Questions posted in the The Urology Forum have been answered by urologists from Henry Ford Health System and by Dr. Kevin Pho.

Question Title: u.t.i. big trouble...

Forum: The Urology Forum
Topic: Urinary Tract Infections


Hello,
Would you please help me to post this to any sights you think might
be helpful and share this any doctors you think might be helpful.
I'm into alot of trouble and are looking anywhere for help.
Thanks,
Brian
--------------------------
I am a 44 yr. old man ...19 yrs. C5 quadriplegic ,living in Tucson. I used external condom cath for years with a progressive history of symptomatic UTI... these were treated with antibiotics and averaged four to five times a year.My drainage was switched to indwelling superpupic two and a half yrs. ago. This was to reduce high pressure and hopefully bring improvement in life quality.
The past year has been a downward spiral chronically symptomatic UTI’s (spasms,
sweating, mounting abdominal pain and diminishing appetite) and no sustained
relief. I have gone from Cipro to Macrobid to Geocillin to Cipro...
I enjoyed an active life in a power recline chair.... working and driving a modified van
daily. I also have a trained companion dog and we were going around town daily....to
work... to market....to park etc.(some compromising for my cycling health issues).
The past year’s continual high level of UTI challenge has digressed me through
stages of not every day driving, to fewer hours up, to more days in bed, to always in bed for two months now.
I have put alot of effort into health awareness and management. Over the years I have
found periods of success with various approaches. Herbals (Uva Ursi,Buchu,Echinecia,
Golden Seal, Marshmallow root, Cornsilk, and others). I’ve also tried Chinese herbals
prescribed by acupuncturists (to raise Chi and suppress damp heat). I drink bottled water, unsweetened cranberry juice often supplemented with 1g. powdered vitamin C(3g/day). I’m drinking soy milk and eating mostly organic. My daily diet is nutritionally excellent. Oatmeal with fruit and yogurt for breakfast....fish, vegies,rice for lunch...afternoon snacks... and typical full dinner using beef, chicken, or tofu for protein and potatoes, yams, pasta for starch and salad or fresh vegies, often followed by a late night snack.
Despite all of my awareness and diligence I find no stable ground. My symptoms have
moved through periods of muscle and joint pain (degeneration) to a weakened state
with sensory numbness (arms, neck and head, ringing ears, inflamed roof of mouth and
skin changes). I think on top of the UTI history recent increases in challenge may be
due to changing from condom to superpupic and or acquiring new viral or fungal
pathogens(EBV,Candida....) . I have been tested negative for HIV.
I have just started irrigating with .25% acetic saline 2x daily. Some have suggested using antibiotic irrigation and one doctor even suggested dilute betatine flushing though I have not tried these.
Does anyone have any experience and suggestions which might help with this seemingly quite serious and frustrating condition?
Thanks for any assistance.
Brian McNelis
brimac@azstarnet.com

My current situation:
I am sick with symptomatic UTI
it is MRSA weakly sensitive to doxycillin and vancomycin
Taking seven days doxycillin
Need serious help Mayo clinic ect.??
Any ideas anyone?
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Dear Brian,
Thank you for your question. You obviously have a very serious situation that needs attention soon. You sound to have been doing wonderful things for yourself much beyond what many spinal cord injury patients achieve.
The key to your urinary problems is to achieve low pressure drainage of your kidneys without involvement of foreign bodies (indwelling catheters). There are many possibilities from condom drainage with cutting of the muscles that hold urine in your bladder to intermittent self catheterization after taking medicine to lower your bladder pressures (not usually an option for quadriplegics due to upper extremity limitations) to surgical procedure to allow drainage to occur into a bag glued to your skin.
Treatment of your infections with your catheter in place will result in more and more resistant bacteria. As long as you have a foreign body in your urinary system with drainage outside of your body, you will have infected urine. Eventually this will damage your kidneys and may result in the formation of stones in your bladder or kidneys.
You need to seek care at an institution with experience in neurogenic bladders. Most academic institutions have a urologist with such expertise.
This information is provided for general medical information purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. We of the Department of Urology at the Henry Ford Hospital have experience with difficult and involved urological problems such as you describe. If you would like to make an appointment [for a second opinion], please call us at (1-800-653-6568). We can also arrange local accommodations through this number if this is your need. Please bring any x-rays [and pathology slides] (not just the reports) as well as any physicians’ notes and lab test results that you may be able to obtain. These will help us greatly.

HFHS M.D.-SAL
*Keyword: neurogenic bladder, urinary diversion





 

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