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This is unbelievable. As soon as my mom gets through a session of antibiotics for a UTI, two weeks later she has another one. This has been going on for about 7 months now. She has a faulty bladder that does not empty properly but I just can't deal with this anymore. She has been hospitalized twice and is now in rehab after falling, again.



I'm going to talk to here PCP about putting her on a daily dose of low antibiotics. I'm also going to see if a permanent catheter might help with this problem. I'm not kidding folks. As soon as she is cleared of one UTI she gets another. I am at my wits end. She was independent until all this started and now she is just sick all the time from the UTIs. Please, someone, offer us some help.

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Instead of estrogen cream externally (or internally which is messy) look into vaginal estrogen tablets. 2X per week inserted. It can make a world of difference.
Brand is Vagifem, generics available:

https://www.vagifem.com/
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I am 74 and began having UTI'S 2 years ago very often. I used the vaginal cream for several months, but did not help. I was finally prescribed a daily low dose antibiotic. This stopped the UTI S for about 6 months. I was prescribed a different low dose antibiotic and didn't have a UTI for 7 months.
This has worked very well for me. Prior to this I was continuously having UTI'S.
I would try to talk to Mom's urologist to request the antibiotic.
Best wishes
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Summernole Oct 2023
What was the antibiotic that worked for you, Chickie? I have asked the urogynecologist for a low dose daily antibiotic for Mom. She did not like the idea. I will see her again this Tuesday and ask her again.
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My mother was a very independent senior six months ago too. She had a complete shoulder replacement and her decline after the surgery is tremendous. Her surgery went well, the new shoulder is great, but she’s had such a decline that it’s just shocking. She’s had about 3 urinary tract infections too. She’s been in and out of rehabs and hospitals too.
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Summernole Oct 2023
I'm so sorry for your mom - and you, Franline. I have really noticed a big mental decline in my mom since February when she started having the non-stop UTIs. They are continuous. She has fallen five times since then and been hospitalized twice and recently got out of rehab. I feel so badly for her because she is aware of the mental confusion. I'm hoping to get her to feeling a little better and then I will take her to a neurologist to see if any medications will help her. Good luck with your mom. You are not alone.
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Try Uquora, I am a victim of UTI infections having 2 to 3 a month. I was taking AZO like candy. My husband saw the Uquora add on TV and ordered it, I have had only 2 UTI in the last year. Its 2 capsuls every morning and every 3 days you mix a packet in 3/4 bottle of water. It tastes like pink lemonade. Each shipment lasts for a month. Hope this helps.
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Summernole Oct 2023
I have seen the commercials, too, and wondered about it. I asked my mom's urogynecologist about it and she said she had never heard of it. I found that hard to believe but I am a little hesitant to get it if it is not recommened by her or my mom's ARNP. I am going to look in to it, though. Thanks for the advice.
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Ask her doctor about estrogen. There’s a patch or vaginal pill that’s an alternative to messy creams.
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Summernole Oct 2023
She is using the vaginal cream. Or, at least she tells me she is.
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I just Googled PNE. What is it you don't like about this procedure?

https://pelvicfloorcenter.org/peripheral-nerve-evaluation-pne/#:~:text=What%20is%20Peripheral%20Nerve%20Evaluation,local%20anesthesia%20or%20numbing%20medication.

It sounds quite useful.
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Summernole Oct 2023
It is the wires in her back that we don't like. She is 92 and has so many other aches and pains. I guess we need to consider it.
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My 78 year old mom had mild, recurrent UTIs for years. She was prescribed Methenamine by her urologist. It's worked like a charm and no side effects. No UTIs since she started taking it.

Also, AZO makes a great over-the-counter product: Cranberry Powder with a Probiotic + Vitamin C to support urinary health.

https://azoproducts.com/products/azo-cranberry-caplets
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Summernole Oct 2023
I have a request in to my mom' doctor to consider the methenamine and AZO capsules.
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Summermole, I would make sure mom is using the estrogen cream. That and a probiotic made all the difference for my mom.
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Summermole's mom been to a urologist. But she hasn't told us what the urologist recommended. Or if there has been any follow-up.
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Summernole Oct 2023
Mom's urologist suggested the D-Mannose, trying to urinate every two hours, the estrogen cream for her vaginal area three times a week and drinking water (but she doesn't push it (?)).

Now she wants to try PNE (Peripheral Nerve Evaluation). It involves the insertion of a couple of wires into mom's back to try and stimulate the bladder to empty. My brother and I do not like this idea.
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My mom is 85, in a NH & has frequent UTIs. She has been hospitalized several times due to UTI w septicemia. Her cognitive function noticeably declines every time this happens. It’s cumulative. She’s had a ureter stent placed & removed a couple of times due to kidney stones. The stent is a foreign body & an optimal place for bacteria to set up housekeeping. It can provide direct access for bacteria. Surgical procedures to place & remove a stent provide optimum times for bacteria to invade & proliferate. Kidney stones also provide a good site for bacteria to grow. Her urine cultures are usually positive for E. coli or MRSA. I think poor hygiene is the primary cause of her UTIs + or - septicemia. The staff @ the NH is lazy. My mother tends to wait to be changed instead of having that done right away. She doesn’t want to piss the staff off by requiring them to change her as needed or frequently. She doesn’t want to get on their bad side so she ends up lying in her own filth for extended periods of time. That is a perfect situation for E. coli/ MRSA to invade the urinary tract. I’ve wondered if MRSA has colonized her urinary tract. If so, she would require a maintenance dose of an antibiotic to keep it in check. Another hygiene problem is bathing. Baths are supposed to be done 3 times a week. I don’t know if she is getting those baths. She does bathe herself, not a member of the staff. In her situation, I think she should be able to bathe daily to ensure EVERYTHING gets clean. I have Sjögrens Syndrome, an autoimmune disease. It’s more common in women & has a genetic link. I’ve tried to get the NH to test mom for Sjögrens. I’ve mentioned this to mom, my siblings & encouraged them to pursue testing. No luck! She has textbook symptoms as do I. If a Dr diagnoses her w Sjögrens & begins treatment, I can’t help but think her health would improve & therefore reduce the incidence of UTIs.
So there are many different variables to consider as to the cause of frequent UTIs. Hygiene, underlying illness including autoimmune disease, bacterial colonization, foreign bodies, (stents, kidney stones), proper treatment without delay & more. Not long ago I came across my maternal grandmother’s death certificate. Listed as a cause of death was UTI with septicemia.
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Summernole Oct 2023
Your mom is in a tough situation. I feel for her - and you. I have heard of several people who have died from UTIs.
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My husband has UTI's a lot that is when his doctor put him on 250mgs of cephalaxin which he takes at night. Also he is on a cranberry pill that helps too.

Why he takes the antibiotic at night that is when the urine pools and the bacteria grow. Since he has been on this regiment he hasn't had an UTI at all. My husband had a catheter put in all that did was give him a lot of pain and made it where he had a bad UTI which he was on stronger antibiotics.

I would wait and give the low dose of antibiotics a try take them at night and with a cranberry pill too to see if that works for her.

Prayers
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Summernole Oct 2023
Thanks, Babs. I am requesting a low dose daily antibiotic. Apparently, it is not popular with everyone on this site. I'll remember the nighttime approach.
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Daily antibiotics will only cause your mom to develop strains of infection that will be near impossible to cure. Catheters also carry their own risk of infection (as a hospital-based RN, we try hard to avoid them). Tactics that can help include:
1 - Putting her on a toileting schedule. Every 2-3 hours while awake, she must be placed an the toilet and encouraged "to go."
2 - Thorough cleaning every time she soils herself with urine or stool. Washing must be from front to back using a mild soap and water. Dirty or wet undergarments must be changed promptly. If she can sit on a commode, a bidet attachment can help with clean-ups.
3 - Plenty of non-caffeinated fluids throughout the day. Many seniors are dehydrated and don't have a good thirst drive when they need more fluids. Make sure she drinks about 2 liters of fluids daily. If she has a fluid restriction from her doctor, use that "number" as your guide.
4 - Some folks have success with low dose hormones in the genital area (vagina and meatus areas) to boost tissues in those areas. Some claim that is helps to thwart infections. I'm not convinced, but talk with her doctor about it.
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Summernole Oct 2023
We have been told not to use a mild soap in that area. Only warm water and a clean washcloth. She knows she needs to try and go every two hours but she sleeps so much that she is not doing that. The water situation is tough as she doesn't like to drink water. She has an estrogen creme she is supposed to use every Monday, Wednesday and Thursday. I'm not sure she is doing that. I'll have to check. Thank you, Taarna. I have heard that some folks to get relief from the daily, low dose antibiotics. I am at the point where I want to try that.
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Summernole: After the U.T.I. is cleared through the course of antibiotic after a complete urinalysis is performed, she could start an RX of Myrbetriq after having seen her urologist. She should also begin taking cranberry tabs and, if necessary, drink pure cranberry juice (not cranberry juice cocktail). This has worked for me, personally. I had two U.T.I.s one month apart and soon remedied that.
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Summernole Oct 2023
Thank you. I have been reading a lot on this site about the cranberry tabs and juice. On other sites, they say there is no confirmation that this approach is successful. I guess we have nothing to lose by trying.
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I have always had chronic UTI's which are excruciatingly painful. The only antibiotics that work properly are prescribed after having a culture done. However, because I was prone to them a couple of times a year or more I went to urologist and also. my gyn. They both prescribed a low dosage of estrogen in a vaginal suppository form. I started a couple of years ago initially on a 2-week course of nightly estradiol cream followed by ongoing maintenance therapy twice weekly.  It has been a lifesaver for me. I also make sure I go to empty my bladder frequently, hydrate, proper cleanliness, etc. I'll never go off it. If your mom has insurance she can get a generic version for a lower cost. Also, I get mine through a pharmacy that uses Good RX. Good luck.
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Summernole Oct 2023
Thanks! She is supposed to be doing the estrogen creme three times a week but I'm not sure she is doing that. I need to be more vigiliant.
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I recently read that pink slime/ mold growing in toilet or shower can cause repeated UTIs. I have no ideas if it’s true, but it’s worth checking some sources.
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My mother went through the same thing. She was at a memory care center, and once we discussed with administration the proper ways to wipe her after fecal matter, and all urine needs to be cleaned it helped. Once the doctor prescribed cranberry pills, she had no more UTIs at all.
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I feel your pain! Since my Mom's stroke she has had recurring uti's which as you know are horrific for the elderly! I did it all, hydrate, cranberry juice, pills and finally her urologist prescribed a medication called methenamine. He said it makes bacteria impossible to grow in the bladder. He also said nothing was 100% but...It works! Knock on wood, Mom hasn't had a uti in a very long time! Like over a year! And as a preventative to avoid falls and in my Mom's case, seizures, when she gets her blood work done they also do a urine culture to check for a uti. This way we can get antibiotics fast if she should have one.
Best of luck to you!
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Summernole Oct 2023
Bless you for the information and I'm happy to hear your mom is doing better. I will look into methenamine.
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As one whose bladder stopped working, my doctor encouraged me to learn intermittent catherizing. Just in, drain, and out. Better than wearing a bag strapped to your thigh. Anyway, I had a problem with frequent UTIs and my doc prescribed low dose Cipro seven days a week. But the look on his face said he wasn’t happy with that. So I took it on my own to reduce it to 3 days a week and it works just as well. Cranberry juice helps, but get the one that just has 5 mg of sugar. There’s a big 5 on the front of the bottle. I’ve also heard others rave about D-Mannose. I’m also using that and so far, so good!
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Summernole Oct 2023
Thank you for the reference to another "faulty" bladder. I think a lot of folks on this site just think my mom isn't cleaning herself and they are not giving due to the bladder that doesn't empty. Mom has been on D-Mannose for a while and I'm not sure it is helping her. Another suggestion for cranberry juice. I am certainly going to get the low sugar for her.
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Saw this commercial recently
https://www.youtube.com/watch?v=901R1dGMdII
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Summernole Oct 2023
I asked the urologist about Uqora and she said she had never heard about it.
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Me too
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Make sure that she is properly hydrated.

Dehydration is a risk factor for a UTI.

What I do for my mother is make sure that she drinks enough water daily, which isn't a problem for her, because I add a little bit of lemonade flavor. Also, when I make her water bottle, I add Vitamin C, Magnesium Chloride, a pinch of salt and a pinch of sugar.

I also wipe her bottom 100% of the time to make sure that it's wiped from front to back.

She is 96 and has not had a UTI.

Peace.
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In addition to you finding the best Urologist possible to treat your mom and making sure she is drinking plenty of water, I think taking a look at her bathroom routine might be warranted. Lots of folks are suggesting drugs and drinks, but no one is talking about the dirty word of "cleanliness."

My mom does not remember to wipe, nor does she really know how when you remind her. Have you thought about installing a bidet onto her toilet? You can get one for about $100 and it's a relatively easy installation. I think if you have elderly folks who do not bathe frequently and have accidents in their pants and who don't wipe well or at all, I think flushing the area with water from a bidet might be helpful at keeping their bottoms clean. I don't know how involved you are when she uses the toilet, but you would more than likely need to be involved in the use of the bidet (pushing the button and helping her dry off) unless your mom is really high functioning. Making sure she is changing her underpants daily or several times a day if needed is also a good idea.

This is a hard one because they still want their privacy and you don't want to be insulting, but you also don't want them back in the hospital.
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Summernole Oct 2023
Thank you for acknowledging the need for my mom's privacy in the toilet but I think I just will have to get more involved to make sure she is doing everything she can to stay clean.
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I just went through this with my husband. Even the low dosage antibiotic. The antibiotics quit working. What they have him on now Is Methenamine along with vitamin c. Supposedly it turns his urine into something the bacteria doesn’t like. I know they have prescribed this to women too.

Good luck.
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Calgal Oct 2023
I also take Methenamine and it works for me
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If she is not emptying completely, that could very well be the problem. I was having chronic UTIs for several years until a great urologist found this.
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Is your mother a diabetic? Female diabetic patients usually get recurring UTIs. Also, using too much antibiotics could cause it to become resistant. Toileting the proper way is an important factor in preventing UTIs. Women should wipe from the front to the back in order to avoid contamination.

Your mom needs to have a check with a urologist.

In the meantime, she should try using Greek yogurt with live cultures.
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My mom had reoccurring UTI’s as well, they were all caused by fecal matter and her PCP would give her the instructions about wiping, what to use to wipe etc. then she had several back to back. While we don’t actually know for sure since they never tested to see if it was cured after the course of antibiotics, I’m convinced it was the same infection. She would get better on the antibiotic and then a few days after the course was finished her behavior would change again (this is the only way we know or suspect UTI since she never feels it). She was sent to a urologist who put her on a heavier duty antibiotic and once it was done and her UTI cleared up she started Hiprex and D-Manose which has seemed to do the trick!

Not everyone is the same but it sounds like your mom (and you) could use a trip to A urologist who deals with elderly paitents.
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A constant low dose antibiotic is not a good idea. I had constant UTIs, strep, and ear infections as a kid. Back then (early 1970s) there was no evidence of this causing problems later.

I am now 51 and am antibiotic resistant. Any time I need antibiotics, I have to take a very high dose. And the pill itself is huge, like swallowing a rock. Sometimes they hurt my stomach. I hate it.

Granted, at your mom’s age, getting resistant may not be as much of an issue.
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I remember my mom's gynecologist put her on a probiotic called rePhresh. And prescribed a hormonal vaginal cream to be applied a few times a week.
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So, the urologist recommended a sling and mom refused?
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Summernole Oct 2023
No. I never said the urologist recomended a sling.
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My Mom’s doctor prescribed Hiprex to help acidify her urine. She also takes Azo capsules. She’s been doing this for a couple of years now. She went from having back to UTI’s for several years to having only one in two years.
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Summernole Oct 2023
Thank you. I will talk to her PCP about this.
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