With so many treatment strategies available, there’s a solution for almost everyone
by Aviva Patz
You may think hitting the bathroom three times during the night, leaking a few drops here or there or feeling unable to go are things you just have to cover up and live with as best you can; if so, think again. Bladder problems affect 75 to 90 percent of people with multiple sclerosis, according to a July 2014 in-depth report in MS in Focus, published by the Multiple Sclerosis International Foundation (MSIF). “Patients need to understand that bladder issues are a symptom of their disease process and not something they should be embarrassed or ashamed about,” says Dr. Marlene Murphy Setzko, a urologist and director of Urologic Services at the Mandell Center for Comprehensive MS Care in Hartford, Connecticut.
That said, it’s understandable that these symptoms are extremely distressing. “One of the first things we learn as infants is how to control our bladder, so losing that ability can dash our self-esteem,” says psychologist Rosalind Kalb, PhD, vice president of Clinical Care at the National MS Society. “It’s hard to present yourself to the world when you’re worried you’re going to wet your pants.”
Perhaps even worse, bladder problems can be debilitating, potentially leading to depression, social isolation, poorer performance at work, skin breakdown, infections and a greater likelihood of needing to move to an extended care facility.
In spite of the discomfort and disability this issue can cause, many people hesitate to seek help. They shouldn’t.
“Seeing and reading all the ads for bladder issues made me think that it was normal,” says Claire P., of Annapolis, Maryland, who was diagnosed with MS in 2001. In fact, while it’s not “normal,” it is common.
In MSIF’s July 2014 survey of more than 3,500 people living with MS in 73 countries, more than a third of those who hadn’t been tested for urinary problems also had not brought up the topic with their neurologist. A quarter said they preferred to manage the symptoms on their own, and another quarter who had not been treated said their neurologist thought testing was unnecessary.
Clearly, bladder issues in MS are under-recognized, underdiagnosed and undertreated. “Patients are often shocked to learn that urologists with an interest in MS actually exist, and that essentially, there is a solution to every bladder problem—and that solution doesn’t have to include adult diapers!” Dr. Murphy says.
Read on to learn what bladder difficulties in MS look like and why they happen, plus the newest treatments and real-life coping mechanisms.
“Taking the steps that will help you get this essential bodily function under control is critically important,” Dr. Kalb adds. “Talking with your doctor or nurse is the first step to finding the right solutions.”
The what and why of symptoms
The bladder has two main functions—to store or hold urine, and to empty effectively. But in people with MS, this often doesn’t go as planned. Why? Chalk it up to miscommunication. We know that in MS, myelin—the fatty substance that surrounds and protects nerve fibers—is damaged. When myelin is compromised, signals traveling along nerve fibers to and from the brain and spinal cord get garbled. “It’s like the game ‘telephone,’ ” Dr. Murphy says. “By the time the word gets to your bladder, it doesn’t know what the word is or what to do.”
The bladder has two main functions—to store or hold urine, and to empty effectively. But in people with MS, this often doesn’t go as planned. Why? Chalk it up to miscommunication. We know that in MS, myelin—the fatty substance that surrounds and protects nerve fibers—is damaged. When myelin is compromised, signals traveling along nerve fibers to and from the brain and spinal cord get garbled. “It’s like the game ‘telephone,’ ” Dr. Murphy says. “By the time the word gets to your bladder, it doesn’t know what the word is or what to do.”
When it comes to storage problems, the most common symptoms, collectively called “overactive bladder” (OAB), include:
- Urgency and/or frequency—the sudden and intense urge to urinate. This may occur even if you just went 10 minutes ago. These symptoms can come from involuntary contractions of the bladder that your willpower is unable to override. They may be triggered by touching or hearing running water, or by passing a bathroom.
- Incontinence—not being able to control where and when you go. It may involve emptying the whole bladder. You may not feel the sensation of a full bladder (until it’s too late) because nerves governing storage lose sensitivity. Compounding the problem is worsening mobility, a common symptom in MS, which can make it challenging to get to the bathroom on time.
- Nocturia—related to urgency and frequency, this involves waking up at night to go.
“Symptoms of overactive bladder become increasingly common with the duration and progression of MS,” says Dr. Andrew M. Shapiro, chief of urology at the University of Maryland Rehabilitation and Orthopaedic Institute.
– See more at: http://momentummagazineonline.com/yes-can-regain-bladder-control/#sthash.BFHUX5lw.dpuf
~~~~~~~~~~~~~~~~~~~~
.
.
.
Visit our MS Learning Channel on YouTube: http://www.youtube.com/msviewsandnews