Trouble Down Below | Fit Pregnancy

Trouble Down Below

Is It Pregnancy or A Bladder Infection?

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Kelli wrote this week, very upset and having an all-around tough time of it. She apparently had a normal period in August but only a speck of spotting in early September. She's having abdominal pain, cramping and urinary frequency. She's taken a few pregnancy tests and they've all been negative. Smart girl that she is, Kelli saw her doctor who told her she isn't pregnant but has a urinary tract infection (UTI); commonly called a bladder infection. Yuck, I hate those things.

Kelli's not convinced she has a UTI because she doesn't have the usual telltale burning with urination. She doesn't have all the telltale pregnancy symptoms either. Her breasts aren't sore but she's nauseated off-and-on and her moods are swinging like pendulum, "in the best of moods one minute then crying or yelling the next." Kelli thinks she's pregnant and the spotting was implantation bleeding. She's confused (I'll bet!) and feeling quite alone. It sounds like she's spending a lot of time in bed feeling upset and sick. Poor Kelli, this does not sound good. You've got a lot going on here. Maybe I can help a little with the pregnancy versus UTI confusion.

Most of the time, women with a UTI know it. They have to pee all the time but when they go, very little comes out and it burns like crazy. Sometimes they have bladder pain and if the infection has moved to the kidney, back pain too. It's the burning and urinary frequency that sends most women straight to the doctor. Ugh. I've had a couple of these suckers. I drove myself to the emergency room once in the middle of the night because I couldn't stand it another minute. I felt like if I didn't pee like a fire hydrant immediately, I'd explode. Then, when I tried to pee, nothing would come out except a few scorching drops. I spent a couple of hours curled up in bed, having a tearful argument with myself. "Just wait until morning and go to the doctor. You'll save hundreds of dollars. But If I wait until morning, my bladder will explode. But if I go to the ER, the bill will be outrageous and there are crazy people in the ER. But if I don't...Good God, I have to go now." I grabbed my keys and credit card and within a few hours, found sweet blessed relief in the form of a good long pee and some antibiotics. OK, maybe that's too much information but I just know, anyone who's experienced a UTI feels Kelli's pain and understands how awful she feels.

About 1-2% of UTIs have no symptoms. These women find out when they go to the doctor for routine prenatal care, physicals or with other complaints. They might be asked to pee in a cup. The nurse will dip the urine with a chemical-treated test strip. This is a screening test (not diagnostic) that checks for lots of things like protein, glucose and bacteria. If that dipstick shows suspicious junk in the urine; that patient might need further testing. I'm going to assume Kelli's doctor did a lab test called a urinalysis with culture and sensitivity to diagnose infection. The Urinalysis part gives quick information: are there bacteria, blood cells and other gunk in the urine? Yes? Treat the patient and move on to part two: Culture and Sensitivity. Culture means they watch the urine for a few days to see what specific bacteria grows in it. Sensitivity means they test it to see which antibiotic kills that critter. Most of the time, doctors start patients on antibiotics after the results of the urinalysis (which takes about an hour once the urine is in the laboratory). If, in a few days, they discover the specific bacteria growing in your urine isn't killed by that first antibiotic; they'll prescribe a different one. If your urinalysis is negative—meaning no gunk or critters—you don't have a urinary tract infection. Urgency, frequency and burning with urination might mean a lot of things: vaginal irritation, vaginal infection and sometimes, pregnancy.

I hope a few days with antibiotics helps Kelli recover from the pain and nausea that's making her so miserable. Though most women don't have nausea with UTIs, some do and some get queasy taking antibiotics.

Kelli is convinced, however, that she's pregnant, no matter what the lab tests say. It's possible. Unlikely, but not unheard of. Sometimes pregnancy tests are negative when the woman peeing on them really is pregnant. Some women know in their brain, heart and soul they're pregnant before their hormones catch up and admit it to the pregnancy test. Maybe that's what's happening with Kelli. Maybe not. Maybe she's just having an irregular menstrual cycle and a nasty UTI.

I'm worried about her lying in bed lonely, confused and just plain miserable. She needs some support. At times like these, women need to look around and ask for help. If Kelli's got a husband, partner, mother, sister or friend, it's time to make a phone call and say, "Help!" Maybe Kelli's usually the one providing all the support and her friends and family don't realize she needs some too.

Kelli, if you're really alone and have no one to talk to about this, I want you to call your doctor today. Tell the nurse what's going on and ask her to have the doctor call you back. Tell her you need more information and support. You might need to get hooked up with some community support services. Your doctor or local women's clinic should have some good resources to start with. Maybe finding a good counselor would help too. There's nothing better than finding a qualified therapist and talking out all the befuddling issues of life; sort of like a mechanic for your mental health. Though you feel like pulling the covers over your head, you'll be far better off taking action to improve your health and wellbeing. Check back in with your doctor. Ask about a blood pregnancy test. Get clarification about your UTI. Take your full prescription. And ask your friends, family or a professional for help. You deserve it, Kelli. If it turns out the next pregnancy is positive, your baby does too. Good luck.

Got a question for Jeanne? E-mail it to labornurse@fitpregnancy.com and it may be answered in a future blog post.

This Fit Pregnancy blog is intended for educational purposes only. It is not intended to replace medical advice from your physician. Before initiating any exercise program, diet or treatment provided by Fit Pregnancy, you should seek medical advice from your primary caregiver.

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