Bladder Confidential: Speaking Truth to Pee Power
If you think about it, peeing is naturally funny. For example, the oxymoronic term ‘adult diaper’ is just plain hysterical. The prospect of wearing one is either icky, hilarious, or a relief depending on your age and urinary health. Gender-bending pee behavior is hilarious, too. My boyfriend pees sitting down whereas I pee more easily standing up and letting it go in the shower. Quite the laugh riot, eh? Okay, not always.
Bladder infections are no laughing matter. I had them chronically all during 2016. Then in 2017, nothing. Funny, but not in a ha-ha way. Funny-ironic, funny-bittersweet. For a while it was kind of a mystery. What did I do differently this year? First, let’s enumerate the facts from last year:
- I might have had the same UTI that didn’t die off entirely with Bactrim last year, but was finally vanquished with a powerful three-day dosing schedule of Cipro in December.
- Last year I kept forgetting to take a single prophylactic dose of Bactrim within a few hours prior to/after having sex. This could have allowed any residual urine to grow bacteria.
What’s different now?
I’m emptying my bladder more completely by bearing down with my newly-sensate abdominal muscles. Where that came from I have no idea. I haven’t been able to voluntarily flex my pelvic floor muscles since an MS flare in 2009. Then one day in January, 2017, I suddenly felt and then flexed my diaphragm muscles, which are located well above the pelvis. I could feel them push down towards my bladder, causing it to empty the small amount that’s usually left over after peeing. It is now July and they’re still working the same way. Very cool, hope it lasts. But what if it doesn’t?
I do have catheters. Not a big deal as long as I can find the right hole. Girls have three. I’m not suggesting that boys have it any easier, but they only have two and one of them isn’t anywhere near the urethra.
The first time I tried to self-cath back in December, I looked like a contortionist in a porn film. I tried it lying down, sitting on the edge of the bed/toilet, and standing over the toilet. The last stance was successful. But wait. Just out of curiosity I tried it again last week to no avail. My urethra is tube-shy.
At first I did what every normal, red-blooded American MS patient does in a situation like that: I sank into complete denial about ever needing to cath in the future. Something to the tune of Ach, it doesn’t matter anyway. I’ll be one of the lucky ones. Let’s hope. Tomorrow is another day.
Every day is unpredictable
But every day with MS can bring a different set of symptoms. Some are welcome, like loosened muscles or a bladder that has wakened out of its stupor. Others you try to show the door but they hunker down in your favorite chair for weeks and drink up all your scotch. What nerve. At first I always feel a little helpless, then resentful because I gave the intruder so much power over me. But then I gather my wits and get a plan. If the unwanted guest is bladder retention, I start telling myself I can do simple things that will help release urine. Here’s my plan:
- Drink a lot more water. Dehydration can cause hesitation in my urine stream.
- Lean forward while trying to urinate. It helps if I also press on my lower abdomen.
- Visualize running water. I picture a montage of faucets running at full throttle. Auditory imaginings help a great deal too.
- Remember to take those prophylactic doses of Bactrim on sexually active days. Bladder infections will cause major urine hesitation.
- Eat very small meals and take Miralax regularly. My IBS with constipation will cause abdominal distention. A constipated colon interferes with my ability to urinate.
The main thing I need to win the battle of the dysfunctional bladder is a plan. When I deploy my plan enumerated above, I defeat urine retention and hesitation. It allows me the illusion that I have some kind of control over my body. This too shall pass. But for now, I’m feeling my pee power and it feels righteous-good.
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