Pills and Thrills

CW: drug use

Does anyone else get really really annoyed at the number of side-effects doctors expect us to tolerate?  

I warn you now, this is a rant and not a useful post.

On Sunday night I was in bad pain.  I don’t really know why or what was causing it, but I knew it hurt more than I could cope with and that I needed to be at work the next day.  So I did what I have been told to do when the pain gets really bad, and took some tramadol.  

I haven’t taken tramadol in a long time because it has a habit of making me a bit whacked out.  I avoid endone for much the same reason.  Both make me spacey and sleepy but send my mind racing at a million miles an hour, leaving my super-active brain stuck in a body that feels like it is suffering sleep paralysis.  I also don’t feel that they have much of an impact on my pain levels.  The next day I feel weak and shaky.  I don’t really like either of them.  Also, they both make you constipated.

Sunday night took things to a new level.  I took my tramadol at around 9pm.  I was fine at first in terms of side-effects and went to bed with a heatpack to wait the pain out. Half an hour later I was genuinely concerned that the doctors had replaced my innocent painkillers with hardcore hallucinogens.  

I’ll preface the rest of my experience by saying I’ve never taken illicit drugs of any kind.  I’ve never even been drunk.  I have no interest in perception-altering substances, so drug users out there may read this and go, “ah, you innocent child, thinking this is bad.”  I don’t know.  My poor little mind was bending.  

By midnight I was still not asleep.  My brain had carried out a really, really detailed mediation between my cat and my dog.  I could talk to animals, you see.  I forced myself to get up and go to the loo and was swaying like a drunk woman.  I could feel the world tilting, melting and floating around me, like my foothold on the earth was tenuous at best.  

When I got back to bed, I started crying because I felt like my arms were melting into one another, and I couldn’t tell my elbows apart.  I felt like my hands were on backwards.  I was being eaten by the bed.  I couldn’t move.  I could just about articulate to my husband what was happening, and I know I sounded pathetic and barely coherent.  

I was awake, my mind racing and my body distorting, until around 4am.  It was nightmarish.  I felt like I was living the Coraline movie.  

When I woke up the next morning, my body was wracked by tremors and I was so weak I could barely hold my phone to send an email to work saying I’d be late.  I was dizzy and nauseous.  The whole day I was tired and weak, couldn’t eat properly until mid-afternoon, and was really struggling to articulate my thoughts.  I would just lose the ability to say things halfway through the sentence, even though my brain was making the right pictures.

The only thing that made my pain reduce?  Time.  And quite frankly, even if the tramadol had worked, I’m not sure it would be worth the hassle.  

I know that I’m far from the only person to experience problems with the pills meant to relieve pain.  I’m far from the only person to have horrible side-effects with something as fundamental to the treatment of endometriosis as hormonal birth control.  I consider the issues I get – bloating, abdominal pain, tender breasts, mood swings, weird cravings, reduced energy – to be relatively minor, because we are told they are common and not really worth troubling a doctor about.  

Why are we expected to have to deal with this?  Why must sick people choose between pain and suffering from their illness and pain and suffering from their treatment?  Why am I in the situation where I’m forced to call in sick, not because I am ill, but because I attempted to use my prescribed medication?  Why, if I go to the emergency department, will I be offered endone as my only option, and be kicked out as soon as I take it?  What else can I possibly do?

Gosh, I hate endo.  

Advertisement

Reframing Part I: Guilt

I recently did a 3-part series on some of the common side-effects of endo, including UTIs, thrush and constipation.  Now I want to do some on the emotional side-effects, beginning with guilt, and talk about reframing the way we think about things to combat these negative emotions.  Please bear in mind I am not a psychologist or mental-health expert – these are just some strategies that I have employed to deal with my own feelings.

I’ve touched before on how incredibly easy it is to feel guilty with endometriosis.  There are as many things to feel guilty for, it seems, as there are people in our lives.  I know that I personally feel guilty for:-

  1. The disproportionate burden of household chores that falls on my husband;
  2. Forcing my colleagues to cover my appointments and deadlines when I am unexpectedly sick;
  3. Not being a reliable financial contributor to the family;
  4. Depriving my husband of the chance to have a normal life with ordinary fun couple activities;
  5. Letting down my clients by not being there for them;
  6. Relying so heavily on my mum when I am supposed to be an independent adult;
  7. Taking up doctors’ time;
  8. Not being as sick as other people;
  9. Being sick in the first place; and
  10. Not being a good dog mum because I can’t walk her…

…to name a few.  I don’t even have mother-guilt to contend with, and sometimes I still feel like a guilt pudding with pain frosting.

So how can I deal with this?  How can you?

Step One: Identify the Culprit

I think step one for me is to identify the specific guilt I’m struggling with.  They all stem from slightly different causes (although the common theme is the idea that I can’t do enough) and all take a different type of internal dialogue to resolve.

You also need to figure out, is the guilt coming from internal pressures and a failure to live up to the standards I set myself, or is someone making me feel guilty (and yes, people can absolutely make you feel something).

If it is someone else whom I don’t have a close relationship with, I tend to burn of feelings of guilt with righteous indignation pretty quickly.  “How dare you judge me?  You have no idea what I’m dealing with!” Which is totally true and justifiable.  Funnily, that anger response is not there when someone I do love and respect does it.

Step Two: Speak to the Offender

If someone you love has made you feel awful and they love you back, the last thing in the world that they would want is to hurt you.  I think the best thing you can do is explain to them why what they said hurts and why their expectations for you are too high.  So many people do not get how horrifically painful endo can be.  It’s not your job to do the emotional labour of trying to educate them, but too often we have to anyway.  See if you can make the pain relatable for them.  Give them an “objective” measure people can understand.  All people tend to accept broken bones, childbirth and being kicked in the testes as very painful experiences – can you relate your endo to that?  If they are more of a visual person, can you describe the pain through imagery?  “It’s like being burned by a really hot fire.  It’s like I have pins and needles in my ovaries.  It’s like someone is stabbing me with a fire poker and gradually trying to drive it right through me.”

If you are the one you are making feel guilty, sit yourself down and frown at yourself.  You know how painful this is.  You know what your body can and can’t endure, and how pushing yourself on Thursday will break you on Friday.  You know the consequences of trying to go beyond your limits, dammit!

Step Three: Reassess Your Standards

Most of my guilt comes from a failure to meet a standard I expect of myself.  This is because I still expect as much of myself now as I did when I was healthy.  If you told me to go out the door right now and run 5km, part of me would probably go “Pfft, I can run it while carrying you on my back,” because I could before I was sick (not the carrying part.  Just the 5km part).  Now I’ll be lucky to manage a single kilometre before something gives out – it’s a lottery as to what.  Trying to remind myself that that is ok and it is not a failure is really hard, but so important.  I wouldn’t expect someone else with my condition to do it, so why on earth do I expect it of myself?  We can be our own harshest detractors.

Talk to the people in your life, as well.  Explain that you have a permanent and debilitating condition and you can’t do all the things you used to.  Make it clear that you won’t simply recover and be back to your normal, healthy self.  That’s gone.

Step Four: Cut Your Losses

If there is someone in your life who is consistently unsupportive and does not believe you, you will eventually come to a point where you realise that you can’t win them over.  If you reach that point, cut them out.  You have enough to deal with and enough people to keep up with already.  You don’t have the time or energy to be wasting on people who don’t have your back.  This is really hard when it is someone you love (or feel you ought to love) really deeply, but realistically, the alternative is to let them continue to wear you down.

It is also hard when that person is someone you have to associate with constantly anyway, such as a colleague.  If they become outright rude, report them to HR or to your supervisor.  If they just stay at the passive-aggressive level, work on developing a shield against their taunts.  It’s like the old adage, those that matter don’t mind, and those that mind don’t matter.  The ones who believe you and support you are your friends.  The ones that don’t are not.

Step Five: Recognise It Is OK

It is ok to be passionate and advocate and educate about this disease.  It is ok to take the time you need to rest.  It is ok to cry and to require medication, and to feel pain even if someone else feels more pain.  It is ok to have new standards.  It is ok to not hate yourself for living a different life.  YOU ARE NOT TO BLAME FOR WHAT YOU CANNOT CONTROL.  You did not ask for this disease or the incapacity that travels with it.  You cannot control it.  You cannot control the fact that you now need different things, and that is ok.

Do unto yourself as you would do unto others.  If your best friend, or your partner, or even a total stranger, was in your shoes right now, would you berate them for not doing the washing up?  Would you tell them they are not good enough because they couldn’t go to work today?  You would not.  You would have compassion and empathy.  Have a little for yourself.

 

So, that’s my five-step anti-guilt programme.  Does it actually work?  Eh, sometimes.  Sometimes I can’t escape the guilt and cry on my husband and then feel guilty for making him look after me and dry my tears, and the cycle begins again.  But I’m trying, all the time.

What makes you feel guilty with your endo?  How do you deal with it?  What do you say to others who judge you?  Let me know in the comments!

 

Oh yes, it’s IBS!

Ah, IBS!  The fun, the joy, the explosive diarrhoea!  Aren’t you just quivering in excitement?

IBS, or Irritable Bowel Syndrome, is the medical term for “something is wrong with your digestive system but we aren’t really sure what.” It is not to be confused with IBD, or Inflammatory Bowel Disease, which is both more easily diagnosable because there are clear physical markers, and far more serious.

That’s not to say that IBS isn’t hellishly annoying and painful – it’s just unlikely to be fatal.  What it will likely do is cause massive swelling, keep you on the hop between diarrhoea and constipation, possibly put some mucus in your poop, and make you unable to eat a wide variety of foods without horrific pain.  Also, nausea.  For no reason.

Doctors have never been able to nail down a cause of it and it seems like it has really become an umbrella term for digestive systems that are a bit delicate, sensitive, and easily upset.  I apparently have it, but I also have a completely normal result for colonoscopies, endoscopies, and whatever-other-method-of-sticking-tubes-down-your-throat-and-up-your bottom-oscopies they can think of.  For me, and for many in my position, the bowel difficulties are caused by endometriosis growing on or near the intestine, and doctors happily cover it with this wonderfully useful catch-all phrase – IBS.

Dealing with IBS

So, what to do if there is something like this going on in your piping?  The first and best way it to look at changing your diet.  I recommend the Low FODMAP diet, which I have discussed here, because it allows you to figure out what your main triggers are.  Bear in mind, however, that it may not solve all your problems.  I still manage to have plenty of stomach upsets even avoiding my trigger foods.  What it will do is make sure that you aren’t suffering more than necessary by putting foods that will irritate your bowel straight into it.

In terms of dealing with the symptoms, I’ve discussed relief from constipation and bloating here.  To my intense annoyance, there really isn’t much you can do about diarrhoea except ride it out.  You can eat foods that you know will constipate you but then you have the risk that everything will swing the other way, and, let’s face it, most of what will constipate you is not healthy.  If you are in serious pain and popping codeine for relief, you’ll probably find that swings you round into constipation territory too.

If you find that your poop is so liquid that you are suffering from faecal incontinence (i.e. you can’t hold it in or you don’t notice that little bits are slipping out), I recommend a good, thick panty liner such as the Tena brand.  Designed specifically for incontinence rather than periods, they are long, thick and hold stacks of liquid.  Importantly, they also hold in smells.  They will hold the little brown demons off your clothes until you can get to a toilet.  Keep a spare pair of clean undies and a pad in your bag as well (I’d recommend carrying those at all times with endo anyway).  It may be embarrassing for you to buy and carry big old incontinence pads, but trust me, it is more embarrassing to poo your pants in public.

If you do suffer from faecal incontinence because of IBS, or for any other reason, you should not feel guilty or bad or embarrassed.  I say this knowing that the few times it has happened to me I wanted to die of humiliation and no one even knew about it.  It feels icky and you feel like a child who can’t even control their own bodily functions, but plenty of adults suffer from it and it is not something you can help or control.  You are not gross or weak or pathetic – you are suffering from a disease and it is not your fault.

If you suffer from nausea, there are prescription medications like maxalon that can help deal with it.  However, some of these can interact very badly with pain medications, so double-check before you dive in using them.  Try ginger tablets or ginger chews to keep the sensation at bay, and double up with peppermint or lemon and ginger tea (peppermint reduces colon pain and lemon and ginger settles the stomach).

Finally, of course, consider what can be done to deal with the root cause, if you know what it is.  If it is endometriosis, talk to your surgeon about whether there is any point attacking it surgically.  There may not be.  Like with endo anywhere else, removing it is no guarantee that it won’t just go back.  Further, the intestine is such a delicate area that some surgeons prefer just to do a straight-up bowel resection than attempt to remove it, especially if it is small or deeply embedded.  Either way, bowel surgery is risky, so you want to be fairly certain that there will be a tangible benefit before going in.  It may be that sufficient medication can reduce the endo growth on the bowel enough to provide you relief from symptoms.

Of course, it may not, and IBS may become yet another unfortunate part of your reality when living with endometriosis.  What fun, eh?

 

Do you suffer from bowel-related complications for your endo?  Have you been officially diagnosed?  What’s your best method of relieving the symptoms?  Let me know in the comments.

 

Gastritis

Trigger warning for dieting, restrictive eating, eating disorders

You thought pain in your lower pelvis was enough, did ya?  Well, guess what.  You get some pain in your stomach too!  At least, you do if you have gastritis.

Gastritis is a condition where the stomach lining becomes inflamed and over-produces acid, often causing a sensation like indigestion (whether you’ve eaten or not) and nausea.  The pain feels like a burning right up under the base of the rib cage.  It can also cause appetite loss, although I didn’t suffer that.  I just didn’t want to eat because it made it hurt worse.  You can also get symptoms as mild (but annoying) as hiccups, or as serious as bloody stool.

Gastritis can be acute, going after a day or two, or chronic.  Although quite a minor issue in the scheme of things, the effects can be really debilitating.  They can also become extremely serious if left untreated – complications from gastritis range from ulcers and anaemia to bowel obstructions, renal issues and cancer.  If you are having ongiong stomach pain, therefore, particularly really intensely, it is a good idea to haul yourself to the doctor or emergency room ASAP.  Unlike my endo, the emergency doctors have seemed pretty keen to treat my gastritis both times, particularly when I told them I wasn’t eating and hadn’t done so in several days.  Apparently, that gets you attention in an emergency room, and they aren’t supposed to release you until you have eaten something.  (Unfortunately for me and my fellow vegans, the only available food at 2am for herbivores is a fruit salad – the worst possible choice for a stomach that is already overproducing acid).

It is also worth remembering, however, that you can have gastritis with no symptoms at all, just like endometriosis.  If you are having an endoscopy for another reason, for example, and the gastroenterologist says you have it, your lack of symptoms doesn’t necessarily mean that they’re wrong.

Thankfully, there are prescription medications, such as acimax and tacidine, available to relieve the symptoms.

Treatment may be relatively simple, but how do you avoid getting it in the first place?  Well, if you just happen to pick it up in the form of a bacterial infection you may just be unlucky.  However, you can also get it from extended use of painkillers such as ibuprofen, naproxen or aspirin, which can inflame and irritate the stomach.  If you are prone to stomach upset from these drugs and can use panadol effectively instead, try that.  Alternatively, switch to natural alternatives such as turmeric.  However, if you need one of these drugs, speak to your doctor about giving you a prescription for an anti-gastritis drug alongside it if you know you are prone to gastritis when you take them.  Also ask for advice about minimising side-effects, such as taking them only on a full stomach.

In terms of dietary triggers, most things that trigger endo, such as caffeine and alcohol, have the capacity to increase your likelihood of suffering from gastritis as well.  Unfortunately, so can onions, garlic, berries, certain greens such as kale, celery, and broccoli, and soy-based foods.  Upsettingly, spicy, fatty and fried foods are bad ideas too.  Because I’ll be your diet wasn’t restricted enough.  Smoking is also a bad idea as that can really upset things internally.  I’ve also been advised by my local GP to avoid drinking around meals as the interaction of fluid and food can cause issues.  No word on what to do when you’re having soup.

A reverse dietary trigger, so to speak, is excessive vomiting, so if you’ve had a gastro bug, or suffer from an eating disorder that compels you to purge, you may find yourself with gastritis.

Like literally every disease ever, doctors also tell you to avoid stress, as gastritis can be triggered by excessive stress.  If they could tell us how to not stress, that would be great.  I’d have to quit my job, be cured and have a guaranteed income of $2k per week to never stress again, at a minimum.

Some unlikely souls, such as those with an autoimmune disease or pernicious anaemia, may also suffer gastritis as a result of that illness.  Sorry folks.  Not much you can do to safeguard except be really scrupulous in relation to all other triggers.

Have you suffered from gastritis?  Is there anything not listed in this article that you found helpful for reducing the symptoms or preventing it?  Let me know in the comments.

 

The Glitz and the Glamour Part II: Thrush

One of the things that bothers me most about endometriosis is how fundamentally unfair it is.  For me, most of that comes from all the other stuff we have to deal with as side-effects.  That’s why I’m writing a three part series on the really glamorous aspects of endometriosis and how to deal with them. 

I like thrushes.  They are cute little birds, with cute little songs.  They strike me as very English.

What I do not like is thrush the yeast infection, aka candida.  It itches and burns in a way I cannot describe.  It’s like when you shave your bikini line and you start to get the itchy stubbly regrowth, only ten times worse.  Unfortunately, it is incredibly easy to get, particularly if you have endometriosis.

One thing I should clear up, which is an alarmingly common misconception.  Thrush is NOT an STD.  Yes, you can spread it through sexual contact, including catching it back off your own partner.  However, people who have never even looked at another person in a sexual way can get it.  Children can get it.  Nuns can get it.  There is no shame in suffering from thrush.

How do you know if you have thrush?

In addition to the horrendous itching, you may find you have little bumps down there as well as a lot of redness, like a rash.  You will probably also notice abnormally thick white discharge, possibly with an odd smell.  If you only have one of these symptoms, go to a doctor and get checked out.  It might not be thrush, but something is wrong if you are experiencing any of these things.

How do you get thrush?

Basically, have a vagina.  The vagina naturally contains small amounts of the yeast that makes up thrush – thrush is when there is too much yeast.  Certain things do encourage an overgrowth of the yeast, including eating too much sugar or not maintaining personal hygiene in your crotch.  I always found I was most likely to have an outbreak around my period, when trying to keep clean is impossible because as soon as you are clean your body just makes more mess.  You should also avoid keeping anything damp down there – if you go swimming and get out of the pool, dry off and change into dry things immediately.  Staying in your wet swimmers creates a warm, damp environment that candida just loves.  Try and wear natural cotton undies whenever possible, as they are breathable.  Synthetic is more likely to make you sweat – again, warmth and dampness.  For the same reason, loose clothes are better than tight ones, although plenty of work environments don’t give much of a choice, particularly if tights are required.

Another important preventative tip is to have a healthy diet and supplement with probiotics – good bacteria in the body can help prevent thrush from growing.  Also take vitamin C to encourage a strong immune system.

Make sure you aren’t douching or using soaps or wipes marketed as vagina-cleaning; they are a gimmick and kill of the good bacteria that live in the vagina and help keep the candida in check.  Likewise, perfumes, sprays or scented pads or tampons are bad ideas.

Two reasons that people with endo are particularly likely to get thrush are the fact that we have to take antibiotics so regularly, and that we are often taking estrogen-based contraceptives.  Both antibiotics and excessive estrogen can upset the bacterial balance in the body and send the candida all wacky.

Personally, I’ve noticed a massive reduction in my rates of getting this pesky infection since I started taking probiotics regularly, and switched to a progesterone-based contraceptive.

How can you treat thrush?

The single best way is to get the anti-fungal medication and soothing cream from your pharmacist.  If you can afford an appointment with your GP first, it’s a good idea, as some infections may seem like thrush but aren’t, and thrush medication may make them worse.  However, if you are prone to thrush you are probably going to be able to self-diagnose pretty well, and you don’t need a prescription for Canesten and its various generic knock-offs.  Because of my terrible immune system, my GP long ago recommended two treatment courses back-to-back.  I get a lot of side-eye from pharmacists about this, but once I say it is doctor-recommended they generally give me what I need.

There are natural remedies for thrush as well.  I have never tried them myself – I don’t want to mess about with anything but the tried and true in such a delicate area, particularly with such a shonky immune system.  However, many women swear by inserting a garlic glove into the vagina or giving themselves a greek yoghurt suppository.  I am not keen on sticking edibles in the wrong end, and leaving them in too long may well cause an infection, so if you try this, please remove the garlic in good time.  If you go down the yoghurt route, make sure it is all natural with no sugar, as candida feeds on sugar.

Other people have suggested tea tree oil on a tampon.  Please be careful with this!  Tea tree oil, especially undiluted, is an irritant and this could sting like a swarm of bees.  If you try this, dilute it properly and do a patch test on less sensitive skin to ensure you aren’t allergic to tea tree.  An alternative might be oil of oregano, but that’s a blood thinner, so don’t use it if you are already on thinners or have a condition that makes blood thinners dangerous.

Coconut oil, boric acid (use with caution!), aloe vera, apple cider vinegar, olive oil, baking soda, and diluted hydrogen peroxide are also all topical treatments that are popular as home remedies.  If you are a normally health and resilient person, you may well be safe relying on these alone (as long as they are applied properly and safely).  However, if you are pregnant, immuno-compromised, prone to recurrent thrush infections, or have or recently have had an STD, it is safer to simply purchase the over-the-counter stuff.  You may be able to use things like baking soda in a bath as pain relief or soothing, but I would not rely on it alone for treatment.

 

Have you had much luck with home remedies?  What do you find the most effective way of dealing with and preventing thrush?  Any tips I haven’t included?

 

 

The Glitz and the Glamour Part I: UTIs

One of the things that bothers me most about endometriosis is how fundamentally unfair it is.  For me, most of that comes from all the other stuff we have to deal with as side-effects.  That’s why I’m writing a three part series on the really glamorous aspects of endometriosis and how to deal with them. 

Of all the physical side-effects we can get from endometriosis, I reckon UTIs (urinary tract infections) have to be the absolute worse.  They are just so horrifically miserable to deal with.

What does a UTI feel like?

Usually, a UTI will manifest as a stinging pain in your bladder and/or uretha (where your urine comes out, and not the same as the vagina, contrary to what people like this genius think).  You may also feel the urge to go to the toilet constantly, even if you’ve just been.  These terms all feel too mild, though.  “Stinging” doesn’t really describe it.  It’s more like acidic fire burning its way through your urinary tract.  The urge to go to the toilet is practically overwhelming.  At best, it is a constant distraction.  At worst, it is pure agony.  With a really bad UTI, you simply cannot function normally.  Some get so bad that they include infection to the kidneys, which I have never experienced but am told is torture.

What can I do if I get one?

There is no cure for UTIs except antibiotics, and you should make getting some your first priority.  Get thee to a doctor, immediately.

However, there are things you can do to relieve the symptoms until the antibiotics kick in.

  1. Take a shower.  Flush cool or warm water (not hot) over that area and make sure it is as clean as a whistle.
  2. Drink Ural.  It’s not the tastiest – kind of an unenthusiastic, bitter lemonade – but it is effective at reducing or relieving the symptoms.  I always keep some in stock because UTIs can strike from nowhere, for no reason, and this is the best method of pain relief I know.  If you can’t get Ural, dissolve 1/4 of a teaspoon of baking soda in a cup of water and knock that back.  It tastes worse than the Ural, but it will help in a pinch.  Just don’t overdo it, as you can poison yourself with excessive baking soda.
  3. Take panadol.  It won’t do much but it’s better than nothing.
  4. Drink heaps of water.  Try and flush that bad boy out by drinking heaps and peeing often.
  5. Sit on a heat pad.  It’s not glamorous, clutching a wheat bag to your nethers, but it may provide some comfort.

Things you should not do include:-

  1. Sticking soap down there in an attempt to cleanse, including things marketed as “feminine products.”  Those are a gimmick anyway and you don’t need them, and they are likely to simply irritate things.
  2. Drinking cranberry juice.  Although cranberries promote urinary tract health, commercial juice is mostly sugar, and sugar just makes UTI’s worse.
  3. Eating acidic, spicy or sugary food, or drinking caffeine or carbonated drinks.  Stick to a really bland, boring diet until the UTI is gone to avoid irritating it.
  4. Wearing tight clothes.  You do not want tight stuff on your crotch while this is going on.  Also try to stick to natural products, like cotton, to avoid a sweaty crotch.

This is all well and good, of course, but the best thing to do is to avoid getting one in the first place.

How can I prevent UTIs?

For people with endo, the likelihood is that you’ll get a UTI at some point regardless of the precautions you take, so don’t blame yourself if you keep getting them.  That being said, you should take them anyway to minimise the risk of contracting one.

  1. Have a diet rich in Vitamin C.  Vit C helps promote bladder health and reduces the likelihood of contracting a UTI in the first place.
  2. Take cranberry supplements.  They really do help.  Also eat lots of blueberries, for the same reason.
  3. Take probiotics.  Having healthy gut flora ensures that your insides are working at peak efficiency.
  4. If you are sexually active, wash immediately before and after sexual intercourse, and pee immediately after.  Activity down there can push bacteria into the urethra, causing UTIs, and urinating helps flush it back out.  Washing the area helps prevent the transfer of bacteria from one part of the groin to another, such as from the anus to the urethra.
  5. On that note, ALWAYS wipe front to back.  If you wipe your anus first and then swipe it forward, you are transferring faecal bacteria right through your vulva and into your urethra.  Bad.  Many infections are coming your way.
  6. Stay hydrated.  Peeing often helps flush out that urinary tract, and ensures healthy kidney function.
  7. Practice good personal hygiene.  Change your undies and pads regularly, and wash down there daily.  Even if you can’t shower as often as you like, take a wet flannel and keep yourself clean downstairs.  It can be very difficult, especially if you are physically disabled or have your period, but staying as clean as you can will really help.  If you have the money and the DIY skills, consider installing one of those clip-on toilet bidets.
  8. Speak to your doctor about having antibiotics on hand if you are prone to them.  I went through a spate where I was having UTIs back-to-back for weeks.  It was awful, and every time I had to go to the doctor and get a new prescription.  I know a couple of ladies whose friendly doctors have given them large prescriptions so that they can pop a pill every time they feel an infection coming on and knock it on the head.  Some will even have one each time they have sex, as that is a particularly high-risk time for those prone to UTIs.  Of course, not all doctors will agree, and are unlikely to prescribe them unless you are coming in all the time with repeated UTIs, so you will have to suffer a fair bit to convince them.

That concludes my advice on UTIs.  Do you have any tips and tricks I’ve missed out on?  Do you think they are the worst side-effect, or is there another that bothers you more?