Hello to all. Did y'all have a good weekend?
Hmmm well its time for another question and answer segment in the ole ECO stomping grounds...
Awww come on its not that bad
Seriously though...
Here is my question.
How does everyone feel about taking Antibiotics to try and prevent future UTI's?
Do you think its worth it in the long run if the body becomes resistant to it eventually?
How about the risk of ulcers?
Did I say this was gonna be easy?
MIL got a UTI and is now on a second medication because the first did not work shes on her 4th day of the newest med. Once she has finished this med her PCP wants to put her on maintenance AB's to prevent future UTI's while I did get the initial script I just dont think its a real good idea to continue with it considering her history of bleeding ulcers. What do you all have to say about this I would love to hear it.

quote:

Originally posted by fat, dumb and happy:
BG. question. i have seen references to scans but i watched a documentary once which said there was no way to tell the degree without an autopsy. what did i miss? i was taught in class the same thing and just monitoring the person's actions and recording them was about the only thing docs could go on. i feel so stupid, like kindergarten. can you help educate me. i am so sorry anytime i hear of rapid deterioration. also this might not be the best time to ask questions, you have enough going on so if anyone else feels like wising me up, thank you. i don't know yet how to look up sights.

Happy I not only did a little research on this but asked the lab about it. What I have learned is that with an MRI they are using a stronger magnetic field to produce better images of the brains soft tissues and while its not the same as when they do an autopsy, they can tell from one scan to another the difference in size and shape and thats what they did for my MIL she had an MRI the last time she had a small stroke, from that one to this one there is a significant change in size.

We used to push it, now we don't. (Fluids that is) But I do understand how hard it can be. This was cut down to roughly 1& 1/2 guarts total liguid a day. that included all water fruit juice, jello, ice cream, and all other substances that would be liguid at room temp, including gravy, sauce, and the like.

Ok you sound as if you are giving way more liquid than I am so now I am confused If MIL is not consuming nearly that much liquid then theres something else afoot here. Hah! Now what the heck could that be?! Oh oh thought processes are getting fried start me on an idea BC...Thoughts?

Mom is mentally functional, so all may be different. Still, because these key electrolytes are low, we were warned not to over hydrate her. Wierd. She knows when she is thirsty and H2O is always at hand.
She gets rather wet oatmeal with fruit and prune juice for breakfast. (used to be stewed prunes, too, but after 2 years, she finally went beyond regular. For lunch, there is Jello( that is a liquid) and the potatoe salad and chicken salad(make it my self, no celery, she gets it stuck in her teeth.) At dinner, there is some protein ( chicken, fish, ets.) with added moisture. Gravy, tartar sauce, etc.
With every meal, a small glass of water and one of fruit juice are at hand. Most times she finishes both, without pushing. always water is at hand. I refuse to let her be thirsty and not have water at hand. Regardless of fluid restrictions that the Doc recommenned.

Actually, it works out for Mom, about what the doc want, and what she wants. Surprised the heck out of me to find we were over hydrating her.

Before bed, she has a snack usually a lot of moisture in that.

Ah ok BC so Im reading that backwards sorta speak. Hmmmm Strange its not like she was drinking much either this whole month. Now Im really confused...
Hee hee he I hear that! Yeah it doesnt take much lol
But seriously this is not a good time for the ole college try so trial and error is out the door...
What do you think.
Tea oatmeal with applesauce Ensure banana soup jello or pudding whatever water I can get her to drink and thats about at the most 16 oz a day
soup consists of about 1 1/2 cups of liquid ensure is like what 8 or 9 oz.
Does that seem like too much liquid to you?
What do you give mom on a daily basis?

Mom's sodium and chloride are always a little down. (for a time , they were way down) Strangely, we can keep them too hydrated. Mom's PCP actually restricted her liquid in take. Her functions actually got better.

Hold up here I am reading articles on low sodium levels in the elderly, Im tellin ya did I not call this??? Is this a dehydration issue or not?
Anybody know?

See Happy Im of the same school I dont know of any scan that shows the deterioration process...evidently they are onto something, not one person there in the group of 3 spoke out against this finding Im at a loss myself
You should see her though she is all over the place she can not sit still at all swaying back and forth needed a gait belt the whole shebang! This is unlike anything I have ever seen from her, and your talkin to someone who actually monitors her for up to 10 hours a day via video feed on a small television. This is frightening to see her like this.
And no BC that would never happen this is only temporary in the SNF right now this is all about her and me getting a little break I havent had one in 10 years (as of July 5) and it looks to me like a picked a right time to force this issue. I need to prepare for the next step of this one so a little me time is just what I yelled for.
the other thing too was her sodium levels were way down

Sorry to hear that BG, I don;t think that was what you were e xpecting, or what any of us are expecting at any time. This is tough stuff. Give it some serious thought, you and Hub.. Is this approaching a hospice criteria.?? Oh, lord , darling . I wish I had that hug thing you do.
TONS of HUGS ........

BG. question. i have seen references to scans but i watched a documentary once which said there was no way to tell the degree without an autopsy. what did i miss? i was taught in class the same thing and just monitoring the person's actions and recording them was about the only thing docs could go on. i feel so stupid, like kindergarten. can you help educate me. i am so sorry anytime i hear of rapid deterioration. also this might not be the best time to ask questions, you have enough going on so if anyone else feels like wising me up, thank you. i don't know yet how to look up sights.

Hey BC I remembered your post and actually went to the store manager here to request it. I throw um in the freezer to later add to her fruit shakes which she loves.
I also finally talked to her Doc today and he explained to me what was going on. This was long overdue I tell ya, well anyhow guess what no UTI thats right not even a smidge!
She is on a real fast downhill slide the scans show increased deterioration from last time they were done.

Maria, I truely appreciate your explaination. I have had several friends that have been given some sort of antibiotic for upper resperatory infections and then ended up with lower gastric disasters, but as you mentioned, killing off the good , allowed a small amount of the resistant bad to run wild.

Probiotics are little researched, but still documented. BG, remember kefir? Sure, I couldn't get My Mom to drink it, but I have seen capsule form to supplement probiotics, as well as smoothies, that include kefir or active yogurts...that do replace at least some of the good guys, but in a long run, have to be sucked down at least 3 x a week and even better daily.
You whip her up smoothies any way some times , right.? Mom resists, but I can bargain with her. I know your MIL, maybe can't come to bargains. But currently, It would seem we have the nasty choice of UTIs or wiped out good bacteria, of which medical science has done little research.. The good guys get the shaft again, and I really don't mean that to be comical.

I think if research could focus on what is involved with being healthy, instead of what is involved with "curing " an illness, Our LOs and ourselves would be far better.

Back to my old grudge against drug companies. Hate to harp

Thank you Torp and Maria.
Torp I love this idea of yours how you treat mom this is more like what I want to do so when we get the PCP situation settled (changed) I will talk to him/her on this approach.

Maria this explanation is faboo thanks for breaking it down these are things Im slightly aware of but not in such detail. I get frustrated with AB therapy simply because I hate taking them and well you know what the mind does then...it shuts down stubbornness reigns supreme and the info doesnt worm its way into the brain
See now thats why there are friends and family they get in when the reading doesnt! Go figure!

quote:

Originally posted by Bunnys_grl:
This is what Im worried about the killing off of good bacteria or her becoming immune to such a high dose.

BG, I hope I'm not buttin' in here, but maybe I can clarify something here.

From what I've learned, I would say that her becoming immune to the antibiotic is not the issue.

What CAN happen is the bacteria can develop *resistance" to an antibiotic when the dose is insufficient to kill the bacteria; the dosing is inconsistent or incomplete (missed doses, etc.) allowing some bacteria to survive and mutate into resistant forms; or when the antibiotic is inapproriate for the bacteria being treated and that bacteria just goes on it's merry way--while any other bacteria, which are being affected can develop resistance because of improper dosage.

The other concern is overgrowth of other normally present microbes--like cadida albicans (yeast). But this is not caused by resistance or immunity to antibiotics. This happens because the bacteria which are killed off by the antibiotics are often the same guys that would normally be keeping the yeast down to acceptable levels. When those bacteria are over-killed, then the yeast can have full reign.

Is dat clear as mud? I know, it can all be very confusing. Just don't worry about MIL becoming immune to antibiotics. Antibiotics will always work against a properly matched bacteria, if given in appropriate doses, in a consistent manner.

Killing off the good bacteria is definitely a concern. I've only known a few people who were on preventive antibiotics, and none of them were elderly. The problems they complained of were digestive (particularly diarrhea) and various yeast infections (thrush, etc.)

A glass of cranberry juice every day and a high dose vitamin C will help ward off UTI's, but I'd ask the doctor about this before starting her on it. Since Vitamin C is water soluable, the excess above what your body uses is excreted in the urine. C is an acid, so if you can keep the urine fairly acid the bacteria can't grow.

Our LO's PCP has had her doing this to prevent UTI for as long as I can remember. Since she is type II diabetic, and even when healthy wasn't inclined to manage her diet well, she tended to have high sugars in her urine which made the bacteria very happy. Since she started the cranberry and vitamin C regimine, she hasn't had another bladder infection whereas previously it was several a year.

Howdy there Em thanks for the reply sweetie. Now on your moms Bactrim what the Mg's?
MIL's is 100mg that sounds awfully high to me, does this sound about right?
This is what Im worried about the killing off of good bacteria or her becoming immune to such a high dose.
I think this is really about me I never take this stuff without a real good reason. I can count on one hand how many times I have taken an antibiotic and still have fingers left! I dont know maybe thats silly to think this way but I want it or other meds to be able to work and do their job when its really needed not just to be taking it when its not necessary...I guess its back to the ole research trail... EEE gads Im becoming a walking pharmacy for heavens sake. Was that in our job description?!

Hey, BG

Mom's been on a daily low dose of Bactrim since the Winter Of Reoccurring UTIs. Miraculously she hasn't had any since. Don't know whether to chalk it up to the Bactrim or the fact that she now has to be monitored every time she uses the toilet...hmm...

I remember either reading or hearing someplace that long-term use of a preventive antibiotic isn't recommended for anyone because it can eventually kill the "good" bacteria we all have in our systems. Brings me back to the horrid yeast infection I got while I was recovering from bronchitis awhile back I brought this up with Mom's PCP. She said the dose was low enough not to fool around with the good bacteria *shrug* Well, considering that Mom's never had a yeast infection or any recurring UTIs, maybe the doc was right.

I echo what everyone else has said about hydration. That was/is Mom's biggest issue surrounding the UTIs. She dislikes cranberry juice, but will drink tea or ice water if you gently nag her

Good mornin Ladies...Did I expect nothing less?? Nope.
Maria no you cant switch the question Pfftt phone a friend ya killin me

Seriously though...the one point I make with ulcers 2 doctors have told me this over a period of 2 years, dont ask, I cant find anything on it either but I figured they know something I dont and with her history of OTC abuse I figured that had something to do with it too.
I should have given the name and dose so I will now
Trimethoprim 100mg. taken daily

Sorry ladies theres no tp use in this house with her she actually washes after bathrooming.
I believe this latest battle with the UTI is caused by less liquid intake she just doesnt want to anymore no matter how I try to give it to her her appetite is lessening also and I always try to beef that one up with more liquid to begin with.
Fruit shakes hey Im the queen of that in this house Im the fruit collection junkie if its sweet colorful and juicy it goes into the mix try a little coconut milk in one of those tasty little things! Nummmy! Oopps off track.
As far as caffeine Coffee or black/green teas their a no no in this house no soda either. Water, natural juices or Chamomile tea is all she drinks...

Im just concerned at this point anything given unnecessarily will compromise her even more in the long run, if we can clear this one up (hopefully some of the confusion with it) I can get her to drink more... right now its like fighting with a child that knows how to skirt around and dump the liquid when Im not lookin since I can see her output doesnt equal the amounts given at all

Mom was on prophylactic Macrobid for several years (she had an indwelling catheter then) during which time she had many, sometimes virulent, UTIs. So I can't honestly say that I saw that the macrobid helped her - it seems like the only thing it may have done was prevent garden-variety bugs from blooming, but it did nothing for more virulent ones. Finally, I stopped giving it to her since it did not do the job we wanted and I see no reason to give any antibiotic preventativly unless there are other abiding concerns. Since I decided to pull the catheter in Dec. (or rather, not have it reinserted after she removed it!), she has continued to have infections, but the causative agents have been more innocuous. The macrobid might be a good idea to reinstate at this point.

My concerns are forming antibiotic-resistant strains, as EVERYONE should be when using antibiotics!

I, too, don't understand the bleeding ulcer concern with preventive antibiotics. I am not aware that the two things go hand-in-hand...

There is NO MEDICATION which prevents all UTIs since they can be caused by like a zillion common pathogens normally found in the urinary and intestinal tract. IMHO, this is a little like giving routine antibiotics to chickens and cows used for food - the resistances caused by unwarranted antibiotic therapy are proving quite troublesome for infections specialists. There is concern that these antibodies exist in the meat that we eat, over time, causing some antibiotics to be less effective in people who eat the meat...

Since your mom is ambulatory, if her UTIs are caused by common, less virulent bacteria, the macrobid may help her. UTIs are prevalent if:
• one does not consume enough fluids in a regular basis
• one has hygeine difficulties (ie. cannot properly clean oneself after a BM)
• one is "run down" from stress, other problems or lack of sleep
• one does not urinate frequently enough
• one has an indwelling catheter
• one is bedridden and the bladder cannot empty itself fully

If you correct the applicable situations, it should keep those nasty infections to a minimum. Having your mil use antiseptic wipes rather than toilet paper is a GOOD idea! Make sure she is wiping front-to-back to insure she is not bringing bacteria forward to the urethral area.

Good luck!