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Re: Dr. Montgomery- allergic to bactrim!
From: Lynn D. Montgomery, MD (anonymous@obgyn.net)
Wed, 16 Aug 2000 16:11:49 -0500 (CDT)
At Wed, 16 Aug 2000, Emme wrote:
>
>I was taking bactrim for a while for UTIs, but then my dermatologist
>discovered that I was allergic to it (got Stevens Johnson Syndrome-
>erethmya multiformae). I am also allergic to cipro. Does that leave
>any hope for me? Also, when I had a cysto back on July 18, shouldn't the
>urologist have been able to tell if I had urethritis or would only the
>culture provide this answer? (I was just in to the ob/gyn last week for
>a pap and vaginal culture). The urologist doesn't seem to want to deal
>with me any more and just tells me to take pyridium. I hate to keep
>harassing doctors about this, but I just want the problem to get
>resolved and go away! :(
Emme,
THE ERYTHROMYCIN PREPARATIONS WILL COVER CHLAMYDIA, SO FROM THAT
STANDPOINT THERE IS HOPE. THE UROLOGIST MAY OR MAY NOT HAVE BEEN ABLE
TO DETECT A PROBLEM AT THE TIME OF SCOPE. THAT IS CERTAINLY NOT THE
FIRST CHOICE IN DIAGNOSING CHLAMYDIA URETHRITIS.
LYNN
>
>At Wed, 16 Aug 2000, Lynn D. Montgomery, MD wrote:
>>
>>At Wed, 16 Aug 2000, Emme wrote:
>>>
>>>My ob/gyn tested for chlamydia and gonnorhea and they came back
>>>negative...is this what you were talking about or would she have to do a
>>>specific culture for urethritis? Also, how would you treat urethritis? I
>>>am going on vacation to Paris a week from tomorrow and just want to be
>>>feeling better
>>
>>FOR THE CHLAMYDIAL INFECTION THAT CAUSES NONGONOCOCCAL URETHRITIS, YOU
>>HAVE TO USE A SPECIFIC CHLAMYDIAL TEST AND SPECIFICALLY SWAB THE
>>URETHRA. IT CAN BE MISSED IF ONLY CULTURING THE VAGINA. THIS IS
>>TREATED WITH EITHER A SULFA PREPARATION SUCH AS BACTRIM OR AN
>>ERYTHROMYCIN PRODUCT. ALSO FOR THIS PARTICULAR INFECTION, I DO NOT LIKE
>>THE "QUICK" TREATMENTS SUCH AS Z-PACKS, ETC. YOU REALLY NEED A FULL
>>7-10 DAY COURSE. IF THE CULTURE IS POSITIVE, I ALSO TREAT THE PARTNER.
>>I WOULD ALSO TRY THE CONDOM THING AND LUBRICANTS. IF THIS SEEMS TO FIX
>>THE PROBLEM THEN AT LEAST YOU KNOW AND CAN BE SEXUALLY ACTIVE...
>>LYNN
>>>
>>>At Wed, 16 Aug 2000, Lynn D. Montgomery, MD wrote:
>>>>
>>>>At Wed, 16 Aug 2000, Emme wrote:
>>>>>
>>>>>Do any of the doctors (or posters) have any advice about how to deal
>>>>>with urethral syndrome? I have to say that out of all the problems I
>>>>>have had to deal with this one must be the most annoying...especially
>>>>>since not that much is known about it. According to my urologist, a
>>>>>cystoscopy revealed no signs of IC, stones, anything like that, so he
>>>>>says I just have urethral syndrome and to take pyridium when I feel
>>>>>pain. That doesn't do much for my sex life though. I don't know if I
>>>>>feel pain because I get "dry" because I'm afraid and expect pain or
>>>>>what. But now I'm scared of having sex (especially since I'm going on
>>>>>vacation and don't want to get sick in a foreign country). The funny
>>>>>thing is once last month wbr>
>>>>>thing is once last month we had sex with condoms and a bit of lubricant
>>>>>three times in one weekend and I was not in significant pain. The last
>>>>>two times we have tried however (with no condoms- I am on the pill) I
>>>>>was in pain and felt ill aftwerwards, and the last time my yeast
>>>>>infection seemed to come back. Could the pH of the semen be affecting
>>>>>me? Or the friction? Could pain during intercourse earlier in July have
>>>>>been due to an undiagnosed yeast infection? My primary care doctor
>>>>>prescribed diflucan when I told him I had yeast infection symptoms, but
>>>>>my ob/gyn said that he was not a big fan of the drug b/c it only killed
>>>>>about 50% of yeast infections. He discovered a rather significant yeast
>>>>>infection at the end of July.
>>>>>
>>>>>Also, as I have mentioned earlier, I do not encounter any pain when
>>>>>urinating, but afterwards (ie. after I wipe and for maybe half an hour
>>>>>or so afterwards) there is a burning/stinging sensation in the vaginal
>>>>>area. To what might this be due? I recently started taking cran
>>>>>supplements again b/c UTIs usually appear in the first week after I
>>>>>start my new pack of pills, but I have stopped for now because I am
>>>>>afraid that it is affecting the acidity of my urine and irritating
>>>>>vaginal tissues. What are you thoughts? Sorry to be so long-winded but
>>>>>I am just looking for answers. None of my doctors seem to be able to
>>>>>give me any explanations for these problems. And I hate to keep going
>>>>>back to them.
>>>>>
>>>>>Thank you SO SO much for your time. I really appreciate the service you
>>>>>provide.
>>>>
>>>>Emme,
>>>>There are several possibilities here. First, there are those who are
>>>>allergic to their partners-particularly the semen. The fact that the
>>>>discomfort was absent when you used condoms speaks to that some. You
>>>>might try a controlled experiment here to rule this option in or out.
>>>>Additionally, you also used lubricants with the condoms, so this may
>>>>also be the answer. Many women find that they get dry and irritated if
>>>>their hubby takes too long during intercourse. The urethral opening is
>>>>very exposed and vulnerable during vaginal penetration and can be easily
>>>>irritated with prolonged intercourse. For this one, you may simply need
>>>>to use some lubricant...
>>>>Finally, vaginitis can cause the vulva and vagina to be easily
>>>>irritated. Further a particular infection involving the urethra can
>>>>cause your symptoms and cannot be detected except by particular
>>>>culture-chlamydia-nongonococcal urethritis. This also has to be
>>>>specifically treated or it will not resolve...
>>>>Lynn
>>>>
>>>>--
>>>>Lynn D. Montgomery, MD
>>>>Director, Maternal-Fetal Medicine
>>>>Rocky Mountain Perinatal Center
>>>>Missoula, Montana
>>>>
>>>>**Note: Opinions expressed here are for educational purposes only and, as such, do not constitute a physician-patient relationship. This information is not intended to supplant the need for you to consult with your physician prior to choosing therapeutic options and/or interventions.
>>>>
>>>>**Private e-mails cannot be entertained due to time constraints, consequently no private e-mails will receive a response.
>>>>
>>>>**Thank you for your understanding ;-)
>>>>
>>--
>>Lynn D. Montgomery, MD
>>Director, Maternal-Fetal Medicine
>>Rocky Mountain Perinatal Center
>>Missoula, Montana
>>
>>**Note: Opinions expressed here are for educational purposes only and, as such, do not constitute a physician-patient relationship. This information is not intended to supplant the need for you to consult with your physician prior to choosing therapeutic options and/or interventions.
>>
>>**Private e-mails cannot be entertained due to time constraints, consequently no private e-mails will receive a response.
>>
>>**Thank you for your understanding ;-)
>>
--
Lynn D. Montgomery, MD
Director, Maternal-Fetal Medicine
Rocky Mountain Perinatal Center
Missoula, Montana
**Note: Opinions expressed here are for educational purposes only and, as such, do not constitute a physician-patient relationship. This information is not intended to supplant the need for you to consult with your physician prior to choosing therapeutic options and/or interventions.
**Private e-mails cannot be entertained due to time constraints, consequently no private e-mails will receive a response.
**Thank you for your understanding ;-)
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