A UTI Experience: UTI, Cipro, and Tendons, Oh My!

Below is a first-hand experience of one of the writers here at Waffles, regarding a urinary tract infection, the antibiotic Cipro, and possible side effects. This story is one person’s experience and not meant to diagnose or cure anything.

Having spent most of the past week dealing with a urinary tract infection, and countless hours reading forums and blogs, I thought I’d share my UTI story here. Instead of writing this article after my problem has been cured, I decided to begin writing this article as it is occurring, and I will update it until it is completely resolved. So below is my experience with a urinary tract infection (UTI), the antibiotic Cipro, and a few home remedies I’ve tried along the way. I’m presenting this in daily entries to show you the progress of my experience.

Day 1 – First signs
It was a Sunday, and the day before going out of town, and I started feeling the classic symptoms of a UTI, namely a burning sensation when urinating, and a constant urge to go. It seemed to come on rather quickly. I started drinking lots of water and taking two teaspoons of Apple Cider Vinegar in water, which in the past seemed to help ward off an ensuing infection. Not this time.

In the past I had dealt with an oncoming UTI but somehow I always managed to dodge a bullet and a full-blown UTI never developed. This time, however, I wasn’t so lucky.

Day 2 – Road Trip & Amoxicilin
I woke up, hoping those symptoms on the first day would be gone, but they weren’t. I also had to drive for 4 hours that day, which wasn’t a pleasant thought in terms of being stuck in a car with a UTI. So before leaving town, I stopped by a friend’s house who gave me a full bottle of Amoxicilin, 500mg. I had looked up common prescriptions for a UTI online and that was listed on some sites as a commonly-prescribed medication for this infection, so I thought it was OK to use. Normally I would never take a medication prescribed for someone else, but I was leaving town and figured it would be OK this time. I also began taking Cranberry pills twice a day. As it turns out, I probably should have visited a clinic instead of taking the Amoxicilin because it didn’t work.

On my drive that day, I ended up stopping about every 45 to 60 minutes. It wasn’t fun sitting in a seat belt with those constant UTI sensations of burning and the urge to go.

Day 3 through Day 5
While out of town I called my regular doctor to make an appointment for when I arrived back home. I continued taking the Amoxicilin, though there was virtually no relief from the symptoms during these days. I had a slight burning sensation with an almost constant urge to go, with varying degrees of intensity. There were times it felt as if it were getting better. I recall marveling at going a few hours without going to the bathroom at one point. Basically I tried to do my best to get to the end of the week when I’d see my doctor, hoping we would get to the bottom of all of this.

Day 6 – Doctor appointment
I finally had my day at the doctor’s office, as the first patient of the day. With it being a Friday, I was happy to be seen before the weekend arrived. I described my symptoms to him and he asked a series of questions. He drew blood and took a urine sample. He said he would be checking for various issues with kidneys, liver, prostate, diabetes, and STDs. I asked him if there was a way to know if this was caused by an enlarged prostate and he said he would compare PSA levels to my prior test last year, which would give us an indication. When I told the doctor that I had been taking Amoxicilin, but that it hadn’t really made any difference, he replied, “Amoxicilin isn’t really the best treatment for these types of infection. Perhaps if you were a 4-year old and hadn’t been exposed to as many bacteria in your life, it might work. But typically Amoxicilin is used for different types of infections than this.”

He prescribed Cipro – 500mg, twice a day for 10 days – and told me that if my blood work showed anything notable, he’d call me back.

I went straight to the pharmacy and filled my prescription for Cipro. The pharmacist told me that if I experienced pain in the back of my knees, to stop taking it and contact my doctor, as ruptured tendons were a side effect of the drug. I jokingly retorted, “So if my knees explode, I should worry, right?” I would later learn that her warning should have mentioned other tendons than just the knees. The pharmacist also told me to avoid vitamins or milk products within two hours of taking Cipro, but didn’t explain why.

So on Day 6 of my infection, I took two doses of Cipro, at 11am and again at 8pm that night. I experienced no side effects, and for a brief period that day, my infection symptoms felt as though they were starting to ease a little.

Day 7 – New Issues
I took two more doses of Cipro on Day 7, at 8am and 7:30pm, but the relief I felt at the end of Day 6 was gone. Most of the day my UTI felt as it had most of the week – a slight burning, and almost constant urge urinate. I felt as if I were going four times more often than normal, and urinating a quarter as much. Almost as if my bladder were suddenly 25% the side it had been prior to the UTI.

Starting around 7pm, I began urinating much more frequently. I was going so often that I started timing it and found that I was going to the bathroom approximately every 20 minutes. When I went, there was a slight sense of relief in pressure for about 10 minutes. I turned to Google in some hopes of reading other comments about UTI frequency. I was starting to wonder if somehow the Cipro was causing this. I also realized I had some caffeinated tea, which is not a good idea during a UTI, as it can increase frequency of urination.

In the evening of Day 7 I began experiencing a completely new problem – my right Achilles heel was very slightly aching. It wasn’t a constant or severe pain, but more like a swell of mild pain that ranged from every few minutes to every 30 minutes. I recalled the pharmacist’s warning about the back of my knees, but not my ankle area. Granted, I had exercised earlier in the day, so at first I thought maybe it was related to that, but I’ve been doing those same exercises several times a week for years, and had never felt a pain quite like that before. So I grabbed the info sheet that my pharmacist included with Cipro (you can view it here), and there was the warning:

Tendon problems can happen in people of all ages who take CIPRO. Tendons  are tough cords of tissue that connect muscles to bones. Symptoms of tendon  problems may include:
• Pain, swelling, tears and inflammation of tendons including the back of the ankle (Achilles), shoulder, hand, or other tendon sites

It further states: Other reasons that can increase your risk of tendon problems can include: Physical activity or exercise…

And finally: Call your healthcare provider right away at the first sign of tendon pain, swelling or inflammation.

I am still wondering if I should have been warned not to exercise, and if that contributed to soreness in my tendons.

Day 8 
I woke up and immediately felt that mild swell of pain in my Achilles heel that I had the night before. I was now convinced that this was unrelated to exercise, so I hit Google once again in search of people with similar experiences. I found quite a few forums and website devoted to Cipro and tendon damage. Even though my tendon pain wasn’t very significant, I decided to stop taking Cipro and call my doctor on Monday – which meant I’d have to go all day Sunday without any antibiotics for my UTI which was now in its 8th day. I only hoped that the Cipro I had taken the prior two days might keep the infection at bay until Monday.

Oddly enough, it seems that the frequency of urination was much better on Day 8. While it was every 20 minutes at the end of Day 7, it was about every 90 minutes as Day 8 began, and up to a couple hours by the end of the day. This was a vast improvement over Day 7. It made me wonder if the Cipro was starting to work, even though I decided to stop taking it. Or perhaps stopping Cipro has actually helped? How would I even know?

I went to the mall for a few things on Day 8, and while walking around, my Achilles heel started hurting on and off, seemingly at random times. The pain was more significant than it had been before. It wasn’t unbearable, but I felt the need to baby my foot until I could get home. I recalled stories of tendons “popping” that I had read about online, and didn’t want to be the next victim of that fate.

I plan to call the doctor first thing in the morning on Day 9 and ask for an alternative medication. I’ll update here as soon as anything new develops.

Day 9
I called the doctor and explained the situation to the nurse. I was told to stop taking Cipro (which I had already done two days ago) and to rest my foot for a week, meaning no exercise. They called in a prescription for Bactrim instead.

Day 10-20
I took a full course of Bactrim, and during this time my symptoms completely disappeared.

Day 23
Three days after taking my last dose of Bactrim, my symptoms returned. My doctor asked me to return for another urine sample. He called the next day and told me that both of the tests I took showed no bacteria, and he referred me to a urologist.

UTI Tips

• Avoid caffeine. Caffeine can irritate your bladder and increase your frequency. I made the mistake of having coffee and tea in the early days of my UTI, and I believe on some occasions it probably made my frequency much worse. Read more in this article at Livestrong.com.
• Drink lots of water. This will help flush out the bacteria from your system. I’m not fond of water, but I’ve been downing it as best as I can to stay hydrated. Of course drinking extra water contributes to the frequent urination, but it is a necessary part of the healing process.
• Though some people suggest using Apple Cider Vinegar as a cure for a UTI, there is also evidence that it could actually cause more irritability during an infection.
• Some people take 1 tsp of baking soda in a glass of water to help a UTI, while others warn that this could cause other problems.
• Cranberry juice can help, but the unsweetened kind is most effective – and the taste is rather harsh.
• Taking a probiotic every day can help reduce the incidence of UTIs.

Cipro
This antibiotic has been around for many years, but in 2008 the FDA issued a “black box warning” which is the strongest warning a drug can have, one step away from being pulled completely. The warning is primarily due to the severe tendon problems that have been reported as a result of using this drug. It has been suggested that magnesium may help with tendon damage caused by Cipro. Read accounts of magnesium and Cipro tendon damage here and here. As with any drug, there is a long list of rare side effects, but it appears that the issue with ruptured tendons is much more common than the typical “rare” side effects.

Further Reading

• Cipro warnings (FDA)