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Increase in frequency?

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    Increase in frequency?

    Hi all!
    I am having what I believe is an increase in urinary frequency that has been creeping up for several months. I do not drink a lot of fluids and still need to go about 15x in an average day (2ce at night). I have had one episode recently where I lost control and had a bit of an accident.

    I had a scheduled checkup with my neuro this week and mentioned it. He did a UA to rule out a UTI (which I did not have) and then had his nurse call me to say he was calling in a prescription for Detrol LA. I have multiple brain lesions and 2 C-spine ones and have been on Aubagio for about a year.

    My question is this: Can my doc be sure the frequency issue is from MS? Does it indicate progression? Is it just one of those things that comes with the territory? My doc seemed to act like this was no big deal, but I am kind of freaking out about what this could mean. Also wondering if 15x/day is really that much? I would love advice from anyone who has dealt with this sort of thing! Thank so much!
    JilliO

    #2
    Originally posted by JilliO View Post
    Hi all!
    I am having what I believe is an increase in urinary frequency that has been creeping up for several months. I do not drink a lot of fluids and still need to go about 15x in an average day (2ce at night). I have had one episode recently where I lost control and had a bit of an accident.

    I had a scheduled checkup with my neuro this week and mentioned it. He did a UA to rule out a UTI (which I did not have) and then had his nurse call me to say he was calling in a prescription for Detrol LA. I have multiple brain lesions and 2 C-spine ones and have been on Aubagio for about a year.

    My question is this: Can my doc be sure the frequency issue is from MS? Does it indicate progression? Is it just one of those things that comes with the territory? My doc seemed to act like this was no big deal, but I am kind of freaking out about what this could mean. Also wondering if 15x/day is really that much? I would love advice from anyone who has dealt with this sort of thing! Thank so much!
    Hi jilliO

    Bladder dysfunction occurs in 80% of persons with MS, so your doc is probably going by that statistic in thinking that the problem is due to MS.

    Bladder frequency was one of my earliest symptoms. My bladder doesn't even have to be full before I get the nerve impulse/urge to go (failure to store).

    Sometimes dysfunction is due to incomplete emptying, whereby the bladder isn't fully emptied out, causing more trips to the bathroom (failure to empty).

    See if this article from the National MS Society helps to understand:
    http://www.nationalmssociety.org/Sym...er-Dysfunction

    Good luck with the Detrol, it might work well for you.
    PPMS for 22 years (dx 1998)
    ~ Worrying will not take away tomorrow's troubles ~ But it will take away today's peace. ~

    Comment


      #3
      Originally posted by JilliO View Post
      My doc seemed to act like this was no big deal, but I am kind of freaking out about what this could mean.
      What do you think it means that's got you so freaked out?

      Originally posted by JilliO View Post
      Also wondering if 15x/day is really that much?
      Since you said that you don't drink a lot of fluids, then yes, 15 times a day is a lot. Generally, people pee 6 to 8 times in a 24-hour day.

      Originally posted by JilliO View Post
      Can my doc be sure the frequency issue is from MS?
      The most suspicious cause would be a UTI, and your neuro tested you for a UTI and ruled it out.

      Next, bladder frequency is common in MS, so that's the next logical thing on the list.

      Next, the older people get, the more common urinary frequency becomes. That explains why there are so many medications available to treat it. Those meds aren't just for people with MS -- most of the people with urinary frequency don't even have MS. So many people have urinary frequency that the condition now has, for marketing purposes, been given its own catchy abbreviation: OAB.

      The degree of suspicion for that depends on how old you are. But no matter, the treatment is the same. My frequency is part age, part MS.

      Another possible cause of frequent urination is high blood sugar, or diabetes. But urinary frequency due to diabetes is usually accompanied by extreme thirst and frequent drinking of fluids. Since you said that you don't drink a lot of liquids and didn't mention extreme thirst, that falls to the bottom of the suspicion list.

      Next, it depends on how big your bladder is. If you're beginning to retain urine and not empty maximally, the capacity of your bladder can become functionally smaller, making it necessary for you to urinate more often.

      For your peace of mind you might want to ask your PCP or neuro for a blood glucose test and a referral to a urologist.

      Originally posted by JilliO View Post
      Does it indicate progression?
      Maybe, maybe not. It might be just the "usual" amount of MS activity just showing up in a new place. But on the other hand, more activity showing up in new symptoms can be considered progression from how things used to be. So yeah, it's not staying the same or getting better.

      But the new symptoms can be treated. And the first line if treatment is the same as for everybody else with an overactive bladder. So try the Detrol -- you might like it. Especially at night.

      Comment


        #4
        Thanks, KoKo & JReagan - I appreciate the insight. I guess what has me worried is that this frequency is the start of incontinence. I know that is probably not always the case, but I find that I am always worrying about what this stupid disease is going to do in 5, 10, 20 years from now. I am 42 and have had 2 kids - so urinary frequency would not be something I'd think would be natural for me at this age, but then again maybe it is?
        I am wondering if getting the urodynamics testing again would yield any helpful information? I don't love the idea of doing it, but would like to know if this issue is related to my MS. I guess I'll try to ask my doctor about it this week before I start the Detrol.
        JilliO

        Comment


          #5
          Yeah this started for me about 5 years ago. I was 35 at the time so age was not much of a factor. It freaked me out pretty badly. I think a lot of the older folks on here tend to not worry about these kind of things because they are normal for aging as well, but when it happens when you are younger it does kind of mess you up.

          During the peak (it got better but like everything else not all the way) I was thinking am I going to be stuck wearing adult diapers at 35? Yeah sorry jreagan incontinence issues when you are young are fair game for freak outs.
          Rise up this mornin, Smiled with the risin sun, Three little birds Pitch by my doorstep Singin sweet songs Of melodies pure and true, Sayin, (this is my message to you-ou-ou

          Comment


            #6
            Originally posted by TaoWarrior View Post
            Yeah sorry jreagan incontinence issues when you are young are fair game for freak outs.
            In the first post, JilliO hadn't said that fear of incontinence was the cause of the freak out, and there's no way to assume that.

            I had to ask because JilliO could have been thinking it was cancer and she would be dead by Christmas. Keeping things in perspective, that's a very different kind of freak out requiring a very different kind of answer.

            Comment


              #7
              I'm just newly diagnosed and have also had slight bladder issues. Not with leakage, but with feeling like I could go when urine gets deposited, even though I know it's really not time to go yet ("neurogenic bladder" I think it's called, where the nerve to the detrusor muscle gets damaged and contracts inappropriately when urine gets deposited).

              At any rate, for me it's mostly an annoyance where my body keeps reminding me "hey, some urine just got dumped in your bladder, you could go pee right now if you want" when I really don't want go to at all and don't really need to either. But it makes you wonder - wow, is there really enough pee in there that I should go now? I don't want to make a mess. When it first started I'd try to just ignore it, because I don't want to train my body to expect to pee all the time. But when you keep feeling the impulse, it's annoying.

              I found some clinical research showing that pumpkin seed oil (and some Chinese and Japanese herbal extracts that I never tried) helps calm the detrusor muscle contractions and generally helps with "gotta go" feelings.

              So I've started taking pumpkin seed oil extract (preferably water-soluble) and it really helps. I started off taking 2x/day, now I take one in the morning. Night time was never an issue for me, but you could take it twice a day if necessary. See how you do with it and let me know.

              Comment


                #8
                Originally posted by kw202 View Post
                ...

                I found some clinical research showing that pumpkin seed oil (and some Chinese and Japanese herbal extracts that I never tried) helps calm the detrusor muscle contractions and generally helps with "gotta go" feelings.

                So I've started taking pumpkin seed oil extract (preferably water-soluble) and it really helps. I started off taking 2x/day, now I take one in the morning. Night time was never an issue for me, but you could take it twice a day if necessary. See how you do with it and let me know.
                Yes; the article that KoKo posted offered some lifestyle change suggestions, but did not suggest supplements.

                I also read that pumpkin seed oil helps, but when I tried it, it didn't help me.

                What works for me is:
                2 Calcium/Magnesium supplements
                2 Uva Ursa supplements

                I take them every night before bed. Instead of getting up once every two hours to pee, I sleep 4 hours, and sometimes, 5 or 6 hours, before I need to use the bathroom at night. This, after many years of my once-every-2-hour trips to the bathroom. ((Is sleeping through most of the night what heaven is like? Wow; I love it!))

                I also find that I have to avoid caffeine after 3:00 pm. Caffeine in the late afternoon or evening also makes for urinary fq for me at night, even if I take the supplements.

                A med that works, too, is Oxybutynin. I found that the 5mg rx that I was initially rx-ed was not enough. I needed three or four 5mg pills throughout the day for them to be effective. I used them prior to finding the supplements; I find the supplements to be more effective than the meds, so I've discontinued the meds.
                ~ Faith
                MSWorld Volunteer -- Moderator since JUN2012
                (now a Mimibug)

                Symptoms began in JAN02
                - Dx with RRMS in OCT03, following 21 months of limbo, ruling out lots of other dx, and some "probable stroke" and "probable CNS" dx for awhile.
                - In 2008, I was back in limbo briefly, then re-dx w/ MS: JUL08
                .

                - Betaseron NOV03-AUG08; Copaxone20 SEPT08-APR15; Copaxone40 APR15-present
                - Began receiving SSDI / LTD NOV08. Not employed. I volunteer in my church and community.

                Comment


                  #9
                  Increase in Frequency

                  Originally posted by KoKo View Post
                  Hi jilliO

                  Bladder dysfunction occurs in 80% of persons with MS, so your doc is probably going by that statistic in thinking that the problem is due to MS.

                  Bladder frequency was one of my earliest symptoms. My bladder doesn't even have to be full before I get the nerve impulse/urge to go (failure to store).

                  Sometimes dysfunction is due to incomplete emptying, whereby the bladder isn't fully emptied out, causing more trips to the bathroom (failure to empty).

                  See if this article from the National MS Society helps to understand:
                  http://www.nationalmssociety.org/Sym...er-Dysfunction

                  Good luck with the Detrol, it might work well for you.

                  I had that same problem with my bladder not emptying all the way. I have to use catheters now, which I am still not used to doing.

                  Comment

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