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Jun 26, 2010 - 0 comments

QUIX - Incontinence - sensitive topic
by addicted2harleys
, 56 minutes ago

Quix - In reference to the incontinence....first off I went back and read the Health Pages on sexuality and incontinence.  I am having some embarrassing issues and I thought maybe I could get some guidance from you.  And, no, I haven't really discussed the "whole" problem with my PCP.

My goes....

1.  I wet the bed twice.  Also I get the urge to go pee, it comes on out if nowhere very quickly and I cannot hold it, which makes me not get to toilet in time.

I did talk to PCP about this and he prescribed the Oxybutinin ER.  This seemed to do the trick.  But, it made me constipated, I think, so I now take stool softeners every night.  

2.  I can't seem to "push" when I have a bowel movement.  It is like that muscle is gone.  I have to wait until my body can release it on its own.  Does that make sense?  I do have a bowel movement most every morning.  Sometimes during the day time and the night time, I "leak" a little...most of the time I don't even know it happened.

I have not discussed this with my PCP.  Actually this is the first time I have mentioned it to anyone.

3.  Sexuality.  I have no sex life anymore.  But, I do know that for the last couple of years I have had problems with vaginal dryness, can't seem to achieve orgasm

Again, I have not discussed this with PCP or anyone else.

4.  New sensation.  Started yesterday afternoon.  A pressure-like very intense pain down in my vaginal/anus area.  This sensation put me in the fetal position and took me to the ER.  This pain is hard for me to explain.  I have never felt it before and I wasn't able to find relief for it myself.  It stayed at a level of 8, but would come in wave-like periods of level 10.  It seemed to provoke my "regular" nerve pain into action and made it increase.

Could all of these issues be tied together?  Can you explain to me what is possibly going on with me?  If so, can you guide me in the right direction to get help with this?

Wow.  I just looked at what they gave me in the ER.  Morphine in my IV.  I gram, it looks like.  I guess this is why my mom had to pull over twice on the way home so I could puke.  

And my neuro is pushing for me to have IV Ig.  Do you have an opinion on that?

Thanks for your help, Quix....and for anyone else who may help me understand this....

Addi - tired of the pain and the poking of needles


by Quixotic1
, 31 minutes ago
Hi, Addikins,

Boy, you and I are singing the same sad, sad song.  If you can't ask private questions here - then where?

For beginners, you need to understand the nerves and muscles that control the process of "normal" urination.  I wrote that up in a Health Page:

Whenever the pressure in the bladder is higher than the pressure of the external sphincter urine will come out.  MSers often have either rampant bladder spasms or weakened sphincters or sphincters that relax at the wrong time.  This can occur below the conscious level and result in urine coming out of nowhere.  So, we can wet the bed or any other time.  My accidents usually happen within seconds of an irge, but sometimes the leak happens before I am aware of the urge.

Yes, Oxybutinin, and ALL of the meds used for Overactive Bladder can have constipation associated with them.   That's what I am on at twice the usual dose.

2)  Loss of ability to push.  Yeah, what IS that??  That started happening to me a few years ago.  I would feel the urge, get to the BR, start having a BM and LOSE THE URGE COMPLETELY!!!  Bummer!!!  Yes, this is due to the loss of a nerve signal and the pushing muscles just flake out.  I hate this more than almost anything.  Or sometimes the urge is lost before anything happens.  Man, when I feel the urge, Katie (don't) bar the door!  I rush to the BR.  Now, "rushing" makes my spasticity kick in so my legs get super-stiff and I Frankenstein it to the bathroom.  Even my poor mom and her walker know the get out of the way.

All of the nerves involved with urination and defection are also involved with sexual function.  So, when they fizzle out often so does sexual satisfaction.  For the dryness though, get some estrogen cream.

Actually the urine should be coming out of the urethra.  This should be the case even in the dastardly disease of MS.   If we start losing urine out our elbows or from our big toes life is going to get very dicey.

That pain sounds horrible!  I'm glad they treated you with a powerful med, though I would hope it was 1 mg of morphine.  1 to 4 mg is the usual dose.  one gram would lead to a cadaver-like state that isn't pretty at all.  Also, heads up that morphine is a stronger constipating agent than the Oxy...  Take precautions now before you set up like cement and need one of Dr. BingBong's Little Rectum Rockets.  I have had pains like that, but they were quick and stabbing.  Thank goodness!

Yes, all of everything you described is very likely related - and most likely due to a lesion in the thoracic spinal cord.

You have GOT to discuss this with your doctor.  If you are too embarassed to say the words, print out your post and give him that.  There are more treatments than just the Oxy...  I will be writing about the full gamut of treatments soon.

My opinion, with the pain that severe, the IV is a minor nuisance.  Get the IV meds.

You need to see a urogynecologist!!!!!!!    !!!!!!!!!!



by addicted2harleys
, 7 minutes ago
To: Quixykins

Thank you so much, Quix!  I needed to hear that.  I will print this out and give it to my PCP on Wed.  I can wait until then, right?

I hate that you understand and experience what I have described.  But, I selfishly as glad to not be alone in it.

You described #2 completely and I loved your description!  Not funny yet extremely hilarious.

The pain was horrible!  And the ride to the ER was excruciating.  It was through the mountains and an hour ride.  It was hell.

Maybe it was 1 mg of morphine.  I thought for sure he said 1 gram tho??  I swear I am still out of it.  I feel extremely druggy.  I got the morphine at around 1 am this am.  I felt the hospital at 3:30 am.  It knocked me on my butt almost instantly when they gave it.  I felt a wave crawl up my body.  VERY strange feeling.  But, it took the pain and for that I am grateful.

So, you say yes to the IV Ig?

Addikins - lol, I like that