IC Disease

Here are a few posts for this week’s edition of IC Disease in the News. 

Holistic Interventions Protocol for Interstitial Cystitis Symptom Control: A Case Study

Interstitial cystitis (IC) is a disabling bladder disorder that leads patients on an endless journey in search of treatment options to control their painful symptoms. Although there are some medical treatments available, no one treatment is completely effective. The Neuman model provides the rationale for the use of holistic prevention interventions with IC patients. Holistic interventions can help IC patients to retain, attain, and maintain system stability. A case study of 1 IC patient, who successfully used holistic approaches to achieve system stability, is described.

Nursing Center

Feline urinary infection not contagious for humans

I have a 5-year-old calico cat of mixed origin that has been exceedingly healthy all of her life until the past six months. During this period she’s had three bouts of urinary cystitis where she frequently strains to urinate and often passes a little blood tinged-urine (in the bath tub, no less). Each time my vet has dispensed antibiotic drops for me to give her and it clears up in about a week. Here’s the kicker — I’ve been diagnosed with interstitial cystitis (my urologist’s words). My question for you; is it conceivable that this condition is contagious between cats and humans?

Edmond Sun

Stress Urinary Incontinence: An Overview of Diagnosis and Treatment Options

Giving birth is known to create risk for various degrees of urinary incontinence (UI) at any time after the birth. Environmental and genetic factors predispose many women to pelvic floor disorders. When a woman determines she is incontinent and has approached her provider, she will need an accurate, proper diagnosis and then consider a selected course of treatment. It is imperative that she is informed of all choices so she can choose the treatment with which she is most comfortable, fits her lifestyle, and will improve her quality of life. Key Words: Urinary incontinence, conservative treatment, pelvic floor exercises, Kegel exercises, surgical treatment, tension-free vaginal tape.

Red Orbit

I have been a regular contributor to the How to Cope with Pain’s monthly Pain Blog Carnival with my other website, Fighting Fatigue.  This month I submitted a post from IC Disease as part of the carnival.  If you would like to view all of the submissions for the How to Cope with Pain blog carnival, click here. 

If you would like to be a part of the How to Cope with Pain blog carnival, you can send your submission in here.  The deadline to submit posts for the August pain blog carnival is August 22nd.

I recently read a really good article that IC patients have a particular “posture”. The article talked about how the ongoing bladder inflammation affects surrounding muscles, larger muscle groups in the body and the postural muscles. The author of the article who talks about the “IC posture” has been a support group leader and she provided some interesting information on Interstitial Cystitis that I had never heard about before.

She says that people with IC have tight hip flexors. These are the muscles that are in the front of the hips. Many IC patients also have tight hamstring muscles. The hamstrings are the large muscles in the back of the legs. Because of these tight hamstrings, the person’s body weight falls into their heels.

When this happens, the rib cage can collapse and leave little support for the head. What compounds this problem is the shortening of the rectus abdominus, which basically runs from the pubic bone (in front of the bladder) to the upper ribs near the diaphram.

When these areas, or muscles are tight and short, standing, walking, lifting, climbing stairs and sitting can be very difficult. The bladder may cause this compromise, but the bladder is also affected by this compromise. When we cannot use our muscles properly, we compensate and often injure ourselves.

Gaye suggests that strengthening, stretching and good body mechanics are needed in order for the IC patient to get relief from the typical IC pain pattern.

Tomorrow Part 2 will include more on needed exercises to treat the “IC posture”.

Back in the beginning of July, drug safety officials imposed the government’s most urgent safety warning on Cipro and similar antibiotics. Officials stated that evidence may lead to tendon ruptures, a serious injury that can leave patients incapacitated and needing extensive surgery. The FDA has ordered the makers of fluoroquinolone drugs (which are a potent form of antibacterial drugs) to add a “black box” warning to their products. They have also been told they need to develop updated literature for their patients that emphasize the risks.

Scientists aren’t sure why the injury to tendons happens with Cipro-type antibiotic use and the risk is tendon ruptures is highly unusual. However, the FDA officials stressed that many of the serious injuries appear to be preventable if patients stop taking the drug at the first sign of pain or swelling in a tendon, call their doctor, and switch to another antibiotic.

The two drugs listed under the warning are Cipro, made by Bayer, and Levaquin, which is made by Ortho-McNeil. Cipro is often used to treat urinary tract infections and Levaquin is often used to treat respiratory infections.

While the FDA officials said that they received “several hundred reports” of tendon ruptures, they would not cite a specific number. The manufacturers of these drugs said that tendon ruptures are a rare side effect but they are complying with the FDA order. The tendon ruptures have been found to be more prevalent in people over 60 years of age who are using these drugs.

Who would have ever thought that the urge or need to pee too much would mess with the mind?  But experiments with rats with overactive bladders shows just that - the need to urinate too frequently changes the brain’s activity.  If researchers find that it is the same for humans as it is for rats, this change in brain activity could explain the disrupted sleep, concentration and confusion problems.

Rita Valentino, a neuroscientist at the Children’s Hospital in Philadelphia, PA says:

“If you have an overactive bladder, you don’t just have a bladder problem. It has neurobehavioural consequences.”

It is believed that approximately 17% of the population have overactive bladder disorder. In people who have this disorder, they have the frequent need to urinate due to uncontrollable bladder contractions.

The study is the first to show that a bladder disorder can have a direct effect on brain function. “This helps complete the puzzle of why overactive bladder symptoms are so disruptive to quality of life,” says Craig Comiter, a urologist at Stanford University School of Medicine in California.

To read more, click here.

Today is not a good day for me at all. I was taking my shower this morning and when I squatted down to pick up my towel that fell I threw my back out. The pain is terrible. I have been under some stress lately so whenever I’m stressed out it seems to settle in my back - weird.

What is really bad about my back going out is we have an event this weekend where I will be on my feet most of the time. When my back goes out I can’t walk very well and I can’t stand for more than a minute or two. This ought to be interesting. It seems like when one thing goes wrong everything does.

Fortunately my IC is not acting up today so I don’t have that pain on top of my back pain. Listen to the Bad Day video above. I thought it was fitting for the day I’m having. Have a nice weekend!

While we might not find a lot of information about IC Disease on the Internet, there is plenty of  Interstitial Cystitis research going on.  The Interstitial Cystitis Association provides as part of their monthly newsletter the latest IC research highlights.  Here are some excerpts from the latest research that is going on in the world of IC Disease!  Thanks Interstitial Cystitis Association for all of your hard work and for this information.

Four Urine Proteins May Mark IC
Canter MP, Graham CA, Heit MH, Blackwell LS, Wilkey DW, Klein JB, Merchant ML. Proteomic techniques identify urine proteins that differentiate patients with interstitial cystitis from asymptomatic control subjects. Am J Obstet Gynecol. 2008 May;198(5):553.e1-6.

Proteomics is a new research tool that looks at a myriad of proteins at once to help discover differences that may reveal disease markers, clues to disease processes, and targets for drugs. This team used proteomics to look at the proteins in the urine of nine IC patients and compare them with those in the urine of healthy people who were the same age, race, and sex.

IC patients had significantly higher levels of four proteins (a uromodulin, two kininogens, and an inter-alpha-trypsin inhibitor heavy chain H4). The team hopes that these proteins might be biomarkers for IC.

Nerves Connect IC, IBS, Endometriosis
Li J, Micevych P, McDonald J, Rapkin A, Chaban V. Inflammation in the uterus induces phosphorylated extracellular signal-regulated kinase and substance P immunoreactivity in dorsal root ganglia neurons innervating both uterus and colon in rats. J Neurosci Res. 2008 May 13 [Epub ahead of print]

These researchers found that when animals had an inflamed uterus, up to three to five percent of the nerve root neurons (near the spinal cord) got input from both the colon and uterus. The inflammation also increased the number of neurons in the colon, uterus, or both organs that contained two neurotransmitters related to pain.

These results indicate that local inflammation activates pelvic organ nerves, even if the nerves don’t come from the organ that is inflamed. This integration of sensations from different pelvic organs at the nerve roots may be a reason why patients often experience IC, endometriosis, and irritable bowel syndrome together.

Thicker Bladder-coating Treatment Yields Good Results
Porru D, Cervigni M, Nasta L, Natale F, Lo Voi R, Tinelli C, Gardella B, Anghileri A, Spinillo A, Rovereto B. Results of endovesical hyaluronic acid/chondroitin sulfate in the treatment of Interstitial Cystitis/Painful Bladder Syndrome. Rev Recent Clin Trials. 2008 May;3(2):126-9.

These Italian urologists tried bladder instillations in 23 women with IC with a combination of hyaluronic acid and chondroitin sulfate, a thicker solution than standard hyaluronic acid. Their theory is that a thicker solution might do a better job of restoring a damaged glycosaminoglycan (GAG) layer than just hyaluronic acid. The investigators did not compare the two solutions against each other but did measure how much better patients were after 12 weekly instillations and then after six months of biweekly instillations.

IC Doesn’t Go Solo
Clemens JQ, Meenan RT, O’Keeffe Rosetti MC, Kimes TA, Calhoun EA. Case-control study of medical comorbidities in women with interstitial cystitis. J Urol. 2008 Jun;179(6):2222-5. Epub 2008 Apr 18.

This study of overlapping conditions in IC patients based on an analysis of an HMO database, which we reported on at last year’s American Urological Association annual meeting, has now been published in a journal. The analysis showed that 23 diagnoses were significantly more common in IC patients than in controls. Seven were other urological or gynecological diagnoses that described pelvic symptoms. Other associated diagnoses included gastritis, child abuse, fibromyalgia, anxiety disorder, headache, esophageal reflux, unspecified back disorder, and depression.

Thanks to a new Medicare ruling, people with IC Disease and others who use catheters do not have to reuse them any longer.  In April, Medicare changed their reimbursement policy on intermittent catheters so that patients don’t have to clean and reuse them. Insurance companies will likely do the same thing.

People with IC Disease who frequently use catheters for bladder instillations will be happy.  This will definitely cut down on their risk of getting urinary tract infections from having to reuse catheters.  I had read an article somewhere that the people who are boiling their catheters to reuse them were still getting UTIs.   

Previously Medicare only covered one catheter per week unless the patient had a proven record of at least two UTIs a year.  Even after the FDA started labeling catheters as one time use products, Medicare still did nothing to change their allowance.  The new Medicare ruling allows for patients to have 2oo catheters a month.  This will help those patients who need to use a catheter after each urination. 

IC patients and others who use catheters regularly have Steve Winter, a spinal cord injury patient, to thank for this new ruling.  Due to his advocacy work, Winter convinced his congressman that catheter reuse is a serious public health problem. 

Here are some of the latest news articles available on pain.   

Cymbalta Approved for Fibromyalgia

Eli Lilly said Monday that its antidepressant Cymbalta (duloxetine) has been approved by the U.S. Food and Drug Administration to treat fibromyalgia, a chronic disorder with symptoms including widespread muscle pain and tenderness.

MedicineNet.com

Depression & Pain

Suffering from pain, especially chronic pain, often goes hand in hand with depression. And depression itself can be physically painful. But, in individuals inflicted by both, how is it determined what came first — the physical or the mental turmoil?

Nurse.com

Is It A Migraine? What Every Woman Needs To Know

Migraines affect 28 million Americans and disproportionately affect more women than men about three to one. Most concerning, however, is the fact that half of all migraine sufferers remain undiagnosed.

Society for Women’s Health Research

Cost-Shifting and Medication Adherence

A broad array of new medications have become available over the past decade to help patients control elevated cholesterol, hypertension, diabetes, depression, and a host of other serious chronic conditions. These drugs have expanded the available tools in the physician’s arsenal and are key ingredients in maintaining the health of millions of people worldwide.

General Anesthesia Boosts Post-Op Pain

Most general anesthetics — used to put patients to sleep during surgery — can increase the discomfort patients feel when they wake up, according to Georgetown University Medical Center researchers.

Washington Post

Marijuana May Be Effective for Neuropathic Pain

The growing body of evidence that marijuana (cannabis) may be effective as a pain reliever has been expanded with publication of a new study in The Journal of Pain reporting that patients with nerve pain showed reduced pain intensity from smoking marijuana. Researchers at University of California Davis examined whether marijuana produces analgesia for patients with neuropathic pain. Thirty-eight patients were examined. They were given either high-dose (7%), low-dose (3.5%) or placebo cannabis.

Newswise Medical News

New Plans to Tackle Chronic Pain

Health officials hope the plans will mean earlier diagnosis and better management of conditions like arthritis and back pain. One in four people report losing their jobs while dealing with chronic pain.

BBC News

This YouTube video from a news report is great and has some really important information for those just diagnosed with IC or for someone who just wants a little background information. The video features an IC patient and details her struggle and how long it took her to get diagnosed. An IC doctor says in the video that it typically takes an IC patient five years and at least five different physicians before getting a proper diagnosis.

This can become a real problem for IC patients because the longer the illness is left undiagnosed the more excruciating the pain can become. The woman featured in the video says that some days she can’t even get out of bed. I can definitely relate to her!

Make sure you watch the video and please comment on your thoughts.