Bladder Dysfunction and MS: Always Test for Infection Before Using Steroids
Living with multiple sclerosis for more than 9 years now, I’ve come to be able to ‘read’ my disease fairly well. I can predict when symptoms may act up, such as during the summer heat and humidity, and I usually know when I should call the doctor. Earlier this spring, however, I completely misread my symptoms.
At first, I started experiencing urinary urgency and extra fatigue. My schedule had been very busy so I wasn’t surprised that I was feeling a little rundown. Over the years, bladder dysfunction has been one of my more mild MS symptoms, so I thought that I maybe I was on the verge of a relapse. But I didn’t want to call the neuro’s office because my schedule was just too busy to think about MS. That, and perhaps I was in a bit of denial.
Then I had a day or two of extraordinary pain upon urination with some visible blood in the bowl. Last year, I had experienced similar symptoms but twice tested negative for an urinary tract infection (UTI). My nurse suspected the cause of my symptoms could have been either kidney stones or interstitial cystitis. An x-ray of my kidneys didn’t show any obvious stones and since my symptoms did not return last year, I didn’t think much more about them.
This time my symptoms improved quickly - great! - and the pain stayed away. However, the severe urgency and occasional incontinence came back which made me think about a possible relapse again. I was traveling and didn’t really have time to mess with a relapse (who does?), so I pulled out my ‘emergency’ supply of oral steroids and gave the pills a go. Happily, my symptoms started to go away once again.
I basically just wanted to tell MS that it should check with my schedule before deciding to cause any problems. I refused to let it keep me from doing what I wanted to do. I was in control, so I thought.
After completing the short round of oral steroids, symptoms began to return - ugh. So a couple of weeks after I had started peeing my pants, I finally call my primary care doctor to be tested for a urinary tract infection. Yes, I know, I know, I should have started with testing for possible UTI. My doctor prescribed an antibiotic as we waited for the cultures to come back. Unlike previous trips to urgent in the prior year, I tested positive for infection.
I began to feel much better within days of starting antibiotics. But the infection must have been a bit stubborn because it took two rounds of antibiotics to completely get rid of it. Fortunately, I have felt pretty good since my infection has cleared up and multiple sclerosis hasn’t slowed me down.
No matter how much I research MS, write about MS, and talk about MS as well as other health issues, I can still mis-read my own body signals and fail to go with the obvious. I am not a medical expert, but a fellow patient learning to live with this disease as best I can.
I’m not sure how many times a community member has come online to ask advice about a possible relapse. I usually tell them about pseudoexacerbations that can be caused by heat sensitivity or infection. And, I always suggest that they call their neurologist. I should listen to my own advice.
In my own case, I had initially considered UTI, but disregarded the possibility because the symptoms were not constant. I didn’t have a fever and didn’t ‘feel sick.’ I failed to refresh my memory and look up the common symptoms of a bladder infection which include:
• Cloudy or bloody urine, which may have a foul or strong odor.
• Low fever in some people.
• Pain or burning with urination.
• Pressure or cramping in the lower abdomen or back.
• Strong need to urinate often, even right after the bladder has been emptied.
My urine did not have any odor and I didn’t have a fever. The pain with urination was temporary and I didn’t have any cramping. My primary symptom, the strong urge to urinate, could easily be confused for MS-related bladder dysfunction.
So what have I learned from this experience? Don’t make assumptions about bladder symptoms. Always get tested, especially when it’s as simple as peeing in a cup.
Be well and I hope you are having a great summer!!