CIC suddenly stopped working after initial 10 days of success

Thanks Jim,

Catheter went all the way in, with only about 2" remaining. No pain.My HMO (Kaiser) gave me a supply of "Covidien/Dover catheters: size 14 Fr/Ch catheters. I think I wilI move up to a size 16. Is there an online site where I can order my catheters?

If you have insurance then you will want to find a good cath distributor and you should consider the single use hydrophillics like Cololplast's Speedicath.  Not only will they supply the catheters but will interface with the doctor and work the insurance. I'll send you some names via PM. If you don't have insurance, then the best value will be the non-hydrophillics which you can re-use. Since you can re-use a single catheter for a week or so, the cost isn't too bad.

Jim

Can you explain that? Why would a diuretic help? Wouldn't it make things worse? 

I am thinking of asking my Uro for a diuretic. 

A diuretic is not a default solution for an obstructive bladder. Yes, it could make the situation a lot worse. Diuretics do have a place in some circumstances but either know exactly what you're doing or work with a urologist.

Jim

If a person has nocturnal polyuria, isn't it worth it to try a diuretic?  I'm pretty sure I have nocturnal polyuria since my sleeping urine output to total daily urine output has exceeded 0.30 for 40 of the last 111 days (64 days if the criteria is exceeding 0.25 and 10 days if the criteria is exceeding 0.40). The percentages are higher for exceeding 0.25 or 0.30 if I just look at the last thirty days.

I'm thinking of trying some foods/supplements (as opposed to prescription drugs) that are diuretics to try to shift the cycle of urine production to occur more during the day and less at night.  I would eat or take these most likely during the afternoon.  Curious to know if you agree with this thought process.

Yes, diuretics can be one strategy for nocturia polyuria. I have had some success with coffee in the past. The idea is to time things so that daytime urine production is increased because if you take the diuretic at the wrong time you could end up with the opposite result! If the nsatural diuretics work, great. Got to experiment. Other strategies are daytime napping (or lying prone) and compression stockings. 

Recently, not sure if it was you, someone posted about taking diuretics for retention and I discouraged it as default strategy, but it's a legitmate strategy for nocturia polyuria. Just remember that increased urine production may have some effect on your bph so closely monitor things, go slowly (meaning tread carefully with rx diuretics) and good luck.

Jim

Almost forgot, sodium. Sodium (salt) content in food can also effect nocturia polyuria by causing the body to retain fluids. Some of us have found that having a salty evening meal (or bedtime snack) can help decrese those bathroom trips. I believe we called it the "Potato Chip Solution" Just keep in mind that salt can raise your blood pressure so if you're on (or should be on) a low sodium diet then this is probably not the best approach.

Jim

I forgot to mention that since I've switched to alfuzosin in combination with dutasteride (Avodart) from Flomax, I've been having periods of not needing to urinate for more than 4 hours during the daytime (total daily urine output, however, has remained roughly the same).  At first I thought that I was retaining urine more than usual, but the bladder scans suggest that this is not the case.

Not sure why you say: "Just remember that increased urine production may have some effect on your bph so closely monitor things".   The idea would be to simply shift urine production not significantly increase the daily total.  Maybe that's easier said than done.

With regards to sodium, I usually have mixed nuts as a snack about 90 minutes before bedtime (without drinking water).  Until recently, this strategy seemed to work somewhat.  I already have a "low" normal blood pressure and the alpha blockers have been lowering it further (although alfuzosin doesn't seem to be as bad as flomax). 

I've been taking magnesium supplements before bedtime for my tinnitus.  Last night it occurred to me that the magnesium might be contributing to the problem.  A google search brought up articles mostly about how diuretics tend to remove magnesium from the body, but I did find a few articles that stated that magnesium helps to reduce water retention. Tinnitus aside, magnesium supplements are often indicated for older people since we tend to have magnesium deficiencies.  I'll be shifting when I take the magnesium, but suspect that by not taking it before bedtime it will not have as a good of an effect on lowering the tinnitus volume.

I think the important thing that I'm learning, and you've mentioned it a number of times, is that LUTS is often not only caused by BPH but by bladder issues,  lifestyle and just natural urination changes with aging (increased kidney urine production at night).    But to me at least, it's very difficult to ferret out these additional factors that affect LUTS if one doesn't keep a "urination" journal.  Bladder scanning is also a help for monitoring PVR.  Urodynamics (at a minimum monitoring max flow rate) can also help to establish baselines to assist in determining if bladder outlet obstruction is worsening or easing (as a result of medication or procedures).

Don't mean to butt in, but I suggest switching to Himalayan pink salt or Celtic Sea Salt from regular old salt... MUCH healthier!!  Regular salt (like regular sugar) is nasty stuff. I get mine at a store called "Sprouts"... Whole Foods has it too... and many places online.

The Himalayan is the only salt in our house (you can buy it at Costco).  However, I rarely add salt to food. I only have salt with the mixed nuts.

Voiding is a complex process that can be affected by many factors. And while BPH isn't the only factor with LUTS it can be a major one. Yes, a void diary can be very helpul as well as a portable bladder scanner. I used to keep void diaries religiously and still use a portable bladder scanner at home very once in awhile although by now I pretty much know what it will read before I scan but in the beginning I found it helpful and educational.

Jim

Hi Tusc, Yes, I have heard of Himalayan Pink Salt and will look into it although being a skeptic by nature I wonder how much better it is than what you find off the shelf.

Jim

If you Google it, you will find it has far less sodium per serving... and 80+ minerals in it... table salt has 2... sodium and chloride.  Unless the internet lies... which happens often!