@s38mmhoser Sorry to hear of your difficulties with the second round. All 9 of my BCG doses to date have been what they call 1/3 BCG dose. I've tolerated that very well, especially when I read of others having difficulties. My second cystoscopy after the second round of 3 was NED, and now I'm scheduled for the third round of 3 BCG instillations in May with the next cystoscopy at the end of June. I've read where a 1/3 dose of BCG is not that atypical and seems to be as effective as higher percentage dosages. You might consider dropping to a 1/3 dose. There are other alternatives such as Gem/Doc or Adstiladrin. Regardless of which path you take, best wishes for a tolerable successful outcome.