Had A Urodynamics Procedure Today

So much of this is confusing.

1-Nitrofuratoin is used as a long-term UTI preventative because bacteria [supposedly] do not build up a resistance to it, and it resides in your bladder. Most [all?] UTI antibiotics target the bladder and are not broad-spectrum. So there's no risk of creating resistant bacteria, and there's no harm done to your gut biome.

2-I am taking K2-7 and D3. I stopped taking the calcium after last Friday's urology appointment, and need to get back with the nephrologist for a second talk on why my blood serum calcium is fine and I'm dumping high amounts in my urine. I also want to ask about supplementing. I'll address ACV below, because it's lengthy and confusing.

3-I have wondered the same thing. The overriding issue is that the field of urology has always told patients that sediment and blockages are "just part of having a catheter." That is beginning to change. I have not seen an anti-bacterial catheter, but what I did come across was an article on the whole catheter blockage issue written by a health agency in Queensland, Australia. One of the things they do is to inject an antibacterial solution a bladder rinse into the bladder via the cath, let it sit, then flush it out [corrected 4/5/23. see this post.] The process is not much different than what I do twice a day with sterile water and is often done by patients. Just like your antibacterial cath suggestion, doing this makes perfect sense to me...even more sense than taking a pill. That Queensland paper listed 3 products, but they are only available in Australia. I could find no domestic version in any of my medical supply houses or in a general web search, although I did see a website for an American urologist who does this procedure...I failed to bookmark it, but I'm going to find it and contact them.

ACV, Lemon Juice and Bladder pH
Let me see if I can make sense of this.

-Bladder bacteria thrives in an alkaline environment
-Bladder bacteria also makes your urine more alkaline
-Some sites say that the things that fight bladder bacteria out-thrive the bacteria in an alkaline bladder
--Because of this, making your bladder more alkaline [counterintuitively] helps fight bacteria
--My urologist just stared at me when I asked about those benefits of making my urine more alkaline

-Lemon juice and ACV are acidic
-When lemon juice and ACV are metabolized, they create alkalizing byproducts
-Counterintuitively, lemon juice and ACV make your urine more alkaline, NOT more acidic
--There are lots of folks in the industry who believe just the opposite. They think that the acid makes your bladder less alkaline.

-I just found out that my stones are struvite
-Struvite stones occur with UTIs, because the bacteria breaks the urea down into ammonia¹
-Because they are bacteria-caused, there are no dietary changes that can help, except as to prevent UTIs
-It's tough to tease out specific advice for bladder struvite stones, because they can also occur in the kidneys
-The low dose nitrofuratoin prevented my stones for 10 weeks
--Many websites recommend acidic drinks to make the urinary tract "less likely" to form struvite stones. I assume this is for struvite stones in the kidneys. Perhaps the drink is still acidic until (or while) the kidneys process it. I do not know exactly where (or how) the acidic drink creates alkalizing byproducts. Or maybe these sites do not realize that the acidic drink changes state and they are giving bad advice.

Because of this, I am in a conundrum as to whether or not to continue (or stop) taking the ACV. It seems to have helped, but correlation is not always causation.

¹Fun fact: Struvite was discovered in bat caves by a German geologist named Georg Ludwig Ulex. He named it struvite to honor Heinrich Christoph Gottfried Struve, a German mineral collector serving as Russian Consul at Hamburg

Struvite forms in modern wastewater systems and is a real problem, aggressively coating the inside of pipes, just as a hard water minerals do.

 

The fact is I have nowhere to go. He is my 7th urologist at my 3rd practice. And I've made tons more progress with him in a short time than I have with others. Besides, this practice has 5 or 6 locations, 40 doctors, a ton of nurses, and they keep several time slots open every day for emergencies. I'm not gonna have that with a smaller practice.

Part of me wonders how he will react to the report that says my lucky guess was correct. His summary said to come back in 6 months, so by then it will be a distant memory. I'm still waiting for the urine culture so the guy can give me a script to know back the bacteria and I can get into maintenance mode...I've not heard from him regarding Wednesday evening's stone lab report.

 

I just got a call from my urologist's office. He wants me to start doing the antibacterial wash that I mentioned was cited in the Queensland, Australia health agency article, so that's good news. The sorta bad news is he wants to do a CT scan to see if there are larger stones still in my bladder and if there are, to decide what to do about them (bladder flush or maybe the same surgery I had when another stone was removed.)

 

No more hot tea or no more iced tea?

I had kidney stones. The only thing I was told to steer clear of was broccoli. Lots of stuff contains oxalate.

And thanks for the well-wishes. I had a bladder stone removed and it was o big deal, but back then I could still pee. I got no idea how "things" would get flushed out these days. I've tried reading about bladder flushes (I've heard of folks getting them to remove sediment) but all I can find are the ones that are done in hospital post-surgery. It's gotta be more that the flushes I'm already doing. I'm concerned that there are more stones because of some sizeable ones that came through the catheter a couple of months ago. Sturvite grows fast.

 

This goes back to my long reply to Mary regarding taking lemon juice and vinegar for bladder sediment. Rumors turn into fact, even in the medical community. Tea has less oxalate than most other foods, but I imagine that someone once said "Tea contains oxalate," and the rest is [rumor-control] history. In fact, I read a statement about a doctor stating "no more iced tea" without any substantiation, and it was hypothesized that he meant what you said, Don...it was a quantity thing. But it was just a guess.

Regarding stones and diet: were you referring to kidney stones (oxalate vs carbonate) or struvite stones? If I could alter my diet to help my odds, I sure would.

 

Thank you for that, Don.

I had not seen that stone primer. I've probably mentioned my kidney stone saga:
-Got my first stones a few months after I quit drinking in 1990
-Passed 10 the first day, uneventfully
-Had them for less than 10 years
-The never gave me back pain, but a couple were tough to pass (and likely trashed my bladder)
-Over 10 years after I had my last stone, hard well water gave me blobs of sandy crystals like a cat (in 2010)
--I remediated the hard water, the sandy splats went away
-I think there's a small stone still kicking around in my kidney, but I'm not forming new ones

These things make me wonder about "intelligent design."

 

Thanks for that, Tony.

This is a different approach I've not read of before. They spray the catheter with an antimicrobial before insertion, and then spray the place-of-entry daily. The idea is to prevent the biofilm that shields the bacteria from antibiotics. It seems that this method is used for short-term catheterization while in hospital...they evaluated the results at Day 7. But one would think that if it gives you 7 days of protection (at a minimum), doing so will defer the onset of the biofilm so as to provide a significant benefit to those whose caths are swapped every 4 weeks (the standard schedule.) My observation is that the rate of sediment production (and bacterial colonization) accelerates over time. So preventing biofilm formation for the initial 25% of the cath time might reduce sediment volume by 50%. People who are having their caths swapped at 3 weeks rather than 4 because of sediment issues (and who are on antibiotics) might be able to go the entire 4 weeks.

Reading this article kind of raises a new question...will direct-injecting antibiotics (as I'm going to be doing) penetrate (or prevent) the biofilm? The low-dose antibiotic that I have been taking worked for 10 weeks, with a fresh cath being inserted every 4 weeks (the standard schedule.) Evidence of bacteria appeared 2 weeks into the 3rd cath. I am still light-years ahead of my nightmare period of bi-weekly ER visit. My last crisis was over 4 months ago, although I did have one cliff-hanger, and fear made me get one cath swapped at 3 weeks...but when I took the cath home and cut it open, I saw I could have gone the entire 4 weeks.

 

Well, I just got my repeat LabCorp urinalysis back. This is the second one in a row that says "Greater than 2 organisms found, none predominant. Please submit another sample if clinically indicated."

The first sample was taken from a fresh cath bag, but was assumed to be contaminated. I went back and had the cath swapped so that a clean sample could be taken directly from it, and now I got the same results. I have had several emergency room (and Doc-in-the-Box) visits with samples taken from bags that were many days old, and never had this. I wonder what my doctor will say. I wonder what's going on.