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My aging friend has noticed significant fatigue and tiredness, all day long, during recurrent urinary tract infections. The fatigue is out of proportion to her usual feeling of being mildly tired. Have you seen this in your elderly relatives or friends

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We are going through this now. My mom was diagnosed with a UTI 2-3 months ago then completed a 5-day prescription for Cipro. Four weeks ago she developed a back ache that is primarily on the left side of her backbone. Never even thought about a UTI, especially since she had just had one. But she again has a UTI, just finished 5-day Cipro on Sunday morning. Last night the back ache was returning. So back to the doc, they are considering a low dose antibiotic to add to her daily regimen.

The increased tiredness associated with the UTI's I had attributed to the back pain. But, now I think it is a combination of the UTI and the exhaustion from the back pain.
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UTI's are the result of a perfect storm: According to the doctor, my MIL's bladder is stretched and prolapsed, as many elderly persons' are. Urine pools there and cannot be totally eliminated. The dark, moist environment is perfect for bacteria to grow.
Then, she would not listen to common sense about preventing falls. Did not use her walker, or sit down to put on pants or pj's. Tried to get to places without asking for assistance even though we repeatedly warned her that she would fall and if that happened she would be at risk of not being able to stay in her home. She was like a little kid trying to get by with something - I do understand her frustration at not being able to do what she used to do, but it is what it is. Unfortunately. She did fall - and broke her hip twice. That made it mandatory that she never be left alone and assisted living would not keep her since she needed two people to get her bathed, etc.
Also, she 'modified' her meds when trusted to take them. She thought the 'cost too much' so began cutting them in half! When meds don't work and one won't take them properly, something has to be done. Also, since she would stop a course of antibiotics mid treatment, infections would come back.
In the nursing home, she gets, I think, 3 baths (or whatever is the minimum required by law) a week. She won't 'pay for extras because I don't want anybody to think I am getting special treatment'. Three baths is not enough when a person is incontinent 'both ways'. Talk about more bacteria!
What evolved is a situation where my BIL sold her home so there was no going back. I do have experience having her in our home and attempting to keep her clean enough. It really is not possible. It takes two people to lift her and to really get her 'parts' clean, well, I don't believe they are doing that in the nursing home. It is pretty intimate and she draws her line. So the end result of all of this is, it is what it is. It is very much like trying to care for a willful (yet loving, just stubborn and with a totally cognizant mind) three year old that weights 160 plus.
In the end, I think there is a lot of blame that gets spread around about who should be responsible for why she gets these so much. What I have learned is that in many ways, SHE is the one, regardless of the fact that in her day, a lot of these subjects weren't even broached or things were viewed differently, who is mostly responsible for where it is now. At this point, maintenance antibiotics (they don't really work), more heavy duty antibiotics if she has a 'bout', and doing the best she and everyone who takes care of her can, to get her to the toilet and bath her semi regularly is about all that can be done.
I'll tell you one thing though. As caregivers everyone on this site knows what a burden physically, emotionally, in every way caring for an old, sick person is. There are things we CAN do to not be those people in 20 or 30 years. Regular, reasonable exercise and a good diet, not being stupid and doing things physically that we should not do (my husband with two knee replacements no longer argues with me about cleaning the gutters. He has no business on our roof of climbing a ladder. He is NOT 'old' at 62 but does have some things going on that tell him it is a bad idea and only bad can come of it!). We pay $35 for that these days. From the explanation the doctor gave me about the bladder problems, I do Kegels. EVERYDAY. They do work and can give one an edge as they age in these matters. Finally, I WILL ask my doctor questions, I WILL take meds as directed, and I WILL be reasonable so that my kids don't throw up their hands and decide I cannot be trusted to take care of myself to some extent. We are on the cusp, people and are looking at our futures if we don't learn from our parents' mistakes.
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UTI's make my mother crazy. I've heard others say the same thing. She's incontinent and it they make her wake up at night much more frequently.

I've heard that having to wear Depends makes the more susceptible to the problem as well.
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Elderly people with neurological problems such as dementia are affected differently when they get UTIs than younger, healthy people. In my husband's case, his whole nervous system "crashes" so that he not only can't understand what he is being told, he can't even figure out how to perform the simplest motor functions such as sitting up in bed, standing up or walking. It can be quite dramatic. I can't say anything about fatigue because that would be the least of my husband's problems when he has a UTI. If the UTI isn't caught and treated very quickly with antibiotics, my husband ends up in the hospital on an IV where he sleeps most of the time. It is scary how something as common as a UTI can present with people who have dementia.
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Time for a complete physical and chemistry panel of your friend. Being tired without the UTI might be hypothyroidism which requires medication. Having a low B-12 makes one tired, but having an infection anywhere in the body ravages your strength because your body is having to fight the infection. Again, as a nurse, I am recommending your friend seek medical attention ASAP.
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UTI's are a fact of life for older females. I am the caregiver for my wife for the last 6 1/2 years. We have fought the battle of UTI's for the last 2 years. Proper hygiene and lots of water are the the most important parts of controlling the UTI's. A maintenance dose of Cipro (250 mg) should be part of the equation also. We use baby wipes front to back for every time she goes. You can try cranberry extract or juice but be careful because they can give you an upset stomach from all the acid. To answer your original question, I believe your friend needs a full blood work-up before doing anything else. Your friend will have to know what is wrong first before trying any other type of treatment.

Good Luck!!!
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After 3+ years of caring for my mother thru UTI's, MRSA, E-Coli and Sepsis I have seen a lot. Everyone has good ideas as cases can vary somewhat. Tiredness is often a UTI symptom espcially if the individaul has reoccuriring UTI's - their body and mind just tire more quickly from the constant fight. But another cause that should be considered esp. in the elderly is their IONIC Calcium level. This is not a regular calcium level and it requires a special lab test and but it is worth it! Aftera 4 day hospital stay where doctors could find no reason for mom's weakness and fatique, a doctor friend advised me to have them check her IONIC calcium. He was spot on and once they discovered it and gave her IV fluids for 2 days she was back to her old self! So there can be and often are other causes and as advocates we have to keep on top of things so they don't get missed!
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My dad is 90 years old, has an enlarged prostate & cancer. Health great never no UTI's until he turned 90. Thank goodness my dad will be turning 91 in November 2017. PSA was normal start increasing when he turned 90 never went over PSA (24) now PSA (11) last checkup. I have been back and forth to the hospital with frequent UTI's the first one was really scary he had Sepsis, but came back strong and healthy. I do preventive care and have his bladder scan once a month at the urologist to make sure his bladder is being empty due to enlarged prostate and check his urine to avoid frequent UTI's. It is awful this is the only thing we have to fight hard to avoid, he wears depends, will work on getting him to go to the bathroom more to urinate, but with the enlarged prostate emptying totally can be a problem . My dad gets lethargic and back pain. This time around his right hand is flimpsy from the UTI always has to go the the hospitalized and stay a few days. I thought I had caught it early just had a checkup on on Sept. 11 urine was good, but back in the hospital again on Oct. 6, 2017 for a few days. This is really scary for the elderly, especially since my dad had Sepsis they did not think he was going to make it, but I knew this was not god's plan. Still fighting the fight to catch it early, considering low maintenance antibiotics daily but this is not a 100 cure this will not happen again, also do not want his body to get immune to antibiotic.
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Urinary tract infections are common with the elderly, but are you sure that there isn't something else going on. Fluids are very important and necessary to help keep UTI down especially cranberry juice. But her excessive tiredness suggests to me that she is very low in minerals or iron. She should have a blood test done to check on this.
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I guess I forgot to mention that pain is a great cause of fatigue, and with dementia often the element of pain is overlooked due to the fatigue. This is my first 'in-put' on this site, so please excuse my wandering from the original question. I find this site most helpful and educational for me, as well as my middle age children. Thank you for your care.
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