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Immunosuppressed and constant UTI...

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Posted 6/23/2014 9:19 PM (GMT 0)
Hi.
Has anyone here experience UTI post transplant? My mom is 14 months post transplant, and has been experiencing UTIs constantly. Her most recent UTI was 3 weeks ago and was treated with antibiotic. Then, today she called me that she's having UTI symptoms again. I just placed a call to the urologist and waiting to hear back from him. However, is this happening bc she's immunosuppressed? Anyone experience this? Any info/advice you can share would be appreciated. Thank you in advance.
Posted 6/23/2014 9:30 PM (GMT 0)
Hi Wd,

Brother didn't have that problem but I found this blurb from Cleveland Clinic:

Approximately 7 to 12 months after transplantation, and beyond, most recipients can develop infections such as influenza, urinary tract infections, and community-acquired pneumonias, similar to those acquired by patients who have not received transplants. Reactivation of human herpesvirus 3 can manifest as herpes zoster, and, although it is uncommon, cytomegalovirus infections can occur. Sinister opportunistic fungal infections can occur as a result of cumulatively high levels of immunosuppression, poor graft function, or heavy environmental exposure.

Three notable scenarios can enhance patient susceptibility to opportunistic infections: acute organ rejection necessitating increased immunosuppression therapy; retransplantation, which restarts the immunosuppression and infection time line; and chronic viral infections, such as human immunodeficiency virus or hepatitis B or C.
_____________________________________

Does she drink plenty of fluids? My ex is in the hospital again, in the past he's had 2 UTI's that got so bad he was septic and in ICU. Each time he was dehydrated.

Maybe someone will help with your question and in the meantime, ask the doctor how best she can avoid getting them, they can be quite serious.

Hope your Mom is feeling better soon.
Posted 6/23/2014 10:13 PM (GMT 0)
I was getting them regularly so I started taking cranberry pills daily.  Have her ask her doctor about them.  Also, she needs to drink lots of water and pee often to help with constant flushing and not holding any urine in.

 

I never pass up an opportunity to pee!

Posted 6/23/2014 10:21 PM (GMT 0)
Hi WD! I didn't know anything about UTIs being an issue after TP, but I sure wish I had. They think that an (untreated) UTI is what eventually triggered Robert's metabolic acidosis and coma. When the test results began coming back while he was still in the ER, the Dr. told me that he had a very severe UTI. I sure wish I had known about the possibility, because I would have been a lot more alert to symptoms. Please remember, Robert's was untreated, so what happened to him is NOT going to happen to your Mom!

Mae, I sure wish I had seen that article. The timeline they give about possible infections fit what happened to Robert perfectly! Thank you for posting it - you should include that in the Hepatitis sticky thread.
Posted 6/23/2014 11:12 PM (GMT 0)
@ Mae... Thank you for the extremely informative information. I will definitely speak to the transplant coordinator about the info you posted and get her input. I did speak to the coordinator a few weeks back about the constant UTIs and she did mention possibly lowering my mom's prograf dosage now that she's over 1 year post transplant. That might help increase her immunity. She is drinking plenty of water as well as cranberry juice. Urologist is sending her for a urine culture and urine analysis...then he can prescribe an antibiotic once we know what strain uti she has.

@DGinSD...the urologist did prescribe cranberry pills/ supplements but transplant team said "no" since supplements are not FDA approved. Love your comment about " never passing up an opportunity to pee"...LOL!!!

@ Splashdancer...did Robert have any uti symptoms? I actually worry about my mom and these constant UTIs. They can become very dangerous if left untreated. I am sorry that Robert had to go thru so much post transplant. He's very lucky to have such a caring and loving partner... You truly have a very special angel watching over you.

Besides water and cranberry juice is there anything else she should be drinking or eating until we get urine analysis and urine culture done tomorrow / results?

Thank you all so much.
Posted 6/24/2014 12:28 AM (GMT 0)
I'm not sure if he did or not, WD. Looking back, I think he did but the closer it got to his 6-month 'expiration date' that his Drs.gave him, the more he shut down and didn't tell me what was going on with him as much. That's why I wish I had known UTIs were a specific problem to be aware of - I would have asked him more questions about certain things I was sensing and feelings I had.

Honestly though, it's not something I would worry about with your Mom. To get so bad that it led to metabolic acidosis, Robert probably had the untreated UTI for a couple of months (and his liver was failing due to that demon HepC). And for the most part, he didn't mention any symptoms. That was probably because he figured he was going to die anyway, per his idiot doctors. Your Mom's case is nothing like Robert's - she takes antibiotics when she gets symptoms and she mentions when she has symptoms. I have a feeling that as she gets even further away from TP, the UTIs will settle down. She's in good hands.

And yes, I believe whether spirit or angel, Robert is around me - I have to believe that.

(And the cranberry juice and water is enough, imo, until the results are in.)
Posted 6/24/2014 1:05 AM (GMT 0)
LOL @ Dany and no missed opportunities :)

Splash, you're right, they can be fatal if left untreated.

I think keeping hydrated is important for everyone, unless you have fluid restrictions due to problems with heart, liver etc.

This brings to mind someone I know who drank so much water when he found out he was going to be randomly tested that day, that it overworked his heart. Sadly he died, all to avoid being fired for smoking pot (tried to dilute the outcome of the lab work).
Posted 6/24/2014 7:54 PM (GMT 0)
I think people don't realize that you can have too much water but it has to be consumed quickly and it is a HUGE amount.  The average person should drink 8-12 glasses a day (throughout the day not in a couple of hours)...I'm sure most don't even drink 8.  So the flushing does help with the UTIs but you have to go pee every hour even if you don't really feel the urge.  That's what works best for me, anyway.  Not letting any fester in my bladder.  Then they go away in a couple of days.  If they last almost a week, I call the doc because I figure it's a bad one that needs a kick :-)
Posted 6/24/2014 8:32 PM (GMT 0)
It's definitely a Uti per the urine analysis but now we have to wait to get the urine culture results to find out what type/antibiotic sensitivity this uti has. The urologist did start her on Bactrum in the meanwhile since it takes 2-4 days for the urine culture results to come back. Now just waiting to her from Transplant coordinator to find out if they want to change her prograf dosage, etc to try and bring up her immunity bc of these constant UTIs.
My mom does drink plenty of water ... She's drinks 6 8oz glasses a day plus a 1/2 glass of cranberry juice. I have a strong feeling that it's bc she's immunosuppressed and that's why the constant UTIs.
Posted 6/24/2014 9:53 PM (GMT 0)
Just as an FYI, the person I spoke of had blocked arteries that he was unaware of, and he DID drink soooo much water in a VERY short amount of time before he dropped from a heart attack. Didn't want anyone to think the drinking water normally is a bad thing :) I try to do 6-8 glasses/bottles every day myself.
Posted 6/24/2014 11:42 PM (GMT 0)
WD,

I had tons of Uti infections pre Tx. I was prone to kidney stones as well. They put me in potassium citrate and u haven't had an episode since 2011. I drink over 3 liters of water a day as prescribed by my docs. My urine always has a tendency to show bacterial infection but they don't treat it unless I get symptoms. I drink cranberry juice and lemonade as well.

I also use moist wipes instead of toliet paper to keep everything super clean!

I see my hep and urologist in July 9th!
Posted 6/24/2014 11:48 PM (GMT 0)
@ Susie...what does the potassium citrate do? Was it prescribed specifically to address your UTIs? And, are you still on it post transplant? Wouldn't the potassium citrate increase your potassium levels? I am definitely going to suggest the moist wipes to my mom... Thanks!
You mentioned that you drink lemonade as well...does that work just like cranberry juice? Is lemonade helpful to prevent UTIs? Is it purely/fresh squeezed lemons?
My moms urine almost always shows bacteria and she too doesn't present with uti symptoms all the time... Strange.
Posted 6/24/2014 11:58 PM (GMT 0)
Potassium citrate is to prevent stones. My potassium was also low so it helps boost my level.

I was told to push fluids for the uti's. Cranberry is best but has high calories. so u also do lemonade ( minute maid diet is 5 calories a 12 oz can)and flavored water( fruit20) so I can get my 3 liters ( 102 ounces)a day!
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