walking infection?

[jay]

hi,

i am 38 years old and went to the doctor today because I have had burning
when I urinate,dribbles,dont feel like I finish,heavy feeling from belly
button to top of right leg and pain from my right side.doctor checked my
urine sample and saw no bacteria.when he checked my prostate and pushed
slightly I was sure I was gonna hit the ceiling.he said I might have a
prostate infection and gave me levequin to take for 14 days.
i also have an ear infection.
hell I feel like a walking infection.
any advise would be great!
does this sound like a prostate infection?
i had the same thing about 4 months ago wich went away after taking Cipro.
thanks,
jay

[alprost]

doctor checked my urine sample and saw no bacteria.

There is disagreement on the significace of Urine testing in relation to prostatitis. Some experts state that prostate infections are always accompanied by a urine infection, others (and I think Dr Shoskes may be one of them) disagree.

when he checked my prostate and pushed slightly I was sure I was gonna hit the ceiling.

Been there!

does this sound like a prostate infection?

Possibly, but impossible to state for definate in the internet. You need to see a Urologist and have further tests done to give you a definate diagnosis.

i had the same thing about 4 months ago wich went away after taking Cipro.

Prostate infections can be very successfuly treated by drugs like Cipro, but research shows that around 40% of patients have a reccurrence in the first year, so you may be one of unlucky ones - You probably need to get your Uro to perform more tests to let you know exactly what is going on.

Whatever you do, you need to keep your symptoms under control to prevent the development of muscle spasm and chronic pelvic pain - That is what most of us on this board suffer from.

[jay]

thanks for the reply!
i have not been to a uro.
my regular doctor said he would send me if the levequin did not work or if the condition comes back.
this is only third day on levequin so its to early to tell.
jay

[alprost]

thanks for the reply!

No worries.

Just a point - most experts DO agree that you should be treated for 28 days with antibiotics as opposed to 2 weeks to prevent reccurnce(if indeed you are one of the small number of patients who have an infection). You might want to discuss this with your Dr.

[Pharaoh]

I have seen several sources that now treat acute prostatitis for at least 6-7 werks to prevent chronic developments. I had an acute prostatitis which was treated with 4 weeks of ABX which cleared to only return after 1 year. In hindsight I wish I had extended the ABX therapy for another 3 weeks.

[TK]

Jay,

This is very important:

Chances are your doctor meant to say "Prostatitis" as opposed to "Prostate Infection". "Prostatitis" -- and the urinary symptoms you described -- is commonly caused by other things other than infections. And based on what you tell us, your Doctor would have had no reason to use the word "infection" in the strict sense.

(I personally experienced symptoms very close to what you describe, and my condition was caused by pelvic floor muscle spasms)

The fact that antibiotics give you symptomatic relief does not mean that the antibiotics are necesssarily fighting an infection. Levaquin and other antibiotics function as powerful anti-inflammatories and inflammation is an important part of the condition you describe.

Also understand that you are in the intial stages of your condition. You condition is not Chronic. In many people, the initial condition slowly resolves on it's own (with perhaps a little help from the anti-inflammatory "antibiotics"). But for many of us, this first early experience was a kind of warning that we had a predisposition to hold tension in our pelvic muscles (Note that you would not neceassarily be aware of this tendancy, even if you were an otherwise physically active person). So if you learn about these things, do some gentle stretches and relaxation techniques, this may help you get better now AND spare you a much more difficult experience years later.

Jay, if you walk with a long stride, or otherwise (GENTLY!) stretch your upper leg / inner thigh muscles, do you experience a degree of relief?

This material will help you :
viewtopic.php?p=5242
viewtopic.php?p=5332

Good luck!

[alprost]

The fact that antibiotics give you symptomatic relief does not mean that the antibiotics are necesssarily fighting an infection. Levaquin and other antibiotics function as powerful anti-inflammatories .

There are actually 3 possible reasons, documented by scientific reseach, why someone may initially improve on ABX:
- Placebo effect.
- Anti-inflammatory effect.
- In those patients who DO have an infection, they DO have antibacterial effects.

Of course, the vast majority of patients DO NOT respond to ABX, and no one should take them for their anti-inflammatory or placebo effects. But, a small proportion of patients DO have an infection and DO need to take them.

Unless they have had a full Urological exam and inform us of the results, there is no way of us knowing why ABX are helping them - hence my advice that this individual should get a referral to a Uro.

and inflammation is an important part of the condition you describe.

Most (> 95%) chronic prostatitis / chronic pelvic pain syndrome patients don't have significant inflammation in their prostates.

But for many of us, this first early experience was a kind of warning that we had a predisposition to hold tension in our pelvic muscles

Again, this is only one possible factor which may lead the the development of CPPS, although I agree with you it is likely to be the cause in the vast majority of cases. BUT WE CANNOT JUST ASSUME THAT THIS IS THE CAUSE IN EVRYONE UNTILL THEY HAVE BEEN EXAMINED.

Moreover, Jerome Weiss, Rodney Anderson, David Wise and 2 seperate pelvic pain physios I have seen personally state that infection IS an initiating event in a small number of patients - the only way to know what is causing someones symptoms is to have a full diagnostic evaluation.

I fully agree with the position of this website that we should not allow any discussion in relation to whether or not chronic prostatitis / chronic pelvic pain syndrome is a bacterial condition - research has proved that this is clearly not the case and debating the issue is pointless (actually, the research is so clear on this issue that there is nothing to debate).

However, I beleive it is harmful not to acknlowedge the scientific fact that bacterial prostatitis DOES occur in a small proportion of patients, and, if it is NOT correctly treated, the protective muscle spasm which may result can overwork the muscle (much in the same way as chronically tensing the muscle uncounciuosly does), and lead to the development of trigger points and CPPS. Physiotherapist Rhonda Korarinos, who served as a consultant to the Stanford Book, cites the following example of how infection may initiate (but NOT cause) IC and pelvic pain in some patients:

A patient who has never had any symptoms before develops an awful bladder infection, culture positive. She is treated with antibiotics, as she should be. Symptoms are, as we all know, frequency, urgency and pain on urination. Maybe the first round of antibiotics does not help, so she goes on a second round. They work. But she has now walked around for 2, maybe 3 weeks with horrible symptoms. Her pelvic floor would be working very hard to turn off the constant sense of urge. This could create overload in the pelvic floor. A trigger point develops, that can now cause a referral of symptoms back to her bladder, making her think she still has a bladder infection. Her cultures are negative..

I'm not being controversial here. If you look at the 'Leading Definition' on this website you will see a variety of potential initiating factors listed, including prostatitis. Link: https://ucpps.men/pelvi ... pathy.html

I beleive, thanks to patients, discussion forums such as this one, and a few leading reserchers, that we are at the crossroads in our ability to understand and recover from these conditions, and that it is improtant to acknowledge that chronic prostatitis / chronic pelvic pain syndrome has multiple causes.

If we don't, and refuse to acknowledge that infection is a reality for a small number of petients, there is a very real danger that we 'throw the baby out with the bathwater', and that this will ultimately have the potential to harm some patients.

[webslave]

Most (> 95%) chronic prostatitis / chronic pelvic pain syndrome patients don't have significant inflammation in their prostates.

That depends on what markers you look at. If you look at subtle markers of inflammation, like cytokines, rather than WBCs, then inflammation is actually the norm. This is because nerves cause mast cells to degranulate in the prostate/bladder/urethra/even testicles.

Moreover, Jerome Weiss, Rodney Anderson, David Wise and 2 seperate pelvic pain physios I have seen personally state that infection IS an initiating event in a small number of patients - the only way to know what is causing someones symptoms is to have a full diagnostic evaluation.

That's true, and this poster, with his ear infection and recurrent prostate problem should definitely be checked out by a uro.

[alprost]

That depends on what markers you look at. If you look at subtle markers of inflammation, like cytokines, rather than WBCs, then inflammation is actually the norm. This is because nerves cause mast cells to degranulate in the prostate/bladder/urethra/even testicles.

Yeah, I agree.

[TK]

Alprost's broader points are well taken:

...it is improtant to acknowledge that chronic prostatitis / chronic pelvic pain syndrome has multiple causes.

If we don't, and refuse to acknowledge that infection is a reality for a small number of petients, there is a very real danger that we 'throw the baby out with the bathwater', and that this will ultimately have the potential to harm some patients.

But in regard to my own reply to Jay, I must reiterate:

I have never and would never deny that infection is a factor in some small set (let's say 5-10%) of chronic prostatitis / chronic pelvic pain syndrome cases and perhaps even a greater proportion of cases in the "initial, pre-chronic phase". My question to Jay was whether or not his physician intended the word "infection" in the strict sense or in the looser, longstanding traditional sense that "prostatitis = infection"; also "anything-that-can-be-treated-with-antibiotics = infection".

My reply also included this statement, [via a link]

If you read this forum in its entirety, you will find a number of cases where people who DID have some of the hallmarks of a bacterial infection were advised to pursue appropriate diagnosis and treatment.

My advice is and remains that newcomers not ASSUME infection (as many do, for reasons we all understand) -- not that anyone deny the possibility of infection.

From another recent post,

.., it makes sense for everyone to start with basic cultures for the pathogens that are associated with the 5-8% (chronic bacterial cases)...

If you do get negative cultures, It's backwards and counterproductive to keep searching for the highly unlikely, "mystery bacteria" before you have investigated the far more likely (and definitely treatable!) pelvic floor / inflammatory disorder.

The quote goes on to address the difficult question: given what we have read about difficulty of obtaining the most optimal tests... and the questions that remain even after we obtain these tests, how far should we go in continuing to pursue "the mystery bacteria"?

The full post:
viewtopic.php?p=5392#5392

I do accept Alprost's point that it may be incorrect to state that most bacterial cases are accompannied by UTI's or some other indication of infection. If indeed, Dr. Shoskes would agree that this is not an accurate statement, than I will try to clarify introductory "Sticky" posts.

Not long ago, I received a private message from one longtime forum member who was quite helpful and entirely correct in cautioning me about using language that might overstate the promise of the "PM / anti-inflammatory" approach.

He began by explaining that, in this instance, he used the private message system in order to avoid introducing confusion into otherwise good advice to a newcomer. The private messaging system is one way to handle these discussion. Another way is to begin a thread that is clearly separate-- particularly when the original thread is a current query from a newbie.

I have enormous respect for Alprost's contributions -- past and present.

But I will ask others to judge for themselves:

If you read this post in it's entirety... with multiple quotes of my own statements you get the cumulative impression that "this TK is some kind of an idealogue" and the advice to Jay was potentially misleading or harmful?

Bear in mind that Jay is already being treated with Quinolones by a physician who would seem to be of the traditional school. I did not suggest that Jay stop taking the antibiotics, but in fact suggested that conditions such as his (early "prostatitis" for lack of better description) often clear up with a little help from the antibiotics. I also pointed out that the antibiotics do function as anti-inflammatories so that he would not make the common mistake of assuming that response to antibiotics is by itself, a sure indication of infection.

And I now stand corrected: I might have mentioned that, yes indeed, Antibiotics do also function as antibiotics in the presence of susceptible bacterial. Sorry Jay, apologies for my sloppy assumption that you were aware of this! I will include it in all of my posts. (Webslave will be delighted to know that I have found a way for my lengthy posts to chew up even more server space)

I have X hours to contribute to this forum and I find myself several putting in several times that because:

1) I cannot stand the idea that someone will suffer as many of us have, just because we did not have access to good information, in context.

2) I understand that others have assumed this active role before; but we can sustain this only so long. Now it's my turn to make a contribution.

I am going to continue to do this as long as I can and as carefully and as accurately as I can. And if anybody has constructive objections to the information that I provide, I will surely take this into account. But I will be damned if I am going to spend one more minute addressing the implication that I am some kind of idealogue.

So those of you who want a debating society*, count me out. I am not going to answer you! My time in future will be spent helping those who need it most -- the new arrivals.

*This is not addressed to Alprost, who has ALWAYS been constructive. I am sure that you did not intend this as an "attack" of any sort and I regret that I must answer here -- not to answer you personally -- but to make sure that my daily work here is not undercut by the notion that I am an idealogue.

Jay, you were already aware that infection was a possibility; You are already receiving treatment for this, and previous posts had provided good advice in this respect .If I previously failed to vigorously second Alprost's sound advice, let me now agree that the best next step is to see a good Uro and try to get appropriate testing.

But since you'd already got solid information about this, my earlier reply was intended to offer you some additional word about another set of real possibilities--inflammation and muscle tension disorder. (Incidentally, I would entirely agree with everything that Alprost wrote about this)

Good luck!

[webslave]

Points well taken, TK. Both you and alprost are valued members here. This is a complex topic, and it's easy to get confused (I frequently do), or neglect to mention every possibility when answering a post. I still think we're doing a better job of advising newcomers than 95+% of urologists in this regard

[DX]

I have to say that some logic is lost in long discussions about effectiveness of antibiotics. The facts from the research:
There is a small percentage of bacterial cases of pelvic pain. These should be addressed accordingly. However, numerous studies proved that there is no statistical difference between placebo and antibiotics when cultures are negative. I have never seen TK argue with that.

Alprost says:
However, I beleive it is harmful not to acknlowedge the scientific fact that bacterial prostatitis DOES occur in a small proportion of patients, and, if it is NOT correctly treated, the protective muscle spasm which may result can overwork the muscle (much in the same way as chronically tensing the muscle uncounciuosly does), and lead to the development of trigger points and CPPS. Physiotherapist Rhonda Korarinos, who served as a consultant to the Stanford Book, cites the following example of how infection may initiate (but NOT cause) IC and pelvic pain in some patients:

Quote:
A patient who has never had any symptoms before develops an awful bladder infection, culture positive. She is treated with antibiotics, as she should be. Symptoms are, as we all know, frequency, urgency and pain on urination. Maybe the first round of antibiotics does not help, so she goes on a second round. They work. But she has now walked around for 2, maybe 3 weeks with horrible symptoms. Her pelvic floor would be working very hard to turn off the constant sense of urge. This could create overload in the pelvic floor. A trigger point develops, that can now cause a referral of symptoms back to her bladder, making her think she still has a bladder infection. Her cultures are negative..

Notice that it says culture positive in Rhonda Kotarinos's quote. So the first line of action should be seeing urologist, but if the culture is negative antibiotics are not likely to help with pain according to research. Isn't getting rid of the pain supposed to be the final objective. Antibiotics could have many different effects on my body, but I only care about two.

IF MY CULTURES ARE NEGATIVE
Q1: Can they help with my pain?
A1:No statistical difference between placebo and antibiotics
Q2:Can they harm me?
A2: There are potential side effects.

In the context of the two questions above there is an easy way to tell if antibiotics have some effects beyond their antibacterial effects when it come to THIS DISORDER - Read the numerous studies of antibiotics in culture negative pelvic pain. We all know what they say.
On the other hand if the muscle tension is there - it is not the most important thing for me as the sufferer how it came to be as long as I can be helped by relaxation and PT and the pain stays away. There is no way to tell if the tension is there, but to try the physical therapy/relaxation for few months. I am certainly not an idealogue and I know TK is not an idealogue. I must admit that it's much easier for me to think logically about this since my pain diminished significantly over the last 4 1/2 months of Stanford/Wise-Anderson Protocol.

I am not a doctor and don't have any medical training

[webslave]

IF MY CULTURES ARE NEGATIVE
Q1: Can they help with my pain?
A1:No statistical difference between placebo and antibiotics

In absolute terms, that's correct. However, the key study in this regard did show an initial improvement over placebo. This improvement faded with time and eventually was no better than placebo. So in the end, it all comes out in the wash, as far as antibiotics go. This tallies with what we have seen umpteen times on the various newsgroups, where posters will report initially feeling better with antibiotics but that they eventually "stop working".

The usual response to this is: "My bacteria are now resistant to antibiotics!!"

[jay]

i am on day three of levequin
symptoms getting worse not better.
my ear infection and runny nose turned into a cough today that I could hardly stop and has lasted all day.
while driving home for lunch I coughed and felt a terrible pain on the right side of my belly from the top of my penis to the right hip bone.all afternoon I felt uncomfortable there and seemed to help to apply pressure with my hand when I coughed.i also have on and off penis pain this afternoon like someone sqeezing the end of it.while home at lunch I dug up some samples of celebrex and skelaxin I had from shoulder injury a couple months ago.i took one celebrex wich may have helped a little(not a lot). are either one of these good for the discomfort?
i feel like I'm rambling but between the clogged ear,stuffy nose,cough and this dam pelvic and penis pain I can hardly think straight.
it might help to mention I do have a weird feeling that I have never noticed before in the spot between my penis and my arse.its like a twinge every now and then.
i am confused about all this.
i was thinking I would give the levequin a couple more days. I keep hoping each morning I wake up I will feel better.
thanks for all your help.any other suggestions or comments I would like to know.
jay

[TK]

Jay,

What I am telling you now is just meant to help you find some immediate relief and perhaps even a way to moderate your symptoms over coming days. As long as you are careful, this can only help you.

For now, try lying in bed on your back. First relax for a short period. Then, spreading your legs apart, just stretching GENTLY so that you feel just a little bit of pull on your thigh muscles. Hold that GENTLE stretch for a count of 20, then relax. (If at any point in this process, you feel any kind of pronounced pain, please stop immediately. I don't expect this will happen, but must mention this as a precaution)

Lying in the same position, legs spread gently apart: press GENTLY on the muscles of your upper leg /inner thigh. Press gently and in various places. Begin with very little pressure. If you are familiar with the techniques of what is called "shiatzu" -- japanese acupressure massage -- that is what you are trying to do. But you don't need to know shiatzu. Just press VERY GENTLY, and then release. Close your eyes and "feel" what's happening. If you do it gently, you will feel a kind of relief. This may be the tension in your pelvic floor muscles just letting up a bit.

Try to imagine a muscle that looks like a "hammock" underneath your perineum. Relax your whole body. Just let your limbs get heavy. Try and get yourself into that state that exists just before you fall asleep. In that relaxed state, imagine that "hammock" dropping down, going slack. Envision this in your mind's eye.

Use any technique that you have learned in the past to get into a relaxed state. If you have a sound recording that ever worked for you that way, use it!

I know that some of this stuff may sound "flakey" to some people. Just suspend your disbelief for now and really give yourself over to the gentle stretches and the relaxation. You may be surprised at how much this can help you!

it might help to mention I do have a weird feeling that I have never noticed before in the spot between my penis and my arse.its like a twinge every now and then.

I couldn't say for sure, Jay, but this sounds a lot like my own experience of pelvic floor muscle spasm. Understand that you should still get basic tests as per Alprost's advice. I am not speaking of "causes" here. Just trying to help you make sense out of what you may be feeling.

Emotionally, try to understand that many have been where you are now and they have gotten better. You can too. Tomorrow very well may be better, but try hard not to pin your hopes on instant improvement. We all have different ways of approaching this, but I think that most people who have found their way forward would tell you that "slow and steady" is the way to go.

Please keep us all posted as to how you are feeling.

Hang in there!