A lot has happened since I last wrote about this in mid-August. My baseline health has actually been pretty good lately (for an ME patient), but this prostatitis has been preventing me from getting the full enjoyment out of it.
A few day after my last post, I made an appointment with my urologist. As predicted, he wanted me to immediately go on antibiotics. I argued. I said that I'd read 90% of prostatitis cases are non-bacterial. He rolled his eyes and chuckled (not in a condescending way - we have a good relationship). He said that while it's true that not all cases of prostatitis are bacterial, it's a lot more than 10%. Based on the fact that antibiotics seemed to cure me last time (arguably) he recommended them again. I protested.
The doctor's said, "let's compromise. I'll write you a 'script and you hold onto it and only redeem it if you get worse." I agreed this was a reasonable plan. Then we agreed on a specific antibiotic: Bactrim. Doxycycline didn't work for me last November and Cipro is apparently the devil (according to others) and I don't want to risk tendon damage.
My plan was to wait a week and see where I was after doing "all the right things" according to the urologist: no caffeine (I rarely have it anyway), hot baths, and anti-inflammatories.
I lasted two days.
It turned out to be the right call because 3 or 4 days after I started the Bactrim, I felt almost 100% better overnight. If it was just the anti-inflammatory affects of the Bactrim (as opposed to the bacteria-killing effects) I would have expected the improvement to be gradual and linear. Instead, it was PAIN, PAIN, PAIN...nothing.
So I dutifully took the Bactrim 2x/day for the full 10 days (also with probiotics twice a day, of course). After the 10th day I felt good...for a few days. Then it came right back.
I went back to the urologist and he prescribed two more weeks of Bactrim. I started back on them after a 3 or 4 day break, which gave me some concern. Wouldn't the strongest bacteria have survived and replicated, I asked? The urologist waived off this concern without explanation.
Once back on the Bactrim, my symptoms mostly disappeared for a couple more days before coming roaring back. So now I'm still on the Bactrim and the symptoms are back. By the way, when I say "symptoms" I'm referring to the fact that when I sit down I get the slight sensation that I've been impaled on a wrought iron spike.
So this time I called my doctor back (I don't need another $45 co-pay, thanks), and he switched me to Levaquin - which is in the same scary family of antibiotics as Cipro, called fluoroquinolones. The problem (according to Dr. Google) is that the prostate is a very isolated organ that is not easily reached by many antibiotics. The antibiotics in the fluoroquinolones family have a unique ability to penetrate tissue and get places that other antibiotics cannot. That's also what makes them so toxic.
*Sigh*. So it all comes down to this once again: live with pain and risk a spreading infection or take a fairly toxic antibiotic and decimate my gut flora. Not an easy choice but I'm going to take my chances with the Levaquin.