Understanding UTIs: Prevention, Treatment, and Myths

You are listening to Boomers Today with your host Frank Samson. Well, welcome to Boomers Today. I’m your host, Frank Samson. Of course, each week we’re very important and very useful information on issues facing baby boomers, their parents and other loved ones.

And I say this on every one of our shows. I thank all of you, and I thank all of you because so many of you are forwarding individual shows our entire podcast station to friends and family to listen to. And that’s why our listeners keep growing each and every day. It’s because of you, So thank you for that.

So many of you are listening on various podcast stations Apple Podcasts, Spotify, iHeartRadio, Audible or just some of you just go to Alexersiri and ask the ask Alex or Syria to take you to Boomers Today. So some of you go to our website also Boomers Today Radio dot com, and there’s plenty of other podcast stations as well that we’re on as well. So thank you so much. But I do know why you share our show, share the show with family and friends.

It is because we have great guests. And I’m not going to disappoint you today because today we have with us Elise false Knight. Alise, I should have asked you how to pronounce your last name. Did I get it right? You did it perfect? Yeah, look at that.

Elise Falt Knight. So, she’s a board certified physician assistant specializing in sexual medicine, women’s health, and urology. She’s also a medical advisor at Aeroflow Urology, a subsidiary of Aeroflow Health, a leading provider of high quality incontinent supplies through insurance. In twenty nineteen, FoST Knight opened up her private practice, the Foster Knight Center for Sexual Health, and implemented the Sexual Health Grand Rounds curriculum at her local hospital and residency program.

Elise is also the founder of Foster Knight Foundation, a nonprofit organization dedicated to the education and training of professionals in the sexual health field and providing funding for access to healthcare services in her local community. So, Leise, thank you so much for joining us on Boomers today. I really appreciate it. Well, thank you so much for having me.

I’m excited to be here today. Yeah. Yeah, a lot to learn. I’m going to learn a lot, that’s for sure.

So you know, as I mentioned, I mean you specialize in sexual medicine, neurology, pelvic health feels how many people may feel uncomfortable talking about. All right, So what threw you to this type of work. Well, it’s a funny story. It actually started with a Viagra commercial and I was in PA school trying to come up with what I wanted my master thesis topic to be.

And I really knew that women’s health and pelvic health was something I enjoyed, I loved talking about. But when that Viagra commercial came on the television, I had a thought of, oh my gosh, if there is a blue pill for men, there must be a pink pill for women. And that was in two thousand and nine when I was in PA school at that time. And when I did the research, there was nothing.

There was zero, and that really fueled this fire in me to do more research on women’s sexual health. And when I went to do this research, all of those articles actually were under your rology journals. So the specialty of sexual medicine is actually under our kind of broader umbrella of urology. And that’s kind of how I got into this.

And when I finished school, I had a urologist that I actually worked with when I was in high school, reached out to me and said, hey, I hear you have an interest in women’s sexual health and urology. Would you like to actually come back home to Western North Carolina. I went to the University of Kentucky for PA school. Do you want to come back home and do this? And I was so excited and said, yes, absolutely, this is what I want to do.

And that happened almost fifteen years ago, and I have been in this field ever since and really came to appreciate all pelvis’s, all bladders, all genitals, and really helping to decrease the stigma and shame with having these conversations. That’s great, that’s good for you, that’s wonderful. So you know, UTIs are probably way more common with women, and I know you specialize in working with women, But I but why is that? Why are women more prone to urinary tract infections than men? So there’s a couple of reasons. One is sought to be potentially the anatomy, and that everything is so closely aligned to the digestive track.

So when we think about valeve movements or hygiene, and that the urethra for assigned women at birth is really short and so it is really easy for some bacteria to go up through the urethra into the bladder, hang out and then cause an infection. We know that with sexual activity, GI issues again, hygiene or even urinary incontinents that can lead you more prone to urinary tract infections. And then also as we get older and we have changes in our hormones that menopause actually increases your risk of urinary tract infections as well. Okay, got it, So maybe I should have asked you before.

The last question is just explaining maybe and you know, as easy terms as possible, uh, to our to our listeners, what a UTI is and it stands for urinary tract infection. But can you explain kind of what what what what it is and maybe even if you want to talk about maybe common symptoms people should watch for for a UTI. Yeah, absolutely, A urinary tract infection means that we have typically bacteria that is not typically seen in the bladder that gets in the bladder and grows and causes irritation to the bladder. And those symptoms can be burning with yourination, frequency of urination, urge, and see pressure sometimes lower back pain.

There could be blood in the urine or there urine could look a little cloudy, and if that infection starts to travel up to the kidneys, we actually may see fever again, back pain, or even feeling the tigued malaise, and those individuals have a risk of becoming what we call septic, where the infection then gets into the bloodstream and that can be a very serious illness that needs hospitalization and ivy antibiotics. So if you have those type of symptoms, don’t take it lightly. Correct Yeah, go to your doctor, go into emergency, and take care of it right. Absolutely.

And you know, one of the things that I have had lots of conversations with my patients over the years is that we should not just normalize the fact that women do have more frequent urinary tract infections. I have several folks that have said, oh, yeah, this is like my fifth infection of this year, and they blow it off. And for us in the urology world, when we think about our guidelines and standards of care, if you’ve had three or more urinary tract infections within a year, within twelve months, you really need to be evaluated by urologists to figure out why you’re having those. Every time you have a urinary tract infection, it’s a hit to your immune system and it’s a hit to that protective lining in that bladder.

So super important to have those evaluated and not just continue to go to urgent care or to your primary care provider and just get another round of antibiotics. Gotcha. So when someone may have a UTI and they don’t know it, it could be maybe confused with other I don’t know, bladder conditions. I mean I mentioned you before we started got on the air here.

You know, I’m in the senior care industry and I hear about it all the time where somebody as a UTI and they start to even lose you know, short term gets some short term memory loss, might act similar to dementia. So what are some of the conditions that could be something mistaken for UTIs. Of course, as our body ages are, sensation to inflammation or changes, especially in the lower urinary tract isn’t as robust as it was, so we’re not getting those typical symptoms of burning with urination or going to the bathroom or frequently this could be now we’re seeing incontinence where we didn’t before. We may see more difficulty emptying out to our bladder.

This could be also, like you said, confusion, and this is really difficult when we are trying to differentiate between dementia, Alzheimer’s, sundowners. You know, we see this sometimes in hospital systems or long term care facilities, and so knowing that our immune system and how our body is sensing thing changes as we get older, the importance of checking a urine can be really helpful. And again, unfortunately there is this narrative in our culture of oh, this must just be something as I’m getting older that I’m having urinary in continence or i can’t hold my bladder as much. But really those things need to be evaluated, and especially if we start to see some confusion, really ruling out or ruling in a urinary trapped infection is key.

Okay, all right, So so what recommendations do you have to somebody? Should they let’s say, let’s say there’s blood in the air, Okay, go right to emergency or try to get an appointment with your doctor. Getting an appointment with your provider can be really helpful and getting that referral to a urologist. The work up for somebody who has visible blood in their urine is going to be a CT scan of the abdomen and the pelvis. We’re looking for a kidney stone or something else that might be going on with the upper tracts of the urinary system.

And then we’re looking inside the bladder with something called a sistoscope, where it’s a long, flexible piece of equipment that has a camera and light on the end of it that we can go through the urethra and look in the bladder to make sure there isn’t anything like a bladderstone or a bladder tumor that it could be causing that blood in your urine. However, you can see blood in the urine when you have a urinary attract infection. And again, like I said, as we get older and we’re not having some of those first line symptoms that we would typically see with burning, once that urinary tract infection has set up shop in that bladder and really cause some irritation to the lining, it can then cause bleeding into the urine. So getting checked out, yes by a urologist is going to be key if that’s happening, and if you have other symptoms, so again like back ache or fever.

Then we might think that again it’s traveling up to the kidneys. We might even do some blood cultures to make sure that you’re not against septic or having something more serious. Gotcha, gotcha. So list we’re going to take a real quick break.

I promise just to recognize our sponsor when we come back. Certainly want you to share with everybody how they can learn more about all the wonderful things you are doing. And then well a lot of other questions, but we want to talk about maybe prevention, you know, how people could maybe prevent UTIs from happening. So we’ll talk about that.

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So learn more go to www dot Beyond Driving with Dignity dot Com. That’s beyond Driving with Dignity dot Com to connect with a senior care authority advisor in your area. So we’re back with Elise foss Knight, who’s Board certified physician assistant specializing in sexual medicine, women’s health and urology and learning a whole lot here. So Alise, feel free to share with our listeners how they could learn more about the great things you’re doing.

Any websites, anything that you’d like to. Share, absolutely well. One of the first things is the relationship that I have and partnership with Aeroflow Urology. I really valued the work that I have been doing with them to really increase access to incontinent supplies and even awareness to people out there that you can get in continent supplies through your insurance, especially if you have Medicaid and Medicaid managed plans.

What I love about airflow Urology and the individuals that they have working they can really support to guide individuals through eligibility, what documentation is need, making sure that we are selecting the right products for you and your incontinence. And they also do home delivery, so you don’t even have to go out of your house to go pick up any of those supplies or walk down the aisle and be completely overwhelmed with all of the options that are out there. Aeroflow states that it accepts more than three hundred insurances across all fifty states and is really designed to simplify that coverage verification, help with prescription coordination, especially with your medical providers to ensure that you’re getting the right prescriptions, and then also monthly resupplies for me. I opened up my own private practice in Asheville, North Carolina, the Fast Night Center for Sexual Health, almost six years ago, really to again increase the awareness that sexual health is an important part too our daily living.

I really wanted to take again the shame and stigma out of having these conversations around our pelvic health and especially around urology when we have folks that are having incontinence, feeling that it’s very oh normal, that this is just something that I have to deal with, but really trying to break down those barriers and saying it’s not necessarily normal, it’s really common, and helping people to understand that there are lots of varieties of treatments and other modalities to help support that person in those public health goals. Great. Great, So why don’t you I don’t know if there’s one website two websites, but feel free to share the websites with people so they could learn more. Yeah, of course.

So the website that you can actually get my information and see my practice is going to be Fossinite and that’s fo s NI g htcenter dot com. And then to check out Aeroflow Urology, it’s going to be Aeroflow and that’s a E R F l O Urology dot com. Great, great, well, thank you for that. Wonderful So let’s talk about we’re on the subject of UTIs urinary tract infections.

I mean, are there effective ways to help prevent UTIs from occurring? There are, and the biggest way that we can prevent is through education, just like what you’re doing today, raising awareness that we don’t need to wait for somebody to have a urinary tract infection to treat it. We are very reactionary in current medicine today and I really want to try to break that cycle and have more proactive preventative ways that we can do this. We know, especially for again female identified individuals, that they on average fifty to sixty percent of women will have at least one urinary tract infection in their lifetime, so that’s huge. We know that this is going to happen, so raising awareness even before it happens can raise awareness on symptoms and management for those individuals.

Hydration is one of the biggest things that we can do. We are very under hydrated here in the United States, So hydration, while it seems counterintuitive, if you’re having an urgency, frequency or urinary incontinence, I shouldn’t drink more, and that’s typically what happens, or our thirst mechanism changes as we get older, so we’re not drinking as much. So just making sure that you were staying hydrated. Typically we’re going to want anywhere from sixty to eighty ounces of water on a daily basis.

And I tell this to my patients all the time. No coffee does not count as has your water intake. Even though we make it with it as I know it. Yes, yes, that is the biggest question.

Listen. I’m a huge coffee drinker too, And one of the things that you can do to set yourself up for success is before you have that kupa cost, make sure you have eight to twelve ounces of water first thing in the morning. We’ve slept all night, we haven’t had any water. That’s a great way to actually combat and help to dilute the urine before you dump some coffee that can have some caffeine and some other irritants in there that can make your bladder have more irritation, inflammation, and urgency.

The other thing is to avoid constipation. So this is increasing your fiber. It’s funny and you might be thinking, well, why are we talking about bowel movements, So we’re talking about bladders, but there’s a lot of overlap in that pelvis. So making sure that you’re getting plenty of fiber.

You’re up move in your body several times throughout the day. When we sit still, so do our bowls, so we want to be up moving around to kick those vowels to move also, and then making sure that we are having proper hygiene. This is again for people with volvas that we’re wiping kind of front to back, that we’re not mixing any time that we’re having a valve movement with that with the urethram. And then also when we’re thinking about sexual activity, I encourage a lot of my female patients to go and urinate after sexual activity, no matter what that looks like for them.

And then as we are getting older, there is something called genito urinary syndrome of menopause, and this term came out in twenty fourteen and there was a urologist, Erwin Goldstein, who was a great colleague of mine, who was sitting on that panel when they were coming up with what should we actually call the changes that are happening in the genital tracks, and he said, we have to make sure that the urinary tract is in these conversations because there are estrogen and testosterone receptors in the bladder in the urethram that as women are going through menopause, that changes, and that shift is going to change the microbiome and lead more women more susceptible to urinary tract infections. You know, we UTIs account for around ten million healthcare visits annually here in the United States, and a lot of that is secondary to those changes in the hormones in those luorinary tracts. So a simple application of some vaginal estrogen cream can actually decrease your risk of a urinary attraction infection by over fifty percent. This is huge and we are very excited to see that there are changes to the labeling system that was on vaginal estrogen and a lot of these warnings that were not relevant are now removed and so there are less barriers for people to use vaginal estrogen.

There is nobody in my practice that I have seen that doesn’t qualify for vaginal estrogen cream. So even if you have a history of breast cancer, colon cancer, ovarian cancer, uterine cancers, I will always tell people, you know, talk to your oncologists. But we know from the research, and there was new guidelines that just came out a year ago by the American Neurology Association that says that over the overwhelming data that we have that this product is safe for everyone. That’s great, great, well, thanks for sharing that.

So you mentioned high fiber diet. We hear that any particular foods you can mention that both help regulate the ball and bladder function, and maybe even which foods to avoid. Yeah, well, it’s funny. I actually think about a supplement that I encourage some of my folks who have more irritation to their bladder and are struggling with constipation.

But alo alo has a lot of fiber in it. There are some alo vera capsules that I think can work great to increase in bulk the stool so that you can have better bowel movements, makes it softer. But then ali vera is actually an anti inflammatory, and when you take it orally, it will get filtered into the urine and can cause decrease inflammation in the bladder to soothe the bladder also, so ali vera, while it’s not necessarily a food, I guess you can’t eat it, but you can drink it is great, or if it’s something that you wanted to take a supplement, you could do that. The other things we have to think about is just like you talked about foods that will help the bowels increase fiber but then also not cause bladder irritation.

So those can be some of your lagoons, your beans. I would avoid any spices to that that’s going to help to decrease any irritation to the bladder. TuS Seeds are a great source of fiber also, and some really good Omega three fatty acids to help out your body and optimizing health as well. Great.

Great, So what is Maybe you could maybe mention more than one if you want. But what’s maybe the most common mistake you see patients making when it comes to UTIs. I think the most common mistake is again thinking that it’s normal or that they just have to deal with this because they have that female anatomy, and really breaking that myth is so important and there is something we can do about it. I think that’s also the concern out there is people think that it’s just something I have to live with.

There really isn’t a whole lot of treatments. I’m just going to go have to get antibiotics every couple of months because this is just me and I’m just more prone to infections, and that is not the case at all. I like to call myself a private investigator, no pun intended, and you know, really figuring out what’s the root of the cause for you of having these infections. Again, like I said earlier, is every time you have a yuriniar attract infection.

It’s another hit to your immune system, and we don’t bounce back after we have infection after infection after infection, So that’s going to be the things that we need to be thinking about. The Other thing, too, is we hear a lot about cranberry as being a protected and while cranberry is a great source of that, if you are only drinking cranberry juice, you’re gonna have to drink like eight of those bottles every single day in order to get the benefits of that that cranberry. So there is a couple of supplements out there. Solve Wellness is one of them, and I don’t have any attachments to these products, but they actually have a product called Jena MD which actually has a it’s called PAC from that cranberry juice extract.

And while I’m in medicine, I’m a horrible sayer of medical medical terms, but the PAC is really important and you want high concentrations of that. So when you can take it in a supplement, it actually has been shown to help to prevent urinary tract infections. So that’s another great way from that prevention side. That’s great great.

So when when people are meeting with their healthcare provider, do you recommend people you talk to do you recommend particular questions or a particular question that they should regularly ask their healthcare provider. I do, and this is something that I encourage a lot of people to prep ahead of time, have a written down on a piece of paper. You can actually forward those questions to your provider through a medical portal ahead of time, or even have them just jutted down on your phone can be really helpful. One of the first questions that I encourage my patients to ask is what type of ladder issue do you think that this is? And if you have somebody who is just poo pooing you or just kind of saying, oh, this is nothing to be concerned about and not engaging in a conversation with you, finding somebody else that can engage with that conversation is going to be really important.

The next thing would be as asking, you know, could this be a urinary tract infection, and if it’s not a urinary attract infection again, what is it? And could this be related to constipation and medication side effect? Could this be related to again menopause related changes? Or for my assigned mail at birth individuals? Could this be a prostate related issue? Another question is going to ask is what kind of urine test can I have? Do you? Another one is do you think I’m emptying my bladder completely? And especially if you’re not feeling that you are, asking for them to check to see if you are emptying your bladder can be great. Asking what are the things that you can go ahead and do right now at home? Another one is when should I worry or go to emergency rooms or urgent care? And then what treatments exist beyond just using pads and waiting? Again, there is not a lot of conversation around this prevention. How can I be proactive? And this is where also asking what are my options beyond those incontinence products? And if this is something that you have been working on, where can I get information about urinary in continence pads? Does my insurance cover that? And that’s where Aeroflolurology can come in to play as well. Gotcha? Gotcha? So at least unfortunately we’re out of time, but I’m going to give you thirty seconds here on this one, so you know, maybe just I don’t want to finish up our interview podcast here and you’re saying, well, I wish Frank would have asked me this, So what’s the question you wish I would have asked you? And feel free to respond then, and you know, we just have a short period of time here.

The question I wish was the overlap of urinary in continents and urinary tract infections. That is another big one that I get again because people think that it’s just common or normal that they have urinary in continents. Don’t assume that what is going on with your body is normal. Maybe think of it more as this is common and that there are treatment options that we can do.

And don’t forget about your felf. Pubvic floor therapists. We know that they are super key in understanding your pelvic floor and how your bladder is working to help prevent urinary incontinence, treat urinary incontinence and also do some UTI prevention. Great great Elise last night.

Thank you so much for joining us on bus today. I really appreciate it, and thank you everybody for joining us. And please, he said. We’ll talk to everybody next week.

You’ve been listening to Boomers today with Frank Sampson to learn more about today’s show, visit boomerstodayradio dot com, and join us next time for another edition of Boomers Today.