cystoscopy please help!

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AnxiousJ
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cystoscopy please help!

Postby AnxiousJ » Tue Sep 18, 2018 5:31 pm

Hello,

I am 2 years post c diff and I have been negative since then. I will be having a cystoscopy in my urologist's office on Oct 17 bc of microscopic hematuria. My urologist wanted to prescribe either Cipro or Bactrim as a preventative but after discussing it with her nurse they settled on one dose of Macrobid. My feeling about this is that I would take 2 Florastor a day along with either Bio K or VSL3 for a monthg or so. I had my gallbladder out in May 2017 (one yr post infection) and had one gram of a 2nd generation IV Cephlasoprin and got through it with 2 Florastor and 2 Bio K a day. I stupidly called my GI this am just to let them know and tell them that I would be having this procedure and increasing my probiotics. I just received a call from the GI's nurse saying that he wants to prescribe me 2 Vanco a day for 6 days. I am certainly no expert but in my opinion this seems like it could be much more harmful and could kill more good gut bacteria. I also called my pcp to let her know and let her know that I disagree with his decision. I think I asked the opinion of too many of my doctors and I wish I had not. I would very much like some advice of someone, particularly someone who has had a cystcoscopy and or taken one dose of Macrobid. Bobbie? AllisS?

Thank you!

Jennifer
Last edited by AnxiousJ on Tue Sep 18, 2018 6:00 pm, edited 1 time in total.

Ril
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Re: cystoscopy please help!

Postby Ril » Tue Sep 18, 2018 5:46 pm

I am not Bobbie or AllisS but Macrobid is a low offender, you are 2 years post infection and survived IV cephalosporin with no recurrence- we were in contact. What I can tell you is my GI has a different opinion. He would advise me to do the Florastor 2x/day starting immediately and for a while after. I have discussed it with him.
In the end the decision is yours but I would do as my dr advised and not take vanco.

Best of luck,
Rita

AnxiousJ
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Re: cystoscopy please help!

Postby AnxiousJ » Tue Sep 18, 2018 6:19 pm

Thank you, Rita! Yes, we messaged before and after my gallbladder surgery last year. I do agree with you and I will more than likely not take the Vanco. That being said, it is VERY frustrating that he has such a difference of opinion. When I spoke with the c diff specialist last year after the same GI wanted to prescribe me Vanco he suggested that I not take it. I didn't. So, should I switch to a different GI now? I think he is a good doctor but I shouldn't have to second guess him and I definitely don't feel comfortable with this. I very much want to call the c diff specialist again but they no longer can answer telephone questions from people who are not patients.

roy
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Re: cystoscopy please help!

Postby roy » Tue Sep 18, 2018 7:05 pm

Drs are only human and if you keep contacting them with hypothetical questions they end up deciding to give you meds and tests that they think you are almost demanding just to stop you contacting them.
Theres no point in changing Drs just to get an opinion that matches your own!
Your 2 years out from c.diff and had MANY negative tests.
C.diff is not a life long illness.
What your asking is no different to saying you had flu 2 years ago and you dont want to get it again.
Nobody can predict if you will catch it again, after so many negatives it would be a brand new Infection not a relapse.
Your healthy and your body deals with many many many millions of bacteria every single day without you getting sick.
Vanco kills more colon bacteria than macrobid.
I would be listening to the Dr that said it's not needed

AnxiousJ
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Re: cystoscopy please help!

Postby AnxiousJ » Tue Sep 18, 2018 7:46 pm

Thank you, Roy. My problem is that I should be able to feel comfortable with the information my GI gives me and the fact that he wants me to take 12 Vancomycin 2x for 6 days to counteract a single dose of Macrobid scares me. I will heed what the specialist told me last year but going forward IDK if I will always second guess what the GI says. I just want my doctor to be knowledgeable about it and how to handle future antibiotics.

AllisS
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Re: cystoscopy please help!

Postby AllisS » Tue Sep 18, 2018 11:33 pm

I had cystoscopy, also for microscopic hematuria, a couple of years ago. I told the urologist that I'd like to avoid taking an antibiotic preventatively, which is what she'd originally recommended. She ended up saying I didn't have to take it. That said, I can't extrapolate from my experience to yours as (1) I'm not a medical practitioner and (2) there may be factors in your situation that are different from what mine were. Still, you could always raise the question with the doctor as to whether it's really necessary to take the antibiotic at all. If you do take it, taking the Florastor seems like a good plan. That's the only antibiotic, as far as I know, that has actual evidence pointing to its helpfulness.
If your illness was preceded by use of a medication, e.g., an antibiotic, please fill out an FDA Adverse Event Report at http://www.fda.gov/Safety/MedWatch/default.htm

NanciT
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Re: cystoscopy please help!

Postby NanciT » Tue Sep 18, 2018 11:49 pm

It often depends on the urologist and what the patient is having the scope for if they order an antibiotic. There are several cases they do not have the patient take one.
Talk with the urologist. We see on this site the question come up often with various procedures. One of the reasons they give an antibiotic is to avoid a bladder infection, but not all patients will get a bladder infection. There are many physicians and dentists that are getting away form prophylactic antibiotics for the very reason...CDIFF

Wishing you the best with the procedure

NanciT

AllisS
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Re: cystoscopy please help!

Postby AllisS » Wed Sep 19, 2018 1:00 am

Nanci is absolutely right. In the space of just a few years, my dentist, for instance, has gone from rigid insistence on preventative antibiotics prior to virtually all dental work (even including tooth cleanings!) for anyone who has had a hip or knee replacement to flexibility about allowing the patient to make their own choices, taking all factors, including individual risk for C. diff, into account.
If your illness was preceded by use of a medication, e.g., an antibiotic, please fill out an FDA Adverse Event Report at http://www.fda.gov/Safety/MedWatch/default.htm

AnxiousJ
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Re: cystoscopy please help!

Postby AnxiousJ » Wed Sep 19, 2018 5:27 pm

Hi All,

I spoke to both my pcp and urologist and they are both strongly encouraging me to take the one dose of Macrobid (500 mg) following the procedure as it may be able to protect from infection. Today, I spoke with the nurse for the c diff specialist's nurse. The doctor is out of the country right now. His nurse agreed that the 12 Vanco pills sounds like overkill and suggested either taking one 125 mg Vanco along with the Macribid and increasing the Bio K and Florastor or just increasing the probiotics. He was leaning to the one Vanco. I'm so concerned. I hope to speak with the c diff specialist sometime before the procedure in mid October. Does the fact that the Macrobid is 500 mg make it riskier? I'm torn...

AllisS
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Re: cystoscopy please help!

Postby AllisS » Thu Sep 20, 2018 12:26 am

Well, the rationale that an antibiotic "might be able to prevent infection" is the stock explanation for prescribing so-called preventative antibiotics. I don't understand why a cystoscopy to explore the cause of microscopic hematuria would necessarily lead to infection; are you prone to UTIs? You might ask the doctor who is recommending it what percentage of patients develop infection as a result of the procedure. Perhaps you could cite this article: http://www.urologytimes.com/modern-medi ... n-uncommon

It's your choice whether or not to take the antibiotic. If you refuse and the doctor then refuses to perform the procedure, you could then look for another urologist who wouldn't insist on the antibiotic.
If your illness was preceded by use of a medication, e.g., an antibiotic, please fill out an FDA Adverse Event Report at http://www.fda.gov/Safety/MedWatch/default.htm

beth22
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Re: cystoscopy please help!

Postby beth22 » Thu Sep 20, 2018 1:46 am

I would definitely not take one vanco pill. That is not enough to stop anything. Personally, I wouldn't take it with Macrobid. I took it with Levaquin and I felt worse than ever. I did not take it with Z pak or doxycycline and I was okay. If you are going to take it, take a correct dosage or don't take any at all.

roy
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Re: cystoscopy please help!

Postby roy » Thu Sep 20, 2018 4:18 am

Are you getting advice from a professional or from the village idiot!
The suggestion to take a low, short course of vanco was dubious.
The suggestion to take just one pill is totaly ridiculous, no more than a placebo!
Possibly because you are asking so many questions they are coming up with answers they think might pacify you.
It wont do any harm but has as much chance of preventing c.diff as a single aspirin has of curing a brain tumor!
Macrobid is considered one of the safest antibiotics regarding c.diff risk.
NO antibiotic has zero risk and that risk remains for up to 3 months after taking it.
Taking a course of vanco "might" prevent c.diff while you are taking it but the fact remains that once your off it the gut flora is still in a bad state and susceptible to c.diff.
In Fact the course of vanco will kill far more good flora than the macrobid and Most Drs who have extensive knowlage would say it could even INCREASE the c.diff risk.
Macrobid is very narrow spectrum and low risk, if your Dr insists on using it I cant see ANY reason to add in another antibiotic that will kill more variety of good flora than the macrobid does


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