Pardon Me, Excuse Me, I’ve Really Got to Go NOW!
Have you ever been in line in a public women’s restroom and had someone fly past you and slip through a newly opened stall door to get to the toilet? What were your thoughts? Probably something to the effect of ‘how dare she skip the line that we’ve all been suffering through’ or ‘what nerve she’s got’ or ‘how rude?!’
Have you ever been the woman who rushed into the bathroom, skipped the line, and simply walked into a newly available stall without even looking at the ladies who had been waiting?
Both sides of the equation
I’ve been both of these ladies on different occasions. Neither situation is ideal. Planning ahead for how to take care of your bathroom needs can become a challenge with MS. Even if you don’t have bladder problems all of the time, when you do it can be embarrassing, uncomfortable, disruptive, and demoralizing, especially in public.
Learning from traveling
Over the past few years, I’ve taken several train trips up and down the East Coast traveling between Washington, DC, Philadelphia, and Manhattan. During these travels, I’ve learned a few things, especially as they relate to the ‘gotta go, gotta go, gotta go’ situation.
If my trip is from Washington, DC, to Philadelphia, I’ve learned to take the opportunity to use the facilities on the train shortly after we pass Wilmington, DE, because we’ll be pulling into Philly soon and people will begin gathering in the aisle waiting to de-board. If I’ve missed this opportunity, at least the restrooms at the train station are larger than they are busy most of the times I’ve been there. It’s only reaching them in time that is the challenge due to the long walk.
Planning my strategy in advance
If my destination is New York City’s Penn Station, then I have to plan my strategy a little more in advance. Things get busy on the train between Newark, NJ, and NYC. It is at Penn Station where I once simply walked past a line of at least 15-20 ladies who were waiting their turn in the restroom. I’m not sure that I’ve ever visited this particular restroom which is centrally located near the Amtrak waiting area when there wasn’t a long line.
This situation was similar to many others where if I didn’t keep moving and get undressed as quickly as possible, the dam on the levy would break so to speak. I’ve even been known - well, probably no one else knew - to discretely get my pants undone while waiting in line to facilitate a speedier drop of the pants to try to beat the stream of urine that was sure to escape before I got appropriately positioned.
Standing still can make it worse
For some reason, standing still for a brief period of time makes the situation worse. It seems that if I pause long enough to clinch my legs together, then the next time they relax - for example, in order for me to take a few steps - the muscles holding back the urine relax too and Lisa ends up with soaked underwear and most likely very wet pants.
Losing the ability to control the flow of urine is a common dysfunction in MS. So are problems with storage of urine, emptying of the bladder, or a combination of problems caused by detrusor-external sphincter dyssynergia (DESD) which is a lack of coordination between the different muscle groups that independently control storage and flow.
Discussing bladder problems with your neurologist
It is important to talk to your neurologist about any problems you are having with bladder functions. There are treatments which may help to reduce complications. But one thing you should NOT do if you are worried about incontinence is to dramatically limit fluid intake. You need to drink plenty of water to stay appropriately hydrated and to avoid aggravating bowel problems which can often accompany bladder problems.
For me, the onset of bladder problems coincided with a period of time where my MS was progressing somewhat rapidly. I was having several relapses with limited recovery in between. This was years ago, however.
My brain subtly warning me
Now, when I begin to have bladder issues, it is often because of a blossoming urinary tract infection or poor attention to my body’s needs on my part. I’ve learned that if the random thought of the bathroom crosses my mind I should act upon it, even if I don’t physically feel the need to go to the restroom...yet. I may not be able to FEEL my need, but my brain is trying to subtly warn me in advance that we’re going to have to make a move soon.
What’s your experience with bladder problems? Are there strategies that you employ to try to manage or prevent problems when you are out and about?
Being prepared helps to reduce anxiety
One last thing. I’ve also learned that it is very helpful to carry a ziploc bag with a fresh pair of underwear just in case I need to store a soiled pair in my purse and swap it out for a clean pair. Individually packaged handi-wipes are also useful to have for when you need to freshen up a bit and plain toilet paper feels insufficient. I've found that being prepared helps to reduce anxiety related to bladder problems.
Do you have a fear of needles and take medication that requires injection?