Massive flare up with 8 weeks till wedding...

[Joe]

Hi all,

About 3 years ago, I had chronic painful epididimus. Went to the doc who told me to fill 3 urine specimen containers. Due to the difficulty of completing this task before running out, I simply squeezed the tip to stop the flow while picking up the 3rd container, so I'd have enough left to fill it. The next day, I had pain in bladder (front of pubic bone). Over the next week it worsened, I had constant spasms (vibrating) all along urethra, and painful to sit, golf ball feeling in perineum and so on, dysfunctional urination (very slow stream, needing to go very often etc.). Saw Uro, 6 weeks norfloxacin + Flomax, no effect. Had cystoscopy, and prostate massage while under anaesthetic. Things seemed to improve a little over the next several weeks following that, and I took the advice of the docs to just try to ignore it. Symptoms never completely resolved, but did improve - I still had painful perineum and I would never even consider going near a bicycle, despite having been a quite serious cyclist in my teens, training up to 400km/week.

Fast forward to last week: Tried doing some gentle stomach muscle exercises (planks), possibly too frequent sexual activity (3 x in 2 days), and took an ssri (escitalopram) tablet (trying to improve PE). The ssri massively flared up my IBS (diarhea), and now I am back to nearly where I was 3 years ago, and only 8 weeks till my wedding!!! Last night, just standing up for 1 hour made the pain in perineum area much worse.

As soon as I noticed a flare up of prostatitis/CPPS/whatever it is, I started taking any accredited quercetin product which I had left over, and Curcumin (Meriva brand, as it has clinically proven bioavailability, and proven anti-inflammatory). Also tried stretching based on HITP. Despite all this, flare-up is worsening rather than improving, and I really don't have time for this. I have just read on someones post here that curcumin can be a bladder irritant? Its so hard to know what to do?? Everything that is meant to help, also might make it worse. I don't want to go on antibiotics again because that will flare up my IBS, and possibly just make it all worse. I don't like taking Flomax, my heart feels weird at night, and I've started feeling sore kidneys area, which maybe is due to Flomax?

The thing is, with the flare up, I get this dysfunctional urination, i.e. slow stream, and occasionally a "flickering" of the stream as if the bladder neck is in spasm. This dysfunctional urination causes urine back up into the prostate (maybe?) causing more inflammation, and the cycle continues. But then again, thats just my guess. Maybe some of you agree/disagree with this opinion.

The thing is, I really need this flare-up to stop ASAP! But what can I do? Should I stop the curcumin, incase its an irritant? Would naproxen/ibuprofen work better? But that also flares up my IBS. I've tried stretching, but maybe that is what was making it worse? I'm not sure if mine is a muscular (ie. CPPS) thing, since it was started by some trauma to the prostate, probably caused urine to back up into the prostate by squeezing tip during urination.

Any advice on how to get over this flare up in less than 8 weeks(!!), or the likely timeframe for resolution if I just wait it out, would be greatly appreciated.

Thanks,
Joe.

[webslave]

Marriage is great, but it also just so happens to be a major stress in life
http://www.stresstips.com/lifeevents.htm

I'd say your current flare is connected to this stress.

The thing is, I really need this flare-up to stop ASAP! But what can I do?

Given your situation, you might try a few benzo weekends.
viewtopic.php?t=1611

[Joe]

Thanks for the reply webslave. Well, this weekend was fairly far removed from a Benzo weekend - dance lessons, shopping for rings, going to the beach, etc. Its difficult because I don't look like theres anything wrong with me, and I can carry on joking, and being fairly normal just trying to ignore the symptoms, and indeed feel that I have to act like theres nothing wrong because its rather embarrassing to talk about, and having this affliction is not an attractive attribute.

Its interesting that there are studies that suggest there is no efficacy of Flomax for chronic prostatitis, but Dr. Shoskes has said on this forum "there are numerous studies showing the efficacy of alpha blockers in prostatitis". Indeed, his any accredited quercetin product FAQ website suggests using both any accredited quercetin product (for pain) and Flomax (for urinary symptoms). So I tried another Flomax tablet, and found that within a matter of hours, my urine stream flow rate was much improved.

My main questions is as follows: Does this tell you something about my condition, the fact that the Flomax worked for the flow rate??

I would like to continue using the Flomax because I fear that the disfunctional urination may be causing reflux of urine into the intraprostatic ducts, causing further irritation/inflammation. But I don't like the reduced blood pressure and feeling that my kidneys don't like it. Do the side effects reduce over time? Is this drug fairly safe, and have no long term side effects? Are there lower doses, or other safer drugs that could do the same? Is Saw Palmetto a herbal supplement with the same effect?

I'm currently sticking to the any accredited quercetin product and will maybe just try the Flomax every second day.

Thanks,
Joe.

[webslave]

If the Flomax helps, continue using it. The biggest/best studies on a-blockers concluded that they are not much better than placebo for CP/CPPS, if memory serves, but if you are having obstructive symptoms that respond, by all means continue. It doesn't offer special insight into your case, unfortunately. It just says that your lower GU tract is somewhat obstructed, probably by inflammation, and that this responds to a-blockers. Yes, Flomax is safe to use, but it does have side effects (use Google). Saw Palmetto is not the same.

Keep up with the any accredited quercetin product too.

[kevkos]

I remember in the weeks/months leading up to getting married. I was a wreck. I didn't have chronic prostatitis / chronic pelvic pain syndrome back then but if I did it would have flared to no end! I'm now divorced and I look back and realize why I was so stressed at the time. I didn't really want to do it. I got married for all the wrong reasons and it took me years to figure out that it wasn't right for me, and especially with the woman I married.

It's sad to me that marriage is such an expected thing in our culture. I can't tell you what I'm going to be like in 10 years, but it's very doubtful that I won't be a much different person than I am today. Now, if two people are able to grow together at a similar rate, it may work out for them. But for the majority, marriages don't work out because they are doomed from the start, when you say you are committing to someone FOR LIFE!

So it is a big huge stressor, and one that unfortunately most people think is just a part of life, when it doesn't need to be. I say if the relationship is working well, why add a marriage to it? If the relationship is not going well, marriage is just going to make things worse.

Anyway, not trying to add more stress to your situation, but just make sure that you are thinking through this stress and where it's coming from. I often use Nathaniel Branden's sentence completion exercises to get to the root of things like this. It's kind of like personal therapy.

[Joe]

Unfortunately I just couldn't tolerate the Flomax - I was completely out of it, couldn't get any work done, kind of dizzy, probably shouldn't have been driving, and so on. Are there any alternatives, because I think it was helping.

How about Allopurinol? What exactly is that. I've read about it a couple of places as recommended for inflammatory cases.

Also, I've read that Quercetin may be cytotoxic in high doses. Any comments?

Kevkos, the only stress right now is whether my marriage will be over before it starts, because of this pelvic BS, but I take your point not to get too stressed out as that could worsen symptoms. I generally know if I'm stressed because my IBS responds sensitively to it before anything else, and I was actually doing really well with that before this prostatitis flare up....

Thanks,
Joe.

[webslave]

There are many different a-blockers besides Flomax. Ask your doctor. Xatral/Uroxatral is an example.

Allopurinol is used to treat gout (high uric acid levels in blood). Not useful for us.

I've read that Quercetin may be cytotoxic in high doses

Where did you read this? What dose are we talking about? Most things, even water, are harmful at high enough intake levels.

[Mike Kavo]

When you are stressed this much "exercise". It will drop the stress I am sure of it.

Find an hour and get on a treadmill and just walk really fast with some relaxation music on until all the stress comes out you (think of nothing just pounding the treadmill). You need to do 30-60 minutes to get it out you I find. 5 minutes stuff is useless. I found a fast walk over a longer time better than running over a short time. Then do stretching (full body NOT just the pelvis) and some resistance training. You would be surprised how this can stop a flare. This is all muscles and nerves and for some reason this breaks flares in me. It is counter intuitive as I used to just try to sit flares out and not do anything that might make it worse - that just drags them on and on.

If really bad I will add a 1 or 2 Tramadol along with this. Benzos do also help in small doses. I would only take one or the other though not together. A-blockers do nothing in me just make things worse by adding odd side effects to the mix.

I now have a treadmill in my office next to my computer now. Walk it off sounds mad but for some reason it works in me! If I feel it coming on BANG on the treadmill. I find this is a more aggressive form of relaxation as when you are really stressed relaxation is very hard to slow down into. But relaxation should also be used as maintenance. Also helps stop you getting fat so happy days all round. ;)

Yeah I had some flare during getting married - you are not alone there! I just grit me teeth and got on with it wish I had known all the exercise stuff then now. In fact tell yourself let's get this done and then I can chill out. These ideas of positive thinking are what you need to spend time thinking about, not how it will ache and hurt during the service etc. No negative thoughts!

I take the point some people get stressed as they do not want to get married but this does not seem the case for you. It is the very nature of wanting the best for your wife that is stressing you. She is marrying you so talk to her about all this let her calm you and reassure you in a way only a woman can. Talk do not bottle it up!

Good luck and all the best for your future life together - do not let pelvic pain rule this life - fight it and manage it and have a great life together!

[Joe]

Thanks guys! I've started walking 20 mins, I find any longer and it can be irritative to everything down there. I absolutely agree, I always used exercise (and racing/competing) as very effective stress relief. With all this though, haven't even considered getting back on a bike (my previous exercise of choice). Exercise flares things up, or at least possibly, its always hard to know with such low number statistics.

As I stated, I couldn't tolerate the Flomax, so I went to see a different GP today who knows a bit about non-bacterial prostatitis, and he suggested Vesicare (anticholinergic) as a replacement for Flomax since I couldn't tolerate it. But this is a different type of drug right? Urinary symptoms are not my main problem - its just pain and muscle spasming all along the urethra from perineum to tip, and a bit of pain in/around pelvic area, painful epididymus etc.. From what I've read, Rapaflo is the only alpha-blocker that is less likely to cause blood pressure problems than Flomax, so thats the one I should try next, right?

He also gave me some celebrex - supposed to cause less gastro side effects than other NSAIDS. So I'll give those a go for a week or so. Are they ok to take with Quercetin??

At least this guy knew about non-bac prostatitis, and he suggested the IBS and prostatitis and PE could all be related to imbalance/instability in the sympathetic/para-sympathetic nervous system.

Still no improvement really... I've been avoiding sex to try to break the flare, but that just can't go on!! Should really be looking forward to the honeymoon, but with this... well, this just has a habit of ruining things that should be the happiest times of my life.

Anyway, any advice on the Rapaflo vs. Flomax blood pressure side effects, and whether vesicare is worth trying, would be appreciated from any of you who know about these things through experience or reading the literature.

And once again, thanks very much for hosting this forum, and for everyone contributing.

Joe.

[webslave]

Vesicare (anticholinergic) as a replacement for Flomax ... this is a different type of drug right?

Yes. Vesicare is a urinary antispasmodic, not an alpha blocker.

Rapaflo is the only alpha-blocker that is less likely to cause blood pressure problems than Flomax, so thats the one I should try next, right?

Rapaflo can cause low blood pressure too. I am not aware of research comparing the two a-blockers, but it may be out there. Use PubMed.

celebrex -... ok to take with Quercetin??

Yes.

[kevkos]

Hey Joe,

I can totally empathize with what you're going through. I'm not sure if this helps but I said I was a nervous wreck before my wedding, but for some reason, the week before all my anxiety vanished! It's like I got to the point of no return but I didn't care anymore! I don't know what it was that led me to this point. But I think this stuff is 95% psychological. Some of it comes down to self-acceptance.

Right now I'm on a roller coaster. I have days where things seem like they are getting MUCH better, then I suddenly get a flare up for several days.

Hopefully you have an understanding and supportive fiance. Hopefully you can find some ways to mentally figure out what it is you are stressing about (yes the wedding, but what exactly is the anxiety from?). Long term you will be much better off to delve into the psychological stuff than to use medication. I'm not against drugs but they are usually short term solutions.

Good luck and keep us informed!