My bladder is doing much better these days, but why?
Investigating a few possible reasons for my improved symptoms
I slept through the night last night. Recently, I’ve managed to do that on most nights. No 4 a.m. bathroom trips for me!
That’s a big deal. There was a time when I’d get up two or even three times during the night for a bladder run. Sleeping seven or eight hours straight is huge.
I’ve been troubled by bladder frequency and urgency for many years during the four decades I’ve had multiple sclerosis (MS). But in the past few years, things have been improving, and they’re now better than they’ve been in ages. Going out for dinner isn’t as much of a worry as it used to be. An eight-hour trip in the car is possible with only one or two stops.
I’ve made a few changes, medically and personally, and I think each has played a part in my improved bladder control.
Bladder medication
After decades of using Ditropan (oxybutynin) for my urinary problems, with limited success, I switched to Myrbetriq (mirabegron) a little over two years ago. In people with MS, the detrusor muscle, which surrounds the bladder, can spasm and act like the bladder is full when it isn’t. Myrbetriq relaxes that muscle and allows the bladder to fill more completely, lessening the urge to urinate quickly or frequently.
It’s expensive, but my neurologist helped me find it at a reasonable price. I think it’s helped.
Food, drink, exercise, and location
I’m also drinking more water and avoiding caffeine.
More water is helpful because urine becomes concentrated if you don’t drink enough. That can irritate the bladder, making it do exactly what you don’t want it to do: spasm. Upping your water intake also helps flush out bacteria, reducing the possibility of urinary tract infections. Staying hydrated seems to have improved my overall energy as well.
I’ve switched to decaffeinated coffee because, despite at least one study claiming that caffeine may be beneficial for people with MS, eliminating it from my diet seems to have helped my bladder problems. It also seems to have worked for former MS News Today columnist Jessie Ace, who says she felt better when she dropped caffeine.
My dinners are healthier. A couple months ago, my wife and I started eating precooked meals from Factor four times a week. I think this has improved our overall health, including my bladder.
Cold weather always brings me bladder problems, and I’m now back in the warm Florida sunshine. Warm weather also encourages me to exercise more. Keeping my pelvic muscles in shape, I think, helps keep my bladder under control.
It’s personal, not scientific
These are just observations, not research, and my experience may not apply to everyone. Like most MS treatments, however, when they work I don’t wonder why — I’m just thankful that they do.
Do you have any hints for bladder problems? Let us know in the comments below. You’re also invited to visit my personal blog at www.themswire.com.
Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Multiple Sclerosis News Today or its parent company, Bionews, and are intended to spark discussion about issues pertaining to multiple sclerosis.
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Comments
Jan
I liked Myrbetriq until it raised my BP and my dr said, no.
Ed Tobias
Hi Jan,
I'm sorry about that. I hope you can find something else that will work.
Ed
Alison Cassel
I also have been working on improving my bladder, going from 4/5 large pads a day to the last fortnight being 1 pad each day with many being wet or damp but not full.
what I have been doing over the past 6 months to try to regain control have been:
Admitting I need help.
Seeing a Physio pelvic floor specialist. This has been the changer for me. They teach you deferring techniques. These are definitely not easy, and come with many an accident but in the end the harder you work at it you will end up seeing the results.
Under her guidance I am now using a tens machine. She is also looking at my hips which obviously due to the MS my left side is affected and I have been given exercises to strengthen them which I can feel the improvement when I walk.
I follow the OMS lifestyle so did not have to change my eating as such but did increase my fluids.
Alison
Ed Tobias
Hi Alison,
It sounds like you're definitely on the right track. I'd not heard of using a TENS for this purpose, only for pain, so I'm glad you passed along that tip. Pelvic floor work also seems to be a great help, if you can keep it up. Obviously, you have.
Good luck,
Ed
Meg Cortright Cadogan
I used to have urgency most of the time despite regular Detrol use. It is surprisingly better now for one main reason, I think. Pelvic floor therapist! She taught me the exercises and I’ve kept up with them which is the key, I still drink coffee, but I quit drinking alcohol which is also a big help. My main problem comes from getting overheated during exercise (cycling for me).but I’ve learned to time my fluid/coffee intake. It’s not perfect but it’s been a big enough change that my hubby notices!
Ed Tobias
Thanks for sharing, Meg. I've done a bit of the pelvic floor exercising when I've had PT. You're right, it's not an easy exercise and it's hard to keep doing it. I'm glad you are and that it's all making a difference. (We hubbies don't notice much, so that's a good sign.)
Ed
Jen
Ed, I had some success with Mirabegron too, but it was only when I also started on Vesicare that I started feeling normal again, bladder-wise. Apparently they work on two different problems -- urgency and control. So the combination is good. And now there is a generic Vesicare -- Solicare -- it's a lot more affordable. Neither is on our Australian Pharmaceutical Benefits Scheme so I'm paying about $85 a month in total, but for the confidence it's worth every cent. And paradoxically, I sleep better if I have a (small) glass of water before bed. I agree, it's to do with dilution.
Ed Tobias
Hi Jen,
I may give solicare a shot. It was never suggested for me. You're right about cost...confidence is priceless.
Ed
Allison Morgan
I was fortunate to be referred to a urologist about 9 years ago who prescribed Myrbetriq for my spastic bladder. It is still working for me, thankfully. It was expensive but not outrageously so. Now that I’m considered a senior citizen (65+), the Province of Ontario, Canada, has a program whereby all I have to pay is the dispensing fee. Nice.
Ed Tobias
Hi Allison -
I wish that Medicare would pick up of of the cost of my meds. It does for some but naturally, not for the ones that seem to work the best. I'm glad that Myrbetriq (which I can never remember how to spell) continues to do the job for you.
Ed
Allison Morgan
I think I’ll look into the Solicare too.
Michelle
I take myrbetriq, very thankful but it only helps some. So I found pumpkin seed extract helps some also. Staying hydrated and avoiding caffeine helps some.
I’ll take what I can get and hope for dry undies. ;-)
Ed Tobias
Hi Michelle,
Interesting suggestion. I wonder if eating pumpkin pie, which I love, would also help. We all want to keep our undies dry. :-).
Ed
Rebecca Jackson Edwins
I just learned recently from MS specialist , Dr. Gretchen Hawley PT,DPT, MSCS, to SIP your water ,(or beverage) at night instead of gulping or big swallows! I have been sleeping 7-8 hours at night! That is HUGE!!!
Ed Tobias
Wow, Rebecca. I never heard that suggested. I'll give it a try.
Ed
Carolyn Meehan
Tried Mirbetriq. Seemed to help some. However I also have constipation and Mirbetriq added to the problem. Since the gastroenterologist said I eat plenty of fiber already and I take generic Miralax I stopped Mirbetriq. I also take lactulose and eat two prunes every day as well as ducusate sodium. Don’t drink alcohol and limited coffee. Maybe Vesicare if no constipation possibilities.
Ed Tobias
Hi Carolyn,
I'm sorry about your combined problems. I suspect the constipation may be putting pressure on your bladder, making that problem worse. I hope you can solve them both.
Ed
KATHY
Hi Ed! I love your articles. I tried vesicare (might have a dementia link) but it wasn't very helpful. I found an awesome urogynecologist. She prescribed therapy, which was not very helpful, and then Myrbetriq.. Myrbetriq was somewhat successful. However, I had read about botox and had her test me to see if my medical problem qualified an it did. I had the low dose botox injections in her office, in June, and it worked well. It abates the spasms for a period of time before wearing off. Studies have shown it to be effective for 6 to 12 months. I have scheduled another procedure this upcoming January.
I have also found improvement by stopping caffeinated coffee (so sad). I now drink decaf
Ed Tobias
Hi Kathy,
I'm glad you like what write and also that botox has been successful for you. I've thought about it but, so far, I'm happy with my Myrbetriq + exercise + drinking water results. I do miss the caffeinated coffee, but I've found some pretty good decaf Keurig pods.
Happy Thanksgiving,
Ed