Am I an idiot?

Anyone who suffers from TMI (too much information) can stop here....

I got to see the urogynecologist today - and yes, she was happy to see me in both of her capacities.  It turns out she has new help at the front desk and both women are struggling to learn their job.... it was perfectly fine to see her as my urologist.

Now for the idiot part - I have a raging UTI and didn't even know it.  The nurse said it was so bad she barely had to wave the dip stick over it to get it to turn pink - ok, she was kidding but she said it was a really bad one.  

So why didn't I know this was going on in my body?  I just thought it was unreasonable that I know where every public bathroom is in every building I visit in this town. I did count my trips to the loo yesterday, and hit 15 by the time I went to bed.  I knew that was excessive and there was a problem, but I had no idea I have a UTI.  No fever, discomfort, aches, anything ..... not a clue. I haven't had a UTI in probably 45 years.  

Her ultrasound showed that my bladder also did not empty.  That doesn't surprise me because that is what I was feeling with having to go so frequently.  She isn't sure if that is due to the infection or a byproduct of MS.  

I am on a week's worth of antibiotics and return next week to be rechecked.  We did talk about the possible need to self-catherize  if this is MS connected because my low blood pressure stops me from taking any of the bladder drugs.  We'll revisit that  if my problem doesn't correct itself.  

So my fun continues.....
Lulu

[Deb61]

I have no idea why you didn't know you had an infection--maybe it's due to lack of feeling in the bladder?  I have no idea.  I do know when I get one and I'm miserable.  

I've heard that bladder infections in MS are very common. I had several this last year.  I don't think my bladder empties fully, either and I'm sure this has to do with the MS.  

Be on the lookout for these, because developing a temperature is to be avoided.

Get well,
Deb

[jensequitur]

I've heard that having a bladder infection without knowing it is actually pretty common!  I think MS symptoms often mask the pain from a bladder infection.  I've only ever had one, and the only way I knew was that my urine smelled like sulfur!  

My honey caught me smelling around the other day, and I had to explain... just a little embarrassing!  My bladder problems are intermittent - usually just a problem with control, rather than not emptying fully.  Usually.

[ShadowsSister]

Hi there, just read your post, it sounds like it might be both.. due to the bladder not emptying and the infection. I am happy your Doctor is going to stay on top of it.  You didn't say if she said anything about spasms in the bladder these usually also are connected to rectum spasms... The main thing is to make sure she stays on top of things,
It can be so hard to try and keep tract of everything going on with our bodies, which is why a log of some kind does come in handy.
Hang in there, don't get discourage this can clear up....

[Momzilla]

I'm with everyone else...I think it's entirely possible to have an infection without knowing.  You know, I don't think I have ever in my life had one.  Kidney -- yes.  Bladder -- no.  I suppose this would fall under that TMI category, too, sorry!

There's also the theory that the loss or decrease in sensation may play a role in your not knowing.  TMI alert:  I have been experiencing this, too.  During my last bad episode in the hospital, I wasn't allowed to get up to use the restroom, and had to finagle a bedpan.  I truly could not tell if I was "done" or had even started, to put it delicately.  So, there's that.

I hope your doc will shine in her new capacity and sort out which symptoms belong where.  And that you feel better.

Take care and feel well!

Zilla*

[syndismilez]

Hi :)
I have had numerous UTI's, most of them I did not know about. They were all due to retention. I found out after almost 3 years of constant UTI's.   I now self Cath and do not get them anymore!  Yeah!!!  I have pelvic numbness that probably kept me from feeling the UTI's. (I dont even feel it when i cath.)  I ended up learning the smell of them!  Ewww! And my skin would break out.
I am not Dx'd but am probable MS.  Retention needs to be addressed. It can cause serious kidney damage and bladder damage!  I am glad your Dr. is on top of it. My primary care doc wasn't and I had to ask for a specialist!  
But Definately you are not an idiot for not knowing!!!  :)
Cyn    

[Lulu54]

Thanks for answering me.  It was just in my head that somehow I should have known something was going on.... :-)

My urogynecologist is wonderful - she has been my gyno for about 15 years... very compassionate, patient, and has all the time in the world during checkups to just talk.  I am so glad she can help me with this and whatever happens next.

My best,
Lulu

[essdipity]

Wow, I'm amazed that one can have a UTI and not know it. I've never heard of that before, but I know the MS forum ladies can't be wrong. ;)

Next week I have an appt. with a urogyn myself. This is at my neuro's insistence. I told him I've been having problems with hesitation, and then stopping and starting. "Problem" is too strong a word, though, because it's really just an annoyance.

My neuo said that I'm retaining, but I don't think he could possibly know that for sure. He also said it can back up into the kidneys and damage them, and that got my attention for sure, so I'm having things checked out.

I'm betting that I'll be told things are completely fine. Got a pint of Ben and Jerry's that says so. Any takers??

Have a good one!

ess

[LATW]

I've had them with out knowing it.  Last one I had was last year. I was not feeling well but didn't know why.  I noticed my urine didn't look normal so went to the doctor. It was a bladder infection.

You can have them without knowing it.  Did you know children can have ear infections and you;d never know?  That has happened here several times and it makes me feel like an awful mother!

LA

[Quixotic1]

Of course you're an idiot.  Oh...., you were wondering about not knowing you had a UTI??  It is totally common to miss the signs of a UTI, the pain, the pressure.  Often the only signs may be an odd odor, increased frequency or even an entire relapse.  An unrecognized UTI is one of the most common causes of relapse, increased spasticity or even mild increase in symptoms that might not rise to the level of relapse or as LA mentions, you just might not feel well.

Retention is the most common cause of recurrent UTIs because the urine is a wonderful culture medium for bacteria.  The longer it stay in the bladder, the longer the bugs have to replicate and cause the UTI.  The closeness of the urethra to the vagina and rectum in women is a setup for UTIs as we women all know.  Who do we speak to about that, anyway?!

Hesitation can be from persistent spasm of the external sphincter which is siupposed to relax, but doesn't or from intermittent relaxation of the detrusor muscle which is supposed to contract and push until the bladder is empty - or both.

The ultrasound that showed that you had residual urine in the bladder shows you have urinary retention.  The bladder retains urine that should have been expelled.  This is either from inadequate strength of the "detrusor" muscle (the muscular wall of the bladder that contracts to push out the urine, or from spasm at the wrong time of the sphinctor muscle that holds urine in and relaxes to let it out or a combination of both.  The combination of bladder wall weakness and spasm of the sphinctor is called Detrusor Sphincter Dyssynergia.

Urination depends on a whole sequence of neurologic actions that must happen in a smooth coordinated sequence.  Some of these are under conscious control and others happen automatically.  It is the topic for a complete Health Page I am writing.

In MS, bladder and bowel problems occur in more than 50%.  And it is one of the most common reasons for people (men and women) to avoid social contact.  Decreased sensation is one of the problems in not knowing you have a UTI.  That familiar and excruciating painful reminder may be gone.

A lot of people with MS self cath.  Once they learn how, it becomes very simple and quick and really can cut down on UTIs and accidents.  It sounds horrible, but it can become just another part of life.  We have several people here that do it.

As far the danger of urine backing up and damaging or destroying the kidneys, this is real.  It is happens more commonly in men, but it is a risk for women also.  It is the main cause of renal failure in people with spinal cord injury.

Urinary health is a major concern for all of us.   Never, EVER ignore urinary symptoms, whether you have a diagnosis or not.  My MS clinic is associated with a Continence Clinic run by two incredible women - both urogynecologists.  This means they are double-boarded in both Urology and Gynecology.  Kathy and I both go there and love the doctor that we see!

Quix

[Lulu54]

Thanks for helping with this discussion.  I AM SO IGNORANT on so many things MS ... do they publish an MS FOR DUMMIES book?  They should if they don't because this darn disease is so complicated.  The nuances of every little thing my body does is quite the difficult puzzle to solve.  But I am working on learning.

Quix, I hope you take all that you have written here and include it in the HP because it is clearly intended for us idiots! :-)

I am happy to report the frequency today has slowed down a bit - I think perhaps the antibiotics kicked in pretty quick.  However, the incomplete emptying feeling is still there.  If it ends up thaat I have to self-cath then so be it... that's better than losing my kidneys.  

My cardio, neuro and pcp all have complaints from me about the frequency problem.  It took the urogyno to actually test my urine.  We talked about the lack of recognition from the other doctors to think about it and she told me she was once told "a hammer only looks for a nail."  

From now on if I have to go every hour I will be going to the urogyno's office!!!

This continues to be quite the ride.....
Lulu

[doublevision1]

There is in fact an MS for Dummies book.  Being somewhat of a dummy myself, it was one of the first ones I read.  It has a ton of good information in it.  I got it on Amazon . ca

[Lulu54]

ohhhh, I should have checked Amazon.... I will be putting that on my must read list.  Maybe I'll get lots of copies and give them as gifts.... Thanks.