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Dr Ted Manos
Dr Ted Manos, Board Certified OB/GYN
Category: OB GYN
Satisfied Customers: 716
Experience:  40 years experience; Board certified Ob-Gyn
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I was recently prescribed Keflex 250 mg daily, for 30 days

Customer Question

I was recently prescribed Keflex 250 mg daily, for 30 days with several refills. I'm on day 25 of the first fill. I have IC since 2008-2010 (formally dx in 2010). I take elimiron, 4x daily (I often forget & only tale 2x daily). My main problem with the IC is pelvic pain - constant. I have no urg/freq. just pressure pain, voiding helps. I was given TPI in Dec of '15 - but I believe I had a uti at the time. Hard to tell if the TPI helped due to pain from uti. Cipro fixed. My concern is how long it's safe to be on Keflex. My doc in dallas is very good, but it was his NP who rx' the Keflex. I also take AZO. I battle yeast inf. Many docs don't recognize the big issues & pain of yeast - these AB's really aggrevate the pain - I have to beg for diflucan. Now I buy in Mexico - so sad. Any advice on the Keflex? I can't take macrobid. I'm resistant now. My IC (I think) is uti initially - that was not treated properly. 8 years later - daily pain & working around it. I'm 47 & otherwise very healthy & fit. No smoke/no alcohol/no caffeine.
Submitted: 1 year ago.
Category: OB GYN
Expert:  Dr Ted Manos replied 1 year ago.

Hello, I'm Dr Manos MD, board certified obgyn. IC is a chronic problem with what seems to be the bladder. The urine usually doesn't show wbc's or grow consistent bacteria. I had a customer in the last week or so concerned with her IC. I've been studying the herpes simplex virus that gains entrance to sensory nerve cells in the pelvic area and could this be a manifestation of an uncommon herpes problem. I advised the customer to get blood drawn looking for antibodies to the herpes virus. Millions of people have history of herpes and millions have antibodies with no obvious infections. You asked if something was missing with your care? What's missing is knowing what's really going on. You might ask your doctor to check for antibodies to the herpes virus and place you on Valtrex 500 mg twice per day if positive. I may be totally off base but maybe not.

Expert:  Dr Ted Manos replied 1 year ago.

I've not heard back from you. I've discussed my theory with other doctors and they agreed the link with the common herpes virus is possible. Waiting for your input

Customer: replied 1 year ago.
Hi Dr Manos, thank you for your responses. I've been tested for herpes numerous times, because I found out a partner I had a one time was dishonest. After ending that relationship. I tested many times (nervous), and each test came back negative. Is there a specific test I should request? I have not had any herpes sores either. The last test was probably 2009 or so. I have not had a new partner since - I did marry a very honest man in 2011, and he is aware that I was exposed by someone who lied. But again, no symptoms & all tests negative. I bet I was tested 6-7x over a year. I was such a nervous wreck - I got tested all the time for peace of mind. You still think I should ask for valtrex??
Expert:  Dr Ted Manos replied 1 year ago.

The test I'm referring to is the test for IgG antibodies to herpes simplex virus type 1 (found mostly in oral lesions ) and Herpes Simplex Virus type 2 found in genital outbreaks. If you had herpes in the past, the tests would be positive even if the virus is dormant. If positive then go with Valtrex and if negative then I can't justify the drug. IgG antibodies is a simple blood test and inexpensive

Customer: replied 1 year ago.
I have not had lesions. I was vaginally swabbed (I freaked out when I learned I'd been lied to by a partner I trusted AND had asked up front, if they were healthy - people definitely lie), just to be safe. so I've had swab tests and numerous blood tests, for both H 1&2, everything always came back negative of antibodies. This was 7-8 years ago for tests - no lesions still & no new partner. My husband has never exhibited any symptoms either. I've also never had a cold sore, ever. No chicken pox as a child.I can ask my GP if he thinks valtrex might help pelvic pain. I really wanted to know your thoughts on how long I should be expected to take 250mg of Keflex daily - for uti prevention? What is normal? Should I worry with vaginal yeast issues with Keflex ? IC is very complicated & for me, a lot of variables came about at the same time. My bladder viewed in December by cystoscope, Dallas Doctor said it has signs of inflammation (increased vestibular ??) - nothing else was suggested after the TPI's - and again, I think I had a UTI, since I went on cipro following the procedure (about 2 weeks later, for 20 days), to finally rid infection. I never rid easily of uti (it's always been ecoli), so I usually have to take AB longer than normal regimen. Thank you again.
Expert:  Dr Ted Manos replied 1 year ago.

You might check IgG antibodies now. If your given keflex take as directed. There is no protocol for IC treatment with various antibiotics. I can't add anything to this topic. Valtrex is a consideration but speculative without IgG antibodies.

Customer: replied 1 year ago.
Thank you. I'll ask that I be tested again via blood tests. My concern at the moment is why I cannot make a user name private as it appears my questions & your answers are subject to being placed in public for anyone to read - and my user name is ***** ***** & PII, it would be a violation of hipaa to disclose this & I have not provided consent. The "sign up" area mush have had it very hidden, I since found language that states my questions are not private. I'm very concerned as we have discussed very private matters. I cannot "edit" my user name? I cannot remove my payment data? I feel like I'm trapped & ive inadvertently released information I intended for permenant privacy. Now it's on the internet forever with my user name as my first/last name. Very upsetting. I want to change this. I was not upset with your answers, but extremely concerned about the inability to change to a more de-identifying user name, and cannot. Please suggest a way out of this program - I can't use it again knowing our threads are public - and I want to erase my information from this data base. ***** ******** *** *** **** - I think I need to speak with some one tomorrow about being removed - since I cannot edit my name.
Expert:  Dr Ted Manos replied 1 year ago.

I only accessed your information on my screen. Your name doesn't appear anywhere except on your latest text. The only info I get is thru my password ***** personal email that I erase after it directs me to Justanswer where I read the chronology of texts. No names except what names the experts text which, of course, are not used for username and password.

Customer: replied 1 year ago.
Thank you dr manos. I believe my original question was never answered, as evidenced by your comment above: "I cannot add to this topic." You advise to take my medication as prescribed. I asked if I needed to be concerned about how long to take it. No answer.What did occur was an exchange of some juicy Internet search words, over herpes & VD, at your coaxing - that anyone can type in a search browser & read for threads. I think I'll use this thread opportunity to convey my disappointment & suspicion that the "justanswer" business-model & focus is more about steering conversations to commonly searched topics (like herpes) and not IC, which is far uncommon & less interesting to many - when compared to the diagnoses of herpes, or concerns and problems with herpes, these days. Justanswer is not patient focused - it's a ploy to find people like me, in need & gullible enough to believe this website is private for all communication. Since that is not the case - justanswer is not private - I'll provide all the negative press I can for my $46. The "justanswer" service uses people for what they are willing to share & does not really care about the patient's medical topic, if it "plain vanilla. If the conversation can be steered to more searchable topics, the more hits that justanswer receives by those searching the web. That was my gut feeling, as it struck me odd that you "went right to herpes & valtrex" without ever asking other questions first. There is no known & certainly no common link for herpes & IC. I have never had a practitioner bring it up, nor have I read about it being connected. I hope anyone reading these threads sees the problematic issues with "justanswer" - and how my frustrations materialized. I called "justanswer" today, and asked they take down my threads - they refused to, but deleted phi; so I know they can remove words & threads, they just won't. Make sure they know I am blasting the pathetic "justanswer" webservice, so others will not fall as innocent victims to these ploys. Justanswer is not patient friendly. I doubt JA wants all this truth open to the public. I'll get a little use for my $46, since I ultimately received no answer for my wasted time & wasted money - I want to put a truth on this service that is not positive - but now very public on the web - as they wish. That ball rolls both ways.
Expert:  Dr Ted Manos replied 1 year ago.

I'm sorry I fell short of providing an answer to your question about length of time you can take keflex. Usually, antibiotics are taken for specific lengths of time for what is being focused on. With most uti's we prescribe for 7-10 days and that is it. IC doesn't respond in a predictable manner and has been the most frustrating condition in all the issues I dealt with in my many years of practice. My advice in the past was to refer to a urologist and that was that. You put all sorts of meaning in my response, including having some type of motivation to swindle the customer. There are many opinions about JA both positive and not. I guess I get frustrated evaluating each question I take on and if it doesn't fit the answer the customer wants there is a point of no answer back from the customer. I'm truly sorry about your level and frequency of pain and trying JA to add to what you've been told by healthcare providers over time

Customer: replied 1 year ago.
Dr. Manos, i want to respond to a few points (since these are public comments), however I was never really able to understand or validate your statement about a patient not wanting your answer - like I had a preconceived idea of what you might say - and anything short of my expected answer, would be a disappointment. I had no idea your answer.Two things happened. You didn't answer the original question (you did now, to say AB's are usually taken for a certain period of time & that's it); and secondly, you went quickly into uncharted waters, presenting the notion that herpes may be my issue. It took me back that you would immediately introduce that (herpes) into our conversation - when I never indicated an issue, and I thought I was pretty liberal with my health status in my first paragraph. Herpes is a very common searchable Internet word, because it's a frequent diagnosis, thanks to people having many sexual partners, unprotected & irresponsible sex - or being lied to, by an otherwise trusted partner. People have lots of questions & want privacy learning about it. So, they take to the web - I presume you (and just ask) know this. Either way, it's a very common dx these days -- but I don't have herpes & that was never of part of my question - and I was bothered that you'd go there without starting with smaller steps - but since herpes (commonly searchable word in a public forum that makes money starting from internet hits, advertising, etc.) makes our threads more "colorful" - yes, I'm suspect. You could have just said -what you finally did about the AB's - I know very well how hard IC is to treat. I live with pain daily - and there appears to be no reason.As the website touted, I was looking for a 2nd opinion on the daily AB (because yes, I know too - AB normally rx'd for 7-10 days), since it was rx'd for a several months.. That was it.I hope all the public learns from our threads & also clearly makes decisions for themselves based upon my experience - hopefully they use a non-descript user name too. I made several mistakes. They main one was going against my gut feeling & signing up for justask. It was not a good use of $46, and cost me extra time & upset dealing with the permanence of the threads & the time it takes to present my side of this upset, clearly & fairly. I take this time for "future readers" to review, since justask won't take down my threads, even upon request. Since that is the case, I'm taking the liberty to publicly denounce the service as "self-serving" more than "patient-serving."
Expert:  Dr Ted Manos replied 1 year ago.

I was off base bringing up the topic. IC is a entity that has no workable theories and that is so frustrating in this day and age. I have discussed IC with urologists and there is no agreement about it. I've not seen genital herpes with IC. Cold sores are common in the lips of the mouth and the virus has been considered in other parts of the body but not observed to be obvious. I was bringing up the virus but not the meaning that surrounds it. I apologize and will be sensitive to the scope of the subject and speculate privately about IC

Customer: replied 1 year ago.
Thank you for your apology. IC patients really suffer immensely enough as it is, and have challenges with practitioners understanding the physical trials we experience, but also the emotional burdens we silently suffer because of the physical limitations brought on by pain. So, lack of sensitivity about our issues (or seemingly so), only adds to our problems & lessens our faith in practitioners to really help our plight. IC is real, it's debilitating & its permanent. Many doctors do not realize the pain, or co-morbid conditions that develop (yeast is a big culprit - many doctors do not take homeopathic remedies working in partnership/connection with tradition medical as a real option), but yeast is real - this is why I was asking about long term Keflex. Herpes is not on our radar for IC & really dives off into a pointless conversation (again unless there is a searchable word phrase for popular searchabilty) for IC assistance. Thank you again for responding to my frustration regarding that notion and accepting responsibility & not running from it. I do admire that.
Expert:  Dr Ted Manos replied 1 year ago.

If I had a patient with what appeared to be IC, I referred them to a Urologist and I breathed a sigh of relief. The relief was in not knowing what was going on. The yeast angle I think I've heard of. I remember listening to a theory that the urinary bladder had a lining very much like an inner tube of an old fashion tire and infection was between the inner lining and the bladder wall. They speculated that overfilling the bladder would cause tears in the lining cells and the infection would drain. That was twenty years ago and I guess it didn't pan out.