Cystitis

November 13, 2017

Hi, Tracy.
My urologist may have solved the mystery of the symptoms I've been experiencing that are similar to a urinary tract infection (UTI). It appears that my bladder is inflamed for reasons other than a bacterial infection. The most likely explanation is a residual effect from the radiation treatments I experienced for eight weeks in February and March.

For the past couple weeks I've had symptoms; then they disappeared; then they reappeared. On one occasion, I was passing cranberry-colored urine, and then it suddenly cleared up. And I do mean suddenly. At one moment urination was painful and bright red, and then it wasn't. This past weekend I decided to cancel travel plans in December because I was suddenly needing to urinate several times a day. Yesterday I stayed home because I was not willing to leave the house. And I have been wearing the adult equivalent of diapers.

This morning I saw the urologist, who gave me a dentamicin shot in the hip to fight possible infections from the procedure that soon followed -- the uncomfortable numbing of my urethra, and then the insertion of a foot-long tube with a camera on the end, that slipped past my prostate and into the bladder, to take a look. This procedure is called a cystoscopy, and it uses a cystoscope, a tube with a lens on the end. It has about the thickness of a catheter. It stung a little, but with the anesthetic squirted in ahead of time, it wasn't much worse than the hot sensation that occurred during urination. In fact, while the cystoscope was entering, I felt like I had to pee. Afterward I did, comfortably.

 Normally, the bladder appears pink, but there were places where mine was red -- inflamed. In the absence of any bacteria, the most likely explanation was collateral damage from radiation dating back to the end of March. The painful symptoms prior to and during urination probably fall within the definition of "referred pain," which means one part of your body is experiencing discomfort that is expressed at another point.

The meds I'm going to take to deal with the inflammation are not inexpensive.  My prescription for pentosan (a.k.a. Elmiron) is $750, but because I have health insurance I pay only $40. Pity those who aren't covered.

PSA update

Buy the way, kiddo. I got more information clarifying what my PSA scores will indicate from now on. My PSA will continue to rise from it's present level until it reaches a new baseline. After radiation, you'll recall, it was less than 0.02. It is now 0.4. My understanding is that it should level out at about 2 or whatever is my "new normal." And then it should stay there. If it doesn't, that will get our attention.

Love,
Dad