My crazy post IM ailment! Questions for the old dudes.

trisumai

My IMLP gave me a 90 minute PR but also left me with this freakish infection.  After IMLP I had my usual soreness.  Then I awoke on Tuesday @ 0200 with this incredible discomfort deep in my perineal area (area b/t anus and penis).  It had this boring, aching discomfort.  Then came the chills.  Also some foul smelling urine.  I did have a similar transient episode several days after my RR#2 but didn't think much of it. Discomfort went away with some Naprosyn and I went to bed.  That morning I felt fatigue and malaise worse than the usual post IM day #2 expectations.  Got in the car and started the journey home but I had   So I did what any clinician does, I ponder the causes.  Trauma from riding. . . nope, wife checked and no bruising or muscle tenderness.  Hemorrhoids. . .nope for the same reason before.  UTI . . .maybe but not sure why a healthy male would develop a UTI.  Then it dawned on me, actually my wife who is a Nurse Practitioner and knows much more general internal medicine than I do.  Prostatitis.  Oh crap, isn't that what old peeps get.  I'm only 41!!  So wife goes to the store and gets an OTC urinalysis.  One is supposed to urinate on this and wait 1-2 minutes for color change.  So I pee on it.  3 seconds later, It is so positive for infection that I swear the color change was more intense than the reference standard.  I began on Bactrim and 24 hrs later am 80% less discomfort/ chills/malaise.  Three days later am almost 100% except for the scratchy throat that decided to tag along. 

I think that being in the saddle for 5.5 hours on RR#1 may have predisposed my little prostate to some trauma and hence the transient chills I got several weeks back.  Add to that the 6+ hours on the bike for IMLP and the fact that I urinated about 6 times while riding set me up for this episode.  I tend to ride on the tip of my ISM seat when I am in aero and the dual points are resting right at my perineal area.  Has anyone out there ever have anything like this?  How long should I wait before I even get back on the bike?  Is there risk for recurrence? Any GU docs input would be fantastic.

Paul Hough

Wow, I will be 56 in a couple months and never even heard of this. I looked it up on line and would guess that the same kind of things that help prevent saddle sores might help this. E.g., use clean bike/tri shorts only for rides and get outnof them immediately after the ride. I have never peed on the bike so I guess that helps too ... save that for your races only if you must, but if you aren't in contention for a KQ then maybe reconsider. Good luck with this.

Dino Sarti

I have had a few bouts with epidimitis. Once I was even hositpalized. They tested me for everything under the sun - STDs, the works. They never have found out why. My first symptom was blood in my semen. That is an eye opener.

So, without your medical background, I am just saying stuff happens.

robin sarner

Kar-Ming.   I am surprised issues like this don't happen more often.        Squashing your prostate and bladder outlet for 5-8 hours.     add dehydration.     great uti set up.        If I get dysuria during a race, I know dehydration is an issue.      I know you're a doc, and i'm a family doc, but imo, just treat the thing for a good 2-3 weeks.      then seek specialist opinion only if an issue in the future.

trisumai

@ Paul, I'm nowhere near KQ but realized in past IMs that it would take approximately 2-4 minutes for each restroom break depending on how many people were there ahead of me. At LP, I went 5-6 times. Perhaps it was due to the cold plus the extra hydration. I figured it saved me approximately 10-14 minutes overall.

@ Robin, am currently much better on Bactrim d#3 (didn't want any issues with quinolones and tendon issue). That's what some of my primary care friends suggested as well. Found out that my little prostate is not completely better when I was trying to earn some SAUs which resulted initially in good feelings but then became instantly painful :-(

cgres123

Kar-Ming great job at IMLP the PR was awesome. Something else to consider would be to switch up to an Adamo seat. They are split down the middle so the taint can rest itself in the center. As you ride forward on your saddle, like a lot of us, the seat will take a bit to get use to on your inner thighs but I find it leaves the walnut alone.