An Open Letter to Dr. Young:
Hello Dr. Young,
In this letter I would like to address the issue of initiating clinical trials with electrolyzed salt water, or super-oxidized water, to test its efficacy in preventing and even eliminating UTI’s in people who self-catheterize.
I have been visiting this forum for about two years now, on behalf of my husband, who began self-catheterizing in March 2008, due to obstruction of the urethra from years of BPH, as well as neurogenic bladder from years of chronic retention. Although my husband is not a SCI patient, I came to this forum because it has the most information on self-catheterizing—more than any site on the web I have visited. We have been able to solve many problems my husband was encountering, just by reading how others on this forum had solved the same problems. For this we are deeply grateful.
But there was one problem that seemed insurmountable—recurring UTI’s. My husband was getting an infection about every six to eight weeks, no matter how many improvements we made in his sterile procedure, etc. We followed all the advice we could get, and nothing seemed to work. His urologist always prescribed fluoroquinolones, which worked beautifully at first, but over time the microbes seemed to be getting used to this class of antibiotics, and so he seemed to be colonized most of the time. We tried other classes of antibiotics, but they worked no better. The problem became critical when the antibiotics started attacking the cartilage in his body—he is an older man, 72 years of age. He had always been active, going to the gym and walking every day, but he actually ended up on crutches with his feet so swollen he couldn’t walk into the bathroom. After doing much research I discovered that although the fluoroquinolones do the best job at getting rid of the UTI’s (at least for a time) they are chrondrotoxic, among other things. I refer you to an article online, “Fluoroquinolones are just plain toxic”, http://www.injuryboard.com/printfriendly.aspx?id=252964 . Of course, fluroquinoones are not the only antibiotics with damaging side-effects. We have experienced real trouble with all of them, when used repeatedly. But Cipro is particularly notorious, causing tendon rupture, cartilage damage, arthritis, just basically interfering with DNA synthesis. Of course you know that the FDA was compelled to put out a black-box warning on Cipro, which is pretty serious, for a black box warning is the strongest possible warning to the public. But, as I said, Cipro is not alone in being cytotoxic when used repeatedly.
When my husband ended up on crutches, it looked like we had hit an impasse we just could not get past—after all our efforts to master the catheterization technique in hopes of a good quality of life. But nobody was talking about any alternatives that were truly effective—something we could really count on to solve the problem. That’s when we came across Bob Clark’s posts about this matter. Bob clearly articulated that the problem stems from the colonization of the urethra, particularly the distal urethra. It would seem that the urethra of those who self-catheterize is like an open wound as far as microbes are concerned. It offers a perfect place for colonization and eventual infection. Why is this, since everyone’s distal urethra is probably colonized? Because people who self-catheterize cannot rinse out the urethra when urinating, since they do not urinate normally. In an article called “Infections of the Urogenital Tract and STD’s” ( http://faculty.ivytech.edu/~twmurphy/txt_202/Urog_inf.html ), the author states, “The flow of urine and mucous through the urinary tract helps eliminate bacteria that have invaded. The distal urethra is colonized by several bacterial species in both the male and female but bacterial numbers are reduced by the washing action of the urine during urination.” Thus the whole problem in a nutshell. And worse yet, the catheter tends to push those unchallenged microbes up into the bladder where they can further colonize and infect.
So we tried Bob’s method, using hydrogen peroxide to rinse the urethra prior to each catheterization. At first it seemed to work beautifully, but there was one catch for my husband. He has a very tight passage through the membranous urethra, just before the external sphincter, and every now and then, if he isn’t careful enough, it will get nicked and bleed a little. With the use of hydrogen peroxide, the nicks weren’t healing up properly. We attributed this to interference with fibroblast formation. So we stopped using the hydrogen peroxide and switched to saline solution. This seemed to help a lot, and he got four months without having to use antibiotics, but he was colonized the whole time, so the saline solution was to weak to really do the job. And using antibiotics only every four months was still not acceptable, health wise.
That’s when we found out about super-oxidized water, sometimes called EOW—electrolyzed oxidizing water. This is actually electrolyzed salt water, and the commercial name is Microcyn. I refer you to an article, http://www.rexresearch.com/elexwater/elexwater.htm , which gives a perspective on some of the uses EOW can be put to . It’s really quite remarkable. So we ordered a lot of Microcyn, and even though it was too expensive for our budget (Veterans Pension) we didn’t care. Going into debt is nothing compared to what we were facing without the Microcyn. Well, to make a long story a little less lengthy, it has been working beautifully. My husband has not had a UTI for seven months, and he is definitely not colonized. We are using the technique outlined by Bob in his posts, but we irrigate up a little further than he does—getting up as close as possible to the external sphincter, without penetrating it. We use the little irrigation apparatus Bob described on this forum.
My question is this: Why haven’t clinical trials been initiated to test the effectiveness of EOW in people who self-catheterize? Surely you are aware of the potential it has to eliminate these dangerous infections and the hazards of repeated antibiotic use. Why was Bob’s heartfelt plea to initiate clinical trials ignored? Why have his important ideas been marginalized? I speak from experience here—following Bob’s suggestions to help us find the right way for my husband clearly saved his life, and it could also save the lives of many others. This is a very urgent matter. When you look right at the problem, it’s pretty foolish to teach a person to self-cath, knowing that he/she will be at risk for recurring UTI’s, no matter how careful they are—without first teaching them to eliminate the colonization within the urethra. It’s like a person leaving the front door unlocked, and then when thieves come in to rob the place, shoot them. This may work—they may succeed in killing the thieves, but the collateral damage will be significant. And all they had to do was lock the front door in the first place. It’s a no-brainer.
Consider the syndrome that has occurred so many times over the course of medical history. To quote a passage form a book entitled Pushing Ultimates: “Back before Pasteur, circa 1785, when hundreds of women were dying from childbirth infection, Alexander Gordon noticed that the cleaner things were in the birthing room the less a women giving birth was susceptible to infection. Though he attempted to spread the word about the need for cleanliness, he was scorned and ignored. Seventy years later Ignaz Semmelweis, aware that hundreds of women were still dying of what was called childbirth fever, took extensive empirical procedures to test the cleanliness element in birthing rooms, especially having doctors wash their hands just before delivering a baby. Yet though Semmelweis did his best, even using empirical evidence to prove cleanliness was essential, he was rejected, ridiculed and ignored, thus thousands of women continued to die because of such arrogant self-willed ignorance.”
Please, Dr. Young, do not allow yourself to be guilty of “self-willed” ignorance. Ignoring this crucial prophylactic step in self-catheterization is actually a violation of the Hippocratic oath, for harm is being done through ignorance and oversight.
I have contacted the representative at Oculus IS, and she says they are ready and waiting to cooperate with clinical trials. Significantly, they have also developed Microcyn in gel form, and this could possibly be used as a lubricant for the self-cathing process, in lieu of or in addition to irrigation of the urethra with Microcyn liquid.
Well, that’s pretty much all I have to say at this time.
May you grasp the sincerity of my intent.
Susanne Lewis