Urinary tract infections

This is number 12 in a series of articles written by Frank S. P. Yacino regarding Alzheimer’s disease. He is the husband and caregiver for his wife Barbara who has been struggling with this disease for over fifteen years.

The accounting of this infection which will be given is how it affected Barbara and how I was able to detect that she had a UTI (Urinary Tract Infection) and what we did to make her better. (If anyone would like more detailed and professional information on this subject I would suggest that you go on-line to Webmd/UTI.)

This infection is quite prevalent in women, although men are also susceptible to a UTI as well, whether they are living a “normal” life or sick with a disease like Barbara has. From what I’ve been told and read about the UTI, it’s very painful and one may feel a burning sensation when urinating. Unfortunately Barbara, being non-vocal now, is unable to tell me that she is in pain when this has occurred to her over the past several years. During our married life she never spoke about this issue happening to her, nor did I ever know her to be on an antibiotic for this infection.

That said I’ll go back to the first time that I was introduced to the UTI. This happened on December 18, 2008 and I soon became well versed on its symptoms and how it affected Barbara. At this time Barbara had been in pampers (briefs) and pad liners for two years and when I would change her I was well aware of the amount of urine that there was in the pad liner each time. Over the course of the years I have learned to watch for several tell-tale signs that have helped me to detect that Barbara may have a UTI.

The first sign which I mentioned in the previous paragraph is the amount of urine in her pad liner. Barbara usually is in bed at night for up to thirteen hours so in the morning her pad should be very wet and heavy. On some of the mornings she would be dry. Then her demeanor would drastically change, she’d become lethargic and moody. Once these symptoms occurred I knew something was not right and would send a urine sample to the Day Care for testing. If the urine is dark, cloudy, and smelly that’s another sign of a UTI.

When Barbara went to Day Care on December 15^th the staff took a sample of Barbara’s urine to test for infection. On December 18^th I was officially notified of the infection, as it usually takes a couple of days to do the testing. If it’s positive, medication is then prescribed for that particular type of infection. The length of time for the medication is determined by the particular “strain” of the bacteria and one medication does not treat each “strain”. Below is listed each time (month/day/year) that I was notified that Barbara had the infection after testing was done and the length of time that she was on the medication. You will notice that the length of time varies based on the “strain” of the infection.

December 18, 2008, on medication for ten days

September 8, 2009, on medication for ten days

November 11, 2009, on medication for three days

February 17, 2010, on medication for three days

July 9, 2010, on medication for five days

August 19, 2010, on medication for seven days

October 21, 2010, on medication for five days

January 13, 2011, on medication for three days

August 17, 2012, on medication for five days

October 21, 2012, on medication for seven days

After the first three UTI episodes, I spoke to the medical staff at the Day Care and it was recommended that Barbara be put on a low-dose antibiotic pill. On November 12, 2009 we began that regimen and it continues to this day. Even though Barbara has had seven UTI episodes since then, one within six weeks, the time from January 2011 to August 2012 was UTI free and we were pleased with the length of that time span. As you can see, within two months of the August episode we had another one. We do our best to help prevent these situations from happening but we just never know when they going to develop.

At one point in time we used baby powder to try to keep Barbara dry whenever we changed her pamper and pad. When I mentioned this to the Day Care medical staff I was advised not to use the powder at all in the groin or buttocks area, but to use Vitamin A & D ointment on the skin. We now use this ointment on a daily basis at each change of the undergarment. The ointment also helps to keep the skin smooth and helps to avoid sores on the skin.

When Barbara had her UTI on August 17^th, I went to the pharmacy to pick up the antibiotic medication and I mentioned to the pharmacist that I usually give Barbara a smoothie each night before she goes to bed. She asked me what I put in the smoothie and I told her blueberries, strawberries, grapes, bananas, apples, pears, peaches, and cranberry juice. She immediately advised me not to give Barbara the smoothie until she had finished that particular antibiotic medication as there could be an adverse reaction between the berry products and the medication. That was important information for me and saved having any complications develop with the medication. I certainly recommend that with any change of medication you speak with the pharmacist about the reactions the medication may have with other medications the person is already taking, or foods that should not be given to the person.

So, are there any other ways which may help deter these infections? On a daily basis Barbara drinks a half glass of cranberry juice and after dinner she has a half cup of yogurt. We also give her water during the day to keep her hydrated. The more liquid that she ingests the more her urine will be diluted and aid in flushing out any bacteria she may have. And finally, be sure to check with the person’s doctor for any other suggestions that may be worthwhile.