Less than 1 percent of the US population has Urinary Incontinence (UI). For those with MS, however, it affects over 80 percent of us. Why is there such a difference?
In MS, because the nervous system is affected, signals do not travel correctly to and from the brain and the nerves that control proper functioning of the bladder. Both women and men can be incontinent, but women are more likely, especially after childbirth. This is my story, but it is also the story of many MSers as well as a many others who are incontinent.
MS causes lifestyle changes, but when incontinence shows up as a symptom, as it did in me, it is all-encompassing, affecting every aspect of my life. Personally, socially, psychologically, physically, and sexually, too, everything has changed. But it can be managed and treated. There is life after incontinence, and there is hope. It can be done.
Embarrassment is such a big part of incontinence. No one wants to talk about it or admit it, even to their doctor. When first confronted with the reality of incontinence, only 1 out of 12 overcome their embarrassment enough to share or even seek medical help. It is often a symptom of something that may lead to serious medical problems. If it is not treated, it can lead to urinary or bladder infections, or even kidney damage.
Not only are people who are incontinent embarrassed - I know I was - but often even friends and family don’t understand. That’s too bad, but with a little more talk maybe they would.
As indicated in the comic strip below, a child or a weirdo may be curious about bathroom practices, but a wheeler with MS would probably know. All of my grandchildren I think, asked me one time or another how I go to the bathroom.
The whole subject is a minefield. Careful now. Let's tread that minefield. Let’s talk about what incontinence means, what can happen, and what we can do about it. This is life with MS.
What Incontinence Means
With urinary incontinence, you may urinate in those little bursts, like when you cough or sneeze, or even laugh. Or you have to go, you know you do, but you just can’t. You go to bed at night and then you get up to go to the bathroom, and you get up again, and again. There is a time when you’re far from a bathroom, and you have to go NOW, no time to think, NOW!! And, of course, there is incontinence when you have totally lost control. You cannot hold it, you cannot stop it, you just go… whenever… where ever.
(The following types are from Urinary Incontinence for Women)
Stress Leakage of small amounts of urine during physical movement (coughing, sneezing, exercising). Urge Leakage of large amounts of urine at unexpected times, including during sleep. Overactive Bladder Urination with frequency and urgency, with or without urge incontinence. Functional Untimely urination because of physical disability, external obstacles, or problems in thinking or communicating that prevent a person from reaching a toilet. Overflow Unexpected leakage of small amounts of urine because of a full bladder. Mixed Usually the occurrence of stress and urge incontinence together. Transient Leakage that occurs temporarily because of a situation that will pass (infection, taking a new medication, colds with coughing).
What can happen
Whether it is the beginning or after living with it for awhile, very few approach their doctors for medical help. It is often a symptom of some more serious medical problems. If it is not treated, it can lead to urinary or bladder infections, or even kidney damage.
Having to sit with damp or wet underwear or use a catheter can lead to both hygiene and social problems. Incontinence interferes with regular daily activities, and it often leads to isolation. This is perhaps the one symptom that does more to cause isolation than any other. All of this can lead to deep depression. Yes, it is very serious.
What can be done about it
So what do you do about it? Each of us manages according to personal preference, ability, and convenience.
- Devices such as catheters or urethral inserts
- Medications such as Ditropan or Detrol
- Dietary changes and reduced liquids and caffeinated drinks
- Physical exercise may increase control, including the Kegel exercises
- Adult diapers and adult undergarments
- Monitoring urinary flow schedules, then scheduling daily activities
- Surgery, but as a last resort and for only some causes
A little about bathroom humor
Is there humor in incontinence? Of course there is. We have to keep our sense of humor.
Bathroom etiquette may be a minefield, but I think it is just another speed bump along the MS path.
Always go to the bathroom when you have a chance.
~ King George V
Notes and Links:
Urinary Incontinence in Women
Mobility IssuesCooking with Multiple Sclerosis
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