iron-deficiency anemia. (Dr. said he’s only seen one woman with lower iron count.)
Began taking daily iron supplements; caused nausea and made constipation much, much worse (always had it
during last 2 weeks of monthly cycle, now it’s all the time).

Since April: Energy level is a bit better with iron,
constipation is much worse with iron
Feeling of heaviness in abdomen, feeling like things are trying to “fall out” from time to time
Feeling of “hitting a wall” with certain positions during sex occasionally
Sometimes, but not always, a bit of soreness & swollen/bruised feeling a day after sex. Beginning to avoid it.
Noticed another bump on inner labia (3rd one to date), which got increasingly larger, bothersome & itchy.


2008 November: UTI symptoms, seemingly triggered by sex, lasted 3 days with usual methods, called OB and began Cystex & Azo, along with Septra prescription I had from general practitioner.
Went in for culture day before Thanksgiving, and again the Monday following. Both cultures came back negative for Bacteria (Could this be because of the antibiotics & pyridium?) Symptoms still persist as of Jan 1 2009.

Dr. didn’t seem to think much of the bump or the “falling out” sensation. Said to keep taking Azo/cystex for the irritation, and if persists he’ll send me to a urologist. Said he’s not sure what could cause it; mentioned offhandedly it could be Interstitial Cystitis. His main concern seemed to be with the heavy periods; sent me for an ultrasound of my uterus, which apparently looked normal, and for an iron count in my blood, which was apparently good now. Nurse called with those results and mentioned an endometrial ablation. Wondering how that would affect my bladder?

Currently doing research and trying different non-prescription/non-invasive self-help methods.

What I’ve done so far:
Acid & Caffeine Reduction
Eliminated all coffee and tea (for years I’ve had a large latte daily, iced tea with every meal, and hot tea in the morning and at night)
Eliminated all juice (again for years I’ve had a glass of cranberry or cran-orange juice every morning)
Eliminated all soda pop, except the occasional ginger ale or root beer when nothing else is available (not hard, not a big soda drinker anyway)
Eliminated most tomatoes & tomato sauces (this is harder than it would seem)
Reduced chocolate down to a minimum (strongly crave this prior to periods, so very difficult to eliminate entirely, but trying)

Medication/Supplements
Began taking Prelief , Tums or Pepcid with most meals
Began taking Cysto Protek twice daily (started Dec 7th)
Take Azo/Uristat or Cystex once or twice a day (how long can I do this? And why are they considered only a short-term treatment?)
Take 2-3 Tylenol each morning and usually 2 before bed.

Rest/Relaxation
Trying to Rest more when I’m not feeling well
Briefed the Kids, Parents & In-Laws, so hopefully they won’t cause me extra stress
Trying to practice deep breathing and muscle loosening, but fear of incontinence makes it hard to loosen up
Sleeping with heating pad (of everything I’ve done – this is the most helpful overall – allows me to sleep all night)
Hot sitz baths with no bubbles or soaps (these are noticeably soothing too)
CuraHeat pads in the daytime (don’t really help)
Extra AstroGlide with sex, and much less sex than usual (down to 2x this month, “hit the wall” and afterward soreness both times)
Tried a muscle relaxant one night. Had an entire pain free day, even without medication, the next day! Not sure if I should try it again.

Not sure if any of it is working. Some days I forget to take any medicine and I’m fine; other days I’m miserable even all “drugged up”. Most days I moderately medicate and just try to make it through the day even though I don’t feel all that well.

To top it off, I’ve now got a cold and would so love to drink some orange juice, or some hot lemon tea. Very frustrating to avoid acids.

Continuing my research. Just began reading about Oxalates. That is discouraging because not much will be left to eat after eliminating acid, caffeine, preservatives and oxalates too (they seem to be in lots of natural foods I like that otherwise are considered healthy ie; broccoli, nuts, beans, spinach). Eliminating those would be far harder for me than the IC diet!

Family History:
Dad has Diabetes and Celiac disease
Mom has same urinary symptoms I do, not diagnosed
Sister has Seasonal Affective Disorder, takes Effexer
Niece has Celiac disease and Hypothyroidism
Daughter has Coarctation of the Aorta


Symptoms:
When I mention UTI/Yeast Symptoms I’m talking about irritation, itching, burning, urge, heaviness, extreme annoyance, but not really pain per se. I don’t have abdominal pain (except period cramps). What I have is an almost constant irritating burning feeling just inside the opening of my vaginal canal. It seems to radiate out from there, sometimes up the canal in a burning way that can almost be described as painful, though not cramp-like pain, more like fire. Or more often it radiates out on the exterior in a burning itching way that drives me nearly insane. It feels dry nearly all the time. Sometimes so dry and scratchy that walking is actually painful. Running, walking, some sitting positions, and riding in a car can be bothersome. Other sitting positions actually relieve it. Sometimes toilet paper or a seam in the underwear will bother it, other times not. Tampons & pads are always itchy and irritating; often I feel rubbed raw by them. However, I don’t feel pain constantly or upon touch. I also have an extreme heaviness in my abdomen. My bladder nearly always feels full, and often I’ll think I have to go but nothing or very little comes out. That feeling is not so much painful as annoying. I can usually ignore the feeling if I know I should not be full, so I don’t run to the bathroom as much now, but the feeling is constantly there bothering my anyway. Sometimes I wake at night thinking I need to go, but after going once, it’s difficult to ignore it long enough to get back to sleep. A heating pad helps tremendously with this; I sleep all night with it.


Questions:
What causes this???

Would eliminating heavy periods help?

I’m thinking so because tampons and pads are so irritating, PMS only adds cramps, heaviness, constipation and chocolate cravings, none of which help.

But would any potential benefits be outweighed by the ablation procedure itself? Might the performance of an ablation irritate the whole situation and make everything more sensitive? Might it make things worse?

Would this actually be classified as Interstitial Cystitis if I don’t have pain, but irritation instead?

What else might it be?

Pelvic Floor Dysfunction seems possible because of the “losing it” and “hitting the wall” feelings.

What sort of therapies or other helps are there for Pelvic floor problems?

Vulvar Vestibulitis? Seems possible too, given the set of symptoms and my lack of actual abdominal pain.

Why is Pyridium not for long-term use?

Would Urelle or Prosed DS help me then, since they seem similar in function to Pyridium?

What about Cystex? Long term okay? Other substitute?

What about this lidocaine gel or msn gel?

If one stays on a low acidic diet long-term, how does one get enough vitamin C and antioxidants?

If one is on a long-term low-oxalate diet, how does one get enough greens & fiber?

Is there a good GynoUrologist / UroGynecologist anywhere? And How do I find one? It seems most urologists are male and focus mainly on male issues: prostate problems, V-reversals, etc., and aren't necessarily all that sympathetic to women's issues.


Thank you so much for reading all this, if you got this far!
: ) melinda

KarenAnne
01-02-2009, 12:27 PM
Melinda, Welcome & so sorry you are suffering. This website has an excellent physician finder-that's how I found my IC specialist. You do not have to wait for your gyn to refer you to a urologist. My first one was not helpful. From what I have learned in my four months w/ IC,VV, & PFD, most urologists have a very small patient population w/ IC & just can not devote the time to them.

As for your uterine ablation, are they suggesting that for heavy bleeding? Is that the cause of your anemia? I thought a uterine ablation was a last resort after trying birth control pills, D & C, etc. I would be getting a second opinion about my uterus. And this website also has wonderful advice about VV, if you are diagnosed w/ it. Good luck & feel better soon.

mello64
01-02-2009, 12:35 PM
As for your uterine ablation, are they suggesting that for heavy bleeding? Is that the cause of your anemia? I thought a uterine ablation was a last resort after trying birth control pills, D & C, etc. I would be getting a second opinion about my uterus. And this website also has wonderful advice about VV, if you are diagnosed w/ it. Good luck & feel better soon.

Thank you Karen!

Yes and Yes on the ablation. Heavy bleeding is causing my anemia and supposedly ablation minimizes or eliminates bleeding (I'm researching that now too, and it looks like more often than not it does reduce it, but not always). I'm 44 and finished having kids, dh has a V, so no reason to worry about preserving my uterus at this point in my life. I'd do a hysterectomy if I thought it would actually help any of this lol. I'm all for any procedure that might alleviate things for my bladder & my privates, but of course I'm worried it might actually make things worse.

: ) melinda

Briza
01-02-2009, 01:02 PM
Questions:
What causes this???
IC-at this time unknown, varying theories. Same for VV.
PFD--there are two types: one where the muscles spasms and contract (sometimes in response to stress (emotional or otherwise)...in this case Kegels not usually recommended; and the other type of PFD where the pelvic floor muscles may be too weak, kegels may help in this case and help with leaking/incontinence

Would eliminating heavy periods help?
I don't know. If heavy painful periods are a symptom or IC symptoms seem related to a woman's cycle, then sometimes a gyn will suggest a laparoscopy surgery to take a look around in the pelvic area to make sure there is no endo or adhesions that could be causing pain or other symptoms. It is not uncommon to have this procedure while in dx process for IC...to see if possibly endo is causing the symptoms, or to rule out endo as possiblity of causing symptoms. Some patients here take the kind of birth control that reduces the number of periods they have per year, and it seems for some that is very helpful. I have had the lap surgeryr, no endo was found. I do not take bc pills, so I cannot comment anymore on that other than what I have read posted here on this board.

I’m thinking so because tampons and pads are so irritating, PMS only adds cramps, heaviness, constipation and chocolate cravings, none of which help.
Yes, VV or PFD could cause tampons and pads to be very irritating. I have had severe VV and pads were intolerable...tampons that I use are Tampax Pearl and using the smallest size possible and only changing them after the max recommended time. Removing a dry, too large tampon is an extreme irritant to the vagina.

But would any potential benefits be outweighed by the ablation procedure itself? Might the performance of an ablation irritate the whole situation and make everything more sensitive? Might it make things worse?
Sorry, I don't know what you mean by ablation procedure...your post was long, so I might have missed that part:)

Would this actually be classified as Interstitial Cystitis if I don’t have pain, but irritation instead?
There are MANY ways that those of us with IC describe our pain: pain pain, burning, stabbing, cramping, shooting, IRRITATION, pressure, always aware of bladder feeling...it took me a couple of years to be able to describe all the varying sensations I feel as accurately as possible.

What else might it be?
Endo, like I mentioned before, might be something to discuss with your dr, esp since you mention painful and heavy periods.

Pelvic Floor Dysfunction seems possible because of the “losing it” and “hitting the wall” feelings.
Do you mean the leaking when you say losing it? If yes, then there might be some PFD issues, but there are meds to help with this. Hitting the wall during sex? Yes, for me that has been a symptom of my IC.

What sort of therapies or other helps are there for Pelvic floor problems?
Physical therapist who specializes in PFD, and probably numerous meds. Many things are trial and error when it comes to what will help with IC, VV, and PFD, and unfortunately, like me, they sometimes occur all at the same time.

Vulvar Vestibulitis? Seems possible too, given the set of symptoms and my lack of actual abdominal pain.
Pain, irritation, burning, inflammation, etc., are common symptoms of VV, whether they occur during sex or after sex.

Why is Pyridium not for long-term use?
Every dr, pharmacist, patient may give you a different reason why.

Would Urelle or Prosed DS help me then, since they seem similar in function to Pyridium?
Most likely...if you respond well to Pyridium (or even if you don't) then the two meds you mention may help you, may be better tolerated, and are considered safer for longterm regular use.

What about Cystex? Long term okay? Other substitute?
I am not familiar with this one except I think it is sold OTC? Check the ingredients to see if it is the same as the pyridium that is sold OTC as Uristat or AZO Standard.


What about this lidocaine gel or msn gel?
I don't leave home without lidocaine gel. I use it for my VV. Wonderful stuff, worth its weight in gold, for me. MSN gel I have not tried. Do an advanced search of the Vulvodynia forum....I know there are posts/threads there that talk about MSN gel.

If one stays on a low acidic diet long-term, how does one get enough vitamin C and antioxidants?
All veggies contain some amount of vitamain C. The extreme low acid IC diet is mainly a guideline for what to use during flares or when symptoms have just started. As patients do the IC elimination diet, they most often find that there ARE other foods that they can tolerate. So once symptoms are under control, hopefully (as in my case) the diet is not so restricted.

If one is on a long-term low-oxalate diet, how does one get enough greens & fiber?
Since I have both IC and VV, this was also one of my concerns...as it pretty much eliminated ALL foods necessary for a healthy diet if I were to do both the IC diet and the low oxalate diet at the same time. I have found that for me, following the IC diet is more important...as my symptoms seem to start in my bladder and work their way down. If I am in extreme VV flare, then yes I will limit my intake of things like spinach or the very high oxalate foods, but for the most part, if I follow IC diet my VV is ok, too.

Is there a good GynoUrologist / UroGynecologist anywhere? And How do I find one? It seems most urologists are male and focus mainly on male issues: prostate problems, V-reversals, etc., and aren't necessarily all that sympathetic to women's issues.
I was dxd by a uro but my gyn is currently my all around IC, PFD, VV doctor. I agree, tho, that most uros see mostly male patients, and getting a IC dx and some compassion along with can be difficult if the dr is not an IC specialist. PFD and VV I believe are more likely to be treated properly by a gyn. Having said that, I saw 6 or 7 gyns over a year's time before I got treatment for my VV...and even longer for the PFD. There are no uro-gyns in my area.

Thank you so much for reading all this, if you got this far!

Yes I made it through I got this far lol, my fingers are gasping for air!!! :) Hope any of this is of some help.

: ) melinda
Take care, Bri: I have IC, PFD, VV, and Vulvodynia:woohoo::help::bonk: but all are well managed at this point. Keep your chin up...finding what helps rarely happens overnight, with just one dr, just one med or treatment, and often requires a lot of trial and error with not only meds and treatments, but also with the diet.

Best of luck!

leelee88
01-02-2009, 02:57 PM
Hello and :welcome: to the ICN

I do think it would be a good idea to see a specialist. It sounds like you have more than just one thing going on..

I wish you the best..