Jim's doctor has ordered Pyridium for bladder spasms. We haven't tried it yet. I have read about it but wanted to get first hand knowledge on others who have tried it. The side effects are a tad concerning. He also takes Oxybutinin.

Thanks!

On a short term use there is little to worry about with Pyridium.

But long term use may increase the effects on the blood that are listed. I have never had a patient who used this every day.
Only for intermittent use.

There is another drug called Urispas. This is often used in
long term care, but may interact with oxybutinin. The Oxybutinin may not be needed if Urispas works.
http://www.rxlist.com/urispas-drug.htm

Pyridium is more of a pain reliever, not an antispasmotic.

Alot would depend on what symptoms need to be addressed.

That's what I thought to Mrs. D that it is mainly for pain. Jim doesn't have pain, just urges. He does have two bacteria's growing, Klebsiella and Ecoli that appear to be colonized since he has no other symptoms except the urge.

A little background. Jim has a urostomy with his bladder intact. He has had numerous UTI's in the past but the fear of treating just because he has bacteria brings about a concern of resistance. It appears he is already resistant to some antibiotics so we carefully watch for any other symptoms. He has had urges since the urostomy surgery back in 2003 and this is a common side effect, as is leaking.

The challenge is recognizing which is a UTI symptom and which is a normal symptom. Urology says leave it alone if he isn't running a fever or having any other symptoms. But this has to be monitored carefully because he has been through kidney failure before which warranted the urostomy surgery thanks to the bladder refluxing. He was also given Mitoxantrone one month before kidney failure. It wasn't known at the time that UTI's were a common side effect of Mitoxantrone and Jim's went undiagnosed. There was back pain and minor leaking but at the time we all thought it was his ms. It was scary to think what we all thought was ms, turned out to be kidney failure.

I also flush his bladder with saline every other day to avoid a buildup of sediment. My plan is to try and get a clean catch specimen for when he sees the doctor on the 7th. As you probably know that is difficult with a urostomy. I am wondering if when they do the testing we're getting sediment which may be contaminating the result.

Thanks so much for your opinion. I truly appreciate it.

How about cranberry extract? This has a substance in it, that prevents bacteria from sticking and staying around. It might work well in conjunction with the bladder irrigations.

The tablets/capsules are better than the juice which is filled with sugar.
http://www.umm.edu/altmed/articles/cranberry-000235.htm
There is a warning about oxalate content for those with history of calcium oxalate stones.

Another thought is the old drug Mandelamine.
I have heard it is no longer available? But that might have been temporary. There is another brand called Uroquid.
Methenamine Mandalate was used for a long time as a urinary antiseptic.
Methenamine Hippurate was called Hiprex...also called Urex.
See it you can get any of these.
Long ago we had an elderly lady on long term Cipro, which caused neuropathy for her....her son came where I posted and tried the Mandelamine, and it worked fine for her. It would be a shame if it is not available anymore!

But I'd try the cranberry...it can be very useful.

Jim takes two cranberry capsules already and I think that is why he isn't having major symptoms because I get a lot of sediment when flushing.

I think that Mandelamine is no longer available. We talked about it with the Urology doctor and Spinal Cord doctor. If I remember correctly they talked about how it was used but not on the market anymore. If you hear different please let me know. I'll also check with his doctor again.

Can you believe that when we went for a second opinion one Urologist suggested I use Betadine to flush Jim? Diluted of course but it didn't sound right to me. We called Jim's regular Urologist and Spinal Cord doctor and they both screamed "NO!" While it sounded good it is not safe to use Betadine internally.

I forgot to mention Jim is taking Macrobid, 100mgs a day to prevent UTI's.

The best person to call is your local pharmacist. A big chain like
Walgreen's with a high volume.

Ask if Urex, or Hiprex is still available. They will have on computer a program from McKesson's or similar warehouse,
and can scan for these items quickly.

The old Mandelamine was made by Warner Chilcott. These little companies merge with others, then drop certain old patents, and mostly sell them off to smaller companies who then make them.
The name may be retained or not. When that happens, the item may go out of production, but may not stay that way forever.

So ask about methenamine (the generic name) and not only Mandelamine.

One of our posters on PN uses a probiotic that is supposed to remove oxalate from the diet.
This link: post #20
http://neurotalk.psychcentral.com/sh...obacter&page=2
This item is not inexpensive tho. But since oxalate is in many foods, it may help.

Here is an oxalate diet as well (you may already have this).
http://www.branwen.com/rowan/oxalate.htm
according to this list, cranberries are not so much of an issue?

I sure hope you find an agent to help... these daily struggles really are tough for patients and I think get short shrift by doctors sometimes.

Thanks MrsD! I'll check out those links today.

You know Sandy, I had a thought overnight. (this happens to me since I have become OLD! --I used to be quicker!)

Our FDA is going thru older drugs (grandfathered into approval) and requiring that the makers submit a new drug application to conform to the newer regulations. Some companies refuse to do this so, the drug disappears. ( it is very expensive in the long run). Then some companies just drop items that are not selling enough to merit the cost to making them.

But it is often still available elsewhere. If you run into this with
Mandelamine, it might be available still in some form in Canada.
The Urex is made by a Canadian company. And since I recall recently hearing that Illinois has a program with Canadian pharmacies for its citizens, you might still be able to get it?
Don't know tho if the lack of FDA approval here would block that. But it is something to keep in mind.

I'll have to check into that. Since Blago was the one who approved the use of Canadian drugs it may have been taken off with Quinn as our governor. Thanks!