Continuing on the stenosis and scarring theme, you’re not gonna believe this one.

So about 2 years ago my doctors and I noticed that every time I had a urinalysis done, either routine or because of a suspected UTI, the results would always show the presence of microscopic blood, anywhere from a trace to large amounts. At first we wrote this off as a side effect of an infection. Well few months ago, in the absence of any bladder infection or prostate issues and with blood still showing up in my urine, it was recommended I follow up with a Urologist to try to nail down the source or cause.

After a couple visits with the specialist and several diagnostic tests, including a pelvic CT scan and Cystoscopy, performed during this morning’s appointment, we finally know the reason behind the mysterious microscopic blood in the urine. Almost immediately after the doctor inserted the scope into my you know what, he ran into a stricture or narrowing caused by scar tissue. WTF?
Crazy as it sounds, just like with the scarring of my upper airway from multiple intubations with a breathing tube, almost the same exact thing happened in my urethra, only this time it was caused from the repeated insertions of Foley catheters. Is it just me, or does anyone else see a trend here?

Fortunately, the Urologist was able to dilate the constriction right there on the spot using the tip of cystoscope, literally stretching out my urethra. According to him, there shouldn’t be any more blood detected in my urine and he predicts I’ll be able to pee like a teenager again. Interestingly, I never really had symptoms of a blocked or narrowed urethra. Cant wait to go to the bathroom to test the doctors prediction. ( yes, I actually wrote this post on my phone less than an hour after the Cystoscopy procedure and before peeing)

In all fairness, with the exception of the scarring in the small airways of my lungs, it was the tubes that started the process of scarring in the other parts of my body. BUT, those “tubes” wouldn’t have been needed in the first place if it weren’t for my asthma. BTW, the reason for the frequent foley catheter insertions, is that anytime you’re intubated and placed on a ventilator ( at least at UCSF), they automatically insert a urinary catheter into your bladder so that your urine output can be closely monitored. So, looking at the treatment of severe asthma in its totality within the hospital setting, its not a stretch to say that is yet another example of a crazy side effect from this crazy disease.

There probably wont be any long term consequences of having a little bit of scar tissue in my urethra, but the same cant be said with the scar tissue in my throat, vocal cords and small airways. Those are mechanical changes that are life altering and that may or may not get worse over time. So far with my throat, Ive had 2 surgeries in just the past 6 weeks to keep my airway open. Hopefully, that will be enough to stabilize things for a while. The scarring inside my lungs however, which is a direct cause from a lifetime of severe asthma exacerbations, cant be fixed and will never go away.

Thankfully there are no other areas on the body I can think of that would require an indwelling tube or catheter for asthma. Oh wait, I almost forgot about IVs and arterial catheters. Frequent insertions of those tubes can most definitely cause scarring and collapse of the blood vessels involved, which is why I also have a venous access port ( VAP).

The fun never ends. And it would seem, neither does the scarring.

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