DEAR DR. DONOHUE: I have a problem with bladder infections. I have been getting one every month for the past three years. I am a 49-year-old female. My doctor gives me Cipro and the infection goes away, but it returns in a month. I have tried some other antibiotics with the same result. A doctor examined my bladder with a scope and found nothing wrong. Do you have any ideas on what I could do? — L.H.
ANSWER: Recurring bladder infections plague many women. They have to do with female anatomy. The female urethra — the tube that drains the bladder — is much shorter than the male urethra, and it opens to the outside world in a place where there is luxuriant bacterial growth. Bacteria can ascend up the urethra to the bladder with ease. Sexual relations contribute to the problem because contact massages bacteria into the urethra.
Some steps should be taken. One is a culture of your urine to see if this is the same recurring bacterium and to determine its sensitivity to antibiotics. You might have a resistant germ, one that no longer completely responds to Cipro or the other medicines you have taken.
One way of handling this problem is to stay on a small dose of antibiotic daily or three times a week for a protracted period of time so that eradication of the bacterium takes place. Bactrim (sulfamethoxazole with trimethoprim) and nitrofurantoin are two antibiotics often chosen.
Or your doctor can give you a prescription for antibiotics to have on hand. You start them immediately when symptoms arise. Early treatment increases the chance of completely getting rid of the germ.
A third option is to take an antibiotic after intercourse.
Cranberry juice (not cranberry cocktail) has helped many to stave off repeat bladder infections. The dose is 8 ounces a day.
DEAR DR. DONOHUE: My teen wears flip-flops all day, every day. We live in a fairly warm climate, and he wears them even during the winter months. I don’t think this is good for his feet. Do you agree? — W.M.
ANSWER: I don’t think flip-flop manufacturers intended them to be substitutes for shoes. They’re for the shower room, beach and a couple of other similar places.
Researchers at Auburn University have examined flip-flop use and have found that constant wearing of them can present potential problems. The foot instinctively adapts to flip-flops to keep them on the feet. Users unconsciously take shorter steps, and their feet strike the ground at a slightly different angle than shoe wearers. When flip-flop users go back to wearing shoes, these foot mechanics persist and cause foot discomfort. Flip-flops provide no arch support and very little cushioning.
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