The Urethra Monologues, Part I: In Which We Embark on the Long Road to Botox

A few months after diagnosis (way back in 2004), it dawned on me that my frequent urination might be related to my MS. My neurologist put me on a few medications over the years in an attempt to calm this symptom None worked great and some came with annoying side effects like dry mouth, which caused me to drink more, which led to more urination, which defeated the purpose.

In 2009, I asked for a referral to a urologist and met with the cheerful Dr. Shin, a young-ish dude with a fauxhawk (hey, it was 2004) and an easy manner -- upon learning we lived in the same neighborhood, he said, "Is it okay if I say hi when I see you? That freaks some patients out, talking to their urologist in public." I assured him it was fine so long as we weren't discussing my urinary habits. I believe Dr. Shin was more accustomed to dealing with men and their man problems, so at my next appointment I saw Dr. Phillips, a kind and good humored guy who knew a thing or two about neurological issues. I liked him immediately in spite of what he had in store for me.

And what was that, pray tell? Urodynamics. Sounds a little like a facet of Scientology, no? Of course, Scientology is full of shit, whereas urodynamics concerns itself with pee. Here's how it goes:

Part one:  I emptied my bladder in a fairly traditional manner (just with the added clean-catch bells and whistles) and then having an ultrasound to see just how empty it was.  I passed this test just fine.



You can be the President. I'd rather be the Pope.
  
Part two: I stripped from the waist down and then sat on a strange throne sort of chair with a round section cut out of the front of the seat. A catheter was then inserted into my urethra, which was pretty damned uncomfortable going in and coming out, but wasn't bad once in.  Three sensors were stuck on as well - one per cheek and one on my left thigh.  These measured nerve function.  I coughed a couple of times for the warm up, and then I had the bizarre experience of having my bladder filled from the bottom up with saline from an IV bag. I notified Dr. Phillips at various intervals of fullness sensation, later learning that my impulses were pretty normal there, barring my feeling full up a little earlier than most. I was then left alone to expel what had been put in, an awkward experience to say the least what with the sensors and tubes and the fact that I was sitting on a chair, hovering over a funnel and beaker. "Don't worry if you miss," said Dr. Phillips. I laughed, secure in my aim. Ha. I missed and missed good, peeing all over the pads they'd left on the floor. When he and the nurse returned, Dr. Phillips said, "You missed!  Honestly, men are so much easier.  We just point and shoot." I was disconnected. The indignity was over.
At the end of it all I learned that my bladder function was all pretty normal except that my full stream (measured when I was peeing on the floor, I think) was about 40% of what a normal person's should be.  This was due to detrusor sphincter dyssynergia, which means my bladder is saying, "Come on, guys! Everybody out!" but my sphincter muscles can't hear them. This explained the hesitancy issues experienced. We started treatment with Doxazosin, which is usually given to men with prostate problems (leading me to believe my dad was right all along - I did, in fact, pee like an old man).  I also stayed on Oxybutynin, which I'd be taking for a while, so we were only adding one variable at a time.

Thus began my attempts to wrangle an uncooperative bladder.

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