My first bout of cystitis prematurely curtailed the exhilarating few days that followed my teenage deflowering. The bewildering and rapidly intensifying pain was later cooingly described to me by my doctor as “stinging” or, more blandly, “discomfort”. Thousands of women get cystitis, I was assured, as if this would soothe the burning in my abdomen and the post-coital guilt that 17-year-old girls are apt to feel even if an unexplained urinary infection does not rip through the lower body barely a day after that first sexual encounter.
I was prescribed antibiotics and the infection vanished, only to bounce back with renewed vigour a few months later. Since then — I am now 32 — I have had probably 22 courses of penicillin and ten days off work because of cystitis.
An attack starts as a faraway tickle along the urethra. Soon, any attempt to go to the loo makes you hallucinate razor blades. Any attempt to stay off the loo, on the other hand, is futile; the infection overstimulates the bladder, tricking the brain into thinking that it is full. For whole minutes you sit there in mute pain, crying or cursing, but nothing happens.
Women are more prone to bladder problems because they have a shorter urethra than men, which means that bacteria are more likely to enter the bladder. Sex can bring on cystitis but anxiety can also act as a trigger. Sometimes the causes are inexplicable or the bacteria don’t show up when your GP sends off a urine sample to the lab. Sometimes you’ll hear cystitis smilingly referred to — usually by non-sufferers or involuntary celibates — as the “honeymoon disease”. But the pain can be so intense and the attacks so persistent that cystitis has been known to cause divorce. I have read books on the subject written by single women who say they have found a cure; that’s after cystitis, or rather their fear of another attack, laid waste their marriages.
A lifetime of repeated infections has made many of these women neurotically obsessed with cleanliness. They believe in avoiding alcohol in case there is a possibility of contributing to the bladder irritation, and washing after sexual intercourse — that is if you must have sexual intercourse at all. “Bottle washing” also means carrying a bottle of water around in your handbag with which to rinse your private parts every time you go to the loo.
I have tried other supposed remedies: cold baths infused with bergamot or tea-tree oil; flushing the infection out with water; drinking sodium bicarbonate or powdered tree bark dissolved in water; sugar-free cranberry juice; hot water infused with parsley; or the grey-green liquid that’s left in the pan after you’ve boiled asparagus.
At the beginning of last year, after three successive infections in six weeks, a urologist to whom I’d paid £200 told me to drink cranberry juice. He then suggested having a biopsy because maybe my bladder was the wrong shape.The precious organ was rescued from that ordeal by Stefan Chmelik, a practitioner of Chinese medicine for more than 12 years who trained in London and China. He had helped a friend of mine who was suffering from irritable bowel syndrome. She said that in the world of complementary medicine he was known as a fixer of “internal problems”. He had treated the pop singer Björk, she said, and was setting up an integrated healthcare service in Harley Street. Everything about him convinced me that he was a charlatan.
But on the phone things began to look up. He was confident of helping my problem and appeared to be more knowledgeable about the precise nature of the symptoms than my urologist. He explained that cystitis, when viewed from a holistic perspective, was not always due to inflammation. In Chinese medicine specifically, there are several types of cystitis, including those brought about by some sort of deficiency or excess. The majority of patients in whom cystitis is diagnosed do not have acute symptoms. More often than not, as in my case, there is a chronic pattern of needing to pee frequently, some discomfort, cloudy urine, a weak back and often a negative urine test.
I eventually went to see Chmelik and he told me, after examining my tongue, reading my GP’s notes and feeling my pulse, that he intended to put things right in three stages: clearing the infection; repairing the bladder; and treating the underlying cause. The first stage involved acupuncture; food supplements, including fish oil, evening primrose oil (as he believed I was deficient in essential fatty acids) and vitamin-B complex; and a bottle of horrible brown herbal gunk that I had to sip every morning for three months, whose ingredients included dandelion, celery seeds and the Chinese dried root angelica known for its anti-bacterial properties; and an intestinal permeablility test.
Chmelik said the acupuncture, apart from helping to ease the pain and aiding relaxation, can have an anti-inflammatory effect. The intestinal permeablility test was a simple urine test to establish how well the wall of the small intestine was working. He said that numerous courses of antibiotics can cause small holes in the gut wall — known as leaky gut syndrome — which can cause toxins to enter the bloodstream, creating an over-sensitive immune system.
From the description I had given of my symptoms, he had identified a yeast infection, so I had to cut out sugar and yeast from my diet.
Some people like the intimacy that holistic doctors establish with their clients. I found it slightly awkward. Why did this stranger have to know how much I slept, or whether or not I was prone to mood swings? A few weeks later, during the second stage of treatment, I had become less shy.
The lab results of the intestinal permeability test showed that the wall of my small intestine was damaged. Chmelik gave me more acupuncture, more herbal medicine, a probiotic to build up the “good” bacteria in my system, and oregano oil (he said it has a strong anti-fungal effect), along with a special food and enzyme-based formula called permavit to repair the mucosal lining of the gut. He also told me to sleep more.
I first saw Chmelik last July; initially weekly for the first month, and then once a month for three months. I have had only one attack of cystitis since, and have spent about £300 — a lot. As a firm believer in conventional medicine I am amazed that the potions prescribed by him worked. Before I met him I had feared that there wasn’t a solution. Now, that anxiety has gone.
