The IC Optimist

The IC Optimist
published by the Interstitial Cystitis Network • volume 5, issue 4 • Fall 2008
A New
Approach
to IC and
Prostatitis
How the
Bowel Can
Trigger
Bladder Pain
Is Your Car
IC Friendly?
Holiday
Foods
& Parties
Departments
The Latest IC Research • Book Reviews • Perfect Fall Flavors
Fresh Tastes with Bev Laumann • ICN Resource Guide • ICN Editorial
from the publisher
The IC Optimist
Publisher:
Interstitial Cystitis Network
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A
s I’m writing this, I’m sipping on a warm mug
of apple cider, well diluted of course to
reduce the acid level, and watching little gusts of
wind blow leaves in rolling puffs down my street.
It’s a lovely, whimsical sight that just makes me
smile.
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Alas, this means that winter and the holiday season are fast approaching. I wanted to take a
moment and wish each of you the happiest of holiday seasons. May the New Year will bring you
peace, joy, comfort and healing.
Featured Writers:
Bev Laumann
Jill Osborne
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The IC Optimist is distributed electronically or
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of the Interstitial Cystitis Network, a medical
publishing company dedicated to providing
information & support for those struggling with
interstitial cystitis, overactive bladder, painful
bladder syndrome and pelvic pain syndrome.
The ICN is a division of J.H. Osborne, Inc.
I have no doubt that 2009 will bring us closer to solving the many mysteries of IC. Speaking of mysteries, we had what I consider to be a spectacular
breakthrough through this summer thanks to a group of four researchers
who have boldly gone where few have gone before. They have proposed
that IC and prostatitis (aka urologic chronic pelvic pain syndrome) be broken into six subcategories (phenotypes) that will help doctors not only
diagnose patients but also take the mystery out of creating customized
treatment plans.
This is, in my opinion, one of the most important proposals I’ve read in
years and I support it wholeheartedly. For some of us, IC is clearly more
than just a bladder disease. Many IC’ers also struggle with IBS, vulvodynia,
pelvic floor muscle tension and anxiety disorder. This article makes me
want to stand up and say “I told you so” to those people who suggested that
IC wasn’t real. I hope you will join me in sharing this with all of your
physicians, not just urologists, so that more patients will be diagnosed
promptly.
October was a big month for the IC movement and the first time in recent
history that an IC Awareness Week was launched, including a brand new
documentary on IC currently being broadcast by PBS stations across the
USA. We were delighted to participate and hope that, next year, more IC
groups will join in.
Of course, we’ve included the latest IC research and news, along with a
wonderful column on Holiday Parties by Bev Laumann. Because driving
can be so challenging for pelvic pain patients, we’ve included an updated
discussion on finding IC friendly yet fuel efficient cars. Yes, friends, the
Toyota Prius might be fuel efficient but it receives poor reviews for comfort
and ease of travel. And to keep the fall spirit alive, we’ve included some
favorite IC friendly fall recipes!
Enjoy and I wish you a cozy and comforting holiday season!
Jill Osborne
2 • THE IC OPTIMIST • FALL 08
contents
4
ICN Editorial: IC Awareness Week 2008!
by Jill Osborne, M.A.
5
A New Approach to IC and Prostatitis
by Jill Osborne, M.A.
8
How the Bowel Can Trigger
Bladder Pain
9
The Latest IC Research
12
Fresh Tastes with Bev Laumann:
Holiday Foods & Parties
15
Is Your Car IC Friendly?
17
Book Review:
Confident Choices:
A Cookbook for IC and OAB
18
Book Review:
Heal Pelvic Pain
19
Perfect Fall Flavors
20
ICN Resource Catalog
Copyright © 2008. Any reproduction is prohibited without prior written
permission from the ICN.
Disclaimer: The Interstitial Cystitis Network website and publications are
for informational purposes only. The IC Network is not a medical authority
nor do we provide any medical advice. Nothing contained in this publication should be considered medical advice and should not be relied upon
as a substitute for consultation with a qualified medical professional. We
strongly recommend that you discuss your medical care and treatments
with your personal medical care provider. Only that medical professional
can, and should, give you medical advice.
Opinions expressed in articles are those of the authors and do not
necessarily reflect those of the ICN or its editorial board. The ICN
assumes no liability for any material published herein.
THE IC OPTIMIST • FALL 08 • 3
ICN Editorial:
IC Awareness Week 2008!
I’m really pleased to end 2008
with an editorial that expresses gratitude. Yes, gratitude! I’d like to publicly thank Baker Norton, Alza
Pharmaceuticals and OrthoUrology
for spending hundreds of thousands
of dollars in IC awareness activities
over the past fifteen years.
Baker Norton was the company
that developed and launched
Elmiron years ago in the early 1990’s.
Alza Pharmaceuticals acquired
Elmiron from Baker Norton and, for
many years, was solely responsible for
IC awareness activities around the
world. They created excellent physician and nursing staff educational
materials and CME’s. They were
always visible and sponsoring urology
conferences. This wasn’t just a company interested in earning a profit.
They saw that patients and providers
needed help and they sought to fill
those needs.
Ortho Women’s Health and
Urology acquired the rights to
Elmiron years ago and have continued the tradition of IC outreach in
many ways. They continue to offer
great educational materials. In fact,
the first information usually given to
IC patients is a nice little kit of
information from the company. But
this Fall, they did something really
special that deserves this editorial.
They, along with the National
Association of Nurse Practitioners in
Women’s Health (NPWH) and the
ICN, created the first EVER IC
Awareness Week from October 2024, 2008. What made it truly innovative was its use of both traditional
media outlets (print, television and
audio broadcasts) and the internet to
spread the word about IC and pelvic
4 • THE IC OPTIMIST • FALL 08
pain. You’ll find podcasts on IC on
the event website (allaboutic.com)
that you can listen to. On local PBS
television stations around the USA,
you’ll also have the chance to watch
a brand new documentary on IC produced by Healthy Body Healthy
Minds who, you may remember, did
a beautiful documentary on IC a few
years ago. This is a new, updated 30
minute episode.
The National Association of
Nurse Practitioners in Women’s
Health also deserve a rave review. As
many of you know, Nurse
Practitioners play a vital role in
many IC and urology clinics and
often are the first contact for IC
patients. They often have much
more time to spend with patients,
and offer extremely compassionate
care. Best of all, they are often very
accessible for patients in crisis and
flares. If you want a highly qualified
professional to pay attention to your
health needs, consider seeing a nurse
practitioner.
IC would not be where it is today,
particularly in terms of patient and
provider education, if not for these
companies and organizations who
have consistently raised awareness.
No single patient group could have
done what they have done simply
due to the costs involved. Thus, we
owe them a debt of gratitude for
their belief in IC, for their dedication of significant money to promote
our cause, for their direct sponsorship of research and, most of all, for
their thoughtfulness.
—Jill Osborne, M.A.,
ICN President & Founder
A New
Approach
to IC &
Prostatitis
by Jill Osborne, M.A.
ICN President & Founder
We’ve always known that IC and
prostatitis patients have different
combinations of symptoms and physical findings. Some have frequency
and urgency, while others struggle
with bladder or pelvic pain. Some
may have Hunner’s Ulcers, while
others little or no visible damage in
their bladder. Some have pelvic floor
dysfunction while others struggle
with a variety of related conditions,
such as vulvodynia and/or IBS. The
diversity found in any group of IC
patients is substantial thus begging
the question: are there different
types or subsets of IC?
Consider the poor results found in
many IC and prostatitis clinical trials. Would a patient with pelvic floor
dysfunction and no bladder damage
respond favorably to an Elmiron trial
given the fact that Elmiron specifically treats the bladder wall??
Probably not. Would a patient with
bladder wall damage and no evidence of pelvic floor dysfunction
respond well to a physical therapy
Phenotypes represent
a new, flexible and
dynamic way of
viewing IC/PBS...
trial? Again, probably not. But, if a
patient has both conditions, they
may respond marginally but not fully
to a specific treatment.
Similarly, a cookie cutter
approach to treatment (i.e. prescribing Elmiron and Elavil) can be ineffective if a patient has not had a full
diagnostic workup. Consider the case
of ICN member Cathy whose doctor
suggested that she have her bladder
removed because none of the traditional IC treatments worked for her.
Prior to surgery, she was sent to a
major IC research center for a second opinion. They discovered that
her bladder was in good shape and
certainly not requiring removal. Her
intense pain was the result of severe
pelvic floor dysfunction that all of
her previous physicians had missed.
Clearly, we need better diagnostic
and treatment tools that assess the
“whole” patient and not just the
bladder, including the many related
conditions that IC and prostatitis
patients often struggle with. Luckily,
we had a breakthrough this summer
when researchers Dan Shoskes and
Ray Rackley (both of the Cleveland
Clinic), J. Curtis Nickel (Queens
Univ) and MA Pontari (Temple
Univ) proposed a brand new classification based entirely on physical
symptoms that they believe will
facilitate more effective and individualized treatment programs.
These “subsets” or “phenotypes”
show the diversity of symptoms and
conditions that patients can struggle
with and allows physicians to better
evaluate the patient as a whole.
Most of all, their proposal validates
those patients who have, for years,
complained that they experienced
more than just bladder symptoms,
including bowel problems, vulvodynia, pelvic floor muscle dysfunction
and more.
How Does a Pelvic Pain Syndrome
Begin?
“Most patients describe an initial
event, such as a UTI, sexually transmitted disease or local trauma that ...
set into motion the events that eventualTHE IC OPTIMIST • FALL 08 • 5
ly led to UCPPS,” they offered.
When the bladder wall/GAG
layer is damaged, urine may irritate
nerves in the bladder wall and cause
mast cells to release histamine. This
inflammation can also trigger pain
which causes the bladder to spasm
and the skeletal muscle of the pelvic
floor to tighten and contract (aka
pelvic floor dysfunction). Pelvic floor
muscle tension can trigger various
bladder symptoms, pain during intercourse and referred pain to other
muscle groups, such as the upper leg
and lower belly (Table 1).
When pain has been experienced
over a longer period of time, neuropathies can develop including an
increased perception of pain, including allodynia (perception of pain
without a painful stimulus) and
hyperalgesia (increased perception of
pain in the damaged area and also
surrounding tissue).
It’s not surprising that the overall
combination of symptoms (pain,
inflammation, muscle tension, etc.),
particularly when experienced over
the long term, can lead to increased
stress and psychological effects such
as anxiety, depression, pessimism,
hopelessness and catastrophizing.
Thus, patients can be left in a
vicious cycle of inflammation, muscle tension, stress and chronic pain.
The good news is this also identifies
possible new approaches to treatment.
Diagnostic Protocol
The authors recommend that a
thorough diagnostic workup be performed, including a comprehensive
history of symptoms, sexual functioning, history of bladder infections,
sexually transmitted diseases, and
surgeries in the pelvis. The patient
should also be assessed for allergies,
IBS, fibromyalgia, chronic fatigue,
vulvodynia, low back pain and
migraine headaches. They also suggest that physicians probe for signs of
depression, anxiety, lack of support,
etc.
Patients should receive a physical
examination of the pelvic region,
6 • THE IC OPTIMIST • FALL 08
Initial Event or Trauma
infection, injury or allergy
Causes Bladder or
Prostate Tissue Injury
Causes Inflammatory
Processes to Begin
Pain Response
Pain Response
Pain triggers bladder
spasms and/or pelvic
floor muscle tension
Chronic Pain
Increased psychosocial
effects
stress, anxiety, depression
Chronic Pain
Chronic Pain
Neuropathies may occur
hyperalgesia, allodynia
Table 1: Inflammatory Sequence
including a full gynecological review
for women and a genital/rectal/
prostate exam for men, specifically
looking for pain or tenderness in the
abdomen, perineum, pelvic floor and
rectum. Bladder and prostate infection are usually ruled out through
urine and/or semen analysis.
Additional testing can be per-
formed to assess bladder health
including cystoscopy, urodynamics,
hydrodistention, ultrasound, and a
bladder anesthetic cocktail.
Based upon the above results,
patients are then classified into six
phenotypes which each have their
own specific treatment plans.
The New Phenotypes
The authors
recommend that a
thorough diagnostic
workup be performed.
The six new phenotypes represent
key clinical treatment areas and
options. Ideally as a patient is
assessed, treatments will be considered in each area where symptoms
are present. Please note that out of
the six phenotypes, a patient can
have any combination of symptoms.
Some patients may have just one
area, while others may have four or
five.
(1) Urinary Symptoms:
Do patients have bothersome fre-
quency, urgency, pain?? Do they
struggle with nighttime voiding? Do
they struggle to empty their bladder?? These patients might be treated
with dietary changes, anticholinergics, alpha blockers, bladder instillations and/or neuromodulation.
(2) Psychosocial:
Do patients struggle with depression?
abuse?? catastrophizing? These
patients can benefit from counseling,
various cognitive & behavioral therapies and/or the use of antidepressants. Stress reduction is also important.
(3) Organ Specific Findings:
Do patients have evidence of damage or trauma to the bladder or
prostate (i.e. petechial hemorrages,
Hunners Ulcers, etc.)? Is the pain
triggered by bladder filling? Does the
pain resolve after the use of an anesthetic cocktail? These patients might
be treated with typical IC and CPPS
therapies such as Elmiron, rescue
instillations, quercetin, bee pollen,
diet modification, etc. Quercetin and
bee pollen, for example, “can improve
symptoms and inflammation in CPPS
(prostatitis) as well as lowering oxidative stress.” Hunner’s ulcers may be
treated with surgery, fulguration,
etc.
(4) Infection:
While empiric antibiotics (medications prescribed before culture
results are available) have been
found to be ineffective and overused in both IC and prostatitis,
there are times when patients may
struggle with infection and/or
respond favorably to antibiotic use.
Infections
may include low count enteroccocus, or unusual infections such as
Ureaplasma, Chlamydia,
Mycoplasma). If patients have evidence of infection (i.e. positive
urine cultures, etc.). they are generally treated with antibiotics usually
selected through antibiotic sensitivity testing.
(5) Neurological/System
Conditions:
Do patients struggle with any of
the related conditions to IC, such
as IBS, fibromyalgia, chronic fatigue
syndrome, vulvodynia or migraines?
These require treatment based upon
those medical conditions. In addition, patients might use neuroleptic
drugs such as amitryptiline, or
acupuncture and pain management.
Stress reduction is also, again, important for these patients.
(6) Tenderness of Skeletal
Muscles:
Do patients have any muscle trigger points, spasms in the pelvis or
belly? These patients are generally
treated with physical therapy. Stress
reduction is also important because
stress can trigger muscle tension.
The use of antispasmodics such as
Stress reduction is
also important because
stress can trigger
muscle tension.
URINARY
SYMPTOMS
Flexeril can be helpful. Chair cushions and modified bicycle seats can
also help.
Conclusion:
Phenotypes represent a new, flexible and dynamic way of viewing
IC/PBS and prostatitis that will,
undoubtedly, provide a better structure for selecting treatments...but
also for creating new, more targeted
clinical trials. It’s a brilliant move!
The only thing we would have added
is a phenotype related of pudendal
neuralgia for those patients who
have unusual positional symptoms
(i.e. pain only when sitting) which
can be the result of a pudendal nerve
entrapment.
Our gratitude to the authors!
You’ve proven, yet again, that you’re
truly innovative IC researchers and
clinicians. We say Bravo!!!
Source: DA Shoskes, JC Nickel, RR
Rackley and MA Pontari. Clinical phenotyping in chronic prostatitis/chronic
pelvic pain syndrome and interstitial
cystitis: a management strategy for urologic chronic pelvic pain syndromes.
Prostate Cancer and Prostatitis
Diseases 22 July 2008
Frequency, Pain,
Difficulty Emptying
Anticholinergics
Alpha Blockers
Diet Modification
Caffeine, etc.
ORGAN
INVOLVEMENT
Evidence of Bladder
or Prostate Damage
Anticholinergics
Alpha Blockers
PSYCHOSOCIAL
SYMPTOMS
Depression, Anxiety
Increased Stress
Counseling, AntiDepressants, Therapy
Stress Management
Stress Reduction
NEUROLOGIC
CONDITIONS
IBS, Fibromyalgia,
CFS, Vulvodynia
Related Treatments
Neuroleptic Drugs
TENDERNESS
OF MUSCLES
Muscle Spasm,
Trigger Points
Pelvic Floor
Physical Therapy
INFECTION
Infx of Atypical
Organisms, etc.
Antibiotic Treatment
Table 2: Phenotypes, Symptoms and Possible Treatments
THE IC OPTIMIST • FALL 08 • 7
How the Bowel Can
Trigger Bladder Pain
Source: Northwestern University Feinberg School of Medicine
What’s the worst that could happen after eating a slice of pepperoni
pizza? A little heartburn, for most
people. But for up to a million
women in the U.S., enjoying that
piece of pizza has painful consequences. They have a chronic bladder condition that causes pelvic pain.
Spicy food — as well as citrus, caffeine, tomatoes and alcohol — can
cause a flare in their symptoms and
intensify the pain. Researchers had
long believed the spike in their
symptoms was triggered when digesting the foods produced chemicals in
the urine that irritated the bladder.
A surprising new discovery from
Northwestern University’s Feinberg
School of Medicine reveals the
symptoms — pain and an urgent
need to frequently urinate — are
actually being provoked by a surprise
perpetrator. It’s the colon, irritated
by the spicy food, that’s responsible.
The finding provides an explanation
for how the body actually “hears”
pelvic pain.
Klumpp conducted the study with
postdoctoral fellow Charles Rudick.
The paper is published in the
September issue of Nature Clinical
Practice Urology.
The Northwestern researchers discovered the colon’s central role in
the pain is caused by the wiring of
pelvic organ nerves. Nerves from this
region — the bladder, colon and
prostate — are bunched together like
telephone wires and plug into the
same region of the spinal cord near
the tailbone.
People with interstitial cystitis
have bladder nerves that are constantly transmitting pain signals to
the spinal cord: a steady beep, beep,
beep.
But when the colon is irritated by
pepperoni pizza or another type of
food, colon nerves also send a pain
8 • THE IC OPTIMIST • FALL 08
signal to the same area on the spinal
chord. This new signal is the tipping
point. It ratchets up the pain message to a chorus of BEEPEEPBEEPBEEP!
“It was known that there was cross
talk between organs, but until now no
one had applied the idea to how pain
signals affect this real world disease,
how the convergence of these two information streams could make these bladder symptoms worse,” said Klumpp,
who also is an assistant professor of
microbiology-immunology at the
Feinberg School.
Nerves from this
region — the bladder,
colon and prostate —
are bunched together
like telephone wires
and plug into the same
region of the spinal
cord ...
The discovery also opens up new
treatment possibilities for “painful
bladder syndrome,” or interstitial cystitis. The findings suggest that bladder pain can be treated rectally with
an anesthetic in a suppository or gel.
Another possibility is an anesthetic
patch applied to pelvic skin. Studies
in back pain show anesthetic patches
applied to the skin can reduce back
pain, Klumpp said.
“We imagine a similar kind of patch
might be used to relieve pelvic pain,
which might be the best solution of all,”
he noted.
How they “caught” the colon
For the study, Klumpp and
Rudnick created a model of a mouse
that mimicked an inflamed bladder
with pelvic pain. Then they injected
lidocaine into the bladder. The pain
vanished. Next they injected lidocaine into the uterus. There was no
diminishment of the pain. Lastly,
they tried lidocaine in the colon.
“In the colon it knocked down pain
just as effectively as if we put it in the
bladder. We thought if the colon can
suppress bladder-associated pain, maybe
it can make it worse in the way that
foods irritate bladder symptoms,”
Klumpp explained.
So, Klumpp injected a small dose
of red pepper into the colon of a normal mouse. The injection didn’t provoke any pain. But then he injected
a small dose into a mouse with pelvic
pain. The pelvic pain worsened.
“We likened it to what happens to
humans,” Klumpp said. “Pepperoni
pizza does nothing to most people other
than heartburn, but when you give it to
a person with an inflamed bladder, that
will cause their symptoms to flare
because the nerves from the bladder and
bowel are converging on the same part
of the spinal cord.”
It’s important to note that both
the bladder and bowel can be irritated by foods. This begs the question:
should we modify the IC diet to
exclude foods known for irritating
the bowel? Luckily, we already do.
Chocolate and coffee, for example,
are notorious bowel irritants. If you
are struggling with diet-induced
flares, take a moment and look at
your diet to see if you are eating any
bowel-irritating foods. You might
consider eliminating them to see if
your symptoms improve.
The Latest IC Research
NIH Launches Effort to Advance
Study of Urologic Pelvic Pain
Disorders
The National Institute of
Diabetes and Digestive and Kidney
Diseases (NIDDK), part of the
National Institutes of Health (NIH),
announced awards to eight academic
research centers to conduct collaborative studies of urologic chronic
pelvic pain disorders by looking for
clues outside the bladder and
prostate. The total research investment for the five-year project is estimated to be up to $37.5 million.
The MAPP research
effort is expected to
lead to critical new
insights into the
underlying causes of
urologic pelvic pain.
“The launch of this novel research
effort is an excellent example of NIH’s
commitment to encouraging translational research,” said NIH Director Elias
A. Zerhouni, M.D. “It also illustrates
NIH’s leadership in furthering innovative approaches to discovering effective
new therapies to help our patients.”
The Multidisciplinary Approach
to the Study of Chronic Pelvic Pain
(MAPP) Research Network is
unusual in requiring investigators to
conduct highly collaborative
research of the most common urologic chronic pelvic pain syndromes
from a broadened systemic perspective. This is a major shift from earlier organ-specific research on the two
most prominent urologic chronic
pelvic pain disorders, interstitial cystitis/painful bladder syndrome
(IC/PBS), and chronic prostatitis/
chronic pelvic pain syndrome
(CP/CPPS).
“The MAPP Network’s expanded
scientific approach will address many
persistent questions about urologic
chronic pelvic pain,” said NIDDK
Director Griffin P. Rodgers, M.D.
“Knowing whether there are risk factors
common to all the disorders and
whether clinical profiles can be identified
for each will provide invaluable, fundamental information for developing treatment strategies.”
The innovative shift in research
focus represented by the MAPP initiative is supported by recent epidemiological studies showing that
IC/PBS and CP/CPPS are frequently
associated with other chronic pain
disorders such as fibromyalgia
(chronic pain of unknown origin),
chronic fatigue syndrome, and irritable bowel syndrome. These latest
findings suggest the possibility of
common underlying disease processes in these chronic disorders.
“The bladder was assumed to be the
origin of the interstitial cystitis/painful
bladder syndrome symptoms and the
prostate was assumed to be the source
of chronic prostatitis/chronic pelvic pain
syndrome symptoms,” explained
Leroy M. Nyberg Jr., M.D., Ph.D.,
the NIDDK urologist heading the
program. “However, in spite of intense
study funded by NIDDK, no organspecific cause has been identified for
either disorder.”
The MAPP research effort is
expected to lead to critical new
insights into the underlying causes of
urologic chronic pelvic pain.
Widening the scope of research will
be bolstered by the perspectives of
project leaders not normally
involved in urologic pelvic pain
studies, but who have expertise in
relevant scientific disciplines. This
will expand the context in which
research into IC/PBS and CP/CPPS
occurs and will encourage a more
comprehensive approach to understanding chronic pelvic pain.
This new reseach network
includes six Discovery Sites that will
conduct the studies and two Core
Sites that will coordinate data collection, analyze tissue samples, and
provide technical support. The
Discovery Sites and Principal
Investigators are:
• Northwestern University,
Chicago - David Klumpp, Ph.D.,
Anthony J. Schaeffer, M.D.
• The University of California,
Los Angeles - Emeran Mayer, M.D.,
Larissa Rodriguez, M.D.
• The University of Iowa, Iowa
City - Karl Kreder, M.D.
• The University of Michigan,
Ann Arbor - Daniel Clauw, M.D., J.
Quentin Clemens, M.D.
• The University of Washington,
Seattle - Dedra Buchwald, M.D.
• Washington University, St.
Louis - Gerald Andriole, M.D.
Pelvic Disorders Affect Large
Numbers of Women
Source: UT Southwestern Medical Center
Newswise — Nearly one-quarter
of all women suffer from pelvic-floor
disorders, such as incontinence, at
some point in their lives, a national
study, including researchers from UT
Southwestern Medical Center, has
found.
The study of nearly 2,000 women
in seven U.S. cities found that 23.7
percent of participants had experienced at least one pelvic-floor disorder, and the risk increased with age.
“This study is the first nationwide
study to confirm what we consider a
high prevalence of pelvic-floor disorders
in the U.S.,” said Dr. Joseph
Schaffer, professor of obstetrics and
gynecology at UT Southwestern and
an author of the study, which
THE IC OPTIMIST • FALL 08 • 9
appears in today’s issue of the Journal
of the American Medical Association.
“Nearly a quarter of all women suffer from at least one pelvic-floor disorder, and, with the aging of the population, this will become more prevalent,”
he said.
The national rate of pelvic-floor
disorders has not been well-studied,
although several regional studies
have found that almost 10 percent of
women go through surgery for such
conditions at some point in their
lives, while one-third of those
women have two or more surgeries.
The current study was designed to
assess the national rate of such disorders. The participating women were
interviewed in 2005 and 2006 at
their homes or at a mobile interview
center and did not undergo physical
examination. The questions were
part of the National Health and
Nutrition Examination Survey.
For the current study, the
10 • THE IC OPTIMIST • FALL 08
researchers focused on three conditions: urinary incontinence, fecal
incontinence and symptomatic
pelvic organ prolapse, which occurs
when women can feel or see an
organ dropping or bulging in the
vaginal area. This can indicate a
dropping of the uterus, bladder or
rectum as supporting structures
weaken.
The researchers interviewed 1,961
nonpregnant women older than 20.
Overall, 15.7 percent of women
experienced urinary incontinence; 9
percent experienced fecal incontinence; and 2.9 percent reported
symptomatic pelvic organ prolapse.
In all, 23.7 percent reported one or
more conditions.
The rates of the conditions went
up substantially with the number of
childbirths and with age. They also
were higher among the poor or less
educated. Obesity also increased the
risk. Race or ethnicity had no effect
on the conditions.
“Physicians with expertise in caring
for pelvic-floor disorders offer a variety
of nonsurgical and surgical treatments
that can significantly improve the quality of life for patients with these problems,” Dr. Schaffer said. “Patients
with pelvic-floor disorders should be
encouraged to seek care from health
care providers, particularly those with
expertise in pelvic-floor medicine and
surgery.”
The study was funded by the
National Institutes of Health.
The research was conducted by the
Pelvic Floor Disorders Network,
which, in addition to UT
Southwestern, includes study authors
from the NIH, University of Utah
School of Medicine, Cleveland Clinic,
University of Alabama at
Birmingham, Loyola University
Stritch School of Medicine,
University of Michigan School of
Public Health, University of North
Carolina School of Medicine and
Duke University School of Medicine.
A Real-Life Multicentre Clinical
Practice Study to Evaluate the
Efficacy and Safety of Intravesical
Chondroitin Sulphate for the
Treatment of Interstitial Cystitis
BERKELEY, CA (UroToday.com
– Author: Phil Hanno MD) - One of
the best studied ‘naturally occurring’
glycosaminoglycans in bladder pain
syndrome has been chondroitin sulphate. Studies have indicated a
deficit of this proteoglycan in the
bladder uroepthelium in BPS. Curtis
Nickel from Kingston, Ontario and
his Canadian colleagues reported on
a multicenter, community based,
open-label, uncontrolled study
designed to assess the efficacy and
safety of intravesical sodium chondroitin sulphate for BPS.
The less-restrictive National
Institutes of Health Interstitial
Cystitis Database Study definition of
interstitial cystitis was the operative
definition. Patients must have had
urinary/bladder pain/discomfort and
urinary frequency/urgency persisting
for more than 24 weeks with a negative urine culture and no other obvious cause for the symptom complex.
A two percent solution of sodium
chondroitin sulphate was instilled by
urinary catheter weekly for 6 weeks
and then monthly for 16 weeks. A
seven point global response assessment was the primary endpoint
requiring marked or moderate
improvement to qualify as a success.
In all, at week 10, 47% of patients
were responders. The O’Leary Sant
symptom score decreased by a mean
of 5 points and the O’Leary Sant
problem score decreased by a mean
of 4.3 points. The responder rate
increased to 60.4% at week 24.
Twenty-eight patients reported 65
adverse events, all mild, and only 20
of those were considered possibly
related to treatment. No safety issues
were identified.
While open-label trials are notoriously unreliable in the study of BPS
treatments, this study does show
proof of concept and suggests the
need and rationale for a well-powered, randomized, placebo-controlled
trial of intravesical chondroitin sulphate for BPS.
Nickel JC, Egerdie B, Downey J,
Singh R, Skehan A, Carr L, IrvineBird K
BJU Int. 2008 Sep 3. Epub ahead of
print 10.1111/j.1464-410X.2008.08028.x
THE IC OPTIMIST • FALL 08 • 11
Holiday Foods
& Parties
a Fresh Tastes column
by Bev Laumann, author of
A Taste of the Good Life,
a Cookbook for An IC Diet.
Since my diagnosis of IC, I have
to admit I don’t look forward to the
holidays in the same way I used to.
In fact, I sometimes wince at the
thought. I know that the hectic pace
of this month will make my diet and
medication schedule more difficult
to manage. I’ll need more sleep and
need to do more advance planning
for my activities. And I wince knowing that I’ll probably need to lay in
some extra supplies of my “emergency” medications to handle a
stress-induced bladder flare.
I’ll have to say “no thanks” more
often when my body’s needs for rest
or food conflict with the social
expectations of others. Yes, once
...I flat out refuse
to stay home and
help the IC do its
dirty work of
isolating me.
12 • THE IC OPTIMIST • FALL 08
again I’ll endure some incredulous
stares and disapproving looks from
the uninformed. But each year I flat
out refuse to stay home and help the
IC do its dirty work of isolating me.
The IC has deprived me of enough.
No way am I going to duck out on
the holiday celebrations I’ve always
enjoyed out of fear of a symptom
flare-up.
For those of us with IC, holiday
parties and family gatherings can be
a big stressor as well as an opportunity for fun. And a big part of that
stress will be struggling with foodrelated dilemmas. At every occasion
this time of year temptation looms in
the form of chocolate treats, alcoholic beverages, or unfamiliar foods
that have who-knows-what in them.
Do I relish a taste now and possibly
suffer later? Or deprive myself now
but be able to function later?
Here are some ideas for managing
at least some of the diet-related anxieties associated with holiday parties
and gatherings:
1. The Dinner Party...
Consider communicating your
dietary situation to the host or hostess well in advance. Chances are if
they care enough to invite you in
the first place, they’ll be happy to
make some reasonable accommodations to help you enjoy yourself.
Give them the opportunity to be
sympathetic and helpful. No need to
go into medical details. Just ask what
they’re serving and tell them your
doctor has you on a diet that avoids
hot spices and certain foods. (I find
it helpful to draw an analogy
between my situation and that of
people with diabetes, stomach ulcers,
lactose intolerance or food allergies-food- related problems that people
are more familiar with).
I try to think of these situations as
an opportunity to educate others
about IC as well. You never know,
the hostess may know someone else
who suffers from the same symptoms
you do but hasn’t been lucky enough
to get it diagnosed. Sharing your
experience may help another person,
and isn’t that what the season is supposed to be about?
2. Parties where alcohol is
served...
First of all, remember that alcohol
doesn’t mix with many painkillers,
antidepressants and antihistamines,
so check with your doctor or pharmacist if you plan on drinking. If
drug-alcohol interactions are not a
problem for you, here are some other
facts to keep in mind:
• Histamine adversely affects mast
cells, and mast cells in the bladder
tissue are thought to be involved in
IC symptoms. Beer and wine contain
histamine. Red wine has much more
than white wine. Alcohol makes the
situation worse by impairing the
body’s ability to break down and get
rid of the histamine.
• Beer and wines also contain a
substance called tyramine which,
like histamine, is a monoamine. No
one’s sure exactly why, but many
high-monoamine foods exacerbate
IC symptoms. Among other things it
does, tyramine closes down the arteries, decreasing blood supply to tissues
and increasing blood pressure. (I
wonder if perhaps less circulation
may mean less opportunity to “wash
out” any inflammatory substances in
the tissue). Beer and red wine are
especially high in tyramine. All aged
Bladder Problems?
Enjoy everyday life,
again!
Some foods are keeping many people from doing the
things they once enjoyed. Are you one of the many who
avoid car rides, little league games, movies and family
dinners because of the effects of acidic foods?
Many people are highly sensitive to food. For some,
various foods can cause occasional heartburn, for others
the "hidden irritant" in foods can exacerbate urinary
problems or bowel distress. In most of these cases, the
problem lies with the unsuspected acid in the foods.
Prelief is a safe, effective over-the-counter product that
can help you stay comfortable. Prelief works by taking the
acid irritant out of foods, so these foods are less likely to
trigger problems. With Prelief you can enjoy life again.
Go ahead...
take that long car ride, cheer
on your favorite little leaguer and
watch the entire movie. A trip
to the grocery store won't have
to include a map to the restroom;
a family dinner can be long
and lingering!
Available in the antacid section at
Albertson's, Eckerd, Long's, Meijer,
Osco, Publix, Rite-Aid, Savon,
Walgreen's and many other fine stores.
Also available by phone or www.prelief.com.
¨
Safe. Reliable. Effective.
CALL 1-800-994-4711
for literature and a coupon
P0212 ©2005 AkPharma Inc.
cheeses like bleu, roquefort, edam,
brie and cheddar are high in tyramine, as are smoked meats and fish.
Beware the double whammy of consuming these foods together with
wine or beer.
• Wines are also acidic.
Champagne and sparkling wines are
the most acid of all wines and they
also have a higher alcohol content.
• Most wines have at least some
naturally occurring sulfites, but
wineries may add more. Sulfites are
known to cause allergic reactions in
many people, whether or not they
have IC. Some IC patients’ bladders
cannot tolerate sulfites. In general,
red wines tend to have more than
white wines. (Onions, dried coconut
and dried fruits may also have sulfites. Beware of the cumulative effect
of drinking and eating foods containing these).
• Very cheap wines may also have
the preservative, potassium sorbate.
THE IC OPTIMIST • FALL 08 • 13
Sorbates are used to preserve candied
fruits too. Some IC patients say they
are sensitive to sorbates.
• Drinks with whiskey, gin, or
vodka may have less tyramine per
ounce than many wines, but more
alcohol. The tradeoff may or may
not work to your advantage, depending on your body’s pattern of sensitivity. Beware of acid from fruit or
carbonation in mixed drinks. (A
pinch of salt can “flatten” carbonation—a helpful trick for some people).
Of all the problems with alcoholic
beverages, acidity is probably the
easiest to deal with. Try taking an
acid-neutralizer like Tums before
drinking. Eating foods containing
egg whites or baking soda with your
drinks may help curb the effect also.
While many IC patients can’t consume any alcohol at all (except when
used in cooked foods), a few find
they can drink limited amounts of
certain things. Everyone’s different.
You could start by experimenting
with these wines that some ICer’s
have successfully tried: Muscatel,
Semillon, Tokay, sweet white dessert
wines, or non-alcoholic beer (which
still contains monoamines, by the
way).
Try taking an acidneutralizer like Tums
before drinking.
3. The office party...
If you don’t want your co-workers
to know you have a medical problem, you may have to explain or
draw attention from your food avoidance. Here are some explanations
other IC patients have given:
14 • THE IC OPTIMIST • FALL 08
• I have food allergies.
• I ate before I came.
• I’m trying an oddball diet and I
won’t know whether it will make me
lose weight if I “cheat”.
• My spouse (or girlfriend/
boyfriend) and I agreed I’d be the
designated driver for tonight.
• I’m taking an allergy/cold medication that doesn’t mix with alcohol.
If you have holiday coping strategies that work for you, especially
food-related ones, please e-mail me
at [email protected] I’d
love to hear about them. May your
holiday season be filled with comfort, joy and peace!
—Bev
© 1998 Bev Laumann
Red and White Candy Canes! What could be more in tune with the
holiday spirit than peppermint? This recipe (adapted from Martha
Stewart’s Living) is scrumptious fun for kids and adults.
Quick Peppermint Ice Cream
Makes 1 pint
1 pint Haagen-Dazs vanilla ice cream
2/3 cup of crushed peppermint candies or candy canes
1/4 teaspoon peppermint extract
Crush peppermint candies by placing between clean kitchen towels
(or paper towels) and hitting with a meat hammer, or other heavy
object. (About 7 or 8 6-inch candy canes will make 2/3 cup crushed).
Sprinkle the extract over the crushed candy. With a large spoon, quickly stir the crushed candy into the ice cream. Ice cream will begin to
soften and turn pink, so work quickly. No need to have it completely
blended. Return to freezer for an hour or two to re-set and let flavors
blend. Serve in fancy bowls, placing an oatmeal or decorated sugar
cookie in the ice cream.
The key to IC-safeness with this
is to use ice cream you know your
bladder tolerates, and peppermint
candies and extract that contain no
artificial sweeteners or stabilizers.
Pie variation: Have a chilled, baked
8-inch pie crust ready. Fill with peppermint
ice cream (you’ll need a quart). Return to
freezer to harden for 3 or 4 hours. You can
top it with decorated cookies, carob chips,
or cake decors. Or just before serving,
place a dollop of whipped cream
on each slice.
Is Your Car IC
Friendly?
Finding a comfortable car is often
challenging for pelvic pain patients.
In the late 1980’s, one of the first
comprehensive research studies on
interstitial cystitis reported that 50%
of IC patients found driving in a car
uncomfortable, if not painful. Why?
It all comes down to the smoothness
of the ride, combined with the comfort of the seats.
With their notoriously tight suspensions, small sporty cars, buses and
trucks often provide bouncy, rough
rides which jar the pelvis and bladder triggering bladder pain and
pelvic floor muscle spasms. Softer
suspensions, particularly those found
in larger cars and SUV’s, absorb the
bumps in the road and are far more
comfortable for IC’ers.
In addition, car seats that are hard
and/or have minimal padding, particularly those found in many foreign
cars and sports cars, lack cushioning
that can help making sitting and
long drives more comfortable.
When we first covered this topic
five years ago, ICN members agreed
that larger American made vehicles,
particularly sedans and SUV’s, were
the most bladder and pelvic friendly
because of their very smooth ride.
They typically offer thicker, more
comfortable cushioning in the seats
and backs as well as softer seat covers. Unfortunately, their gas mileage
is poor.
We spent much of the summer
asking IC patients about their experiences with the smaller, more fuel
efficient vehicles. Were they comfortable and worth the investment?
American Made Cars
Not surprisingly, Fords scored
quite well. ICN Donna offered “We
have a Ford Focus and it’s amazingly
comfortable for me.” Claredale reports
that she loves the ride of her Ford
Explorer. TiffRN83 said “My mustang
is great… the seats are comfortable, the
seat warmers are in the right place so if
I’m flaring, I turn one on to help
decrease the pain. Plus it has a
smoother ride than my past two cars,
both Monte Carlos.”
The Chevy Tahoe Hybrid got a
rave review by one ICN member,
Lfane, who said “It is amazingly comfortable. The farthest we have driven it
so far was three hours and I had no
problems…. It doesn’t ride like a truck,
has a much smoother ride and it has
heated seats as well.”
Similarly, one member said “I
bought a 2007 Pontiac Grand Prix….
It handles turns very well and you can
barely feel bumps when you happen to
hit one.” The soft, heated seats were
a highlight “The seats are the most
comfy that I have been in, more so than
my dad’s Lincoln.” One man raved
about his 2007 Lexus because the
seats were so comfortable and very
easy to adjust.
Chrysler and Dodge faired far
more poorly. Claredale offered “I
rode in a Dodge Dakota a couple of
months ago for a 30 minute ride and by
the time I got home, I had to take a
pain pill and then take a very hot bath
to calm down. I felt every section of the
interstate on that car ride.” Still
another reported that her family’s
Dodge Durango is a “total bladder
killer.” ICN President Jill Osborne
said “I don’t know why my mother’s
THE IC OPTIMIST • FALL 08 • 15
Dodge sedan was so bladder provoking
but there were times when, after even
just ten minutes in the car, I was almost
crying in pain. On the other hand, my
Buick Rendezvous is perfect. I can drive
anywhere and almost any distance without too much discomfort.”
International Cars
The international mid-size sedans
received better reviews than before.
Volvo S40 and S80 sedans received
good reviews due, primarily, to their
very smooth ride and suspension.
NewLife wrote “I test drove a 2008
Volvo S40 and was very impressed.”
The Hyundai Azera and Nissan
also received rave reviews for the
soft, heated seats and “cushy ride.”
The Toyota Prius received poor
reviews. Two members reported that
the seats were too hard and the ride
far too bouncy and jarring. A third
who won a Prius in a contest offered
“We took it on a trip to Florida. Going
down, we split the trip up into two 6
hour days and it wasn’t too bad.
Coming home, we drove straight
through and I thought I wasn't going to
make it. I hurt all over. I was really in
extreme pain.”
The Toyota Camry, regular and
hybrid, had much better reviews
from several of our participants. ICN
member Amaranthe offered “My current car is a Toyota Camry. It has been
great. It gets awesome gas mileage, and
the seats are comfortable too. Also, it
has a smooth suspension so it doesn’t jar
me around a lot.”
Honda received mixed reviews
mostly due to complaints of hard
seats. One IC patient reported that
the new, small Honda Fit car was
surprisingly comfortable and had a
smooth ride even though it has a low
suspension. The large Honda
Element also had a good review “We
“Thanks to Bladder-Q,
I have my life back again.”
—Antoinette Jean
NATURAL - SAFE - EFFECTIVE
Money Back Guarantee
Learn more at www.thenaturalbladder.com
16 • THE IC OPTIMIST • FALL 08
Larger American made
vehicles, particularly
sedans and SUV’s,
were the most bladder
and pelvic friendly
because of their very
smooth ride.
have a Honda Element. Its extremely
roomy, very comfortable, seats can be
laid down to sleep two… gets approximately 29 mpg, incredibly comfortable… Wouldn’t trade it for anything!”
Still another patient raved about her
new Honda CRV, particularly for the
heated seats.
Audi, Saab and Mercedes received
lukewarm reviews at best.
More cars definitely worth a test
drive include Buick sedans and
SUV’s, as well as the Nissan line of
sedans and crossovers. Both the
Buick Enclave (which replaced the
Buick Rendezvous) and Nissan
Murano are well known for their
very smooth suspensions and comfortable seating. Don’t forget to drive
not only on the freeway but also over
bumpy roads.
Once you pick two or three strong
contenders, see if you can rent one
from the dealer or a local car rental
service for a few days. Driving it
around town is a great way to determine if it will work for you. The one
feature we urge you to consider is
heated seats. Heat can help to calm
and soothe the bladder and pelvic
floor muscles during longer drives.
Share your car story or review in
the ICN Support Forum on our website.
Book Review:
Confident Choices:
A Cookbook for
IC and OAB
Julie Beyer’s latest book,
“Confident Choices: A Cookbook
for IC and Overactive bladder” will
be a lovely new diet resource for
patients around the world. A perfect
complement to her first book
“Confident Choices: Customizing
the IC Diet,” Julie uses this new publication to walk the novice patient
through essential IC diet basics in a
style that is simple, easy to understand and inherently practical. It’s a
perfect resource for patients who are
afraid to eat for fear of causing an IC
flare. The section on “rescue menus”
alone will be greatly appreciated by
patients currently struggling with a
sensitive bladder. Yes, Virginia, you
can eat when you have IC but you
With a positive and
encouraging tone and
style, Julie reminds
her readers about
key nutrition basics
and offers short,
concise discussions.
must choose your foods carefully.
With a positive and encouraging
tone and style, Julie reminds her
readers about key nutrition basics
and offers short, concise discussions.
She offers an excellent list of IC
friendly food substitutions. For example, pear or blueberry juice can be
used in place of lemon juice or vinegar in many recipes. She includes a
step by step guide on how to do an
elimination diet to determine which,
if any, foods you are sensitive to. She
offers a wide variety of recipes for
breakfast, snacks and appetizers,
soups, salads, breads, main dishes,
vegetables, pasta, desserts, candies
and beverages.
One new and great idea she
includes is a printable shopping list
of IC friendly foods that patients can
take to the grocery store to make
good, informed decisions about their
diet.
Some of you may wonder how this
book differs from the best selling “A
Taste of the Good Life: A Cookbook
for an IC Diet,” written by Bev
Laumann. Like Bev, Julie has an
impressive knowledgebase. You know
that you’re reading material that has
been created with a tremendous
amount of thought and research.
Where Bev’s book is ideal for
patients who love to cook and spend
time in the kitchen, Julie’s books are
perfect for patients who want to
approach diet simply or who simply
don’t want to spend a lot of time
cooking. It’s an easy yet very educational read. Bravo Julie for a job very
well done!
Confident Choices: A Cookbook
for IC and OAB is available for $24
or $20.40 for ICN Angel Subscribers.
All of the IC diet books are available for purchase through the ICN
store. You can buy them online at:
http://www.icnsales.com or place
your order by phone (707)433-0413.
THE IC OPTIMIST • FALL 08 • 17
Book Review:
Heal Pelvic Pain
Heal Pelvic Pain: The Proven
Stretching, Strengthening and Nutrition
Program for Relieving Pain,
Incontinence, I.B.S. and other
Symptoms without Surgery offers readers relief and recovery for pelvic floor
disorders through a program of
strengthening, stretching and relaxation exercises, massage techniques,
nutritional basics, and self-care therapies—without drugs or surgery.
The book provides two different
exercise programs. One addresses the
pain syndromes related to urinary,
bowel, or sexual dysfunction—
including incontinence, irritable
bowel syndrome, urinary and/or
bowel frequency, urgency or retention, pudendal neuralgia, prostatitis,
endometriosis, pelvic inflammatory
disease, and more. The other program addresses pelvic floor muscle
weakness and poor coordination
resulting in incontinence, pelvic
organ prolapse, and/or decreased sexual response.
The book is easy to read and use,
and offers photos of all of the exercises and massage techniques guide
readers every step of the way. Here’s
what readers will find in the book:
• Programs that can ease the pain
and discomfort of bladder, bowel
and/or sexual dysfunction without
surgery or drugs
• A way to relieve pain in an intimate area
• Methods for enhancing sex life
well into the elderly years
• Tips for strengthening the pelvis
before, during, and after pregnancy
• A muscle-strengthening regimen that boosts sexual pleasure,
eliminates incontinence, increases
18 • THE IC OPTIMIST • FALL 08
the body’s core strength and pelvic
stability.
• Guidelines on foods and beverages that ease discomfort and assist
in bladder and bowel disorders
• Suggestions for stress- and painreducing home spa treatments
• Patient testimonials
• A comprehensive resource
guide.
The book empowers
readers with a
“symptoms monitor”
to track pelvic floor
disorders...
The book empowers readers with
a “symptoms monitor” to track symptoms and the impacts of pelvic floor
disorders in daily life. As the reader
goes through the exercise and treatment recommendations, he or she
can track improvement and progress
on the symptoms monitor.
Author Amy Stein is the founder
of Beyond Basics Physical Therapy in
New York City, which specializes in
the treatment of pelvic floor dysfunction, pelvic pain, and manual therapy for men, women, and children.
She lectures nationwide and has
been featured in both print and
broadcast media. She is a contributor
to the medical textbook, Female
Sexual Pain Disorders: Evaluation and
Management, and serves on the board
of the International Pelvic Pain
Society.
Healing Pelvic Pain is available
for $16.95 or or $14.40 for ICN
Angels Subscribers in the ICN Store.
You can buy them online at:
http://www.icnsales.com or place
your order by phone (707)433-0413.
Perfect
Fall Flavors
On these cool, frosty evenings of
Autumn, a steaming bowl of rich,
thick soup topped with warm, crusty
croutons can make a perfect, comforting meal. Luckily, Fall also brings
many great vegetables and spices
that you can play with, particularly
pumpkins, acorn squash, butternut
squash, cinnamon, cloves and nutmeg. Here are some very easy, simple
and bladder-friendly recipes that can
help you celebrate this glorious Fall
season.
Roasted Butternut Squash Soup
1 medium size butternut squash
(about 2 pounds)
3 cups broth (either vegetable
or chicken)
2 whole carrots
Extra virgin olive oil
1/2 tsp pepper or to taste
2 tsp minched oregano or 1/2 tsp.
dried oregano
Dash garlic salt (optional)
Sour cream (optional)
Preheat oven to 350 degrees. Line
a baking sheet with aluminum foil.
Cut the butternut squash in half
lengthwise and remove the seeds.
Clean carrots and slice lengthwise.
Please carrots and squash (skin side
up) and on baking sheet and brush
generously with EVOO. Roast in
oven for roughly 50 minutes or until
tender.
Remove from oven and allow to
cool slightly. With a spoon, remove
the squash from the skin and place
(in two batches) into a food processor or blender with small chunks of
carrot. Use small amounts of broth
to provide enough liquid to blend
easily. Blend until smooth and then
pour into a soup pan or kettle with
the remaining broth. Add pepper
and oregano. Cover and simmer for
ten minutes, stirring occasionally.
Pour into bowls and top with a dollop of sour cream and toasted walnuts.
• The carrots add a slightly different flavor. For a pure butternut
squash taste, simply leave the carrot
out.
• If you love garlic, feel free to
roast garlic cloves or add a dash of
garlic salt to the soup.
• If you like creamy soups, add
1/2 cup of milk or half and half to
the soup mixture while it’s simmering.
• Top with roasted pumpkin
seeds.
Fast, Homemade Croutons
Using a bread of your choice (a
sweet French bread is ideal), slice
into one inch thick cubes. Coat or
spray with a slight amount of butter
or margarine. Place in a 350 degree
oven for ten minutes, flipping croutons occasionally, until slightly
browned.
While that is baking, combine 2
tablespoons of grated parmesan
cheese, 1 tsp garlic salt (or to taste),
1 tsp paprika, 1 tsp fresh chopped
parsley and place into a paper bag.
Add hot croutons to the paper bag
and shake thoroughly.
Serve hot, toasted croutons on a
soup of your choice.
Baked Acorn Squash
Each acorn squash provides two
servings (1/2 squash per person). Cut
washed acorn squash in half, crosswise or lengthwise, then scrape out
seeds and stringy portion. In each
hollow, place:
1 tsp. brown sugar
1 tsp. butter
1/2 tsp. cinnamon
dash of salt
Place upright in a baking pan and
add 1/4 inch watch at the bottom of
the pan. Bake in a 400 degree oven
for roughly an hour or until tender.
Remove the cover during the last
half hour so that the sugar will
carmelize and brown.
Serve as is, or for festive occasions, remove the pulp and mash
with butter. Place back into hollowed out squash sides and top with
a dab of butter and sprinkle of cinnamon or nutmeg.
THE IC OPTIMIST • FALL 08 • 19
Roasted Root Vegetables
Original Monkey Bread
1-1/2 pounds root vegetables: white
potatoes, sweet potatoes, parsnips,
carrots, turnips, and/or rutabagas
1 medium onion, peeled and cut
into quarters or halves (optional)
4 cloves garlic, unpeeled, tips
snipped off so they can be
squeezed out after roasting
(optional)
2 to 3 Tbsp. extra virgin olive oil
1/2 tsp. salt
1/2 tsp. ground pepper
2 Tbsp. fresh or 1 Tbsp. dry
rosemary, chopped
3/4 cup granulated sugar
3/4 cup light brown sugar
2 tsp. cinnamon
Dough for 3 loaves of white bread
or honey sweetened whole wheat
bread (homemade or frozen)
1 stick butter, melted
Preheat oven to 450 degrees F.
Scrub, peel, and cut vegetables
into long, slim julienne strips or as
small chunks. Toss vegetables, onion
and garlic with EVOO and place in a
heavy roasting pan lined with foil.
Roast for 30 minutes, stirring occassionally. Add spices, and continue
roasting and stirring for another 15
to 20 minutes, or until vegetables are
nicely browned. Serve hot. These are
a perfect accompaniment to pork
chops!
This recipe is made all the easier
by the many “ready to bake” bread
doughs available in most supermarkets! Heavily grease a 10 inch tube
cake pan or a pan of your choice.
Combine the sugars and cinnamon
in a bowl and mix well. Tear off
small pieces of dough and roll each
piece into a ball. Dip into melted
butter and then roll in sugar mixture
until coated. Place in pan. Continue
coating balls of dough until the pan
is 3/4 full. Cover with a kitchen
towel and let rise until the dough
reaches the top of the pan, roughly
30 minutes.
In a 350 degree oven, bake one
hour or until a skewr comes out
clean. Unmold, serve warm with
butter or jam! Half the fun is the
family just pulling the pieces of
bread off!
Quick & Easy Monkey Bread
2 cups Jiffy mix or Bisquick
2/3 cup milk
2 tsp. cinnamon
2 tsp. granulated sugar
1/2 stick of butter, melted
Preheat oven to 425 degrees.
Combine the sugar and cinnamon in
a small bowl and set aside. Blend
milk and biscuit mix until a stiff batter is made. With floured hands,
make small balls of dough. Roll
dough first in the butter and then
the sugar mix. Place in a greased 9”
pan and bake until golden, approx.
ten minutes. Serve hot with butter
and jam!
Pumpkin Bread
This recipe was adapted from a
Pumpkin Bread recipe that appeared in
a very small cookbook (1980) called the
Closet Gourmet written by Casey
O’Hara McKinley.
In an electric mixer, mix thoroughly:
CYSTOPROTEK
is a patent-protected, all-natural oral dietary
supplement in soft gel capsule form that
has been developed and clinically tested to
help promote interstitial bladder health.*
The anti-inflammatory properties
in CystoProtek’s unique natural
formula helps reduce the pain
and symptoms of interstitial
cystitis, while helping replenish
the damaged glycosaminoglycan
(GAG) protective layer in the bladder.
*This statement has not been evaluated
by the Food and Drug Administration.
This product is not intended to diagnose,
treat, cure or prevent any diseases.
®
PROMOTES BLADDER HEALTH BY REPLENISHING
THE PROTECTIVE LAYER OF THE BLADDER*
20 • THE IC OPTIMIST • FALL 08
For more information, or to order CystoProtek
go to www.cysto-protek.com or call 1.888.317.0001
1 cup sugar
1/2 cup brown sugar
1 cup strained pumpkin
1/2 cup salad oil
2 eggs
2 cups flour
1 tsp. baking soda
1/2 tsp. cinnamon
1/4 tsp. ginger (scant)
1/2 tsp. nutmeg
1/4 cup water
1/2 tsp. salt
Fold in 1 cup raisins.
Bake in two buttered loaf pans in
a 350 degree oven for 65-75 minutes
or until sides pull away.
Persimmon Cookies
This recipe came from Mrs. Annabel
Welch and is an Osborne family
favorite.
1/2 cup butter
1 cup sugar
1 beaten egg
1 cup persimmon pulp
1 tsp. vanilla
1/2 tsp. soda
2 cup flour
1/2 tsp. cinnamon
1/2 tsp. nutmeg
1/4 tsp. cloves
1/4 tsp. salt
1 cup raisins
1 cup chopped nuts
Preheat oven to 350 degrees.
Cream butter and sugar. In a separate dish, mix persimmon pulp and
soda. Add to butter mixture with
egg. Mix thoroughly, then blend in
remaining ingredients.
Add raisins and nuts to batter.
Drop in spoonfuls on an ungreased
cookie sheet. Bake for ten minutes
or until golden brown.
Pumpkin Waffles
Sift together:
2 1/2 cups all-purpose flour
1/3 cup packed light brown sugar
2 1/4 tsp. baking powder
1 tsp. baking soda
1/2 tsp. salt
2 tsp. ground cinnamon
1 tsp. ground ginger
1/4 tsp. ground cloves
Whisk:
4 large eggs
1 cup well-shaken buttermilk
1 cup milk
1 cup canned solid-pack pumpkin
3/4 stick (6 Tbsp.) unsalted butter,
melted
Vegetable oil for brushing waffle
iron or cooking spray
Preheat waffle iron. Add the dry
ingredients to the pumpkin mixture
and whisk until just smooth. Brush
waffle iron lightly with oil and spoon
batter into waffle iron. Cook according to manufacturer’s instructions.
Serve hot with your favorite syrup!
Pumpkin Bread Pudding
1/2 loaf sweet french bread (or
raisin bread) cut in cubes
1 c. canned pumpkin
1/2 c. brown sugar
2 eggs
1 tsp. vanilla
1/2 tsp. ginger
1 can evaporated skim milk
Preheat oven to 400 degrees.
Place bread cubes in 9 inch, buttered
pie plate. In medium bowl, combine
pumpkin, brown sugar, eggs, vanilla
and ginger. Stir in milk. Pour over
bread, coating it with pumpkin mixture. Bake in preheated oven 25 to
30 minutes until knife inserted near
center comes out clean. Cut in
wedges to serve (8 servings).
Hot Mulled Pear Juice
4 cups pear juice
1 cinnamon stick
3 or 4 whole cloves
brown sugar to taste*
Combine all ingredients in a
saucepan over medium heat. Bring
to boil and then simmer, briefly, for
ten minutes to blend the flavors.
Strain and serve hot!
Of all the juices, pear juice is the
lowest in acid and most bladder
friendly. While you can certainly try
this drink with full strength juice,
you might want to consider diluting
it to reduce the overall acid level.
*Sugar to taste is optional.
THE IC OPTIMIST • FALL 08 • 21
ICN Resource Catalog - December 2008
Interstitial Cystitis Network, PO Box 2159, Healdsburg CA 95448 (707)433.0413
Website: www.ic-network.com www.icnsales.com
Living with a bladder, prostate and/or a pelvic disorder can be challenging. Luckily, a wide variety of resources are now available that can help
you, today, gather knowledge and gain control over your symptoms. Your purchase underwrites the IC support services that we offer to patients
throughout the world. We thank you for your support! Please note that prices are subject to change at any time.
ICN Subscriptions
Are you looking for the best information on IC/PBS? The IC
Optimist Quarterly Magazine provides comprehensive
information on the latest IC research, news stories, self-help
strategies, the IC diet, clinical trial announcements and much
more!! Best of all, your subscription helps to underwrite the
more than 300,000 support sessions we provide, at no cost, to
patients in need on our website. We couldn’t do it with our
subscribers! If you’ve found our IC Optimist magazine and/or
our website helpful, please consider supporting our work by
becoming an ICN subscriber.
ICN Angel Subscriptions $60 per year
Includes the IC Optimist quarterly magazine and ICN Annual
Special Report by email or print (your choice), as well as 15%
off most purchases in our shop except for items that are
already discounted such as 3 packs.
ICN Gold Subscriptions - $40 per year
Includes the IC Optimist quarterly magazine and ICN Annual
Special Report by email.
ICN Silver Subscribers - $20 per year
Includes the IC Optimist quarterly magazine by email.
Books On IC/PBS, Diet, Pain Care & Related Conditions
New! Confident Choices: A
Cookbook for IC & OAB
Author Julie Beyer RD has now
created an cookbook ideal for
patients who are afraid to eat for
fear of irritating their bladder. In
addition to great menu ideas, she
offers many simple yet flavorful
recipes
Public Price: $24
ICN Angel Subscriber Price: $20.40
Shipping Weight: .75 lbs
Confident Choices: Customizing the IC Diet
Written by a registered dietitian Julie Beyer RD for IC
patients, this book is ideal for patients who are struggling to
eat a healthy, balanced diet. Includes many ideas for
breakfast, lunch, snacks and dinner.
Public Price: $20
ICN Angel Subscriber Price: $17
Shipping Weight: .55 lbs
A Taste of the Good Life: A Cookbook for an IC Diet by
Beverley Laumann
If you’re struggling with diet, “A Taste of the Good Life”
explains why foods can bother our bladder, what to avoid, and
how to find IC friendly foods! Includes extensive reference
lists and wonderful recipes. One of our faves is the Carob
Cake.
Public Price: $28.50
ICN Angel Subscriber Price: $24.23
Shipping Weight: 1.6 lbs
Interstitial Cystitis Survival Guide by Rob Moldwin MD.
The #1 book on IC, it covers diagnosis, treatments, pain care
and much more. This is THE book that you should bring to
every doctors appointment to credibility test proposed
treatments. It’s also excellent to share with family and friends.
22 • THE IC OPTIMIST • FALL 08
Public Price: $13.99
ICN Angel Subscriber Price: 11.89
Shipping Weight: .75 lbs
A Headache in the Pelvis (5th ed.) by Anderson and Wise
Based upon the Stanford Univ. Pelvic Pain Program, this
book discusses, in depth, a chronic pain management program
for patients with IC, prostatitis and pelvic floor dysfunction.
Public Price: $32.95
ICN Angel Subscribers: $28
Shipping Weight: 1.5 lbs
Please Understand: The IC Guide For Partners
Written by two dedicated, loving couples (the Sandlers &
The Gliddens), this unique book offers a sensitive and
empowering discussion of the issues which can affect and/or
intrude upon our lives.
Public Price: $11.99
ICN Angel Subscribers: $10.19
Shipping Weight: .23 lbs
ICN Special Report Series
Our annually produced special reports receive rave reviews for
providing an easy, in-depth review, of topics which IC
patients struggle with.
(1) ICN Special Report on the IC Diet
(2) ICN Special Report on Managing IC Flares, 2nd ed.
(3) ICN Special Report on Bladder Pain
Public Price: $10.00
ICN Angel Subscribers: $8.50
Shipping Weight: .25 lbs
Overcoming Pain by A. Platt, Jr., P.A.-C., S. Platt, M.D.,
and C. Hedrich, R.P.T.
Overcoming Pain is a wonderful resource for patients
struggling with chronic pain. The book discusses pain
treatments, particularly medications and their appropriate use
and dosages as well as pain procedures, the use of opiates and
alternative therapies. It also offers practical suggestions on
how to work with physicians as well as handling a daily life
while struggling with pain.
Public Price: $16.95
ICN Angel Subscriber Price: $14.40
Shipping Weight: .88 lbs
Overcoming Overactive Bladder
For the 17 million people in the US who suffer from
overactive bladder, this book includes the latest physical
techniques and strategies for coping with overactive bladder.
Public Price: $16.99
ICN Angel Subscriber Price: $14.44
Shipping Weight: .52 lbs
First Year: IBS by Heather Van
Vorous
The First Year: IBS offers a
comprehensive and sympathetic
approach to managing irritable
bowel syndrome (whether you're
newly diagnosed or have been
struggling for years), by an author
who has dealt with the disorder
since childhood and prevailed.
We recommend this book highly!
Coping with Anxiety
It is very normal to experience anxiety when faced with a
new, confusing and/or painful condition. This book offers ten
simple ways to relieve anxiety, fear and worry. Don't let
anxiety dominate your life. Do something about it today!
Public Price: $16.99
ICN Angel Subscriber Price: $14.44
Shipping Weight: .47 lbs
Public Price: $15.95
ICN Angel Subscriber Price: $13.56
Shipping Weight: .5 lbs
The Feel-Good Guide to Fibromyalgia and Chronic Fatigue
Syndrome
People wrestling with fibromyalgia and chronic fatigue
syndrome don't want a bunch of political baloney about how
misunderstood and hard to control their condition is-they
want to feel good again. This book helps them build a
personalized treatment plan that really works, using any and
all treatment resources.
Healing Pelvic Pain
New! Written by Amy Stein
PT, Heal Pelvic Pain offers
readers relief and recovery for
pelvic floor disorders through a
program of strengthening,
stretching and relaxation
exercises, massage techniques,
nutritional basics, and self-care
therapies
Public Price: $16.95
ICN Angel Price: $14.40
Shipping Weight: .75 lbs
Public Price: $14.95
ICN Angel Subscriber Price: $12.71
Shipping Weight: .64 lbs
Alternative (OTC) Food Supplements
Prelief (120 tablets)
This is the most popular acidreducing supplement used by both
IC and IBS patients to help them
eat a more balanced diet. Ingredients:
calcium glycerophosphate, magnesium
stearate
Public Price: $12.99
ICN Angel Subscriber Price: $11.04
Shipping Weight: .15lbs
CystaQ - 60 capsules
CystaQ is one of the “old favorites” of urology patients who
find that quercetin helps to reduce inflammation in their
bladder. In Fall 2002, yet another study was presented by Kym
Kanaly MD et al. which demonstrated that CystaQ oral
therapy was 'well tolerated and provided significant
improvement of bladder symptoms in patients with IC and
vulvodynia.' Ingredients: Quercetin, Bromelain, Papain, Black
Cohosh, Wood Betony, Passionflower, Valerian & Cranberry
Powder & Gelatin.
Public Price: $39.99
ICN Angel Subscriber Price: $33.99
Shipping Weight: .17 lbs
Algonot Plus - 120 soft gels
The first supplement developed by IC researcher Dr.
Theoharis Theoharides. It is a natural product, free from
artificial colors or flavors, corn, milk products, preservatives,
salt, starch, sugar, wheat, yeast or beef byproducts. Ingredients:
Chondroitin sulfate (300mg from shark cartilage), Glucosamine
Sulfate (300mg from shellfish chitin), Quercetin (300mgs from the
saphora plant) and olive kernal seed oil, gelatin (pork), beeswax,
soy lecithin, glycerin, purified water, titanium dioxide and carob
extract. If you are allergic to eggs, fish or olive oil you should
consult your doctor before taking this product.
Public Price: $39.00
ICN Angel Subscriber Price: $33.15
Shipping Weight: .6 lbs
Azo Standard
May relieve symptoms such as pain, burning, urgency and
frequency of urination associated with irritation of the lower
urinary tract. Contains the #1 ingredient prescribed by
doctors and recommended by pharmacists for urinary
discomfort. Beware, you will pee orange! Ingredients:
Phenazopyridine Hydrochloride
Public Price: $9.99
ICN Angel Subscriber Price: $8.49
Shipping Weight: .06 lbs
THE IC OPTIMIST • FALL 08 • 23
CystoProtek - 120 soft gels
CystoProtek combines the
anti-inflammatory properties
of quercetin, glucosamine
sulfate and rutin in a unique
natural formula with the
compounds chondroitin
sulfate and sodium
hyalonurate that help
replenish the GAG layer in
the bladder. A retrospective
open label study of
Cystoprotek in IC (released
in 10/06) found that the
product is beneficial and well
tolerated in PBS/IC. The 269
patients participating in the
study experienced a 51.2%
inhibition of their IC symptoms. Ingredients: Chondroitin
sulfate (300mg from shark cartilage), Glucosamine Sulfate
(280mg from shellfish chitin), Quercetin (260mgs from the
saphora plant), Rutin (40mgs from the saphora plant), sodium
hyaluronate (20mg from chicken) and olive kernal extract, gelatin
(pork), beeswax, soy lecithin, glycerin, purified water, titanium
dioxide and carob extract. If you are allergic to eggs, fish or olive
oil you should consult your doctor before taking this product.
Public Price: $39.00
ICN Angel Subscriber Price: $33.15
Shipping Weight: .6 lbs
DH Quercetin with Aloe
Public Price: $19.49
ICN Angel Subscriber Price: $16.57
Shipping Weight: .15 lbs
DH Glucosamine and Chondroitin with Aloe
Public Price: $26.49
ICN Angel Subscriber Price: $22.52
Shipping Weight: .32 lbs
DH Calcium & Vitamin D with Aloe
Public Price: $13.49
ICN Angel Subscriber Price: $11.47
Shipping Weight: .30 lbs
DH Buffered Vitamin C with Aloe
Public Price: $14.49
ICN Angel Subscriber Price: $12.32
Shipping Weight: .30 lbs
Manno Max D-Mannose Powder
If you’re struggling with recurrent e-coli based bladder
infections (as confirmed by urine cultures), D-Mannose is an
interesting option to explore. Research has demonstrated that
d-mannose (found in cranberries and blueberries) inhibits the
ability of e-coli to cling to the bladder wall.
Public Price: $26.99
ICN Angel Subscriber Price: $22.94
Shipping Weight: .30 lbs
Manno Max D-Mannose Tablets
If you’re struggling with recurrent e-coli based bladder
infections (as confirmed by urine cultures), D-Mannose is an
interesting option to explore. Research has demonstrated that
d-mannose (found in cranberries and blueberries) inhibits the
ability of e-coli to cling to the bladder wall. Contains 60
tablets. Ingredients: D-Mannose, magnesium stearate
Desert Harvest Aloe
Desert Harvest conducted a
formal clinical trial to study the
effectiveness of aloe in reducing
bladder irritation and IC
symptoms. In a double blind,
placebo controlled clinical trial in
IC patients, 87% of participants
received relief from at least one
symptom of their IC. 50%
received relief from all or most of
their symptoms. Ingredients: Whole
Leaf Aloe Vera
Public Price: $34.99
ICN Angel Subscriber Price: $29.74
Shipping Weight: .20 lbs
*These statements have not been evaluated by the Food and Drug
Administration. This product is not intended to diagnose, treat,
cure or prevent any disease.*
Public Price: $37.99
ICN Angel Subscriber Price: $32.29
Shipping Weight: .20 lbs
Home Urine Testing Kits
Azo Home UTI Test Kit
(3 Test Strips)
When an IC flare feels
exactly like the worlds
worst UTI, it’s only normal
to guess that it’s an
infection rather than a
simple flare. Some IC
patients have taken
antibiotics needlessly
because their urine cultures
were actually negative for
infection. Having a UTI
Test Kit on hand can be a useful tool in helping you to
24 • THE IC OPTIMIST • FALL 08
determine when to request a urine culture. This new urine
test kit checks for Nitrite AND Leukocytes (white blood
cells) in the urine, the same UTI test pads that most doctors
use. Easy to use and read in just 2 minutes!
Public Price: $12.99
ICN Angel Subscriber Price: $11.04
Shipping Weight: .20 lbs
Alkalive pH Strips (80 Test Strips)
Manufactured by pH Ion, this new test kit will allow you to
test the acid or alkaline level of your urine.
Public Price: $8.99
ICN Angel Subscriber Price: $7.64
Shipping Weight: .20 lbs
IC Friendly Beverages
Diet modification remains the foundation of IC self help! The
foods and beverages we consume can have a significant effect
on the severity of our symptoms although these symptoms will
vary from person to person. We offer foods and beverages that
are more easily tolerated by tender bladders. From low acid
coffees to low acid fruit products, each item was selected for
with thought, care and, of course, taste testing.
Euromild Low Acid Coffee Ground Roast
(Specify Decaf or Regular)
Euromild was brought to the ICN years ago by a patient who
had tried it and found it mild enough for her bladder. We've
since sold this to thousands of IC patients who have found it
to be far more bladder friendly than others! Makes about 40
cups. Comes in a resealable fresh lock bag
Tummy Mint
This blend contains just the right combination of sweet
peppermint, delicately floral chamomile, and fennel to calm
your stomach quickly but gently. Ingredients: Peppermint
leaves, Chamomile flowers, Fennel seed, licorice root, and natural
mint extract (contains soy lecithin).
Public Price: $2.99
ICN Angel Subscriber Price: $2.54
Shipping Weight: .09
Public Price: $6.99
ICN Angel Subscriber Price: $5.94
Shipping Weight: .4 lbs
Puroast Low Acid Coffees
The Puroast® Process is an all-natural process that does not
create the acids that affect the stomach. Available in ground
and whole bean, decaf and regular, Puroast offers a wide
variety of low acid coffees. Whole bean orders should be
placed on our website or phoned in!
Regular Roast (House Blend, Dark French Roast,
Hazelnut, Vanilla)
Public Price: $9.99
ICN Angel Subscriber Price: $8.49
Shipping Weight: .85
Decaf Roast (House Blend or Dark French Roast,
Hazelnut, Vanilla)
Public Price: $10.99
ICN Angel Subscriber Price: $9.34
Shipping Weight: .85
Peppermint Tea by Yogi Teas
A very popular tea, peppermint is known to calm spasms in
the gut, soothe indigestion, stimulate appetite, ease travel and
calm morning sickness. caffeine-free INGREDIENTS: organic
peppermint leaf
Public Price: $4.99
ICN Angel Subscriber Price: $4.24
Shipping Weight: .15
Celestial Seasonings Gingerbread Spice Herbal Tea
This roasted carob is perfect for the fall and winter with rich,
ginger, cinnamon flavor! 100% Natural! INGREDIENTS:
listed on our website
Public Price: $4.99
ICN Angel Subscriber Price: $4.24
Shipping Weight: .18
Celestial Seasonings After Dinner Teas
These roasted carob teas are light and flavorful. Comes in
three flavors: Almond Sunset, English Toffee and Vanilla
Hazelnut! INGREDIENTS: listed on our website
Public Price: $4.99
ICN Angel Subscriber Price: $4.24
Shipping Weight: .18
Knudsen Organic Pear Juice Boxes (3 pack)
This appears to be one the lowest acid juices that we've
found. INGREDIENTS: listed on our website
Public Price: $4.49
ICN Angel Subscriber Price: $3.82
Shipping Weight: 1.75 lbs.
IC Friendly Foods
Hero Blueberry Preserves
A blueberry preserve made by the
Swiss company Hero - all natural
ingredients, no preservatives, no
artificial flavors or colors - and
great blueberry flavor. 12 oz.
INGREDIENTS: blueberries,
sugar, glucose syrup, fruit pectin,
citric acid.
Public Price: $5.49
ICN Angel Subscriber Price: $4.67
Shipping Weight: 1.2 lbs
Pear-Pear or Pear-Blueberry Bars box (16 bars)
This 100% natural all-fruit snack bar friendly snack bar tastes
great, is fat free, contains no cholesterol, is low in sodium and
is a good source of dietary fiber. Contains no artificial
ingredients, flavorings or preservatives. This bar is the
equivalent of eating two fresh pears! INGREDIENTS: listed
on our website
Public Price: $20.99
ICN Angel Subscriber Price: $17.84
Shipping Weight: 1.5 lbs
THE IC OPTIMIST • FALL 08 • 25
Dr. Oetker's Organic Muffin Mixes
Our favorite muffins are light, flavorful and sinful without
irritating our bladders. They are also low in sugar and don’t
have that chemical aftertaste found in typical brand name
mixes. Perfect for a Sunday brunch, an afternoon tea or just
sitting with a book and a cup of peppermint tea. Comes in
four flavors: Carrot, Oatmeal, Corn and Apple Cinnamon.
INGREDIENTS: listed on our website! Makes 12 muffins
Public Price: $4.49
ICN Angel Subscriber Price: $3.82
Shipping Weight: 1.00 lb
Dr. Oetker's Organic Vanilla
Cake Mix
This wonderful cake mix tastes
like a homemade vanilla wedding
cake. It’s absolutely yummy and
what we use for all of our family
celebrations. Best of all, it doesn’t
have any of that cloying chemical
aftertaste found in most cake
mixes. This cake is definitely
yummy! INGREDIENTS: organic
wheat flour, organic cane sugar,
baking soda, cream of tartar, salt,
locust bean gum, organic vanilla flavor, natural flavor.
Public Price: $4.49
ICN Angel Subscriber Price: $3.82
Shipping Weight: 1.00 lb
Dr, Oetker's Organic Vanilla Icing Mix
A perfect match to the cake mix, this icing mix tastes like
homemade butter cream frosting. It’s very easy to make, is
easily spreadable and covers a normal sized cake. Ingredients:
Organic icing sugar, salt, organic vanilla flavor (contains gum
arabic).
Public Price: $4.49
ICN Angel Subscriber Price: $3.82
Shipping Weight: 1.00 lb
Bob’s Red Mill Homemade Gingerbread Mix
Using stone ground organic whole wheat pastry flour, a
special blend of premium spices and natural cane sweetener,
this easy to prepare cake is moist, rich, delicious and full of
the nutritious whole grains. It has a mild yet flavorful taste!
INGREDIENTS: organic whole-wheat pastry flour, brown sugar,
organic evaporated cane juice, organic unbleached white flour,
organic wheat gluten, dried molasses. organic ginger, cinnamon,
baking soda, sea salt, baking powder, allspice.
Public Price: $4.49
ICN Angel Subscriber Price: $3.82
Shipping Weight: 1.00 lb
Alice’s Stick Cookies (4 oz)
When we sampled this cookie, we
fell in love. It has a light,
satisfying toffee flavor that is
wonderful! It definitely deserved
its award as Best Cookie of 2004
and 2006. ! INGREDIENTS:
flour, malted barley flour, niacin,
thiamine, vitamins B1 and B2, folic
acid, butter, sugar, imported cane
sugar syrup, baking soda and vanilla
extract. NO EGGS, NUTS OR
26 • THE IC OPTIMIST • FALL 08
PEANUT OIL.
Public Price: $5.95
ICN Angel Subscriber Price: $5.06
Shipping Weight: .25 lbs
Dr. Oetker’s Oatmeal Cookie Mix
This cookie mix flies off the ICN shelves for a good reason. It
delivers pure, unaltered flavor in every bite of purely delicious
oatmeal cookies. Add our carob chips for a fun alternative.
INGREDIENTS: organic wheat flour, organic cane sugar,
organic rolled oats, salt, baking soda.
Public Price: $4.49
ICN Angel Subscriber Price: $3.82
Shipping Weight: .9 lbs
Almond Caramel Chews from Nunes Farms
While chocolate is a no-no, caramel is completely IC friendly
and these organic chews are just what you need to satisfy that
craving for something sweet. INGREDIENTS: Cream, Sugar,
Corn syrup, roasted almonds, milk, vanilla, salt, lecithin.
Public Price: $4.99
ICN Angel Subscriber Price: $4.24
Shipping Weight: .60 lbs
New! Soft Black or Red Licorice
from Lucky Country
All Natural soft, smooth black or red
licorice from gourmet licorice
producer, Lucky Country. Two
flavors: Black or Red
INGREDIENTS: molasses, wheat
flour, cane sugar syrup, sugar, coconut
oil, glycerin, licorice extract, soy lecithin,
natural flavor, natural colors, salt.
Public Price: $4.49
ICN Angel Subscriber Price: $3.82
Shipping Weight: .4 lb
Honey Essence English Toffee
From the rich, buttery centers made with fresh-from-the-hive
honey, grade A almonds and farm-fresh butter to the
delectable hand-dipped carob and almond coating - this is
truly English Toffee Extraordinaire! Ingredients: Center honey, almonds, butter, natural flavors, salt, and baking soda.
Carob coating: carob powder, nonfat dry milk, whey, palm kernel
oil and soy lecithin.
Public Price: $14.99
ICN Angel Subscriber Price: $12.74
Shipping Weight: .65 lb
Honey Essence Honeymoons
A celebration of our two favorite
sensations, crunchy and chewy.
Decadent honey, caramel and
mixed nuts (almonds, cashews and
pecans) - hand-dipped in carob.
Ingredients: honey, butter, cream,
pecans, carob powder, cashews, almonds. palm kernel oil, dry
milk, whey, lecithin, vanilla, algin, agar, and natural flavors.
Public Price: $14.99
ICN Angel Subscriber Price: $12.74
Shipping Weight: .75 lb
Carob Chips (Vegan)
If you’re missing your fave chocolate chip cookie, never fear!
Carob chips are IC friendly, taste wonderful and make great
cookies or cakes! These vegan chips contain no dairy
ingredients, no refined sugars, and no harmful trans fats.
Ingredients: Whole grain malted barley and corn, fractionated
palm kernal oil, carob powder, soy lecithin.
Public Price: $4.99
ICN Angel Subscriber Price: $4.24
Shipping Weight: .65 lb
Goldie’s Carob Bar
If you miss your favorite chocolate bars, these are a great, IC
Friendly alternative. Two flavors: Rice Crunch or Plain.
Contains no refined sugar, no preservatives, no chocolate,
cocoa or caffeine and tastes great. 6.5 inches long by 3 inches
wide. INGREDIENTS: barley malt, fractionated palm kernel oil,
carob powder, rice crisp (rice, barley malt), soy lecithin.
Carob Powder
Do you miss making chocolate cake or cookies?? Have you
ever tried baking with carob?? It's wonderful, especially the
carob cake recipe found in A Taste of the Good Life! Use as
an equal replacement for cocoa in your favorite recipes, or use
three tablespoons carob powder plus one tablespoon water in
place of each square of chocolate.
Public Price: $4.49
ICN Angel Subscriber Price: $3.82
Shipping Weight: .22 lb
Public Price: $5.49
ICN Angel Subscriber Price: $4.67
Shipping Weight: 1.20 lbs.
CD’s and DVD’s
Guided Imagery for Relaxation for IC and
Pelvic Pain
Created by a Nurse Practitioner at William
Beaumont Hospital (Michigan), this CD was
developed specifically for patients with IC,
pelvic pain and pelvic floor dysfunction. In a
research study, more than 45% of the group
using this CD twice a day were moderately or
markedly improved. In addition, pain scores
and urgency significantly decreased. We hope
that you benefit from this CD and suggest
listening to track 2 'Letting Go' once or twice
a day or especially during IC flares.
Public Price: $15.00
ICN Angel Subscriber Price: $12.75
Shipping Weight: .20 lbs.
New Dawn Pilates For People with Pelvic Pain
Created for patients struggling with pelvic pain
disorders, this DVD is ideal for individuals who
are seeking new, gentle exercises that will not
flare their symptoms. Because many patients can't
perform long, intense workouts, this DVD has
shorter segments, which allows patients to
personalize their workout according to their
capabilities. In addition to a 47 minute complete
workout, it also offers targeted workouts for
warming up, arms, abs & back and legs.
Public Price: $29.99
ICN Angel Subscriber Price: $25.49
Shipping Weight: .20 lbs.
Bladder & Prostate Friendly Chair Cushions
One of the great frustrations of having interstitial cystitis, overactive bladder, prostatitis, vulvodynia, prostatodynia, pudendal
neuralgia and/or pelvic floor disorders is that sitting can be excruciatingly uncomfortable. These cushions can definitely help.
Bladder & Prostate Friendly Chair Cushion
This unique design, created originally for patients with broken
tailbones, happens to work almost perfectly for patients with
IC, urethral and/or general tenderness because of a deep
groove that fits comfortably under the crotch area and reduces
pressure to those tender tissues. We offer FOUR cushions of
varying firmness. The cushions are 16 inches wide by 14
inches deep. Inside, you'll find firm, supportive side sections
with a flexible, soft, grooved foam that reduces pressure on
the crotch, urethra, prostate, etc. The cushions are covered
with a durable dark blue poly-cotton cover.
Cushion Sizes:
B-SOFT: This cushion is made from 2 inches of soft foam and
is best for those from 75-125 lbs.
C-MEDIUM: This cushion is made from 3 inches of soft foam
and is best for those from 125-175 lbs.
D-FIRM: This cushion is made from 2 inches of firm foam and
is best for those from 175-225 lbs.
E-EXTRA FIRM: This cushion is made from 3 inches of firm
foam is best for those from 225-275 lbs.
Public Price: $22.99
ICN Angel Subscriber Price: $19.54
Shipping Weight: 1.75 lbs
THE IC OPTIMIST • FALL 08 • 27
Heating Pads
BodiHeat Heating Pads – Three
Pack
This are, by far, the most popular
heating pads that we will. Imagine
a heating pad that lasts for 12
hours, is light and can adhere to
the outside of your undergarment.
We've found it! Made with the
same technologies used for the
tiny heating pads used in gloves
and shoes during the winter
months, this pad is much larger
and has an adhesive backing. One
time use only, it lasts for 12 hours!
EndoFEMM Washable Cover
The EndoFEMM™ Pad WASHABLE COVER is designed as
a protective barrier for the heating/cooling pad when placed
in the microwave or freezer and keeps the pad clean.
Public Price: $3.99
ICN Angel Subscriber Price: $3.39
Shipping Weight: .26 lbs
Public Price: $36.99
ICN Angel Subscriber Price: $31.44
Shipping Weight: 3.57 lbs
BodiHeat Heating Pad – Ten Pack
This deeply discounted pack contains a total of thirty onetime use heating pads! (Not eligible for angel discount)
Warm Whiskers Wraps
These adorable heating pad will cradle your body with gentle
warmth and fragrant herbs. Works wonders on stiff necks,
back spasms, poor circulation and arthritic pain. Heat in the
microwave for 90 seconds and soothing moist heat will work
on sore muscles for about an hour.. Choose One: Black and
White Cat or Tan Bunny.
Public Price: $6.99
ICN Angel Subscriber Price: $5.94
Shipping Weight: .20 lbs
Warm Whiskers Sleepy Pete Lamb
This lazy lamb has a microwaveable insert filled with
buckwheat and lavender. Just the right size to soothe an
aching back or defrost cold aching feet. Sleepy Pete can also
be used to warm a child's bed. Made from fleecy plush with a
velvety face and feet. 24' long
Public & Subsriber Price: $37.50
Shipping Weight: 2.6 lbs
EndoFEMM Microwaveable Heating Pad
The EndoFEMM™ Pad is designed specifically for women &
girls who suffer from chronic pelvic pain from Adhesions,
Endometriosis, Irritable Bowel Syndrome (IBS), Interstitial
Cystitis (IC), Menstrual Cramps, and Vulvodynia. With
seven compartmentalized sections and "kick stand" bottom,
the pad design provides even heating or cooling and a shape
that doesn't shift while gently hugging the pelvic area.
Covered with supple polyester fleece that is super soft against
the skin. Comes in a lavender color Pad Dimensions: 16.0"W
X 10.5"H
Public Price: $29.99
ICN Angel Subscriber Price: $19.54
Shipping Weight: 1.75 lbs
Public Price: $36.99
ICN Angel Subscriber Price: $31.44
Shipping Weight: 2.63 lbs
Warm Whiskers Cat Hot Water Bottle
This cute cat plush cover turns the traditional water bottle
into something magical. It¹s great for cold nights, sore
muscles, aching heads and icy toes. Cozy plush chenille cover
helps retain the heat. Bottle included. 15" tall.
Public Price: $28.99
ICN Angel Subscriber Price: $24.64
Shipping Weight: 1.25 lbs
Restroom Supplies
Perineal Wash Bottle
Are you struggling with urine burn?? This clear, empty wash
bottle is one of the most effective ways to reduce that
irritating sensation. Just fill with water and rinse yourself off
after you use the restroom!
Natracare Intimate Wipes
This soft, cotton wipe contains natural plant extracts of
Calendula and Chamomile. Alcohol and paraben free,
biodegradable with no synthetic preservatives. 12 wipes in a
portable, self-closing packet
Public Price: $2.99
ICN Angel Subscriber Price: $2.54
Shipping Weight: .06 lbs
Public Price: $4.49
ICN Angel Subscriber Price: $3.82
Shipping Weight: .19 lbs
Travel John
Patients who struggle with driving in a car, or who are
concerned about finding a restroom quickly, will find the
Travel John a great option. They are small, will easy fit in a
purse and fits comfortably over the urethra so that you can
void easily. Urine quickly solidifies thus creating no leakage.
Don't let IC isolate you at home. Comes in plastic packs of
three!
Seventh Generation Baby Wipes
This product came highly recommended by several IC
patients who found them soothing 'down there,' particularly
after using the restroom. Chlorine free and unscented, these
wipes are moistened with aloe vera, vitamin E and water.
Contains 40 unscented cloth wipes, perfect to fit in a purse or
glove compartment.
Public Price: $7.50
ICN Angel Subscriber Price: $6.38
Shipping Weight: .50 lbs
28 • THE IC OPTIMIST • FALL 08
Public Price: $4.99
ICN Angel Subscriber Price: $4.24
Shipping Weight: .55 lb
IBS Products
IC patients struggle with IBS symptoms including diarrhea, constipation and/or a combination of the both. Heather Van Vorous,
author of the best selling book on IBS: 'First Year: IBS', has a product line that can help reduce IBS symptoms and discomfort.
Heather’s Tummy Tamers: Acacia Fiber
Acacia fiber,is 100% soluble, soothing and ideal for patients
struggling with IBS. Clinical studies have shown that soluble
fiber helps soothe and regulate the bowel, relieves IBS
abdominal pain and cramping and alleviates BOTH diarrhea
and constipation. It is safe and healthy for daily, lifelong use
and has no gluten, sugar, salt, artificial sweeteners, citric acid,
oxalates, or yeast. Ingredients: organic acacia
Heather’s Tummy Tamers: Peppermint Oil Capsules
A recent survey of clinical trials declared peppermint oil
capsules the 'drug of first choice' for IBS patients with
constipation or diarrhea, to alleviate general symptoms, and
to improve quality of life. Peppermint helps relieve abdominal
pain, diarrhea, and urgency from IBS. 90 capsules per bottle.
Ingredients: peppermint oil extract, ginger oil, fennel oil, gelatin,
glycerine, enteric coating, water, carob.
Public Price: $19.99
ICN Angel Subscriber Price: $16.96
Shipping Weight: 1.24 lbs
Public Price: $12.95
ICN Angel Subscriber Price: $11.00
Shipping Weight: .16 lbs
Dry Mouth Products
Dry mouth can be a very uncomfortable side effect of common IC treatments. But dry mouth can also have an unexpected
consequence, a potential increase in dental cavities. The Biotene line of products can help.
Biotene Dry Mouth Gum
Biotene Dry Mouth Gum effectively helps to reduce harmful
bacteria and plaque while relieving oral dryness. Contains
natural salivary enzyme protection and protects between
brushings in sugar-free, mint flavored gum pieces. Contains
no saccharin. Ingredients: listed on our website. Net Contents:
16 pieces
Public Price: $2.69
ICN Angel Subscriber Price: $2.29
Shipping Weight: .10 lbs
Biotene Dry Mouth Liquid Moisturizer
Biotene Dry Mouth Moisturizer is a refreshing liquid solution
that quickly diminishes dry discomfort, mouth odors, and
other symptoms of dry mouth. Sodium lauryl sulfate free
with a fresh and appealing flavor. Contains five moisturizers
and 18 amino acids and proteins plus calcium and omega-3.
Ingredients: listed on our websitee.
Public Price: $8.99
ICN Angel Subscriber Price: $7.64
Shipping Weight: .20 lbs
Biotene Sensitive Toothpaste with Dry Mouth Protection
Biotene Sensitive Toothpaste helps protect against tooth
sensitivity while fighting cavities with gentle dry mouth
protection. Sodium lauryl sulfate free with a fresh and
appealing flavor. Active Ingredients: listed on our website
Public Price: $8.99
ICN Angel Subscriber Price: $7.64
Shipping Weight: .33 lbs
SuperLysine Cold Stick
Use everyday to protect your lips from the sun, a common
cold sore trigger. Contains all the same healing, relief giving
and preventive nutrients as the ointment.. This moisturizing
petroleum-free convenient Coldstick also heals cracked or
chapped lips. It can be worn under lipstick. Apply as often as
needed.
Public Price: $5.99
ICN Angel Subscriber Price: $5.09
Shipping Weight: .05 lbs
Personal Products
Very Private Body Wash
Very Private pH balanced Body Wash is a skin-friendly, low
sudsing cleansing and conditioning formula for the overall
body and the intimate area. It leaves skin feeling fresh, clean,
and helps prevent irritations and infections in the intimate
area. Hypoallergenic, fragrance free, dermatologist tested and
approved. Ingredients listed on our website. 6 fl oz.
and enhance the pleasure of intimacy. Ingredients listed on our
website
Public Price: $14.95
ICN Angel Subscriber Price: $12.71
Shipping Weight: .25 lbs
Public Price: $14.95
ICN Angel Subscriber Price: $12.71
Shipping Weight: .50 lbs
Desert Harvest Aloe Vera Personal Gel
Desert Harvest Aloe Vera Personal Gel is a completely
natural, chemical-free personal lubricant that can be used for
intercourse or internal physical therapy. Ingredients: listed on
our website.
Very Private Intimate Moisture
Very Private Intimate Moisture feels and functions like a
woman's own moisture to relieve vaginal dryness instantly
Public Price: $11.99
ICN Angel Subscriber Price: $10.19
Shipping Weight: .35 lbs
THE IC OPTIMIST • FALL 08 • 29
IC Resource Guide Order Form
Quantity
Item Description
Weight
Amount
Subtotal
SHIPPING & HANDLING (US Priority Mail)
Please add up the total weight for your order and enter the appropriate shipping
fee. International orders should be phoned in for an international shipping
estimate.
0 to 1 lb. ………. Add $4.80
3.1 to 4 lbs …….. Add $14.25
1.1 to 2 lbs …….. Add $8.25
4.1 to 5 lbs …….. Add $16.80
2.1 to 3 lbs …….. Add $11.40
Your shipping rate may be reduced in our offices if your order will fit into a flat
rate envelope or box. For a shipping estimate, please call us!
Shipping
TOTAL AMOUNT DUE
Name: ________________________________________________________________________________________
Address: ______________________________________________________________________________________
City: _____________________________________________________ State: _____________ Zip: ______________
Home Phone: _________________________________ E-mail: ___________________________________________
PAYMENT METHOD (Circle One: Check or Credit Card)
Credit Card Number: ______________________________________________________________________________________
Name on Card: _________________________________________________ Expiration Date: ____________________________
3 digit security code from signature strip on back of card: ___________________________________________________________
Signature: _____________________________________________________ Today’s Date: _______________________________
Checks or money orders should be payable to the ICN in U.S. Dollars. Please allow 3 to 4 weeks for delivery.
RETURN POLICY - We can provide a credit card refund for items returned within two weeks, we provide a store credit for items
returned within 15 to 30 days of purchase. We cannot provide refunds or credits for items returned after thirty days. Items that are
NOT returnable include: all food items, items with broken security seals (supplements, audiotapes, CD’s, DVD’s). Chair cushions
with broken protective covers.
To place your order, please fill out the form above and mail to:
Interstitial Cystitis Network, PO Box 2159, Healdsburg CA 95448 USA
Phone Orders: (707)433-0413
www.icnsales.com
30 • THE IC OPTIMIST • FALL 08
About Us
The Interstitial Cystitis Network is a health education company dedicated to interstitial cystitis and other pelvic pain
disorders. Our mission is to present the best research, information, and support directly into the homes and offices of
our users (patients, providers & IC researchers). In addition to our magazines and newsletters, the ICN offers the only
nationwide support services for patients in the USA & Canada, currently providing more than 300,000 support sessions
a month via our website (http://www.ic-network.com),
Our contact information:
Interstitial Cystitis Network
PO Box 2159
Healdsburg, CA 95448 USA.
Orders: 707.433.0413
Patient Assistance: 707.538.9442
FAX: 707.538.9444
This IC Optimist is published four times a year and is available
by US Mail ($60/year) or e-mail ($20 Silver or $40 Gold
Subscriptions). Professional subscriptions are also available.
Material contained in the IC Optimist is copyrighted, all rights
reserved. It may not be reproduced in whole, or part, without
advance written permission. Reprint requests should be directed to: [email protected]
What is IC?
Interstitial cystitis (IC), also known as painful bladder syndrome or bladder pain syndrome, is a condition that results in
recurring discomfort or pain in the bladder and the surrounding
pelvic region. The symptoms can vary greatly between individuals and even for the same person throughout the month,
including an urgent need to urinate (urgency), a frequent need
to urinate (frequency) and, for some, pressure and/or pelvic
pain. People with severe cases of IC/PBS may urinate as many
as 60 times a day, including frequent nighttime urination
(nocturia).
Pain levels can range from mild tenderness to intense,
agonizing pain. Pain typically worsens as the bladder fills and
is then relieved after urination. Pain may also radiate to the
lower back, upper legs, vulva and penis. Women's symptoms
may fluctuate with their menstrual cycle, often flaring during
ovulation and/or just before their periods. Men and women
may experience discomfort during or after sexual relations.
IC affects patients of all ages, races and cultures. It is found on
every continent in the world. Though it was previously thought to be a disease affecting mostly women, new studies
suggest that men suffering from chronic non-bacterial prostatitis may also have IC, thus dramatically expanding the
population data. It is not unusual for IC to run in families, nor for patients to struggle with a syndrome of related
conditions including: IBS, anxiety disorder, vulvodynia, pelvic floor dysfunction, allergies, migraines and fibromyalgia.
There are many treatments and self-help strategies now available that can help improve bladder symptoms dramatically.
One excellent place to gather information is on the IC Network website (http://www.ic-network.com), where you can
read extensive articles on IC as well as participate in our support forum and chats.
We welcome you! We believe in you! You are not alone!
THE IC OPTIMIST • FALL 08 • 31
My Mom Has
Interstitial Cystitis
A PAINFUL BLADDER STORY
Ages 6+
includes ten fun
home activities &
a big word hunt!
Helping children understand IC, bladder basics,
the IC diet, doctor visits, medication safety and
how they can help around the house.
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Written By Jill Heidi Osborne, MA
5
$12.