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Medical Forum / Diseases and Disorders / Prostate BPH / October 2004My story - what next? (quite long)
Hi I am a 58 year old male who thought he was fit and well until the beginning of September. I came back from holidays on Saturday 4th feeling great but on the Monday I felt feverish, hands shaking, slightly nauseous, the lot. That night I kept getting up to urinate, something I didn't do more than once per night before, and it burned slightly when I passed water. I went to the Doctor the next day and he said I had a urinary infection and put me on Ciprofloaxin, but I felt steadily worse and by Thursday I was wanting to urinate every few minutes, but nothing much was happening. I was too bad to leave the house to visit the Docs and he came to me, diagnosed a full bladder and I went to hospital where I was catherterised. ( 1.5 litres) The next day (Friday) I was seen by the ward urologist, put on Flomax and sent home to return on Sunday to have the catherter removed. I did and it was, but I continued to retain water so after a couple of hours the catherter was replaced and I was sent home and told to return in two weeks. I went back as instructed and after removal of the catherter I again retained water, although I was now able to pass water myself normally, about 200 to 300 ml., without problem. The retention was steadily building up and after several hours I had about 500 ml left in my bladder after urinating, so I was catherterised again. The next morning the ward urologist told me that I had BPH and also that my bladder had stretched, which was causing some retention. When I asked if it would return to normal he said he hoped so. He suggested that I try self-catherterisation and once I had the technique off I was sent home and told to return at the end of November as an out-patient to see how I was doing. I am now self-catherterising twice a day. I don't seem to retain much water at all during the day (between 75 - 150ml) and at night I usually get up about 4am and do it for the second time, passing on average 300-400ml by myself and 200 - 300 with the catherter. It seems I have two problems, BPH and an enlarged bladder, although the bladder problem was probably caused over a long time by the BPH. Has anyone else suffered similar symptoms and if so did their bladder eventually return to normal size and stop retaining water after urination? Would TURP procedure help the bladder return to normal? I don't think PVP is offered in the area of UK (Teesside) I live. I'm seeing my own doctor again next week and I'm going to ask to be referred to a consulatant privately as I'm not sure I'll see one on the NHS, and I would like to know my long term prospects and options. At the moment I have not had any tests other than the manual digital examination on my first admittance. Are there any tests that I should be asking for, that might pertain to my symptoms? I have taken anti-histamines since I was 18 for allergies - hay fever, rhinitis etc - and I understand from looking at articles on the net that this could affect the prostate, but the urologist did not seem particularly interested when he asked what medications I was taking. Should I attempt to live without them? I'm still taking Flomax, before bed to reduce unpleasant side effects. Sorry this has been long and thanks for bearing with me. Like everyone else this sort of thing happens to I have been on a steep learning curve for the last few weeks, trying to understand just what it is that crept up on me and changed my life so quickly. Thanks Dan Hi, Let me have your E-mail address and I will send you some local information that might help. Derek PS remove NOX to reply. > Hi > I am a 58 year old male who thought he was fit and well until the [quoted text clipped - 71 lines] > Thanks > Dan It sure sounds like you are getting really crappy care. First of all, you should definitely try to STOP taking the antihistamines. They can make things MUCH WORSE. You should get a PSA test, too. I hope you get to see a competent urologist who at least CARES! Mel > Hi > I am a 58 year old male who thought he was fit and well until the [quoted text clipped - 71 lines] > Thanks > Dan Sounds just like my own history, Dan, except that I have been suffering from BPH for about 8 years. I'm 58 now. When I first learned of the problem, I was taught how to self-catheterize 2X daily. I did that for about 4 years. Finally, after noticing that I was able to have a full-flow and complete evacuation immediately after an ejaculation, I pestered my Urologist as to the reasons why. Was it because excess prostatic fluid was expressed with a resulting lessening of the blockage caused by the BPH? Was it due to the relaxation response of the smooth-muscle tissue (which is what the body's tubes are made up of - among other things)? At that time we began experimenting with antihistamines, blood-pressure lowering drugs, etc. (I don't have high blood pressure). We eventually discovered that Hytrin (Terrazosin) eased the worst symptoms of the BPH, and I was able to stop the ICC (Intermittent Clean Catheterization). This worked for another 4 years. However, last February, I abruptly stopped urinating entirely, suffered a major urinary tract infection, and had to begin ICC immediately. At first I catheterized almost pure blood. An emergency room visit, an indwelling Foley catheter and massive antibiotics eased the worst symptoms. After a couple of days the Foley was removed (at my insistence since I developed a very painful ulcer at the meatus (outlet of the urethra/penis). I went back to ICC. After many doctor visits, cat scans, digital exams, cystoscopy, ureteroscopy (a look up into one of the kidneys to determine the cause of a possible blockage which turned out to be an anomaly, nothing serious), and continuing, more resistant strains of the same infection (a staph infection), I finally had a TURP. (Six months had passed - while I continued ICC and various antibiotic therapies.) That was 2 months ago. For the first month I was a very sick, sore guy. I had to use the Foley for almost all of that time since I, too, suffer from an enlarged, floppy bladder that retained much urine. Now, after the first month of recovery, I have a good stream, no longer feel that I am having a hot bat stuffed up my rectum whenever I pee (now it's only just a slightly uncomfortable feeling), and am quite happy (especially, when I have to pee pretty bad and don't have to fool around with the catheter to do it - what a relief!). My urology people did speculate that an enlarged, floppy bladder has a very good chance of recovering some muscle-tone and being able to function normally after either a TURP or a long period of ICC. They said it could take as long as two-years to do so and that I should always drink lots of water. Consequently, I am looking forward to that also. At the same time, I feel that it is already returning to normal. My next flow-test is scheduled for November 10th and I'll have a better idea. I am still, however, plagued by the recurring infection. By now, we have utilized every possible antibiotic to which the organism has any sensitivity (determined by at least 10 urine cultures and sensitivity screens). I am concerned about this but feel that it can be beaten. I might have to spend some time in the hospital having IV antibiotics. I also take huge vitamin C doses 2X daily and some naturopathic bladder remedies (but, so far, have seen any good reason to do so since they really don't seem to do anything for the problem.) Tests that you really must have, in my opinion, are a PSA test, flow test, and cystoscopy (so they can really diagnose the BPH positively). My urologist also called for a cat-scan to be certain that kidney stones were not causing a blockage (they were not, I didn't have any at the time). Good luck with your problem. Kevin > Sounds just like my own history, Dan, except that I have been suffering > from [quoted text clipped - 82 lines] > Good luck with your problem. > Kevin Remember that this guy is in the UK the NHS does not throw money at a series of tests as in the U.S. where the patient or insurance company is picking up the tab Derek. Thanks for your replies. Derek, I would be very grateful for local information. I e-mailed you yesterday - did you get my post? If not (I've had problems with Ntl) I'll try again using Yahoo. MB, I'm trying to manage without the anti-histamines for a few days, using a nasal spray, and we'll see how it goes. I have year- round rhinitis which is very irritating without medication. As far as quality of care goes, as Derek said, the National Health is geared towards giving excellent care in emergency situations but you tend to be put on the back burner once you're no longer classed as in danger. It just does not have the resources to do speedy tests on patients who aren't critical, although in time I may get some of the ones you mentioned. As I said in my first post I'm going to ask my GP to refer me to a consultant and if he recommends any of these tests I will find the resources to pay for them to be done quickly. Kevin, Thanks for such a long, interesting and detailed post. I was particularly interested to read what your urologists had said about a floppy bladder being able to recover after a period of ICC. When I get to see the consultant I will ask about this. Good luck with your fight against that infection, it sounds like a trial to live with. To all, I'm sorry about my irritating mis-spelling of 'catheter' all the way through my first post - in future I will check what I've written before posting! Dan Dan: Donnt wory bout speling--itz nevah bodered me. Let me know how the cessation of the antihistamines works out. All I can say is for ME it made a WORLD of difference. I get a lot of sinus problems and it is frustrating not to have that in my arsenal. Also, I get major back problems and many of the muscle relaxers (mostly flexeril) are no-no's. Very frustrating!!! I am one of the few it seems that has had EXCELLENT EXCELLENT results with flomax (meaning great results and virtually no side effects!). Mel > Thanks for your replies. > Derek, I would be very grateful for local information. I e-mailed you [quoted text clipped - 25 lines] > posting! > Dan > Thanks for your replies. > Derek, I would be very grateful for local information. I e-mailed you [quoted text clipped - 25 lines] > posting! > Dan Perhaps a bit off topic but an example of the NHS in times of emergency and ignoring what the patient tell them . On the evening of 30th September my wife developed a pain under her left breast and towards her waist. The next morning she said it was painful when she took a deep breath. As the day went on the pain got worse but she would not phone the doctor. I was beginning to think pulmonary embolism but other symptoms were missing. She got through the evening but could only sit in a very upright position to be comfortable. She went to bed at midnight and woke up an hour later in severe pain. She also felt cold but sweaty. I phoned the newly set up NHS24 who deal with out of hours problems as our GP's now only work 9 till 5. I described the pain to the nurse who I was put through to and was told to give her two paracetemols. I said that the pain was more severe than one to be cured with that. I gave the phone to my wife who gave an update on the pain which was getting worse by the minute. The nurse said that she would send a doctor to see her within the hour. The pain was still getting worse and she then said that she would send an ambulance. Within five minutes two paramedics arrived in an ambulance, followed by two more in a car, followed by two more. The bedroom was getting a bit crowded. They did an ECG which was OK and gave her two aspirins to chew before fitting an oxygen mask. The ambulance took us to hospital and fortunately it was a quiet night for them with only a cardiac arrest patient before her. She was examined and another ECG was done which was again OK. She then had a chest X-Ray and some blood tests. The X-ray did not show anything so we waited for the blood results. The young doctor said that while they were not negative for signs of a blood clot they were only slightly positive. She gave her a shot of Heparin and a pain killer and said that the consultant would see my wife in the morning and decide if a CAT scan should be done. The CAT scan was done in the afternoon and showed nothing wrong and around 7pm she was told that she could go home. ER was by this time chock a block and patients on trolleys and wheel chairs were lining the corridor outside the assessment ward. I protested at her being released without a cause being found for the pain which was by now slight. We were told that 60% of patients admitted with chest pain did not have a cause found for it. From the position of the pain we had never been convinced that it was cardiac related and it seem too low down to be in the lung. The discomfort in the area continued and by the Monday my wife felt nauseous and had vile smelling breath and a nasty taste in her mouth. Several times after eating small meals she wanted to be sick. Last week she went to her GP who prodded the area which made her jump. His first thoughts, gastritis or an ulcer and set the wheels in motion for an endoscopy but in the meantime arranged for a barrage of blood tests. I asked why not use the blood tests already done by the hospital but he said that they had only done ones that were cardiac and lung related. His other expectation was a positive for Helicobacter Pylori. The blood tests did show Helicobacter Pylori and he has now started her on triple therapy to clear it and any ulcer she may have. Derek I would have guessed gall bladder or pleurisy. I hope things are resolving. Mel >> Thanks for your replies. >> Derek, I would be very grateful for local information. I e-mailed you [quoted text clipped - 95 lines] > triple therapy to clear it and any ulcer she may have. > Derek It was the wrong side for the gall bladder which had been removed 30 years ago. Derek. >I would have guessed gall bladder or pleurisy. > [quoted text clipped - 111 lines] >> triple therapy to clear it and any ulcer she may have. >> Derek |
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