Older newbie

[Clay]

Last March, I was a vigorous 62 year old, playing tennis twice a week, working part time, living a good life. Weren't those the good old days? I got really sick, starting with a 2 week knock-down stomach flu, finally including multiple CTs, biopsies, and a gallon of blood tests. I've been diagnosed with lymphocytic colitis (after a 30 pound weight loss), interstitial lung disease (clearing nicely now), bad liver (better now), muscle spasms, and prostatitis. Almost all the other problems are disappearing and finally allowing me to concentrate on the pelvic pain. I found enough info on the internet about chronic prostatitis / chronic pelvic pain syndrome to realize that what my urologist was telling me didn't really fit the symptoms, and he did recommend I read Headache in the Pelvis. Given my history of panic/anxiety/post traumatic stress, I'm pretty sure this is the right place for me.

So now I'm unemployed, in pain, unable to use NSAIDs (due to the colitis), and my tennis game sucks. I'm so glad to have found you all and the wealth of information collected here.

I have bouts of intense pain in my penis and rectum, and my urine flow is sometimes constricted. I'm on an alpha blocker and Proscar, but I don't know if either is helping. I've found that Xanax helps a lot, and I take hydrocodone as needed. I have a meditation tape and I'm taking a class called Mindfulness. I have a referral to a different urologist that I'm avoiding. I find that sitting immediately worsens my symptoms, especially if my knees are really bent.

I have a few questions I'll put in individual threads, but the most obvious one after reading here for hours is this: Why are you all so young? I've heard that when older men have your symptoms, they are just assumed to have big prostates. Why would whatever happened to you young guys NOT happen to an older man? At a prostate exam last year, I was told my prostate didn't seem overly large. I kinda doubt it just expanded, even if that fits with what the urologist wants.

[webslave]

The peak age for chronic prostatitis / chronic pelvic pain syndrome is around 30-32. I guess you got it because of the abdominal cramping and colitis that led to a guarding and tense pelvic muscle response. The massively escalated anxiety that came with your unwelcome new disease would only have made it worse.

BTW, BPH symptoms are not really like chronic prostatitis / chronic pelvic pain syndrome symptoms, which are much more severe.

There are lots of threads on what to do to help yourself here, so I'll talk about the colitis instead (makes a change ).

Firstly, with your particular form of colitis keep away from (in addition to NSAIDS), antidepressants, ranitidine, carbamazepine, ticlopidine, and flutamide -- all suspected as causes in some cases of LC, although the only report of a rechallenge has been with ranitidine.

Dietarily, avoid caffeine, and, when appropriate, lactose-containing products (if they exacerbate symptoms).

In LC there is a fairly frequent occurrence of spontaneous remission of symptoms, so don't lose hope!

Other treatment is usually with Imodium/Lomotol, then, failing that, with budesonide and bismuth subsalicylate, then steroids, then azathioprine, then surgery.

Example:

One possible treatment algorithm is as follows:

• First line: Loperamide (Imodium AD) or diphoxylate/atropine (Lomotil)
• Second line: Bismuth subsalicylate, three 262 mg tab tid for 1-2 months (effective in up to 90% of patients); mesalamine, 3 g/d for 8 wk; or cholestyramine (especially if bile acid malabsorption is documented), at a mean dose of 8 g/d.
• Third line: If patient is still not responding, a 2-month course of budesonide or a 2-week course of high-dose prednisone (60-80 mg/d) before tapering can be prescribed. Longer courses of budesonide may be beneficial, and, while systemic adverse effects may occur, little or no adrenal suppression should be anticipated. Longer courses of prednisone (up to 2 months before tapering) may be needed in some patients, but recurrence is common after its discontinuation.
• Fourth line: Some refractory cases may benefit from azathioprine (approximately 2 g/kg/d) or 6-mercaptopurine, but responses often take months to occur.
• Patients who respond to treatment, but experience a recurrence, will often respond again to the same previously effective medication.
• Surgical Care: If colitis is refractory to continued medical therapy or if effective medication cannot be tolerated, colectomy or ileostomy might be the only effective therapy; however, this seldom is necessary.

[rider fan]

I've been diagnosed with lymphocytic colitis (after a 30 pound weight loss), interstitial lung disease (clearing nicely now), bad liver (better now), muscle spasms, and prostatitis.

I've had Crohn's disease for years, and even though LC isn't directly related to what I have, I thought I'd let you know about a couple easy tips that have helped me.

I find that paying attention to my intestinal flora helps control my symptoms. So two things I do are:
1) Aviod refined sugars as much as possible. If I indulge in these I'm almost guaranteed to pay for it for days. I also avoid artificial sweeteners.

2) Take a good probiotic every day. The one I take is refrigerated and contains 24 billion active bacteria (supposedly) of a variety of strains.

If your symptoms flare up, careful with prednisone. I try budesonide first.

[scoobysnacks]

were all so young, true, but remember, its not really our prostate, sure it might be irritated, but thats the result of constricted pelvic floor musculature, not the prostate getting enlarged or bad this young.

[webslave]

But the prostate can be and usually is involved, as well as the bladder, and in some cases urethra and testes too.

[LightningTree]

Yeah,

For example, I am usually symptom free due to all of the good relaxation and stretching, except fo this week where I picked up a swollen prostate. That may be because I went back to sitting at a desk eight hours a day. Or maybe I grabbed a virus off of campus.

In any case, I had some urethral stinging this week, as well as prostate swelling (hard to urinate.) Outside of the prostate/bladder, I am absolutely pain free. So sometimes the bladder/prostate link comes in first. Why? Its a mystery. Quercetin might help. I'm going to try that.

I would imagine that for a 60 year old, the prostate is naturally enlarged, so the prostate directed symptoms could be a little more trouble than for younger sufferers such as Scoobie. Proscar should help shrink his prostate.

As for your tennis game, I'm not sure what would help. Perhaps we should ask Connors or Macenroe. Macenroe strikes me as the type to get CPPS!! :)

I think the best thing to do is
1) Try to do meditation twice a day and
2) Stretch before and after your tennis games for 30 minutes. Read AHIP to figure out how to do the stretching and meditation.

Don't let the anxiety wind you up. It makes recovery much easier. I know, easier said than done. Took me over two years.

[Clay]

Thanks for your responses.

Given my recent history of diarrhea and anxiety, I really think I have the same syndrome as everyone else here. It came on abruptly - one week I was a little uncomfortable, the next I was in the emergency room at midnight begging for pain meds. It was mostly in my penis for a couple months, then moved back to my rectum more. It seems to react almost as much to relaxation techniques as to anything else.

I'd still like to know if there is anyone else here over 50!