I am trying to understand what is happening with my response to instillations, so I can decide what to do. (although I'm beginning to become aware that trying to making sense of this condition may be a futile endeavor
)
I was diagnosed mid-July after a week and a half of symptoms, and one of the diagnostic tools used was the anasthetic challenge. I responded within minutes, with a significant decrease in discomfort.
After that, I received 5 more instillations of the same recipe (heparin, lidocaine and sodium bicarb) on a weekly basis. With each one, my number of good days increased, and the symptoms were less severe when they returned. Between the 4rth and 6th, I went for 9 completely symptom free days! I was struggling right after each one a bit more each time-with urethral burning or burning after releasing the instillation. I was willing to put up with that because the trend of getting better was so clear.
My doctor told me that he usually only gives 4 to his patients, and that after that they are carried on Elmiron and Hydroxyzine (which I started about 3 weeks ago), and suggested I stop having them weekly and just go in when I'm in a flare.
Anyway-(and I'm finally coming to the point) I haven't had an instillation in almost three weeks, and my trend line of improvement seems to have reversed. Less and less symptom free or mild symptom time, and the symptoms are more like in the beginning when they return. I've had two incidents over the past week during which the symptoms increased dramtically and suddenly to pre-treatment levels. The first time they subsided just as dramatically after 12 hours. The second time started Friday evening, and is still going on.
So, I'm trying to understand what is happening. Am I just having those mysterious flares (for no reason-I'm still on the elimination diet and have been since diagnosis), or is it possible the bladder coating the instillations were providing has already washed away? Does that even happen? Is this prognostically significant-I mean if the bladder coating washed away so quickly, does that mean I'm sicker than I thought-or that the Elmiron won't stick too? My doctor says there is no evidence to support continued use after the initial 4 nor is there any to support not using them, and he is willing to let me call the shots on it. He did say I need to consider the fact that I'm struggling with them afterward.
Does anyone have any experiences that would help me make sense of this?
Thanks, and I apologize for the massive information overload. I never know what is important and what isn't!
Debbie

I was diagnosed mid-July after a week and a half of symptoms, and one of the diagnostic tools used was the anasthetic challenge. I responded within minutes, with a significant decrease in discomfort.
After that, I received 5 more instillations of the same recipe (heparin, lidocaine and sodium bicarb) on a weekly basis. With each one, my number of good days increased, and the symptoms were less severe when they returned. Between the 4rth and 6th, I went for 9 completely symptom free days! I was struggling right after each one a bit more each time-with urethral burning or burning after releasing the instillation. I was willing to put up with that because the trend of getting better was so clear.
My doctor told me that he usually only gives 4 to his patients, and that after that they are carried on Elmiron and Hydroxyzine (which I started about 3 weeks ago), and suggested I stop having them weekly and just go in when I'm in a flare.
Anyway-(and I'm finally coming to the point) I haven't had an instillation in almost three weeks, and my trend line of improvement seems to have reversed. Less and less symptom free or mild symptom time, and the symptoms are more like in the beginning when they return. I've had two incidents over the past week during which the symptoms increased dramtically and suddenly to pre-treatment levels. The first time they subsided just as dramatically after 12 hours. The second time started Friday evening, and is still going on.
So, I'm trying to understand what is happening. Am I just having those mysterious flares (for no reason-I'm still on the elimination diet and have been since diagnosis), or is it possible the bladder coating the instillations were providing has already washed away? Does that even happen? Is this prognostically significant-I mean if the bladder coating washed away so quickly, does that mean I'm sicker than I thought-or that the Elmiron won't stick too? My doctor says there is no evidence to support continued use after the initial 4 nor is there any to support not using them, and he is willing to let me call the shots on it. He did say I need to consider the fact that I'm struggling with them afterward.
Does anyone have any experiences that would help me make sense of this?
Thanks, and I apologize for the massive information overload. I never know what is important and what isn't!
Debbie
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