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Should I do another bladder instill or not??

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  • Should I do another bladder instill or not??

    Hi Gals.
    I am so confused about whether or not to do another bladder instill or not. I had my first one this past Friday and it was a disaster. I had the heperain,marcaine,kennalog,biocarb instill done. Well after holding it for the required 2 hours, I could not pee at all. They had to cath it out. I believe it swelled things up down there and I could not pee. Thank goodness I was able to pee small amounts after they cathed it out, but my stream was so thin and I had to push to get pee out. My stream finally went back to my normal after the next day.
    I am sure I had some reaction to one of the meds used in the instill. I think possibly the marcaine, but not for sure. I felt a little less pain yesterday so wonder if it helped a tiny bit. But I sure dont want to go through all that again with not being able to pee and being cathed. That was sooooo painful. My urethra was in so much pain after that and it felt like I was peeing needles for hours and actually had a tiny bit of blood in my urine.
    They want me to do the instills every Friday for 6 weeks. I am not sure if I should do them again though. I think they would have to omit the marcaine and possibly another drug, but dont know for sure which drug could have swelled me and caused the urine retention. What do you ladies think? I have to call my urogyne, but I hate calling there because I always get a nurse, can never talk directly to the doctor. I dont think she even offers any other treatments really.
    Dont get me wrong, if the instill just did not help, I would do it again in a second, but I had that horrible reaction and could not pee and had more pain immeditely afterwards and all night. Even if I just had pain, I would not mind trying again, but dont want to go through that not being able to pee thing again and having to have the stuff cathed out. That caused me more pain than you can imagine.
    What should I do? WHich drug was the likely culprit? Would it be the marcaine, which numbs everything, the kennalog which is a steroid, the heperain which is a blood thinner, or the biocarb which is an acid reducer I think. I thought maybe it was the marcaine since it numbs stuff and could have numbed my nerves, but I am not sure. The nurse acted like it was not normal for that to happen with me not being able to pee it out. I think maybe it might have helped with the pain after a couple days went by, but not enough for me to have to go through all that again, and maybe it may be worse the second time around who knows. Any suggestions?
    Jen

  • #2
    Jen,

    If I were you, there would be no way in hell I would do that again! If they cant be sure as to what caused your bladder to act that way the why take the chance in doing that again. ya know?? Maybe the other girls will help ya. but I dont think it sounds like a good idea.

    (((HUGS)))
    Rachel
    ***Rachel***

    Dance like no one is watching
    Love like you've never been hurt
    Live today like it's your last

    Dxd with IC in June '06

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    • #3
      The mercaine did nothing for me with pain. That is why I have the lidocaine. Just try one ingredient at a time. If you are fine with it then keep doing the instills and see what happens. That is how I found out just the heparin/lidcaine for me. Trial and error.

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      • #4
        So sorry Jen that it was painful for you. I wish I have an answer for you. Everyone is different, some gets help with it and some don't.

        Just sending hugs, Trishann

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        • #5
          Thanks gals.
          I am really so confused about all this. I feel like maybe the instill did help a little with the pain after the first couple days, but I did not like that immediate reaction I had and not being able to pee. Something definitely did not agree with me in that instill. I could ask the doc if I could try one thing at a time, but even that I am a little leary of. I think the only thing that would really benefit me as far as the meds they use with the instill would be the kenalog(which is a steroid) and maybe the heperain, though I dont see how a blood thinner can help.
          I have to call the nurse sometime tomorrow and I wish I could talk to the doctor. They never let me talk to the doctor, the nurses are always relaying all my messages. I hate that. How am I to know the nurse is telling the doctor everything I want told.
          Thanks again for all the info. I still am at a loss. I need pain relief, and dont think this doc offers anything else other than the instills.
          Jen

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          • #6
            The heparin is supposed to coat the bladder wall. Like the Elmiron would do. Not really sure how it works other then that. Good luck with it next time if you decide to do it. Don't you even get to see the doc when you go there? Maybe make an appointment just to go in and talk with him.

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            • #7
              I agree with Waterflow...I would make an appt with your Dr. to discuss what happened and how to proceed. Like you, I had trouble urinating after the first one, but after that, my Dr. changed the formula and included sterile water in the instill to increase the volume so I could go afterwards. That may be the only tweak you would need. I dont know, but I would discuss your concerns with your Dr. I am sure that he will want to know and can make adjustments that will work for you. We are all so different, and the same formulas that work miracles for one person dont do anything for someone else.

              As for the heparin, it does coat the bladder, but it also helps to thin the walls of the bladder to help the other meds absorb into it. That is why most people get relief from the instills even after they urinate them out...b/c alot of the ingrediants have absorbed into the bladder wall.

              In my case, it took several instills for me to see a noticiable difference day to day. After the first one, like you, I couldnt urinate. After the second, I couldnt hold it for as long as they wanted, but my bladder spasms calmed considerably. But, the next day, they were back. After about 6 treatments, my relief began to last for a few days at a time. That's when I started getting them 3 times a week in the office.

              Now, I do them at home and they are r/xed for me to do every day, but I have to do them every other b/c my urethra gets too irritated if I do them daily. But, I (usually) get several hours of relief from them, even after all this time. But, equally important, since several parts of my bladder lining are damaged, I need something to coat it to help with the pain and to prevent further damage. The heparin does that. Even if the instills quit helping with my pain, I would still do them to prevent further damage to my bladder lining. (I dont take Elmiron or Cytotec, but they also help protect the lining of the bladder.) Some people instill the Elmiron into their bladders for this purpose, since there is some question about the amount that reaches the bladder when Elmiron is taken orally.

              I also like Waterflow's idea of isolating the ingrediants, to see if one of them is causing a problem. You might ask your Uro if that would be possible. IF the heparin was causing you problems, they might switch to instilling Elmiron. If Marcaine caused the problems, they could switch to Lidocaine, etc.

              Utimately, you and your Uro may discuss this and decide to discontinue the instills. But for now, I definately hope you will schedule an appt with your Uro to discuss your concerns.

              Hugs,
              Amy

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              • #8
                Amy, thanks for explaining how the heparin works! I have been wondering how it helps with the pain/peeing. Since the bladder wall is fine now I know it goes through the lining into the nerve part and numbs that up for a while. Thanks for making my life a little bit easier in the mind department.
                Now I will go back and do half in the morning and then half in the evening. It doesn't last long no matter what the amount is. That info really has made it so much easier to understand. Oh, I have sterile water added to mine also. ALways have.
                Last edited by waterflow; 03-27-2007, 02:51 AM. Reason: editing

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                • #9
                  Hi Gals,
                  Thanks Amy and waterflow. As far as getting an appointment to see my doctor, forget it, I cant get in to see her until the end of May,heck I can hardly ever get a chance to talk to her even. I am always talking to a nurse it seems and they converse with the doc back and fourth and relay all the messages. It is ridiculous.
                  I am going to try and call the doctor today and tell the nurse I want to talk to the doctor, but who knows if I will get my request or not. I am really thinking about switching doctors. I talked to a lady who has IC and she is seeing this doctor not to far from where I live, so I am thinking about maybe seeing him. The only bad thing is, it takes forever to get a first apoimtment usually so I may have to stick with my doctor for now.
                  I think the instill did help me some as far as the pain in concerned, as I have felt less pain these last two days. But I was in alot more pain right after the instill, and could not pee. Oh , and what you said Amy about maybe having them add sterile water to make more volume, well I actually drank alot of water an hour after I had the meds put in my bladder and believe me, I had a full bladder, but still could not pee at all after I held the stuff for two hours. To be honest , I did not even feel all that pee in me as I was numb down there. The total instill volume they put in was about 90ccs which is about 3 to 4 ounces I think. Well when they cathed it out, I had about 375ccs of liquid come out, so my bladder was full, I just could not pee.
                  I believe the bladder neck was swollen up somewhat and that is why I could not pee. The reason I say this is because my urine stream when I did finally start to pee was very very thin and that lasted for about a day. On Sunday, my bladder pain was less though, so I figure it must be the instill helping somewhat. I just wish I knew which med was helping and which one was the one that swelled me up and made it where I could not pee at all.
                  I still feel somewhat swollen inside though. Last night I peed like 15oz out in the middle of the night which is really odd for me. I never could go that much in one sitting. Dont know if that is a coencidence or not. But I do feel like when I pee, especially in the middle of the night or in the morning, my stream is weak and is always starting and stopping. I just dont get it.
                  I will try and cal the doc today and see if I can talk to her. Thanks for the replies.
                  Do you think it would be fine to ask the doc of I could use just the kenalog(steroid) and the heperain in the instill and just omit the marcaine and biocarbonate?
                  Jen

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                  • #10
                    I have heard of ICers being sensitive to the bicarbonate and using sterile water instead. You might ask your doctor about trying that.

                    Donna
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                    • #11
                      The bicarbonate made my pain worse big time but I still tried it for 3 weeks in a row. you need something added for pain I would think and the only thing I know of the marcaine or lidocaine. Amy might have a better idea since she seems to be very good at knowing things. If you can't get to see the doc hardly at all maybe a new doc would be the way to go. My uro I can see anytime I want as long as he is in the office. Mondays and Fridays he works at the hospitals. When I first went one of the woman who worked the phones hated me. One time I went to see uro I heard her tell him to tell me to stop calling. I was calling to much for her. Next time I went she was gone. Some who work the phones think they run the place and doctors won't know unless they are told.

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                      • #12
                        Hi waterflow.
                        I actually think the marcaine may have been one of the meds that caused me to swell and not be able to pee. I am not sure on this, but I was thinking since it numbed me so much to the point where I could not even feel anything, maybe that is why I could not pee at all. I am not sure though, as it could have been any of the drugs I suppose.

                        I called the doctor and she is suppose to call me later today(I hope). I am not sure what to do though. I think maybe something in the instill helped me a little as today and yesterday I have felt less pain, but also one of the meds I did react to since I could not pee, and I dont want to go through that again as being cathed was EXTREMELY painful for me.

                        I am trying to go over in my head what could have caused me to not pee and swell me up. I may be wrong, but maybe it was the marcaine or biocarbonate or maybe even the heperain. I dont think the kenalog would have caused the reaction since it is a steroid which is suppose to be an anti-inflmmatory drug, but I just dont know. I was thinking of asking the doc if I should just have the steroid put in, but not sure if that is the way to go. This is so frustrating to say the least. My pain is coming back now, and I have no clue on what I am going to do or if she even has any treatment options left.

                        I am really getting depressed as I know that there is no other help out there for this disease other than these instills. I mean I cant even get any meds for pain, and even with those meds, they will not heal the bladder at all, just help with the pain, but the bladder damage will just get worse and worse in time, or at least that is what the one doc I saw before said. He said that without the instills I would just get worse ans worse until my bladder shrinks. This is depressing. Thanks for listening.
                        Jen

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                        • #13
                          That doc who told you, you will get worse with time (even with the instills) is wrong! Yes, some people do (and I am one of them) but lots of people do get better or stay the same. Don't let what he said throw you off the instills. That is a dumb thing to tell someone. I suppose diabetics should just stop doing their insulin?? You might be better off finding another doc. After what I went through with some I know now I should have been more demanding and not trying to be the nice little patient. I did have a go around with my uro about pain meds but after asking and asking and a few other things he finally did give them to me. I am his only patient who has pain meds. I'm his only IC patient as well. It seems I am the only IC person in my city. Think you need a long talk with your doctor to help ease your mind and questions. Getting the right instill combo can be a hard long road but if it helps (which it does with me) it is time well spent.

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                          • #14
                            I actually dont see that doctor anymore who said IC will get worse if not treated.
                            I am on my third doctor now as it is. There are not many good doctors in Chicago I guess that know anything about IC.
                            As far as the instills, well if if were not for the fact that the stuff swelled me up and I could not pee, I would probably not have an issue with trying it again, but that was just to much pain and to scary to go through again in my opinion.
                            If the doc could tell me which med was the likely culprit, then I would try the instill again, omitting the bad drug. But I dont think she will know which one caused me to have that reaction. I may not be able to do the instills again and in that case, there really is no other treatment that works or at least that is what I was told.
                            I do seem to be getting worse and worse as time goes on. When this all started in May of last year, it started off like a bad UTI and then went away for about 4 months then BAM, it came back and worse. Well, I had a regular cystoscopy done in December and was Dx with IC. Well even since December, I have gotten steadily worse and worse it seems. So I believe I will just get worse if I dont get any treatment. This is what is scary. I think it is likely all autoimmune related. I wonder if oral steroids would help. Thanks for the reply Waoterflow. I will keep you updated on what my doctor has to say or offer when I talk to her today, that is if she calls me back.
                            Jen

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                            • #15
                              Have you tried any of the pills? THere is more then just the instills. I take 4 cystoprotrek, 100 mgs. of hydryzine at bedtime, have the tens 24/7, heparin/lido instills once a week and now the vicodine. How about the prelief? That helped me for a while.

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