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[gomer]

UpDate.......

Last week the voiding issue got worse. I was able to at least see a NP at the practice my former private urologist was at.

As soon as they checked my PVR, my day was carved in stone. I was instructed on the spot how to self-cath (no fun) and that alone was a bit traumatic. Half way through draining my bladder I got light headed and woosey. I barely was able to finish and remove the cath. I was scared for a few moments and they almost panicked.

They called 911, so here I am pants down, everything hanging out in the wind w/docs nurses and 911 standing there, but got covered quickly. I refused to go to ER. They thought I might be having a diabetic hypo, but I tested at 101 (perfect) but fed me some punch and chocolate pieces just in case, probably a drop in BP response to the bladder emptying. They made me at least get some lunch before going further.

They sent me home with an appointment for bladder testing (next week) and supplies to at least self-cath for now. They said self-cathing would may be temporary, at least till the bladder testing, & that if it was going to be a long term thing they would Rx catheters. The next day I got a call from a never heard of cath supplier about the Rx the urologist called in. I asked the supplier if I could get a smaller cath, so they called the urology practice and they OK'd the change. I am GLAD I did, those Fr 14s were not much fun, the 12s delivered today are easier than the 14s for me, and least less uncomfortable.

They gave me a printout of their testing and I will give my VA MS neuro a copy, so he knows what is going on, plus I have some related MS/bladder questions for him next week. Actually I should know more by then, the bladder testing is scheduled the day before I see my MS doc.

Gomer Sir Falls-a-lot

[Ga dancer]

Hi Gomer,

Have you had your tests yet?

I am worried about your last post and need another update.

[gomer]

Hi GA........

I had my testing done yesterday w/o any side effects/problems. My prostate is enlarged some but not a lot. Regardless I do have a couple stricture points and scheduled for surgery mid Oct. I asked the doc/urologist if the surgery will eliminate the need to self-cath. He did not think it would, just help me pee better.

I had to come in with a full bladder (test orders) and thought I pee'd flood (a little better than my average), over 200cc, and they cathed me and got over 300cc additional (PVR) or triple again the NIH max std.

As for what happened last time. MY fam doc said it was most likely a auto-reaction to the sudden deflating of my bladder & having MS increases the chances of it happening Micturition syncope. This time they emptied my bladder slower. I have a few Qs for my MS neuro tomorrow, if I remember to ask them. The strictures (& bladder spasms) are also making it a little harder for me to self-cath sometimes.

Gomer Sir Falls-a-lot

[Ga dancer]

I wish they had something easier for retention than having to self-cath.

Do they believe the retention caused the chronic kidney failure problems? I am in that group of people with rising Creatinine above 1.7 to 2 and falling Glomerular Filtration Rate lower than 40. I was reading that when you have to try to force bladder emptying by pressing down that the urine can go up instead of out causing kidney problems.

I am now wondering if this maneuver has caused my kidney failure because I have a lot of trouble with expelling urine. The retention has not been checked for years but was not too bad when checked; however, my MS has advanced in so many ways since then.

[gomer]

You just made a very interesting point GA.......

Never thought about just the act forcing urine out causing it to back up into the kidneys causing damage. I have routinely forced urine out for some time, never gave it a thought. I have heard about retention causing increased pressure causing urine to back up into kidneys and damage.

My blood pressure and diabetes have both been in good overall control especially in recent years. The retention/forcing could be another, maybe an even more important factor in my k-bean decline.

"The retention has not been checked for years but was not too bad when checked" That can be part of the problem. Since I started having to self-cath I get anywhere from 80ml to 280ml (aprox). When I was able to get in to at least see a NP after the problem night, my PVR was 305 and under controlled conditions in last Tuesdays test it was even a little higher.

One problem can be is "when" its checked. It could vary a whole lot and harder to catch. For all I know I could have been having retention problems for years (never checked) and not know about it, causing damage over a period of time. My latest eGFRs have ranged between 35 - 41.

Thanks GA.........

Gomer Sir Falls-a-lot