I’m back in Maryland. After two days — 16 hours of it spent on the road — and 1,104 miles, not a single accident. My bladder control meds must’ve worked.
The semiannual trip my wife and I take between Florida’s southwest coast and the suburbs of Washington, D.C. is never easy, particularly because we travel with a cat and a dog. Getting in and out of hotels with two pets, pet food, and cat litter is tough for most folks. Add the fact that I usually use my scooter to get to our room, my wife has back problems, and neither of us is a spring chicken, and it makes the trip especially daunting.
But the toughest part for me is playing rest stop roulette. The clean places with easy access never seem to be in the right place at the right time when I gotta go.
Traveling with an unstable bladder
My MS bladder can be a roller-coaster ride, and I’ll bet it’s the same for you. Sometimes it’s urgent, sometimes it’s frequent, and sometimes it’s both. Sometimes it’s better behaved than other times. My general on-the-road pattern is to have no urges for several hours, but then, when I decide I’d better stop and go, I have to go before I get to the place to go. The same is true when I’m checking in at a hotel.
During this trip, however, my urgency was under control.
What changed?
There are several possible explanations for my success. I’ve cut way back on caffeine, which is a bladder irritant. Even my morning coffee, with rare exceptions, is decaf. On the morning of a drive like this, I skip my coffee entirely, drinking only water during the day.
I’ve changed my bladder medication from oxybutynin ER to Myrbetriq (mirabegron). Since doing that, I’ve been able to sleep through the night, getting up to eight hours on most nights without a bathroom run. Myrbetriq is expensive, but it seems to be doing the job.
It also may be the result of Lemtrada (alemtuzumab) treatments. Both my bladder and bowel problems seem to have improved after being treated with Lemtrada.
Also, after much searching, I’ve found incontinence underwear I feel confident in. The company LivDry also sells insertable pads for extra protection. Usually, this insert absorbs whatever accident I might have. So I’m able to remove it in the men’s room, toss it in the trash, and replace it without having to take off my shoes and pants, which would be necessary if I needed to change the protective underwear itself. (Sorry if I’m oversharing.)
There are many similar products, of course, but this seems to work best for me.
Yet on this trip, there was little or nothing to absorb. What was the key?
The mind matters
I think a lot of my bladder troubles while traveling have been psychological. A 2015 study published in BMC Urology concluded that there was “a positive correlation between perceived stress levels and urinary incontinence symptoms.” And this sort of trip has always been stressful for me.
So adding an extra layer of absorbency to my incontinence underwear gave my mind the stress relief it needed. Combining that with the results of my new bladder medication, Lemtrada, and a no-caffeine diet kept this boy dry.
Oh, and there were no accidents for Freddie the cat or Toby the dog, either. They were very good boys!
(Featured image by Laura Tobias)
(A version of this post first appeared as my column on the MS News Today website.)
