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Dr. Owen
Dr. Owen, OB/GYN (Doctor)
Category: OB GYN
Satisfied Customers: 55752
Experience:  Board Certified: Ob/Gyn & Preventive medicine, US Medical Graduate
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I am 6 weeks and 2 days pregnant, and my hcg levels were rising

Customer Question

I am 6 weeks and 2 days pregnant, and my hcg levels were rising fine, until this latest test. I usually test every 55-60 hours, so not a full 3 days , but more than 48 hours. so at 55-60 hour intervals, my hcg over the last week was 7500, then 16700, then 36525, and now 59851,

My concern is the last blood test. It should have doubled in a 60 hour window. All the other previous ones more than doubled, so does this mean something is wrong? I have no bleeding, no spotting and no pain. and as I said, Im 6 weeks and 2 days pregnant, so what is going on with the hcg not having doubled?
Submitted: 2 years ago.
Category: OB GYN
Expert:  Dr. Owen replied 2 years ago.
Hello, and I am pleased to help, use of my answers are for educational purposes only.
Well your levels are a bit on the high side to be doubling - so at this point, you just need to watch with vaginal ultrasounds - and hopefully by 7 weeks you see a fetal heart beat.
so, doubling past about 10,000 does not fit the 'rule of thumb'.
Also, your doctor should be looking into a molar pregnancy which is not a normal pregnancy.
Dr. Owen, OB/GYN (Doctor)
Category: OB GYN
Satisfied Customers: 55752
Experience: Board Certified: Ob/Gyn & Preventive medicine, US Medical Graduate
Dr. Owen and other OB GYN Specialists are ready to help you
Customer: replied 2 years ago.
Thank you,

but with molar pregnancy, the hcg levels would normally be much higher wouldnt they? Also, based on this last hcg number, do you think it is normal that the number did not double or more than double in 60 hours? would this be considered normal?
Expert:  Dr. Owen replied 2 years ago.
Well they can be - but not always - but I do look for a molar pregnancy especially when the number starts to approach this level and no fetus is seen yet - so it does need to be what is known as the differential diagnosis.
NOw, this might not be a molar pregnancy, but hopefully your doctor is at least thinking about it,.
So, at 6 weeks you do have a higher than normal level of HCG - but it is seen at this level with normal pregnancies so you do just need to keep a watch on this.
Thank you
Dr. Owen, OB/GYN (Doctor)
Category: OB GYN
Satisfied Customers: 55752
Experience: Board Certified: Ob/Gyn & Preventive medicine, US Medical Graduate
Dr. Owen and other OB GYN Specialists are ready to help you
Customer: replied 2 years ago.
Hi,
I wanted to let you know I saw my ob today. Today, I am 6 weeks and 3 days pregnant. My ob was able to see the yolk sac as well as see the heart beat and she said heart beat is AT LEAST 150 bpm. also, she said there is only 1 fetus, so no twins.

So is 150 beat per min good at this stage in pregncy? also, now that she has seen the heart beat and embryo, are my chances of miscarriage a little lower?
Expert:  Dr. Owen replied 2 years ago.
Yes, that is correct, MUCH lower chance of a miscarriage - so congratulations.
Have a good evening.
Customer: replied 2 years ago.
Thannk you, but you did not answer my ? about heart beat
Expert:  Dr. Owen replied 2 years ago.
Yes, 150bpm is a very good heart rate - around 140 to 170 is what I normally see.
Take care.
Dr. Owen, OB/GYN (Doctor)
Category: OB GYN
Satisfied Customers: 55752
Experience: Board Certified: Ob/Gyn & Preventive medicine, US Medical Graduate
Dr. Owen and other OB GYN Specialists are ready to help you
Customer: replied 1 year ago.

Doctor, can you please answer a ? for me because other wise I will have to wait until tomorrow afternoon for my doctor to call and explain. I have been having extreme amount of frequent urination since 2nd trimester of my pregnancy and now I am 3 weeks postpartum and still going pee every 1 hour to hour & half and I have a constant urge. they did a test for a UTI and the culture results just came back online, but I do not understand them. I am going to copy and paste them and can you please tell me if I have a UTI, and if so, what is the antibiotic I need to be on? Thank you so much


 














Urine culture resultFinal Report
GREATER THAN 100,000 COL/ML ENTEROCOCCUS
ORGANISMECOC
Expert:  Dr. Owen replied 1 year ago.
Try typing in the results...
Customer: replied 1 year ago.

it says final report is Greater than 100,000 COL/ML ENTEROCOCCUS AND right below it , it says ORGANISM: ECOC

Customer: replied 1 year ago.

does this mean i have a UTI?

Expert:  Dr. Owen replied 1 year ago.
okay you have an UTI - urinary tract infection and YOU need to be on antibiotics to get this taken care of - and when you have this - this usually tells you which antibiotic will work - so you might need Macrobid, Keflex, or Cipro.
I hope this helps
If you have more questions, please ask
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Dr. Owen, OB/GYN (Doctor)
Category: OB GYN
Satisfied Customers: 55752
Experience: Board Certified: Ob/Gyn & Preventive medicine, US Medical Graduate
Dr. Owen and other OB GYN Specialists are ready to help you
Customer: replied 1 year ago.

This is actually a big relief for me because this whole time I have been thinking I have IC or an overactive bladder and was going to see the urologist. I have some followup ?s to ask you


 


1) In terms of a UTI, since I have it, do you think that is why I am going pee every 1 hour and such urgency? Or do you think even though I have a UTI, I still could have overactive bladder? I do not have any burning with the frequent urination.


 


2) as far as the organism that showed up in culture, which one of these antibiotics specifically would get rid of the specific bacteria that I have?


 


3) also, is it normal to go pee every hour with a UTI?

Expert:  Dr. Owen replied 1 year ago.
Yes, an UTI would cause you to urinate all the time.
You might still have an overactive bladder - but COrrect the infection first and see what happens.
What you should do is get an antibiotic that is 'Sensitive' to the Enteroccus and this is usually shown next to the result, but Macrobid should work
I hope this helps
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Dr. Owen, OB/GYN (Doctor)
Category: OB GYN
Satisfied Customers: 55752
Experience: Board Certified: Ob/Gyn & Preventive medicine, US Medical Graduate
Dr. Owen and other OB GYN Specialists are ready to help you
Customer: replied 1 year ago.

Thank you. I have never been diagnosed with overactive bladder. I was going to go have the cystoscopy done to find out in 2 weeks.


 


- in your professional opinion, is this a common UTI after having given birth 3 weeks ago and do you think my urinary problems will go away after the antibiotics?


 


- If I do end up having an overactive bladder, are the medications that are available like deterol going to make me pee like a normal such as 5-6 times a day, or would the medication only improve the frequency and have me go pee from every hour to every few hours?

Expert:  Dr. Owen replied 1 year ago.
yes, I do see UTI's commonly after delivery.
As for overactive bladder - there are medications and a good medication for Overactive bladder (OAB) is Detrol LA (either 2mg or 4mg) per day.
More than likely after you correct the UTI, the OAB will be much improved.

I hope this helps
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Dr. Owen, OB/GYN (Doctor)
Category: OB GYN
Satisfied Customers: 55752
Experience: Board Certified: Ob/Gyn & Preventive medicine, US Medical Graduate
Dr. Owen and other OB GYN Specialists are ready to help you
Customer: replied 1 year ago.

sorry to bother you, I am confused. How can I know if this frequency is from the UTI or if I even have an over active bladder? How is an overactive bladder diagnosed? Because I assumed that my frequency and urge of urination will go back to normal after I finish the antibiotics, but you think I will still have OAB?

Expert:  Dr. Owen replied 1 year ago.
Well the only way to really to is to Treat the Infection first with an antibiotic and if you still have this over active bladder (OAB), when the infection has been totally treated, then you will know this is from OAB.
But, you CAN use BOTH the antibiotic and also the medication for OAB such as Detrol at the same time.
So, go ahead and treat both that way you feel well.
If after you have been treated effectively for the UTI, then see what happens when you stop the Detrol or similar medication IF you have used both the antibiotic and Detrol at the same time.

I wish you well
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Dr. Owen, OB/GYN (Doctor)
Category: OB GYN
Satisfied Customers: 55752
Experience: Board Certified: Ob/Gyn & Preventive medicine, US Medical Graduate
Dr. Owen and other OB GYN Specialists are ready to help you
Customer: replied 1 year ago.

Hi Dr,


My ob doctor just sent me an email saying she saw that I do have a UTI and has prescribed me amoxicillin antibiotic. This is not one of the antibiotics you mentioned above.


 


Does this antibiotic work for the specific bacteria that I have? and also, I am very prone to nausea and vomiting, will this antibiotic cause me a lot of nausea ?

Expert:  Dr. Owen replied 1 year ago.
Amoxicillin is a good medication for Enterococcous - so that will work too
This medication should not cause nausea and vomiting.
I wish you well
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Dr. Owen, OB/GYN (Doctor)
Category: OB GYN
Satisfied Customers: 55752
Experience: Board Certified: Ob/Gyn & Preventive medicine, US Medical Graduate
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Customer: replied 1 year ago.

Hi Dr,


wanted to let you know I started the antibiotic for the UTI last night. So far I have taken 3 pills and my next dose is in about 2 hours. I am still feeling the same amount of frequent and urge to urinate. Is this normal? How long does it take before the frequency and urge go to normal?

Expert:  Dr. Owen replied 1 year ago.
Yes, that is fairly normal - it can take a few days for a UTI symptoms to resolve - as the bacteria infection irritated the lining of the bladder and the urethra - so it does need to heel.
so, give it a few days.
I Hope this helps
If you have more questions, please ask
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Dr. Owen, OB/GYN (Doctor)
Category: OB GYN
Satisfied Customers: 55752
Experience: Board Certified: Ob/Gyn & Preventive medicine, US Medical Graduate
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Customer: replied 1 year ago.

Thank you. So if after the antibiotics are gone if I still do not have relief from the frequency, would they normally have me test again to see if the UTI is still there. and if the UTI is still there, what do they do at that point?

Expert:  Dr. Owen replied 1 year ago.
yes, they would test you again if you still have symptoms of a UTI.
IF you still have an UTI - then you should have a culture done to see WHICH antibiotics would be MORE sensitive - and you might need another antibiotics if you still have an UTI.

I hope this helps
If you have more questions, please ask
Please click on EXCELLENT, thank you
Customer: replied 1 year ago.

They just checked me again for a UTI and it came up negative, so the antibiotics apparently cleared up the infection, however, I am still going pee 1-2xs an hour and have constant urgency. I think I have over active bladder and I wanted to ask you some ?s about it


 


1) I never had this problem til about 10 months ago. I used to go pee only about 4xs a day. What do you think caused this? and do you think its permant or will go away?


 


2) if they give me deterol LA, will it only slightly make me go pee less or will it put me back to normal at 4-6xs a day of urination?


 


3) if the medications do not work for me or I can not tolerate the side effects of them, what is my solution to this problem? This is incredibly debilitating for my life as I can not go to movies, party, etc.


 


Thanks

Expert:  Dr. Owen replied 1 year ago.
Hi
This is probably what is known as 'Urge' incontinence and yes Detrol LA can help with urge - start with a 2mg dose and if necessary then increase to 4mg dose.

Also, trying to 'Train' when you urinate - and holding your bladder in can help too - this can be tough to do, but it can help - it will take a lot of will power, but it is possible.

As for tolerating Detrol LA - most women tolerate it - but if you can not, then get seen by an Urologist for other possible solutions - there is even a device called Interstim - but you do not seem like you need that yet.

I hope this helps
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Dr. Owen, OB/GYN (Doctor)
Category: OB GYN
Satisfied Customers: 55752
Experience: Board Certified: Ob/Gyn & Preventive medicine, US Medical Graduate
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Customer: replied 1 year ago.

Do you think this is a permanent problem or will go away?


 


- also, in terms of if the medication, how much of the urge and frequency of urination will the Deterol LA bring to me? I mean will it bring me back to urinating like I used to 4-6xs day? or will it be only slightly effective in bringing down the urge and frequency?

Expert:  Dr. Owen replied 1 year ago.
Many times this is something that does resolve -
Usually Detrol should cut down your urge/ frequency by 20 to 50%, and hopefully urinating just 4 to 6x's per day.

But, do get seen by an Urologist - but you should also get a cystoscopy done to check the inside of your bladder checked.

I hope this helps
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Thank you
Dr. Owen, OB/GYN (Doctor)
Category: OB GYN
Satisfied Customers: 55752
Experience: Board Certified: Ob/Gyn & Preventive medicine, US Medical Graduate
Dr. Owen and other OB GYN Specialists are ready to help you
Customer: replied 1 year ago.

Hi, wanted to update you that I had a KUB ultrasound done and everything came up normal, I also had a cystoscopy done and that too showed everything was normal. I am literally unable to do much or go out of the house much as I am urinating 1-2xs an hour and even when I go pee, I still constantly feel the urge,


 


You said many times this goes away, in your experience with patients, how long does it usually take before this goes away? I have been dealing with this for almost a year now,


 


also, if I am urinating around 25-30xs a day, in your expereince, does detrol LA 2mg have enough of an effect to stop the bladder spasms completely to where I would only pee 4-5xs a day or will it only help a little bit to the point that I will still pee over 10xs a day?

Expert:  Dr. Owen replied 1 year ago.
okay - this appears to be getting worse -
And since you are having this much urge
then I would consider something called Interstim

http://www.everyday-freedom.com/

Also, if you do consider this - make sure this is done by an Urologist or an Urogynecologist - and here is a group of Urogynecologists out of Atlanta, Georgia that does this procedure

http://www.miklosandmoore.com/interstim.php

I hope this helps and I am sorry this is still continuing

Dr. Owen, OB/GYN (Doctor)
Category: OB GYN
Satisfied Customers: 55752
Experience: Board Certified: Ob/Gyn & Preventive medicine, US Medical Graduate
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Customer: replied 1 year ago.

thank you,


So at this point, are you saying that the detrol would not stop this for me?


 


and as far as this interstim, does this completely stop the bladder spasms and urgency symptoms and are there any big risks such as having to use intermittent catherer , because I do not want to be using cathers as I am only 33 yrs old

Expert:  Dr. Owen replied 1 year ago.
Well if the Detrol is not helping and you are already at the maximum dosage per day, then you can change to a more powerful medication such as Ditropan instead and see if that helps

As for Interstim - this is done in stages - so before there are any permanent implants - there is testing done to see if the Interstim will actually work
Customer: replied 1 year ago.

No, I think there was a misunderstanding, I have not tried the detrol yet, they want to consider giving it to me at my next appointment,


 


Thats is why I am asking you, in your experience, does the detrol usually make this problem I am having stop to where I am peeing at a normal 4-5xs a dayl, or will it only help a little?

Expert:  Dr. Owen replied 1 year ago.
okay - well Try the Detrol first - start at 2mg per day, then if necessary - increase to 4mg per day.

SO, yes, try the Detrol and hopefully this will start to help you - you are still quite young, and more than likely this will help you
Dr. Owen, OB/GYN (Doctor)
Category: OB GYN
Satisfied Customers: 55752
Experience: Board Certified: Ob/Gyn & Preventive medicine, US Medical Graduate
Dr. Owen and other OB GYN Specialists are ready to help you
Customer: replied 1 year ago.

thank you but what I am specifically asking you is - in your experience, will the detrol stop these spasms and I will go back to peeing like I used to a year ago about 4xs a day, or will it just help a little in your experience?

Expert:  Dr. Owen replied 1 year ago.
Well usually Detrol will stop it and if you need More help increasing the potency to a stronger medication such as Ditropan might help.
You really just need to try this.

Also, get evaluated too for IC - Interstitital cystitits - because a medication called Elmiron might help too.
Dr. Owen, OB/GYN (Doctor)
Category: OB GYN
Satisfied Customers: 55752
Experience: Board Certified: Ob/Gyn & Preventive medicine, US Medical Graduate
Dr. Owen and other OB GYN Specialists are ready to help you
Customer: replied 1 year ago.

Hi Dr Own, I saw the urologist today & had a post residual ultrasound done as well as a cystoscopy. The pvr number was 79 which doc said means I am emptying my bladder well. the cystoscopy showed nothing abnormal and he was very unhelpful. He offered me no solutions and said this is NOT a urology issue. He did not think detrol would help me. He said a nephorolgist may shed some insight. I am completely in tears and frustration as I am spending a majority of my day/night in the bathroom, peeing about 2.5-3 liters and about 18-26xs in a 24 hour period. I can not hold a job and cant possibly live a functional life this way. I have no idea what to do or who to get help from.


 


can you please offer some advice on what you think this is? Based on my own research, I have come up with some possibilities of multiple scrlerosis, diabetes insipidus, or possibly kidney problems.


 


How can someone who barely drinks 1.5 liter of liquid produce this much urine this often?


 


Please help!

Customer: replied 1 year ago.

Hi Dr, did you see my ? I have not received a reply

Expert:  Dr. Owen replied 1 year ago.
Hello
I'm sorry I was offline - I'm back

Did you at least get any medications such as Detrol or Ditropan to help?
Customer: replied 1 year ago.

No nothing. No meds. So what do you think is going on with me and what do you advise me to do next?

Expert:  Dr. Owen replied 1 year ago.
I'm looking back when this question started - are you still pregnant?
Customer: replied 1 year ago.

no, I had my baby in mid nov, and I thought back to it, and this problem had started about 2 months before I got pregnant, but at that time, it was less severe, I was going pee about 10xs a day. But until that time ( about two months before I got pregnant) so until Jan of last year, I never had this issue, I would pee only 3-4xs a day with no urgency


 


The doctor said I am emptying my bladder just fine

Expert:  Dr. Owen replied 1 year ago.
But you do have urgency - and hence a Cystoscopy showed there is nothing visible - so there is no clear 'fix' from an urologist standpoint - so surgery is not something that would help -
But, this a something that is nerve initiated - so Urgency can be controlled with Medications such as Detrol or Ditropan - and I would hope you could at least get one of your primary care doctors to prescribe this to you.
Also, yes, I would see a Nephrologist - but unlikely a kidney issue, more of a bladder / urgency issue.

Also, you should also get pelvic biofeedback - sometimes that might help too.

Your ob/gyn might also be able to refer you to an Urogynecologist too for help - it sounds like the Urologist was not interested in helping you at all.

But, I would try the Detrol or Ditropan - see if that helps
Dr. Owen, OB/GYN (Doctor)
Category: OB GYN
Satisfied Customers: 55752
Experience: Board Certified: Ob/Gyn & Preventive medicine, US Medical Graduate
Dr. Owen and other OB GYN Specialists are ready to help you
Customer: replied 1 year ago.

so in your opinion, could this be diabetes insidius? and will the nephorolgist be able to rule out any kidney problems?


 


In your opinion, will this eventually go away or will I have to live with this for life?

Expert:  Dr. Owen replied 1 year ago.
It could be - but a Nephrologist would have to look at that too.
I would really try to use Detrol / Ditropan - because if this is urgency - these medications will help and this Usually will go away -
Plus, I would also do the Biofeedback PHysical therapy - any doctor can set you up with a physical therapist who does this - it is also called 'Bladder Training'

I wish you well
Dr. Owen, OB/GYN (Doctor)
Category: OB GYN
Satisfied Customers: 55752
Experience: Board Certified: Ob/Gyn & Preventive medicine, US Medical Graduate
Dr. Owen and other OB GYN Specialists are ready to help you
Customer: replied 1 year ago.

thank you very much,


 


just a couple of ?s -


 


1) who is the doctor I can go to to rule out diabetes insidious? gynocology or nephrology or my internist?


 


2) If my body is producing large amounts of urine, I think I am peeing about 3 liters a day, how can the detrol stop the over production of urine?


 


3) when you say this will go away, do you mean as long as I am on the detrol, or do you think it will get to a point where it will go away on its own when i take no medicaitons?

Customer: replied 1 year ago.

hi dr, i never got a reply back to my follow up ?s

Expert:  Dr. Owen replied 1 year ago.
I'm sorry - I never saw them - but I do now....

1. For diabetes indipidous you can seen an Internal Medicine, Endocrinologist, or a nephrologist.

2. As for stopping a Lot of urine - then a nephrologist would be the type of doctor to see - about 2500 mL (2.5 liters is actually normal) - so 3 liters is not that excessive - but Detrol can help with Urgency.

3. This urgency can go away - sometimes it is a matter of 'retraining' how and when you urinate. That is why I have suggested Physical therapy .

I hope this helps
Thank you
Dr. Owen, OB/GYN (Doctor)
Category: OB GYN
Satisfied Customers: 55752
Experience: Board Certified: Ob/Gyn & Preventive medicine, US Medical Graduate
Dr. Owen and other OB GYN Specialists are ready to help you
Customer: replied 1 year ago.

so are you saying that even though I am producing a lot of urine, that it is actually the URGENCY that is making me go pee so much, and not the fact that I am producing so much urine?


 


In terms of the physical therapy you are talking about, what doctor can refer me to this, and can you please explain what this therapy involves?

Expert:  Dr. Owen replied 1 year ago.
More than likely it is the Urgency that is causing this - but I would suggest seeing one or two of the doctors I have suggested.

There is something that some physical therapist can do called 'Bladder Training' and this can help you possible to 're-learn' when you 'should' urine so that your bladder is not over stimulated.

Dr. Owen, OB/GYN (Doctor)
Category: OB GYN
Satisfied Customers: 55752
Experience: Board Certified: Ob/Gyn & Preventive medicine, US Medical Graduate
Dr. Owen and other OB GYN Specialists are ready to help you
Customer: replied 1 year ago.

Hi Dr,


Wanted to update that I am going to see a urogynocologist specialist as well as a nephorologist next week. In the mean time, my primary care physician ordered a bunch of blood test as well as a urine test OSMOLALITY, URINE and I just got the results online- I am not a doctor, but to me, they seem to be normal. I had some ?s on a couple of them''


 


- first, the glucose fasting ( I fasted for 12 hours) my result is 96 and it says standard range is 60-99 wouldnt this put me at a borderline prediabetic level?


 


-there was a blood test done for ALT ( have no idea what this is) but it says standard range is <36 and my result was 35 so whatever this test is for, would I not be considered on the border or is this normal?


 


-The osmolalty urine result for me was 1003 and the osmolalty serum blood was 294. are these normal?


 


 


Based on this, I believe this rules out diabetes insipidus, or kidney problems which could be causing this urinary issue for me. Is that correct?

Expert:  Dr. Owen replied 1 year ago.
Your glucose is EXCELLENT - this is not borderline - it is very good.

ALT - this is a liver enzyme - and 35 is still VERY GOOD.

The osmolality of urine is Going to be very high - because it contains 'waste' such as salts - so it will be very high - so that is expected and very normal.

So you do not have diabetes insipidus and your kidneys look good.

I hope this helps
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Dr. Owen, OB/GYN (Doctor)
Category: OB GYN
Satisfied Customers: 55752
Experience: Board Certified: Ob/Gyn & Preventive medicine, US Medical Graduate
Dr. Owen and other OB GYN Specialists are ready to help you
Customer: replied 1 year ago.

thank you- so I wanted to ask couple things


 


- In regards XXXXX XXXXX glucose, it says standard range is 60-99 and mine being so close to 99 ( mine 96) how is it that I am not considered on the border?


 


- and based on the cystoscopy, I do not have bladder cancer, no endometriosis, the ct scan showed no problems with stones or tumors in my kidneys, I am not diabetic, you are saying I do not have diabetes insipidus for sure, and my doctor said I do not have a prolapsed bladder''


 


So would you say at this point that I may have a neurological problem? ( I have no signs of anything weird) or in your opinion what is causing this urine problem?


 


ps: I got my internist to prescribe the detrol la 2mg and I started it yesterday, but so far no change in my urination frequency or urgency

Expert:  Dr. Owen replied 1 year ago.
No, your glucose is not borderline - those ranges are the 'normal' ranges - so it is not borderline - so still very normal.

Your lab values show you do not have Diabetes insipudus.

You might have what is known as 'Neurogenic bladder' - that is probably what you are referring to

Give the Detrol some time, and you might need to increase to 4mg per day too. A stronger medication would be Ditropan.

I wish you well and hope you have a good day.
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Dr. Owen, OB/GYN (Doctor)
Category: OB GYN
Satisfied Customers: 55752
Experience: Board Certified: Ob/Gyn & Preventive medicine, US Medical Graduate
Dr. Owen and other OB GYN Specialists are ready to help you
Customer: replied 1 year ago.

I got the test results of all the blood work and the sodium urine and sodium blood test, and everything came back normal, as well as my creatine and my BUN, so I am assuming I do not have any kidney problems as well, is this correct?


 


I also measured how many times I went pee and how much I went in the last 24 hours starting at 5pm yesterday pacific time and I was surprised to find out that I went pee a total of 14 times in 24 hours, and my TOTAL urine measurement in that 24 hours was 28oz- which is less than a liter, so I am thinking I am not suffering my polyuria. Is the amount that I am peeing normal?

Expert:  Dr. Owen replied 1 year ago.
This is great news as you do not have any kidney problems then.

And, yes you do not have polyuria - but you are urinating more frequently - so that tells me this is more neurogenic / urge incontinence - and this can be corrected with medication such as Detrol or Ditropan In addition to bladder training (which a physical therapist can help you with).

So, I think you will be able to get help for this

I wish you well
If you have more questions, please ask
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Dr. Owen, OB/GYN (Doctor)
Category: OB GYN
Satisfied Customers: 55752
Experience: Board Certified: Ob/Gyn & Preventive medicine, US Medical Graduate
Dr. Owen and other OB GYN Specialists are ready to help you
Customer: replied 1 year ago.

thank you I have a few ?s


 


- by urge neurogenic do you mean I have a neurological problem like MS or parkinsons?


 


- Do you think this is IC?


 


- and will this urge go back to me urinating at normal frequency if my bladder is trained? To where I can go pee every 4 hours?

Expert:  Dr. Owen replied 1 year ago.
No, not at all - urge / neurogenic bladder has nothing to do with MS or Parkinson's - sometimes your bladder can be 'over-stimulated' and trying to RE-Train your bladder usually helps.

I have also found success with a medication called Elmiron which is normally used for IC - Interstitial cystitis of the bladder.

You should be able to get back to urinating 7 to 10 times per day

I hope this helps
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Customer: replied 1 year ago.

sorry , but I am a bit confused.


 


So if I am not urinating more than 1 liter in a 24 hr period, does this urge problem mean that I need to train my bladder to go LESS FREQUENTLY, but when I do go- then to pee more? or even if I go less frequently will I still be urinating only 2ounces at a time?


 


- and I really do not have any pain, so do you think this is IC or just overactive bladder?


 


-I used to urinate about 4xs a day before this problem started, but you are saying that I should be able to urinate 7-10xs a day, which seems excessive. so does that mean that even with medication I will still pee as often as 7-10xs a day?

Expert:  Dr. Owen replied 1 year ago.
Yes, you should urinate on average about 200 or so mL, and you are urinating much less than that based on what you have told me tonight.
so, yes you want to urinate more PER time you go to use the bathroom and urinate less frequently.

You unlikely have IC, but sometimes the Elmiron might help - sometimes it is worth a try if the detrol or ditropan does not work well enough.

Urinating 4x's per day is okay, but you 7 is sometimes a better number.

I wish you well
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Customer: replied 1 year ago.

So from what you are saying, I basically have a overactive bladder with my main problem being URGE to constantly go. So with the medication and bladder training, will this urge stop completely or will I always have some of it?


 


- also, how do I get my body to not have to go to the bathroom during the night when I sleep? In a 8 hour sleep time at night, I have to go on average 2-3xs


 


-lastly, I have realized I do not drink much of anything in a 24 hour period. I drink at most 1.25 liter of fluid a day- mostly consisting of soda and juice, but if I start drinking more fluids and more water- won't that just make me pee more frequently with more urge?

Expert:  Dr. Owen replied 1 year ago.
Well more than likely with Bladder Training and use or medication such as Detrol or Ditropan should help you.

There are Physical Therapists who specialize in Pelvic problems such as urinary bladder Re-Training.

And, you should be able to make it through the night without urinating, and usually we suggest no caffeine, no fluid after dinner.

I hope this helps
If you have more questions, please ask
Thank you
Customer: replied 1 year ago.

But in terms of actually drinking more fluids, water, which my body needs to produce more urine, what I am asking is- if I start drinking more fluids- even if its more water and less caffeine, wont that just make me pee more frequently with more urge?


 


and I still do not understand- how do I get the night time urination to stop?

Expert:  Dr. Owen replied 1 year ago.
Actually water should help produce more urine, but less urge to urinate as there will be less 'salts' in the urine to irritate the bladder - so drinking less caffeine, etc will help.

And, drink less after dinner helps too to prevent you from having to urinate when you are asleep. So, it is okay to get up once per night and urinate, but getting up 2 or more times is a bit unusual. So, this really comes back to using Detrol, with bladder training, and also drinking water, but stop drinking all fluids after dinner - this might help you.

I hope this helps
If you have more questions, please ask
thank you
Dr. Owen, OB/GYN (Doctor)
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Customer: replied 1 year ago.

so than are you saying it is a good idea to increase my fluid intake to about 2 liters a day, but make most of that be water?


 


and I started the detrol a few days ago. So I have taken 3 pills in 3 days. So far, no side effects. How long do the side effects take to kick in if I have them? and how long before the medication starts to work to decrease urge?

Expert:  Dr. Owen replied 1 year ago.
yes you should, especially with water as this can help decrease the 'sensitivity' within the bladder.

And, give the Detrol some time to work too.

Give it at least a week, and 2mg is the low dose, as you might need to increase to 4mg per day.

I hope this helps
and I wish you well tonight
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Customer: replied 1 year ago.

Hi Dr,


I wanted to update and let you know I have now seen all sorts of specialist and they have done blood work, kidney scans, urine tests, and everything has come back negative. So they are telling me I just have an overactive bladder and want to have me do timed voiding when I urinate as well as send me to biofeedback. The urogynocologist told me since I have so much urge, that even when I get the urge to urinate, I should hold it and not go until my next timed void. I wanted your opinion on if you think this will work for me? ( I have been on detrol LA 4mg for over a month and its really not helping me) do you think its possible I may have some urinary bacterial infection that is rare and does not show up on regular urinalysis and perhaps the doctors need to look for it specifically? or do you thinkk this is just overactive bladder?

Expert:  Dr. Owen replied 1 year ago.
And, have you had Cystometrics and an cystoscopy?
Customer: replied 1 year ago.

yes both showed everything is fine. They did the ultrasound as put syringe or something and found that I do not have a retention problem

Customer: replied 1 year ago.

did you see my reply?

Expert:  Dr. Owen replied 1 year ago.
Did the Detrol help and did you use any other medication?
Customer: replied 1 year ago.

no the detrol is not helping much at all, its only giving me bad side effects of blurry vision and dry mouth. and none of the doctors put me on any other meds

Expert:  Dr. Owen replied 1 year ago.
IF all the testing has been normal, including the cystometrics, the Cystoscopy, the Urinanalysis, and urine cultures, and if the Detrol is not helping then more than likely this is just something that will require bladder training for OAB - Over Active Bladder - and to Help, I would suggest finding a Physical Therapist as they can help you with 'BioFeedback' mechanisms to help you.
Usually an Urogynecologist, Ob/gyn or Urologist can give you the names of PHysical therapists near you who can do this type of behavioral training.

I hope this helps
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Customer: replied 1 year ago.

I have some ?s to ask you


 


- they have scheduled me for a biofeedback appoinment to have 4xs once per week. Is this what you are talking about in terms of the physical therapist?


 


- in your opinion, will the timed voiding and biofeedback help? do you think this problem will resolve and I will pee normal like 4-6xs a day?


 


- do you think there is a chance it could be a rare bacterial infection that they are not looking for in the urinalaysis?

Expert:  Dr. Owen replied 1 year ago.
Yes, that is exactly what I am talking about for the biofeedback.

Yes, the timed voiding and biofeedback helps - and it will be HARD and DIFFICULT at first, but put your mind to it and that is where the biofeedback will help.

And, then eventually YOU should return to normal
I wish you well
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Customer: replied 1 year ago.

so you do not think this is a rare bacteria they have not seen and that is what is causing this?

Expert:  Dr. Owen replied 1 year ago.
No, I do not think this is a rare bacteria - because if this was the case - then the Urinanalysis would such Leukocyte Esterace, Nitrates, and also WBC's (white cells) would be greater than EPI's (epithelial cells) - so since that was normal, then this is not a rare bacteria.

I hope this helps
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Customer: replied 1 year ago.

hi dr, I want to ask ? of you


 


So I just had baby on november 2012, and at my post pardum checkup they did pap smear, and the hpv part came back negative, however, they said they found some abnormal cells. ( this is very first time I have ever had an abnormal pap) so they did biopsy, and said they found low grade dysplasia... no sign of cancer, but I am really scared. I know cervical cancer is a slow progressing cancer. I do not have a history of it in my family.


 


I would like to know- what do you think chances of me developing cervical cancer from these low grade abnormal cells are? and do you think I will have a normal pap test when they redo this in 1 year? again, the hpv was negative

Expert:  Dr. Owen replied 1 year ago.
Low grade Dysplasia is OKAY - this usually goes away on its own and you really do NOT need to worry about this.

Staying healthy and if you smoke I suggest to quit. and Please do not worry about this.
The chances of this developing into cancer is close to zero since you are getting this treated and evaluated - so please do not worry.

I hope this helps
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Customer: replied 1 year ago.

hi, thanks for your reply. So they are having me do another pap test in about 6 months to a year and I wanted to ask you some followup ?s


 


1) is that soon enough to have this looked at again- a pap in 6 mo to a year?


 


2) how likely is it that the next pap in a year will be normal?


 


3) even if these are abnormal cells, they can do a leep procedure I read to take off the abnormal cells. Is this successful? and will any of this cause me to not be able to get pregnant or affect fertility? I am 33yrs old and would like to have one more child in about 2-4 years

Expert:  Dr. Owen replied 1 year ago.
Yes 6 months is Perfect and Usually if you do not smoke the dysplasia should be GONE - it usually is as your own body treats itself.


A LEEP is not usually done for Low Grade as it is not needed.


So you really do not need to worry about this

I wish you well
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Customer: replied 1 year ago.

well, I do smoke. I smoke about 7-8 cigarettes a day, and to be totally honest and realistic, I do not plan on quitting right now, for a few more years, so having said that, is it still likely the abnormal cells will be gone in 6 months and I will have a normal pap then?


 


also, not sure if you read my ? about the infertility/pregnancy , but I would like to know, will any of this, even if the abnormal cells do not go away, will any of this affect my fertility or chances of getting pregnant in 2-4 years?

Expert:  Dr. Owen replied 1 year ago.
Well the best way to stop the low grade dysplasia and to allow your cervix to heal is to stop smoking, we know that is the best way to have a normal PAP the next time.

This will not affect your fertility, so please do not worry about this.
I wish you well
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Customer: replied 1 year ago.

Im sorry, just so I understand, as I have anxiety about this, if I do not stop the smoking, what is realistically and likely to happen with these abnormal cells? are you saying they will turn into cancer? I just want to know realistically what is likely and the worst that can happen if I do not stop smoking.


 


Thanks

Expert:  Dr. Owen replied 1 year ago.
Smoking and low grade dysplasia can cause you to continue to have low grade dysplasia or increase to high grade - so hence we HIGHLY recommend stop smoking - because the ONLY way you cure these type of cervical problems is to stop smoking - that is the Only way - there is no way around that.

So, you stop smoking you CURE the cervix - very simple

I hope this helps
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