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Thread: New t12

  1. #11
    Quote Originally Posted by SCI-Nurse View Post
    Re: biofeedback for your bladder what were your Urodynamics results?
    Since it is most likely neurogenic it depends on what biofeedback she is doing and what the bladder is doing and if you have any type of control.
    CWO
    I'm going to get another opinion from a urologist next week. the one i saw said that i have an overactive bladder, gave me Vesicare and told me i'd be taking it for life. BS!!
    The biofeedback nurse told me to buy dilators to weaken my tight muscles, so i could work on strengthening them the right way. I've definitely weakened them because i've had so many accidents (in public and private) since they've been weakened. Now is the time to strengthen them...much easier said than done. any tips??! the bladder muscles seem to tighten up right after she loosens them up by pressing on them. The EMG show that they're shooting up towards tightened when i'm relaxing. I feel the urge to go to the bathroom, then i go. I'm stuck wearing Poise depends type pads all the time, and still I piss my pants..
    Life is what happens to you while you're busy making other plans. -- John Lennon

  2. #12
    First off - it is all about your pressure, pressure, pressure (don't want to have kidney failure. And only Urodynamcis can tell you that pressure).
    think of it like your blood pressure-no one reallycare what your pressue is in your arm but it is the way to measure and treat and prevent hypertension which can lead to heart disease, strokes, kidney failure and death. So Urodynamics and the testing of the bladder first and foremost is looking at potential issues-early- like testing blood pressure an a routine basis.

    So,,, in a nutshell-SCI bladder 101- everyone is different and you can NOT just go by your level of injury, your ASIA classification, only your symptoms( look at that but need the test), your injury ( important but can't tell everything- etc.. So here is more information so you can make a decision and ask more questions of the doctor and try and get a better understanding fo the bladder/sphincter/kidneys and how your SCI has affected this. The nervous system is very complex, and the bladder is really complex and therefore so are you.
    So...to know exactly what is going on-you must have complete video urodynamics (i.e. pressure testing , x-rays while to filling, voiding etc). The bladder(detrussor ) is a muscle, The sphincters (each one is a different type of muscle).
    So what did the Urodynamics show? Is that what the urologist looked at? If you have NDO-neurogenic detrussor overactivity or commonly called overactive bladder-what is your max capacity? What is your post void residual?
    You need to be on an anticholinergic like Vesicare-because the bladder is spasming at a small capacity (and you don't have the normal warning and you can't inhibit the contraction at all) and is from the SCI and its response to your injury- has nothing to do with control or weak muscles.The anticholinergic relaxes the bladder so it will hold more and stops the overactivity of the bladder.Biofeedback won't help this because it is not conscious. What Biofeedback MIGHT help- but we really don't use it very much for SCI- is if you took the medication and still had urgency symptoms but no bladder contraction and it can help you to learn to ignore those.
    Do you have DSD? Detrussor sphincter dysnergy- that is when the bladder is contracting, the sphincter is supposed to open and let the bladder drain but doesn't- lets a little out at a time.
    Can't say what you would need for your lifetime but reevaluate your symptoms and do repeat urodynamics.
    Also were your resting and voiding pressures ok ? High pressures are common and Vesicare will help with that.
    You do NOT want to have high pressures and have kidney issues in the future. This used to be the number one cause of needed renal dialysis or death from kidney failure years ago. (And should the meds not keep leaking, accidents, high pressures down that is when Botox is probably the next option.)
    I strongly suggest you make sure everything you are doing is safe for your kidneys-FIRST- then take what it helps to so you won't have accidents etc.. and then worry about voiding and what you will need for the future or not.
    Yes the anticholinergics like Vesicare (we use more Oxybutynin but same class) help you hold more, move the contraction till later (and you can try and void with that if your voiding pressures aren't sky high) and keeps the pressure down. I am assuming-on urodynamics your pressures were safe or if not this biofeedback person needs some education.
    Think of the Vesicare as helping with your biofeedback and see.But since I don't have your total picture- and the urologist should- you really need to look at it- and who ordered the biofeedback if not the urologist?

    For those of you with a NDU-neurogenic underactive bladder -aka areflexic bladder - or one that is hypocontractile with low amplitude contractions- that is different- pretty much totally opposite you wouldn't have high voiding pressures but you would still need urodynamics periodically to make sure your resting or filling pressure don't elevate because over time they can- bladder becomes less compliant or stiff due to collagen build up. An intermittent cath should be the intervention.
    If leaking in between, may need anticholinergic but that is usually more sphincter issue. ( If don't have a UTI- a UTI makes the bladder overactive and leaking occurs so that can be a symptom or UTI. - lekaing when don't usually or more leaking and should be treated.)
    Also in SCI- even if you can walk and everything else is normal- doesn't mean your bladder will be and vice versa.
    If someone wants me to look at your specific urodynamics results you can send them to me in the private messages- but I need results of the complete study to look at- up until Sunday when it is turned over to another nurse.


    CWO

  3. #13
    wow...thats a lot in a nutshell!
    I go to see the biofeedback nurse tomorrow, i'm going to print out your whole response and take it with me.
    My former urologist did urodynamics and was not very helpful, didn't really explain anything, didnt even give me the results, but told me i'd be taking Vesicare for life.
    I'm going to see another urologist, who will have those results to go over with me and i believe he'll do another test.
    I thought that biofeedback was done in an attempt to retrain muscles so that drugs wouldn't be necessary. I'm not about taking so many drugs at all.

    Thanks again, I'll be in touch.

    Lisa
    Life is what happens to you while you're busy making other plans. -- John Lennon

  4. #14
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    Quote Originally Posted by LIP26 View Post
    wow...thats a lot in a nutshell!
    I go to see the biofeedback nurse tomorrow, i'm going to print out your whole response and take it with me.
    My former urologist did urodynamics and was not very helpful, didn't really explain anything, didnt even give me the results, but told me i'd be taking Vesicare for life.
    I'm going to see another urologist, who will have those results to go over with me and i believe he'll do another test.
    I thought that biofeedback was done in an attempt to retrain muscles so that drugs wouldn't be necessary. I'm not about taking so many drugs at all.

    Thanks again, I'll be in touch.

    Lisa
    I have urodynamics about every 2 years. I have pressure to push the urine out but I can't hold it in. I have a neurogenic bladder. I have never catheterized and I use Enablex to stop bladder spasms.
    T12-L2; Burst fracture L1: Incomplete walking with AFO's and cane since 1989

    My goal in life is to be as good of a person my dog already thinks I am. ~Author Unknown

  5. #15
    do you have any bowel issues? mines neurogenic as well.
    Life is what happens to you while you're busy making other plans. -- John Lennon

  6. #16
    I went to the other urologist, who was nice..i liked him a lot better than the first one. i started taking the vesicare again the week before seeing him because i had a lot of accidents and was fedup!!
    i walked into the doctors office and gave a urine sample...then the nurse used a machine on my lower abs to see if i emptied my bladder. my number was 371 and normal is anywhere from 100 to 150 :0( no, not emptying....
    he suggested double voiding, like go once then about 15mins later go again.
    the end all was continue taking vesicare for total of two weeks and double voiding, then for two weeks just try double voiding. to see him again in a month.
    after i spoke with him and made my followup appt, i went to the restroom again and asked the nurse to measure how much had emptied and my number at that point had decreased to 125 -- NORMAL!!
    I guess thats what I'm doing for the meantime is double voiding.

    he recommended seeing a gastroenterologist for #2.
    Life is what happens to you while you're busy making other plans. -- John Lennon

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