Mind Games, Voiding... and Over-sharing
As I mentioned in an earlier post (Random Unsolicited Advice for the Newly Diagnosed) the fact that many of us will suffer bladder and bowel issues is one of the cruellest jokes MS can play, especially when you consider that many people are diagnosed in their 20s and 30s.
But really, there's never a good age to find yourself logging the location of every toilet on your route.
The MS Trust explains that "In MS, damage to areas of the spinal cord or brain that control the bladder can cause different types of problems:
- urgency - a desperate urge to go to the toilet with little or no warning
- frequency - needing the toilet more than eight times a day
- hesitancy - difficulty in emptying the bladder
- retention - a feeling of incomplete bladder emptying"
With this in mind, here are some more top tips!
I am NOT a medical person. My only qualification for writing this is the fact that I have had - and continue to have - some (if not all) of those problems
What follows is based on my own experiences and a series of embarrassing half-remembered conversations with specialists and professionals. If you're having these issues, you are advised to go and have some of your own.
WALK DON'T RUN
The best piece of advice I had from a Urologist was not to run to the toilet. Apparently running does something to weaken your pelvic floor. I find that if I get the urge, it helps if I walk in a really exaggeratedly slow manner. Plus it looks cooler than running to the loo whilst clutching your unmentionables.
KEEP YOUR FLUIDS UP
When you start thinking about bladder issues, you might think that the obvious thing to do would be to simply reduce your fluid intake. Hilariously, this can lead to an increased feeling of urgency. Thanks for that!
Best thing is to keep your fluids up but think about what goes in. Alcohol and caffeine (i.e. the fun stuff) are obviously both irritants - caffeine is found in some fruit juices, especially orange juice. Cranberry juice is really good and water... well, there's basically nothing in water to irritate your bladder. so I try to drink as much of that as I can (when I'm at work, when I know exactly where the toilets are)
As I mentioned BEFORE, if I'm walking or driving and I get the urge, I'll start counting backwards from 400 in 3s. I read this technique in a magazine article about tips to help you sleep. The theory is that - as opposed to counting sheep - this is just repetitive enough to send you to sleep without being totally mundane. It never worked for me as far as getting to sleep's concerned, but it does the job if I need to keep "the wolf from the door".
I mentioned this to my Urologist when I was going through a bladder retraining programme a couple of years ago, and she saw lot of sense in it. Any distraction is good.
KNOW YOUR ENEMY
Basically the bladder is a pretty stupid muscle, with an incredibly short memory. If you go to the toilet when your bladder is (say) 20% full or less, then next time you're at 20% it will remember and will send messages up top.
So the thing that all parents say to their kids when leaving the house ("have you BEEN? Go on, have a try...") is pretty much the worst thing you can say.
But we all say it - and if you have MS, you're probably guilty of having the odd "try" yourself.
I dont have an answer for that, but a bladder retraining programme gave me some ideas. It's UNDENIABLY WEIRD but I spent three weekends measuring my fluids - incoming and outgoing.
Yes, gross - but because I knew how much had flowed in each direction, it gave me confidence to tell my misfiring mental messages that, actually, I KNEW that there was nothing in there.
DO IT AGAIN
But one last trick my urologist taught me is the delightfully named Double Voiding. This helps to avoid retention - basically, you go to the toilet (and this only works in a cubicle!) then you get up, maybe walk around a little bit, then you sit down and have another go. I'm not that sure about the biology but this really does help - I know I've had occasions where I've been convinced that I was empty, only to get THE URGE almost immediately. Double Voiding - on top of everything else - really helps me.
Another epically long post, but I thought this one was important enough to warrant it - If you have Bladder issues, what helps you manage them?
Do you have a fear of needles and take medication that requires injection?