Continuing Rehab

Readers, please notice the dates on all entries. Part I of My Bladder Cancer Showdown took place in 2018 and 2019. Part II, titled Long-term Recovery, took place through most of 2019. These blogs summarize my experience. In the last one, I was scheduled for out-patient surgery. 
April, 2019: We went to the Urology Surgery Center on April 8. Dr. C removed the supra-pubic catheter and port. He also corrected the tight urethral stricture to improve my urinary flow. The good news was that he found no evidence of cancer.
Less than two weeks later, I suffered a serious UTI (urinary tract infection) that required antibiotic treatment. Ultra-sound showed a large amount of residual urine in the bladder after voiding. I was told to catheterize myself twice daily to empty my bladder completely.
May, 2019: I had another UTI in early May despite doing self-cath twice daily. Dr. G prescribed antibiotic treatment for 10 days to be followed by a single maintenance dose of the antibiotic daily for 50 days.
In the meantime, I was referred to a rehabilitation facility for out-patient physical therapy to improve my balance and strength. I went for two hours twice a week, and by late May I could see definite improvement. I was strong enough to do some gardening, which I enjoyed very much.
June and July, 2019: My bladder symptoms flared again in early June, a few days after I finished my antibiotic. They improved when Dr. G put me on another antibiotic. I continued doing self-cath twice a day.
My physical therapy continued through June and early July. By then I could walk (with my cane) about half a mile daily around my neighborhood. I was slow, but was making progress. My therapist discharged me in late July.
Dr. G did my one-year follow-up cystoscopy in his office on July 16 and had good news. There was no evidence of any bladder cancer. He advised me to continue my anti-cancer diet.
August and September, 2019: Another UTI flare-up hit me in late August. Dr. G put me on an antibiotic to take twice daily for one month. It helped at first, but I developed severe symptoms again in mid-September.
The urine culture showed growth of bacteria resistant to my antibiotic. Dr. G put me on another antibiotic and told me to do self-cath four times daily.
October, 2019: On October 8 I had my 15-month cystoscopic check-up. Dr. G saw no evidence of bladder cancer and the bladder lining looked healthy. He told me I could stop my antibiotic and begin tapering my self-catheterizations.
Six days later, UTI symptoms returned with a vengeance. Dr. G put me back on the antibiotic and I resumed my self-cath four times daily. The antibiotic was not much help. It had clearly lost its effectiveness.
Four miserable days later, the urine culture was finally reported to Dr.G. He called me immediately to say the culture grew an unusual E. Coli bacterium resistant to all oral antibiotics except nitrofurantoin.
Dr. G prescribed nitrofurantoin to be taken twice daily. He also mentioned an over-the-counter (OTC) medication called D-mannose. Not an antibiotic, it was said to improve bladder resistance to infections.
It was clear that correcting my urethral stricture had not solved my urinary problems. The big problem was that my bladder muscles weren’t strong enough to completely empty my bladder. Warm urine pooling there was a set-up for repeated infections. If D-mannose and continued self-catheterization could prevent these infections, it would be marvelous.
[Blog to be continued next week.]
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