UTI Prevention Protocol (for TBI)

[Ryan’s Rally LLC]

Just remember, I’m a caregiver with no formal medical, therapeutic, or nutritional education. This protocol is what — through years of trial & error — I developed for Ryan. Please let me know if any/all works for your situation!

Ryan’s UTI Protocol:

• Catheter. Ryan only uses an external catheter (also called “condom catheter” or “Texas catheter”). We never allow an indwelling catheter to be inserted… even if hospitalized. We thoroughly wash his penis and put on a new twice daily.
• Urine Collection Bag. Like the condom, we replace this (& tubing) every day. Although less effective, instead of replacing daily, one can be reused if disinfected with white vinegar. It is important to drain any urine from the collection bag and tubing often… don’t wait for it to fill up. This keeps urine from backing up and accumulating in the catheter.
• Water. Ryan gets at least 2,000 ml — but usually 2,500 ml (2.5L) — of water every day. This keeps his urinary tract system flowing and prevents the urine stagnating. Be careful not to overdo water because it can cause sodium imbalance in the brain.
• Raw Organic Vinegar. Ryan gets 100ml of Braggs Raw Organic Vinegar to 1,000ml of water throughout each afternoon. This raises his urine acidity; which kills bacteria.
• Cranberry Pills/Capsules. Ryan takes cranberry supplements, a proven defense against UTIs, several times daily.
• Urine Test Stripes. We used these daily (until the UTIs were under control). Often we would catch UTIs before Ryan became symptomatic (pain). The presence of both Leukocytes and nitrite — that are not typical — indicates a probable infection. I say “not typical” because Ryan has a bacterial colonization and these are always present in trace amounts, so we watch for higher levels. If this happened to Ryan, we immediately sent his urine for testing/culture and had him on antibiotics before it was even painful.  This might be a way to get ahead of the seizures for patients that suffer them from the response of the parasympathetic system to pain. As an added bonus, these also measure “specific gravity” which is nothing more than hydration.
• Urine Color, Appearance & Odor. Check the urine each day for signs of infection: Dark color (should be pale/straw color), Cloudiness, and foul smelling.
• Low Dose Antibiotic. Ryan takes a very low dose of an antibiotic daily. The one the put him on is called Macro BID (also called “Nitro-Fur”).
• Bladder Spasms. These are common in TBI and cause urine to be retained in the bladder, hence UTIs develop from stagnation. Ryan takes a drug called “oxybutynin” that relaxes his bladder.
• Methenamine. Like vinegar, this affects the acidity of urine. Ryan was prescribed this 4 times daily.

The first 7 items can be done immediately, but the latter three need a doctor’s script (as does sending urine for culture). We also keep a product called AZO Maximum Strength (UTI symptom relief) on hand for when he becomes symptomatic. It’s good stuff for making him comfortable (but won’t cure the UTI). Don’t be alarmed by the color of the urine when taking this because it will look bright orange.

It might be worthwhile to periodically perform bladder/kidney/abdomen imaging to see if stones or some unknown blockage exists.

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