View Full Version : Back from the Urologist - with Detrol...
05-04-2009, 06:25 AM
I saw my Urologist this morning. It was an easy, uneventful visit.
I described everything going on with me in painful detail. My doctor is incredibly conservative in his treatment. He said that his next step would be a pelvic ultrasound, the next step would be cystoscopy/distension followed finally by a CT scan. He doesn't want to do any of the foregoing at this point.
What he said to me is that it's not important to try to figure out exactly what we should call my problem, or how to define the problem. What he said is that all he needs to know is that I have a chronic history of bladder problems, he's seen the insider of my bladder and knows it is chronically irritated, and, most importantly, I am presently uncomfortable / in pain.
He sent me away with Detrol and Macrobid and asked that I take one of each once a day for 30 days. The doctor explained that the bladder is a fundamentally primitive organ that does not do a good job of "resetting" itself, so to speak, after a flare up, or an actual infection. He said the Detrol should help relax my bladder.
We'll see. The jury is out! I've tried Urelle recently with no success. I guess it's time to have an open mind and some patience, and give the medications a chance to work.
But I must say that I like the doctor's approach. Patient X has pain, I will treat Patient X so that she feels better (whether I call it IC, painful bladder syndrome, overactive bladder, etc. is inconsequential to the patient who just wants to feel better).
05-04-2009, 06:47 AM
One more thought -
I'm not sure why he prescribed the Macrobid.
The doctor did mention that he thinks many flares begin with a mild infection. I don't know about that. I mean, I KNOW what an infection feels like at any stage. I have great expertise there. And, as of today, they took a urine sample and I have no infection. I didn't think I did-- these symptoms just don't feel like a UTI to me. They aren't the same.
05-04-2009, 08:43 AM
Glad you are happy with your doctor. I think he gave you the macrobid just to make sure you don't have a low grade infection - for some with IC, antibiotics seem to help with inflammation and hence, pain. I was surprized that if he knows your bladder is showing irritation, that he gave you a med for over active bladder. I went through the whole gamut of those - detrol, vesicare, sanctura, enablex, etc... None of them even touched my urgency and frequency. You may want to ask about stronger antispasmodics. One that worked great for me was Ditropan xl (I took the generic of it). Sorry the urelle didn't work. There are two sister meds to it prosed and utira-c you can look into. They also sanitize the urine and turn it blue. The ingredients are just slightly different, so some people do better on prosed than urelle. I use utira-c with good results. I guess you've probably tried the pyridium, which is the one that turns urine orange. That is mostly used for short term. The blue ones are safer for long term usage. In the mean time, since your bladder is showing signs of inflammation, have you tried any natural alternatives? Have you looked into cystoprotek? I take that everyday. Also my doctor recommended 2000 mg of fish oil tablets every day. Each capsule contains 1000 mg of oil, so you only have to take two per day. She swears she has had patients go into remission on that alone (not me!). Also flax seed oil capsules help with inflammation and calcium citrate can help remove crystals from your urine, making it "smoother" to pee out so it can reduce urethral type irritation. Of course you need to check with your doctor to make sure these supplements don't interfere with your precription meds. All of these are easy to find, even in supermarkets. Except the cystoprotek that has to be ordered on line - you can see a link for it on the far left. I hope this helps. One more thing is to find a good probiotic to replenish your gut after taking antibiotics. It can help espeically if you are having any issues with yeast. Good luck to you.
Reminds me quite a bit of my uro's approach - conservative, slow and steady. We tried several oral meds - using each for 30 days before adding another to the mix. Detrol LA was my first med (I'd already done 10 days of a broad spectrum antibiotic "just in case".) The Detrol actually did help me a little bit and my primary symptoms were urgency and frequency.
I found that I needed a combination of meds to really do the trick - no one med in isolation helped me completely at the start. Kind of a cumulative effect, I guess, and Detrol was one of the last ones I could give up without flaring, so it was definitely a help to me. Now I just take Elmiron for IC.
Anyway, it was frustrating initially to have to wait, wait, wait, but I am SO glad now that he did it that way. Aside from a diagnostic cysto w/ hydro I've not had to do anything invasive in the 8 years since I've been diagnosed.
05-04-2009, 11:38 AM
Conservative approach often a very good approach! Sometimes that is best to be Rxd just one med at a time to determine how it works for you, and then add other meds as needed and yes, for many of us it does take a combo of meds to control our symptoms best, but very diffcult to determine what is working, what is not, what is causing side effects (if any) if starting off with a variety of meds all at once. I like your doctor! :) He seems very calm and has a very clear and realistic goal in mind, which I'm sure is shared by you...to treat your symptoms as best as possible to eventually get you back to feeling "normal" as possible. Very good!
Yep, it does take some patience when trying the MANY different meds and treatments that are out there, but it will all be worth it in the end, I promise you, because the majority of us DO eventually find what works for us, whether it is just one med or a combo of meds/treatments/self help stuff, including diet!
Wishing you the very best! Oh, one thing I would like to add is that I am very glad (in hindsight, that is lol) that I was NOT treated heavily for my pain w/ narcotic meds in the beginning stages (first two years) because if I had been then I am certain I would not have been as well able to determine how each other non-narcotic med or DIET was working for me. I was eventually Rxd a low end pain med, which I still take as needed, but NOT having been put on long-acting or RTC pain meds of any sort in those first couple years was really a help for me in being able to determine what my diet triggers are and how well the other self help stuff and non narcotic treatments help me. After the first year I was Rxd this low end pain med and yes I was and am extremely greatful for that:bow::bow::bow: lolbut I have always taken it only as needed and sparingly. And especially now that my symptoms are mostly under control with diet, I rarely need it...once a day at most for "normal" IC days and not at all when I am having no pain.
Hang in there, it sounds like you have made a good dr/patient match...hopefully success and relief is right around the corner!:)
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