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To Your Good Health: ‘Pacemaker for the Bladder’ Is One Option

Dear Dr. Roach: I was diagnosed at the Mayo Clinic in Minnesota with interstitial cystitis. They treated me by stretching my bladder for five full days, putting medicine in the bladder, and put me on the drug Elmiron. About every two years this had to be done, and it really did help me.

At the Mayo Clinic in Jacksonville, Fla., they had a new treatment, called an Interstim device, which they placed under the skin. This is kind of like a pacemaker for the bladder.

This is the best thing that ever has been invented. I hope this will help other people as much as it has helped me. I just hope this will tell other women that there is help for them, and no more pain or pills. — G.P.

Answer: Interstitial cystitis is a painful condition of inflammation of the bladder wall. Ninety percent of those affected are women. It isn’t an infection, and antibiotics are not effective. You have mentioned three (or four) powerful treatments: Bladder distention — filling the bladder with water helps some people with symptoms, possibly by increasing bladder capacity. Topical medications, such as DMSO, can be instilled into the bladder during distention, which helps many people as well. Elmiron (pentosan) is effective for many people, but it can take months to start working, and it’s expensive. The Interstim device is indeed like a pacemaker for the bladder. It usually is reserved for those who continue to have symptoms despite other treatments.

I thank you for taking the time to share your experience with this condition, which often is not diagnosed for years and can cause dramatic loss of quality of life. Some of the members of www.ichelp.org, a help and support group, have been very vocal on my Facebook page (www.facebook.com/keithroachmd) and are a great resource for those with this diagnosis.

Dear Dr. Roach: My eye doctor just told me I have dandruff on my eyelashes. I never heard of such a thing. What is it, what bad things is it doing to me and how do I get rid of it? — K.R.

Answer: What you have is properly called seborrheic blepharitis. “Seborrheic” means “oil-secreting” and “blepharitis” indicates inflammation of the eyelids. It can be primarily of the outside or the inside eyelid, but the inside is more common. Inflammation there can affect the glands that help lubricate the eye, causing symptoms such as red, itchy or gritty eyes, red or swollen eyelids, crusting and sometimes blurry vision. It’s not clear what causes the inflammation. It’s a chronic condition without a cure, although it can be successfully managed, in most cases, with good eye hygiene. Covering the eye with a warm water-soaked cloth for five to 10 minutes several times daily, immediately followed by a gentle eyelid massage, is effective for most people. Washing the eyelid with water or with a small amount of baby shampoo can be helpful as well. More severe cases may require antibiotics or anti-inflammatories, as ordered by the treating provider, who can be an ophthalmologist, dermatologist or general doctor.

Dear Dr. Roach: What is the best thing I can do for a pulled muscle? — R.H.

Answer: A pulled muscle comes from exercising or stretching a muscle too suddenly, which can tear some of the muscle fibers. The best initial treatment is rest and ice. Sometimes wrapping the affected muscle in an elastic bandage can make it feel better. Pain medication is OK, but I recommend avoiding aspirin since occasionally that can worsen the bleeding that often happens when muscle fibers are torn.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or write to P.O. Box 536475, Orlando, FL 32853-6475.