Yes, it's 4:10 a.m., and I'm awake with what is almost certainly a UTI, which I've developed after having sex with a new partner a day or so ago. I posted here a few times in advance of sleeping with him, asking about advice/feedback on alternative treatments for staving off UTIs after intercourse (D-Mannose, Cystex), since I have a long history of getting infections (always related to sex - and yes, he and I were both tested for STDs before doing the deed, so this is definitely a UTI and not something else). I am at my wits' end and don't know what to do. After suffering from many sex-related UTIs that were indeed cultured out and caused by bacteria, I was for years able to have a "normal" sex life by taking 50 mg of the antibiotic Nitrofurantoin/Macrobid prophylactically after sex. That worked well and made me feel like I had my life back. But about three months ago I had a breakthrough infection using that regimen, which made my urologist suggest that I had developed a resistance to the antibiotic. Developing a resistance was always my worst fear, since using the antibiotic every time I had sex was really my last resort. And now my last resort doesn't work any more, and I have no idea what to do.
[This is a long post, but please please read more if you can!]
So I went into this new relationship with the prophylactic antibiotic no longer an option. The new man and I had sex Monday morning (it's now 4 a.m. on Wednesday morning). In an effort to throw everything and the kitchen sink to try to stave off an infection, I immediately started big doses of D-Mannose, cranberry, AND Cystex tablets, and continued them at regular intervals all through Monday and Tuesday. I felt ok on Monday, but on Tuesday, even though I wasn't having urinary frequency or other urine symptoms, I was starting to notice a little low back discomfort and was feeling run down/flu-like, nauseated, and developing a sore throat. These are always the main indicators for me that I am indeed dealing with a UTI - I can tell that my body is trying to fight off an infection. I wondered if taking all that Cystex was in fact working TOO well, and masking urinary symptoms, so I stopped taking it Tuesday afternoon, and sure enough, Tuesday night and up til now, I'm starting to have that all too familiar twinge in my urethra and bladder. First thing in the morning I'm going to go to my urologist to give a sample and get it cultured, but seriously...WHAT THE F--K?!?! I made my damn bladder so hostile to any bacteria - how the hell did anything actually take up residence in there? It blows my mind.
I just don't know what else to do. It's looking more and more like even though I want to go the natural route, that's just not an option for me at the moment. Which is so upsetting, because I know that once I get on the antibiotic train, I really can't get off again. It starts to become such a vicious cycle - take the antibiotic, lower your body's ability to fight things off naturally, and then become increasingly dependent on the antibiotic and risk developing yet another resistance (which is scary - the last infection I had didn't respond to my prophylactic antibiotic OR Cipro, which was pretty terrifying). I so, so want to use D-Mannose and have it work for me, since there are literally thousands of great reviews of it on amazon and other sites...but I just don't think it's working. If the urine sample I give in the morning cultures out a bacteria other than E.Coli, then I guess we have the answer why the D-Mannose doesn't work (it's only supposed to work for E.Coli based infections).
In all honesty, I think my current realistic options are to:
1) Continue the 50 mg prophylactic Nitrofurantoin/Macrobid regimen I was on before. Another urologist I spoke to and my family doctor both suggested that even though I had a breakthrough infection on it once before, it might still be somewhat effective for me going forward (though I don't really understand how this is possible if it already failed once).
2) Start a different antibiotic prophylaxis after sex. My family doctor - who herself suffers from recurrent UTIs - prescribed me a different low dose antibiotic to take post-coitally (250 mg Keflex), but this idea just makes me so nervous. The worst WORST case scenario is to burn through all available antibiotics and become resistant to them, and then be really shit out of luck when I need them at some other point in my life. So the thought of starting a new antibiotic, using it for a while, and then having it fail me is scary as hell.
On the other hand, if I do continue to get UTIs, and am unable to control/treat them with something natural, then I have to go on long, 10+ day courses of big time antibiotics to treat infections once they've started. From that perspective, is it maybe not so damaging to do the low-dose antibiotic regimen, if it seems that I'm going to be doomed to take antibiotics one way or the other? Better to do something small prophylactically than take out the big guns once an infection has taken root? I've also considered "natural" antibacterials/-microbials like grapefruit seed extract and uva ursi, but at this point, feel like I'm done experimenting with that kind of stuff, since all the "evidence" for it working is anecdotal and I'm afraid some of it might be kind of a scam.
From what I understand, antibiotic resistance is very complex and not entirely understood. Some folks I've spoken to say that once you're resistant to an antibiotic, you're resistant forever. Others say that no, bacteria are always changing and being replaced, and an antibiotic that doesn't work for you at one point in your life may work for you again later on. So I'm kind of unclear as to how I should understand that breakthrough infection I had on my prophylactic Nitrofurantoin - does that mean that I'm doomed to always get breakthrough infections on that med, or was that a one time thing?! Ugh.
Are there any others out there with ideas of what I can do? I'm so desperate. I really, really like this new man I'm dating, and I know how destructive these cycles of infections can be for the health of a relationship. They're the reason my last boyfriend and I broke up, and I'm terrified that I'm going to have to spend my life alone because I won't ever be able to have a normal sexual relationship with anybody.
And last but not least - I do, of course, know about all the precautions one should take to avoid UTIs: wipe front to back, pee before and after intercourse, drink water, make sure sex is well-lubricated. I don't use hormonal birth control nor do I use condoms - I have a copper IUD - since I know both of these can create irritation and contribute to the problem. I even use this special "bottle washing technique" before and after sex, NEVER have sex after having a bowel movement, and even wear brand new cotton underwear if I think I'm going to have sex so there's no possibility of any leftover E.Coli that survived the washer/dryer sticking around on my underwear and getting near my urethra. Seriously, the precautions I take are basically a part-time job.
Again, apologies for the length of this post. I'm more or less going to be awake for the next four hours until the doctor's office opens, but writing all this out made me feel better. If anyone took the time to read this and has any suggestions, I'd be so grateful to you.