DEAR DR. DONOHUE: I spent five days this month in the hospital with a urinary tract infection. The medical team could not tell me where I caught the infection. One answer was that the E. coli germ, which we have in our bodies, travels to other parts of the body and infects them. I am now at home. -- P.M.
ANSWER: The "urinary tract" is the kidneys, the ureters (the tubes draining urine from the kidneys to the bladder), the bladder (the storage receptacle for urine) and the urethra (the drainage channel from the bladder to the outside world). Lower urinary tract infections are infections of the bladder, urethra or both. They usually can be treated at home with antibiotics. Their symptoms are frequent urinations, burning upon urinating and pain in the low abdomen.
Upper urinary tract infections involve the kidney. They are more serious and have more dramatic signs and symptoms, like high fever, chills, sweats and flank pain. They are mostly treated in the hospital with intravenous antibiotics.
Where did your infection come from? Probably from your colon, which teems with bacteria. E. coli is one of those bacteria. E. coli can often be found on the skin of the rectum and in adjacent structures. From there, it's not a great distance to the urethra, the bladder's drainage tube. Once it enters the urethra, it ascends into the bladder, and from there it can reach the kidneys.
An enlarged prostate, because it blocks bladder drainage, sets up men for urinary tract infections. Women get more of these infections than men because their urethras are shorter, and bacteria can travel up them easily.
In fewer instances, bacteria from a distant body infection, like an abscess, can travel via the blood to the kidneys and start an infection.
The booklet on urinary tract infections discusses this topic in greater depth. Readers can order a copy by writing: Dr. Donohue -- No. 1204W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient's printed name and address. Please allow four weeks for delivery.
ANSWER: If the black is pooled blood, a doctor can bore a tiny hole into the nail and let it out. If the blood has congealed, it has to stay there and you have to wait until it's absorbed by the body, which will happen in time. That might take a couple of months.
If the nails themselves have become discolored, then it takes six months for a new nail to grow from the base to the nail tip.
ANSWER: No, it did not. It was purely coincidental that you suffered a stroke and had been using a hand-held massager.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.
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