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“Humor is the shock absorber of life; it helps us take the blows.” Peggy Noonan
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Thanksgiving Office hours: The office will be open Monday Nov. 21 , Tuesday Nov 22 and Wednesday Nov 23.  The office will be closed Thursday and Friday.

Please note as we get closer to the end of the year the schedule will become busier!
INTERSTITIAL CYSTITIS BOOK REVIEW
One of my lovely IC (Interstitial Cystitis) patients suggested that my patients and I might benefit from a new book and she was right!
THE INTERSTITIAL CYSTITIS SOLUTION by Nicole Cozean, P.T. and Jesse Cozean just came out. I read it this weekend and think that most patients will find it quite educational.
(Amazon link THE INTERSTITIAL CYSTITIS SOLUTION )
There are no new mind blowing treatments found in the book, but it does give much hope and it does an excellent job in explaining the currently available treatments.
The frustration: We still do not know what causes IC.
I differ from the author in a few areas. She reports that “90% of IC patients are food sensitive.” I have found only 50% of my IC patients to be helped by diet changes. But, it is the easiest change to make, so I still strongly suggest everyone try the IC diet for at least three months.
Ms.Cozean did an excellent job of explaining the concept of nervous system upregulation, which helps explain why long term narcotics do not work for IC.
The book has many questionnaires that can better help you define your symptoms and make communication with your doctor better.
There is a section on the connection between migraines, IBS, fibromyalgia, chronic fatigue and IC. The writer is a physical therapist. So, it came as no surprise that the best sections in the book were on the connection between the pelvic floor muscles and IC.
In her suggestions for drug therapy, I use everything that she suggested, except cyclosporine A. I think the evidence for its helpfulness is minimal and its side effects and cost are prohibitive.
I think that the two treatments that are under-utilized in my practice are bladder Botox injection and peripheral and central neuromodulation. I believe that all three have great value in the treatment of the IC patient who has failed simple treatments. Third party payers don’t want to pay for these therapies and the therapies have been maligned by a few unsatisfied patients on the internet. But, I think all three therapies have great benefit for the complex IC patient.
I would like to see more of my IC patients with chronic pain get good care from a psychiatrist. The stress of dealing with a chronic illness that drains your energy can be depressing. Many of my patients are very resistant to this aspect of their care. But, the patients who have been willing to take all of my suggestions get the best outcome.
I use physical therapy, acupuncture, hypnotherapy, massage, visual imagery, drugs, and surgery. Each patient’s therapy has to be individualized for best success! Ms. Cozean stresses this concept in her book.
I have been treating IC since 1986 and I have never said this before: “I think every IC patient should buy this book and read it.”  Please know that I do not know the author and have NO relationship with her. I simply think the book would be very helpful to my patients and to their family members. In fact, if enough IC patients are interested, I would be happy to conduct a book club on this book at my office. Of course, you must read the book before the book club. Contact me via the patient portal, if you or your IC friends would like me to facilitate the book club.
Dr. Martha Boone
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