Diary of a Mad Bladder
Bladder dysfunction. It doesn’t even need a punchline. It’s a two-word joke, completely self-contained. If you don’t have it, that is. The sound of those words makes the sufferer wince. But those with a healthy bladder hide a smirk behand their hand and think of those OAB commercials with the animated bladder on legs stalking people as they try to shop, sight-see and sit through a movie. Whenever I see that commercial, I wonder why the bladder is a dark pink. The stalking behavior feels right, but not the color. To my mind, the red spectrum indicates infection. But that’s not the cause that an OAB drug treats. Maybe I’m overthinking this.
Before I go on with my diary entry, here’s some info on the subject. According to my doctors and the pee literature, we have two varieties of nerve-related bladder dysfunction:
This causes involuntary contractions resulting in a feeling of urgency, possibly followed by urine leakage. Urgency can return shortly after the bladder is emptied. In multiple sclerosis patients, it is commonly caused by nerve damage in the spinal cord above T12. The severity of symptoms might vary according to the degree and location of the nerve damage.
Neurogenic (flaccid) bladder
This is the opposite of spastic bladder. Instead of a frequent urge to urinate, the bladder sends few signals to empty. Attempts to empty are often fruitless, causing urine to be retained to then travel back up the tubes towards the kidneys. This can result in chronic bladder/kidney infections. In these cases the patient uses a catheter to empty the bladder.
Efforts to treat spastic bladder
I have spastic bladder, but lately some other factors have caused problems. I’ve taken 10 mg Vesicare for eight years and it has successfully quieted my urgency and reduced the number of times I urinate. However, I developed a problem with urinary hesitancy while on the drug. Attempts to get the stream going got rather creative as I ran the sink faucet, envisioned a montage of dancing spigots spewing water in a kaleidoscope of color and movement, and barked a one-word command to pee!
Sometimes it worked. Other times I sat so long my legs went numb. My urologist gave me a catheter set and told me how to find the glory hole. I’m still looking.
Finding the solution
One day last December I accidentally found the solution. I lost my Vesicare refill and couldn’t refill it for another two weeks, so I went without it. Instantly I could pee on demand. No loitering, no numb legs, no visualization necessary. Another upside was that my hair started growing in the bald spots along the front hairline. I now have enough hair to wear bangs again! But you won’t find hair loss on the list of side effects. I reported this to my neurologist and her theory is that it caused hair loss in combination with other drugs I’m taking.
The downside of going off Vesicare is that urinary urgency and frequency returned. This is not a big issue since I’m home most days and can use the bathroom at will. But lately the urgency has become distracting and, once again, I want to quiet it. We decided to have me try the 5 mg lower strength Vesicare as needed. She also suggested I talk to my urologist about whether the older version of Ditropan still exists, the kind that wears off every few hours, to try as needed.
Meeting with the urologist
I have a May 29 appointment with the urologist and I’m looking forward to getting her take on my issues. In the meantime I’ve been on the lower strength Vesicare. It has quieted the urgency without causing urinary hesitation. So far, so good. I hope I can keep my new hairline. My sister gave me a new haircut with bangs and it looks good. More hair makes me look younger. At 60 I need all the help I can get.
- Neurogenic Bladder, by Patrick J. Shenot, MD, Associate Professor and Deputy Chair, Department of Urology, Sidney Kimmel Medical College at Thomas Jefferson University. Last updated Sept, 2016.