Friendship for three leads to triangle Interstitial cystitis drug can affect
Dear Amy: I became friends with a co-worker, “Marilee,” two years ago. We developed a great friendship. I recently invited another girl, “Trina,” into our friend group.
Recently, though, Marilee and Trina seem to have bonded and are gradually excluding me from things.
I am feeling left out and hurt by this. The only time they do want to hang out with me now is to take part in my photography hobby, which involves using my expensive equipment. I feel like they are taking advantage.
They’re not trying to hide it from me, either.
I have not confronted them.
Are they trying to be hurtful? — Left Out in Lancaster, PA
Dear Left Out: “The rule of three” refers to the symmetry inherent in a trio. This surfaces in art, music, design and even comedy. The triangle conveys a sort of pleasing and complex balance, and this balance seems to work except for when it comes to human relationships. That’s when an equilateral triangle becomes an isosceles, often with one person isolated at the farthest point.
This challenging “odd man out” human dynamic happens at every stage of life — from childhood to old age.
I very much doubt that you have done anything wrong.
It doesn’t matter whether they are trying to be hurtful; they are being hurtful.
Your choices are to swallow your own honest reaction and accept your new status as the equipment provider, or to be honest regarding how this makes you feel. It is brave to admit your own vulnerability, and I think you should, understanding that you cannot change them.
You say, “I understand that you two have developed a good friendship, but I have to be honest with you: I feel really left out, lately.”
Dear Dr. Roach: Could you discuss Elmiron side effects and the pending lawsuit? I have been on this for years for interstitial cystitis. — C.H.
“Interstitial cystitis” is a term used for chronic bladder pain when no other cause has been identified. It is not well understood. It appears that some of the protective layers of the bladder are damaged, allowing irritants in the urine to attack deeper layers, causing pain. There may be an autoimmune component to the disease. There does seem to be a family predisposition.
It’s important to identify individual triggers to symptoms. Some people do better with more fluid, some with less. Pelvic floor physical therapy can bring great relief to many with IC.
If medication is indicated, amitriptyline is usually the first tried, and is effective for many. It is not effective for all, and pentosan polysulfate (Elmiron) is then often tried. It may take three to six months to see maximum benefit. It appears to work by repairing the damaged protective layers.
In 2018, a paper identified damage to the macula (the center of the retina) in people who had been taking the medication for an average of 15 years. A further study in 2019 confirmed that people taking pentosan polysulfate may develop pigment in the retina.
A lawsuit claims that the drug manufacturer withheld knowledge about this.
People with IC should be made aware of this potential side effect. Those with vision symptoms should have a visual examination.
Although there is no official recommendation to do so, those who have been taking Elmiron for years should get an ophthalmologic examination. Knowing whether there is any toxicity is important in deciding whether to keep taking the medication. People may still choose to continue the medication despite this toxicity.