Question: I have talked to you before and you were very reassuring. I am going to send you a copy of the question I was asking someone else. He didn't really answer it.
I had a uti in XXXXXXX Keflex didn't eradicate it. Took macrobid and urine was clear on dipstick for a couple of months even though minor urethra and vaginal irritation continued. Started using vaginal estriol cream (I am 64 year old, post menopausal). Symptoms increased a bit, still not horrible, in September. Had white cells on dip. Took macrobid 2 weeks. Again clear urine dip and symptoms reduced but not totally gone. Now it's back again. Cultured it and ecoli is present. Symptoms still relatively minor... Urethra and vaginal irritation is main symptom and that is off and on. This time the Dr put me on one week macrobid with change to ampicillin afterthat... Low dose, 250 mg 3 times a day dfor 6 weeks. I hate to take antibiotics and just wondering of that sounds Okay. I don't understand where this is coming from and I worry alot and am pretty scared. I'm not sexually active either. I use cranberry tabs and d-mannose and other anti inflammatory supplements and drink lots of water. Sometimes I don't feel anything. My doctor thinks there may be an access in the bladder, which is why he is treating long term. But I don't see anything on the internet to even suggest that possibility. Also, my sister is deathly allergic to penicillin so I have always refused it. Dr says that is not a valid reason and it is the safest. I'm also worrying about cancer. But Dr said my urine showed normal amts of epithelial cells and rbc so he says that shouldn't be a concern. Please help... I'm really nervous.... Can't sleep

That's the question.... I hope you can help.

Why wouldn't I take the macrobid? I have another infection, or it never went away. I don't have the report. But there was 100,000,ecoli, mod wbc, cloudy urine. He prescribed the course I sent to you because it came back. Urine was clear, by dipstick, of wbcs for 4 weeks, then symptoms worsened and there were wbcs again and the culture was as I said. I don't take anti-inflammatory meds. I meant supplements XXXXXXX turmeric, resveratrol, fish oil. My symptoms are not bad but more irritating. Mainly centered around urethra and vaginal area. Bladder doesn't hurt. And the other discomfort is relatively mild but gets a bit worse when the wbcs are back.

I did go to the gynecologist who said I was dry and said to use the estriol cream in small arts. That was a couple of months ago, after the first infection. Don't I need to get rid of this ecoli? Does it mean I have a bad immune system? I don't really get sick alot normally. And I haven't had a blood test for diabetes for 3 years but it was perfect and there's zero glucose in my urine now. I worry about all this!
No, now I'm more scared since you're talking about all those needed tests. What are all those for? I just went to the gynecologist. Nothing was wrong but dryness. Because you're telling me about all those tests, now I fear you're thinking something bad.... I'm suppose to go out for town for Thanksgiving and I'm afraid to go.... My doctor wants to do the longer course of antibiotics I described to try and rid the infection and keep it away.
If there's no protein or glucose in my urine, isn't that a good sign?

So I shouldn't do it like he said... twice a day for a week and then low dose ampicillin? Macrobid alone obviously hasn't worked. I know about the a1c. I believe it was about 5 the last time. My doctor said if this was from diabetes, there should be sugar in the urine.... Because the sugar in the urine would be causing the symptoms etc. Also, why did you mention those other tests? Is any of this indicative of some systemic problem? That's what you've got me worried about now. Dr said there's nothing in the urine or my symptoms to suggest kidney problems. Why the CBC, Creatinine and LFT other than routine? I'm thinking of myself as unhealthy now. And what about all those other tests you mentioned? Are you thinking something bad? I don't have ins, btw.
Did you see this one? I appreciate your diligence. So I guess I need to know of there's reason to think this is an indicator that my tests would be off now when they never have been. Or were you just saying everyone should have routine screening? I'm going out of town and I don't wanna think of myself as sick.

I talked to my doctor about these tests etc and asked him if diabetes could be causing this. I'm also worried about my immune system. He said, like you, quit worrying, this is not a huge deal. He said that, while we should order routine tests, he wouldn't expect anything to be different and that this doesn't indicate that something systemically is going on because I have no fever or other signs of systemic problems. He also said my immune system is fine (he's known me a long time and that I'm rarely sick and, if I am, it's not usually bad). He also said, that if this was from diabetes, he would expect sugar in the urine because that's what would be causing the bacteria to flourish. But no urine test has ever shown glucose. He said, yes, a1c is best measure but, relative to bladder infection, there should be glucose to connect it to diabetes. Besides, I wasn't even pre-diabetic 3 years ago so wouldn't expect such a dramatic change especially since I exercise and am not over weight. Though it is in my family, so I need to check.... But not because of bladder infection (because no urine sugar). Do you agree wit have all this? I hope so because I sure would like to let this go and enjoy my trip out of town next week.

Just to be clear, if diabetes is causing uti, sugar should be in urine as that would be the cause, correct? That's what my doctor said. So, while we agree that it is prudent to check a1c, it wouldn't be the causative agent here because of lack of urine spill. And do you agree that I should stop worrying about immune system problems etc or systemic problems connected to this? I would be having other problems according to my Dr which I haven't had.

Seems like there would be protein in the urine. And I do know that it's the urine sugar that causes frequency of urination because the body is flushing out the sugar... Also seems like it would take some time to do the damage. And, as I said, no sugar and no protein should atleast be a positive clue that the a1c isn't likely to be too high... Especially since it has never even been borderline....