waterfall....

I had my bladder scanned today. Well, I suppose there’s a first time for everything.

It was essentially an ultrasound to determine how much fluid remained in there after an evacuation.. If there’s more than about 150ml left in there immediately after you’ve had a pee, apparently that’s a sign that you’ve got a functional problem. I had 37ml, which I’m told was pretty good. Nothing to worry about, anyway.

Of course, my visit to the continence clinic this morning is yet another gift of my multiple sclerosis. MS has affected my muscle strength, and the worry is that some of the muscles that have been affected are the ones that control my bladder. It’s apparently relatively common for people with MS to experience a number of bladder-related issues, from leakage to full-blown incontinence. In my case, I’ve had a problem where my bladder doesn’t seem to empty properly, leaving me with an urge to pee almost immediately after I’ve just been. Under some circumstances, I also get a rush bladder, where I suddenly get a desperate urge to pee. As you can imagine, none of this is much fun. I mentioned it to my neurologist last time I attended the clinic, and I got referred to the continence clinic.

Before attending, I was asked to keep a diary for a week detailing my visits to the toilet. It was quite instructive. The very act of journaling each visit forces you to think about your visits. I’ve always been one of those people who goes to the toilet when it’s convenient, not necessarily when I have a desperate urge. After all, the wise man goes when he can and not when he has to, right? Well, perhaps not. As I charted each visit, I became much more aware of how often I go out of habit rather than out of necessity: I go before I eat my lunch and before I got to a meeting…. Whether I need to go or not. If you can squeeze out a bit, then it’s worthwhile isn’t it? Actually, maybe not.

The average person apparently pees between 5 and 8 times a day. According to my charts, I usually went 7 or 8 times, but occasionally went 10 or 11 times or more, with several visits in quick succession. My MS may indeed be affecting my bladder function, but the nurse in the clinic this morning suggested that I start trying to re-train my bladder (and my pelvic floor muscles) and to be much more aware of going when I need to go. I reckon I can work on that. Immediately after I got to work this morning after the clinic, I felt like I needed to pee at around 11:30. I said to myself that I would try and hold on until 12:00, and I actually made it all the way to 15:30. One possible explanation for this new found bladder resistance was that I didn’t have any coffee at all this morning. I would usually have a cup of fresh coffee from a cafetiere as soon as I get to my desk, but not today. The nurse at clinic suggested that, if my bladder function looked fine, then the problem was likely to be bladder irritation. Did I drink coffee, because caffeine is both a diuretic and a bladder irritant? Hmm.

Slightly reluctantly, I bought myself some decaffeinated tea on the way to work and didn’t make any coffee when I got in. One swallow does not a summer make, but it’s definitely given me food for thought and ample reason to think about what I drink. Actually, I’ll probably keep my morning coffee in my routine for now, but if I stop drinking caffeine after 10am, then I’ll see if it has any positive effect on my bladder later on in the day. Perhaps the clipper tea I bought isn’t very good, but the major drawback of decaffeinated tea that I’ve noticed so far is that it just doesn’t taste as malty as I’d like. But, if the alternative is to resort to medication (and maybe catheterisation), then it’s definitely worth giving it a shot,eh? I don’t actually find caffeine to be much of a stimulant: it doesn’t stop me sleeping if I have it after dinner and, although I drink proper coffee every morning, I don’t miss it when I don’t have it. Cutting it out of my life shouldn’t really be all that much of a wrench. I’ll give it a go, anyway. The nurse mentioned that probiotics might help too, so I’ve added them into my morning pill routine along with the fish oil, vitamin D, vitamin B complex, glucosamine sulphate and the magnesium & calcium that I take every day too. Why the hell not? Many more and I’ll be able to stop eating breakfast.

You guys are cool with this level of sharing, right? I’m pretty much set on full-disclosure when it comes to my MS, so...... I guess it's too bad if this is TMI.

**UPDATE**  There's a great fact sheet on Bladder issues and MS available from the ever-brilliant MS Trust.  Access it here.  I'm off to download a bladder diary app for my phone.  Oh, the glamour!