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UTI and “Eat, Pray, Love”

Eat, Pray, LoveI really didn’t expect to like Eat, Pray, Love. In fact, since its publication in 2006, I’d been avoiding it like the plague. “Typical new-agey, Oprah-y, girly-book,” I thought. Nothing in it to speak to me.

Then I saw the trailer for the movie, and I was hooked –- probably because I, like mostly everyone, love Julia Roberts. I immediately downloaded the book on my iPhone using the Kindle App and began to read.

First, let me say that Elizabeth Gilbert writes exceptionally well, and the book is actually a joy to read. I, of course, loved the Italy eating part. But more surprising to me, I wasn’t turned off by the whole yoga, Guru, find-yourself stuff. This is because Gilbert writes it all with a reporter’s curiosity and a skeptic’s eye, and frames it not as a belief system, but as a tool for self-discovery and peace. (Plus, I’m really good at skimming if I get bored.)

Too bad Gilbert’s curiosity and skepticism does not extend to the healthcare she receives while in Bali. She accepts the curative powers of a warm leaf placed on an oozing, infected cut without even wondering what leaf it might be or how it might have worked. Was it the heat (most likely) or something else (possibly)? I was dying to know.

She Xeroxes pages and pages of traditional medical treatments without sharing a single one with us in any meaningful way. While I’m pretty sure 99 percent of what was in there was bunk, there might be a few gems that would serve medical science. Unless Lizzie made a second copy, we’ll never know, will we?

But it was the UTI that really got to me.

The UTI

About 9 months into her year of discovery, Gilbert, after a prolonged self-enforced sexual hiatus, takes a Brazilian lover. Not surprisingly, she shortly thereafter comes down with a bladder infection:

After all those nights of not sleeping and all those days of too much lovemaking, my body struck back and I got attacked by a nasty infection in my bladder. A typical affliction of the overly sexed, especially likely to strike when you’re not used to being overly sexed anymore. It came up as fast as any tragedy can strike.

In the old days, Ms Gilbert’s affliction would have been called “Honeymoon Cystitis.” Now we call it “post-coital cystitis.” And she’s spot on, that it seems to occur more often than not when sexual activity takes an upswing in frequency. Usually things settle down after awhile -– probably because we settle down after awhile.

Gilbert, a seasoned cystitis vet, recognizes her symptoms immediately, and practically within minutes is at her friend Wayan the Medicine Woman’s home. Wayan tries more than a few herbal concoctions, none of which seem to be working. Then, just as Gilbert is about to give in and take the antibiotics she’s brought with her for just such an occasion, Wayan throws the kitchen sink at the problem:

Then she went into the kitchen and produced a giant glass mixing bowl full of leaves,roots, berries, something I recognized as turmeric, some shaggy mass of something that looked like witches’ hair, plus eye of what I believe might have been newt . . . all floating in its own brown juice. There was about a gallon of it in the bowl, whatever it was. It stank like a corpse.

Drink, honey,” Wayan said. “Drink all.”

Lo and behold, Gilbert is cured!

In less than two hours I was fine, totally healed. An infection that would have taken days to treat with Western antibiotics was gone.

Now I don’t know what was in that brew, but do you think maybe the GALLON OF WATER might have had a little something to do with its magical curative powers?

Hydration, after all, is one of the mainstays of cystitis treatment. It’s not rocket science –- you dilute the bacteria, flush it out, lower the colony count and thus give your immune system a good shot at clearing things up on its own. Gilbert maximized the chances of this working by recognizing her symptoms and starting hydration almost immediately.  What was floating in the water probably had very little to do with her cure –- unless there was a cranberry or two. Cranberry juice, after all, has been shown to block the adherence of e.Coli to the bladder wall.

Now, I think it’s fine that Gilbert avoided taking antibiotics, especially since her sympoms lasted a few hours at most.  What I take issue with is her lack of curiosity as to what might have cured her. A simple conversation with a doctor, while researching her book (and she does lots of research on many areas, including a fascinating foray into the history of the Italian language) and she might have unearthed the amazing curative powers of hydration, giving her reader’s a little healthy skepticism and a bit of knowledge. Instead, she fills their heads with woo-woo.

Could Gilbert have caught something else?

I also found myself a little worried that Gilbert might have picked up more than a UTI from having sex with her new lover. He tells her she does not need to worry about birth control because he’s had a vasectomy. I took this to mean they did not use even a condom. (Given how open Gilbert is about her experiences,  I think we would have heard about a condom if one had been there…)

This guy’s been on his own in Bali for what, five years?  Not so smart, Elizabeth.

Bottom Line

Enjoy Eat, Pray, Love for what it is: A beautifully written story of one woman’s journey to find inner peace and love. If you find yourself booking a flight to Italy to eat pasta, be my guest. But I’d hold off on medical tourism to Bali for now if I were you.

As for me, I’m still going to see the movie. I do love Julia, after all.

If you think you are getting a UTI

Drinking water is definitely a good idea. You can mix it up with a little cranberry juice if you want. If this resolves your symptoms, great. If not, call your doctor for an antibiotic. And don’t wait too long –- the symptoms can get pretty bad pretty fast.

Most UTI’s will respond to cheap, generic antibiotics. Sulfamethoxazole with trimethoprim (SMTP) and macrodantin are the ones I prescribe most often. If your infection does not respond to the antibiotic you’ve been given, it’s most likely due to resistance, and a culture and change in treatment are warranted.

Emptying your bladder after sex and staying hydrated are good ways to prevent post-coital UTI’s. Cranberry juice or pills may help. If, despite this, you get recurrent cystitis, you may be treated with prophylactic antibiotics for use after sex.

Like Gilbert, my patients travel with an antibiotic just in case they get a UTI, along with a little something for a yeast infection –- I call the combo “Dr P’s travel kit.” Try to stay well-hydrated while traveling, especially if you’re having sex more frequently.

And if you’re traveling alone looking for love -– pack a few condoms, won’t you?

*This blog post was originally published at tbtam*


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