Hello Heidi: I got your email and am writing back on site so others can possibly benefit. Thank you for writing to me and thanks to Lisa for suggesting it.
I'm sorry you are having such nuisance bladder problems. Recurrent UTI's are very annoying. Assuming your doctor has ruled out other causes for your UTI's (ex: cystitis, kidney diseases, etc.), then I may have some useful suggestions for you.
1. I used ergonomic tricks for over 10 years to stave off self-cathing because I worried about getting more infections from self-cathing. It may sound silly and look absolutely absurd, but who cares, it works. I wrote about this on my blog and got positive comments from other MSers.
Relieve yourself in sitting position, as usual. Bend forward to a 45 degree angle and hold position for 60-90 secs. Let any urine release. Now lean to your right side lifting left buttock off the toilet seat. Hold for 60 seconds and release any urine. Now lean to your left side, lifting up right buttock. Hold for 60 seconds and release any urine. Believe me, this works! Body positioning is key for this to work. You will be good for at least two hours because you are empty. Try to limit your intake of tea, coffee, juices, alcholic drinks, or energy drinks since they stimulate your bladder moreso. Stick to water, no more than 3 sixteen ounces spread out over your day.
2. Regarding your every 7 week UTI's and knowing you have PPMS, I would suggest that after you try the example I outlined above, to then examine your hygenic habits and eating habits. So many items are scented these days, sometimes we don't even notice it. Keep track of the hygenic paper products you use - are they perfumed or stored in an area where you store cleaning products where the scent can carryover? Do you use scented feminine products (douches, pads, paper products)? Are you a powder user? Do you wear nylon cothing next to your body without the benefit of a cotton barrier (underwear or inserts)?
3. Regarding foods - which is often the biggest culprit after scented products - I found that cinnamon was my personal culprit and it seemed that when I treated myself to homemade chocolate chip cookies, cheesecake (cinnamon in the crust), or anything that had cinnamon as an ingredient, within 3 days I had a UTI. It took more than three months for me to figure this out because of the many ingredients in foods. So read your labels, keep a food diary (write down everything!) and see if your trigger is food related. A food diary may be the only way to narrow this down.
4. Neurogenic bladders often do not totally empty and that is the reason why most MSers must self-cath. Self-cathing the first time will be hit or miss until you get to know where YOUR urethea is located in your anatomy. The position you assume to self-cath can be awkward and (if in the company of others) sometimes embarrassing. But sometimes you need another set of hands to help you, so don't hesitate to ask a special someone.
***Self-catherization is the last resort....you don't want to go there if you don't have to. But if you do, positioning in order to self-cath is the hardest part. Experiment with what works best for you.
It will certainly require some getting used to also. Some women can put a bended leg up on the toilet, use a hand held mirror in one hand and the lubricated catheter in the other and insert. Other women can squat down to within 10-12 inches of the floor, place a hand held mirror on the floor and insert. Some women can sit on the toilet and bend back far enough and insert. Still others can lie down in bed, bring knees up to chest and using a hand held mirror (or not) then insert. Once you get to know where your urethea is located, you can actually stand, spread your legs and insert, but that takes a while of practicing to get the hang of it.
5. Self-cathing has its pros and cons. The cons of course are possibly re-infecting yourself by using less than clean conditions and re-using catheters. Self-catheters should be used once, and then thrown away. The pros are endless but include hours of comfort, extra sleep during the night, and reducing embarrassing moments.
6. Catheters in general. At some point with MS, many of us must resign ourselves to the fact that we need a catheter in place all the time. Catheters can be intra-urethral or super-public (inserted through a tube in the belly). Some people realize that a catheter in place during a long car ride, plane ride, etc. assisted by a leg or belly bag can be most comfortable and reduce stops thereby making the driver happy! A Johnny or Jane bottle is also handy. As for sleeping, catheters assisted by a bed (drop) bag, most certainly will eliminate bathroom runs and allow for a full night's sleep. I use a bed bag every time I get a UTI so that I do not run to the bathroom constantly, only to eek out a few drops.
7. For my own personal experience, by watching my diet with a food diary and knowing my food triggers, I have had only one UTI this year so far - and it was non-food related. It was because of swimming in a public pool on a cruise in April. It was the first time I had been in chlorine in five years and I just knew it was going to cause a UTI. Sure enough....Within 24 hours, I had a UTI.
A reminder to ANYONE who takes bladder medication to deter urine output (not people who take medication to promote urine output - ex: Lasix): When you get a UTI, the last thing you want to do is restrict urine output. I myself stop my Detrol until antibiotics are done. I want the infection OUT as soon as possible and do not want the urine to stay in. Consult your doctor first before you make changes in your medication schedule.
I hope you find some useful information here and that you will write back to let us know how you are doing,