posted
It's been 10 years since I last got a UTI, but I have one now, no question. Of course it would start on a Saturday night.
Last time I got one, the first antibiotic I was put on didn't work and it turned into a kidney infection and I spent a week in the hospital on IV antibiotics. I would like to avoid that if possible.
It takes my doctor usually a couple of days to work someone in. But he's a family friend and I do have his home number that I am VERY loathe to use, since I know how little free time he gets and I want to save that for real emergencies.
Is there anything over-the-counter to treat cystitis nowadays? I know exactly what the doctor will do, whenever I DO get in to see the doctor. He'll make me pee in a cup. Say "wow, you have cystitis", and give me whatever the best antibiotic for that sort of thing is now. It is extremely unpleasant to have to wait until Tuesday or Wednesday for this to happen, just because of the misguided healthcare laws in our country. Anyone who has ever had a UTI will understand what I mean. And risking a kidney infection seems foolish in the extreme.
In the meantime I will drink as much fluid as possible, though I can't have juice because of the sugar content. So I will drink enormous amounts of water and spend lots of time sitting on the potty. I'll also take my normal 4 gm of vitamin C a day. I may up that to 8 gm, in fact. Is there anything else I can do? Are there any UTI drugs that have become over-the-counter in the past 10 years? (And is the problem of bacterial resistance to antibiotics any worse in countries like Guatemala in which antibiotics are over-the-counter drugs?)
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Available at a drugstore near you, Uristat. Also available, some other options -- including an OTC test kit for UTIs, which I think you can also find at any drugstore.
Good luck, and feel better soon -- UTIs are the pits! *shudder*
Posts: 32919 | Registered: Mar 2003
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I definitely wouldn't wouldn't recommend calling your doctor's home number, but there should be a physician on call. Call the clinic number and you can have the doctor paged if necessary. However....
You may not be at as much risk of a nasty kidney infection as you were years ago. If your diabetes was under poorer control then that was a risk factor for bad infections. You should probably check your blood sugar (I can't remember if you check it these days or not since your hgA1c was around 5.8.)
There are NO over the counter antibiotics that will help. Fluids can help, and there is some data behind cranberry useage helping. (For you I'd recommend the pill form--less sugar calories)
What do the healthcare laws have to do with your uti?
I wouldn't necessarily make an appointment to see him in the office at all. If you just have symptoms like frequency or burning, then call Monday morning and ask if you can drop off a urine specimen. Then they can call you in a prescription. Cheaper and faster for both you and the doc.
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Cranberry juice has done wonders for me in the past. That and cranberry extract pills. I don't know what's in it that works so well . . .
Posts: 1903 | Registered: Sep 2003
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Thanks rivka, and Theca! I will do all of that. Theca, my diabetes was in much BETTER control back then. What happened, though, was that the antibiotic I was given first didn't work well. It took about a day and a half to start providing relief of my symptoms and then a couple of days after that, it quit working again. I told the doctor but he decided it was just residual pain and gave me something to relieve the pain in my bladder. After 2 or 3 more days I got fever, a pain in my side, and just rapidly got very sick systemically. He examined me and when I howled with pain after he thumped me in the kidney, he realized I had a kidney infection and admitted me.
What I meant about the healthcare laws is a frustration that you as a doctor aren't so aware of, because you don't experience it, nor does your family. For we ordinary folk, though, we have to get in to see a doctor, which may take several days, before we are able to get badly needed drugs. Sometimes if we are too sick to get up, drive, etc, we just wait until we're feeling better. If the healthcare laws made more sense in this country, there would be someone, a nurse practicioner, perhaps, or online doc or some other option like that so that medical care and drugs were available. Here that is against the law. In Guatemala, for instance, antibiotics are over the counter. It's just frustrating to be kept from access to something you need very badly, because doctors 1) have a monopoly on its legal distribution and 2) are not freely available to see you on a free market basis.
The supply of doctors is held artificially low, for instance, because of how few places there are in medical schools. There are multiple candidates for every slot, but they are turned down for admission. This ensures that there are always many more patients needing care than doctors have time to see. So rather than doctors offering a wide variety of services and options, like house calls and so on, you are left with very little choice. You are at their mercy.
My cats, I have to say, have far better healthcare than do I. Part of that is because they happen to have one of those one-of-a-kind angelic fantastic doctors. But part is because the laws in this country have not been as favorable to veterinarians as they have to doctors.
Please don't take this as an attack on individual doctors, on their abilities, or on how much they care. There are many wonderful doctors in this country, including our beloved hatrack doctors, who lovingly care for us from their hearts, working in their off time. We are very lucky to have them, and don't appreciate them enough. Our health care system in this country, though, is certainly broken. We really should fix it.
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Blood sugar is 168 fasting. Wow, I'm glad you told me to check. It's been so good lately that I haven't been checking routinely. But this is the first time I've had over 110 fasting in a long time.
Any sort of illness does that, for some reason. I didn't feel bad like it was high. Is it because of cortisol increasing when you are ill, in response to the stress?
Okay, I did what you said and called the doctor on call. He called me in something, which I'm going to get now. Yay!
Should I save a urine sample from before I start taking the meds, just in case? Is that worthwhile or not?
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Hmmm. I agree that some things need to be changed. I don't agree with anything you said in paragraph #2 or #3, however. The clinics I have worked with often get people same-day appointments with the doctor or with the nurse practitioner. Over the counter antibiotics would be a Really Bad Idea and most American docs would agree with that assessment. The reason docs don't make housecalls much is not because there are so few docs, but because housecalls aren't reimbursed very well. Lots of things I do aren't reimbursed very well, come to think of it. Some docs do lots of stuff online.
Um, it is possible that the infection is raising the sugar. Or that your raised sugar made it more likely to get an infection. You'll have to watch it and see if it comes down. Well, if you save the urine now, by the time the clinic would want it, it wouldn't be good anymore. Nope, I wouldn't bother. Just let him know if the med doesn't improve things in 48 hours.
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Glad you got a doc to call you in something. I'm one of those that hates bothering doctors on the weekends, but in a case like this it is necessary.
Hope you get some quick relief that is such an uncomfortably, painful condition.
Posts: 14428 | Registered: Aug 2001
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Thanks, Theca. The drug I got is ... well, the bottle says SULFAMETHOXAZOLE/TMP DS TA LM. (Not sure what those last letters mean.) Qty 14, 1 tablet PO BID (for SEPTRA DS tablet).
I got some of these cranberry tablets, too, and if I may ask, does anyone know what this stuff is? The bottle says they have 990mg Vitamin C, 10mg Zinc, 300mg of blueberry bioflavonoids, 200mg cranbery std. ext. (9% anthocyanidins and 30% organic acid) Vaccinium oxycoccus (berries). Then it says "equal to approximately 2000 mg of cranberry powder". The last ingredient is what concerns me most, "Uva Ursi herb powder, 300mg, Arctostaphylos uva-ursi (leaves)" I want to be sure there are no drugs in it that might be contraindicated for diabetes, or have interactions with antibiotics, vioxx, protonix, or enalapril, or else have a bunch or stimulants or something like that. I don't usually take "herbs" since they are mostly just untested drugs, it seems. Does anyone have any idea what that stuff might be?
One more question, why are caffeinated liquids contraindicated? I don't drink coffee or tea, of course, but I am drinking caffeinated diet drinks now and I know that they told me to drink uncaffeinated liquids when I had the UTI before. I know that caffeine is a diuretic, but isn't that what you want, to urinate frequently and flush it out? Why is it bad? I don't understand.
Also I want to apologize that I always seem to be ranting at the health care system every time I have contact with it. I really do appreciate what we have. I just see how it could be so very much better, and think we ought to do something. Also the whole thing with my father really soured me. So it's like a responsibility, or something, that I feel, to point out the problems, especially to doctors, who experience so very different a system than do lay people, so that we can hopefully make things better.
[ February 08, 2004, 03:27 PM: Message edited by: ak ]
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As a pharmacist I will echo Theca and say that antibiotics should not be over the counter. We are having a horrible time in parts of this country with resistance. MRSA seems to be prevalent now and VRE is on the rise.
Most doctors that I know would probably phone a 'script in after explaining the symptoms and knowing you had had a UTI in the past.
Sounds like you were unlucky with your previous UTI and found a resistant or unussual bug. It takes 3-5 days to accuratly ID a bug. Most people don't want to wait that long for treatment. So doctors do the next best thing which is an educated guess. Based on prevalance and general bacteria type (bacilli, cocci etc). Most UTI's are from E.Coli. Most E.Coli is suseptable to general antibiotics such as what your on. Occasionally you will find a bug that won't respond. In that case a stronger antibiotic is required.
Caffeine is a diuretic. The reason you should avoid it is because most people do not adequately drink enough water nor do they replace what the diuretic wasted. Sulfa drugs (which your on) require lots of water to get it into the bladder and to make sure it doesn't crystalize (unussual).
As for drug resistance in other countries. I suspect that if it's a third world country, there are not accurate records kept in the first place. In other first world countries, resistance is also a problem. Canada, for example, requires a prescription for most anti-biotics, but not all. They are allowed to sell antibiotic eye drops OTC for people with pink eye.
BTW, the number of people applying for medical, pharmacy and nursing school is going down. Less and less people want to get into these fields. You are also correct in stating that we are not graduating more people each year (as we should).
Personally, I am benefiting from the current pharmacist shortage. I am not tied down to a particular job. I can find a new job if I wanted easily.
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