Spasm or Hesitancy?

[ddemos]

I am just getting over a major flare, cleaned up my diet, and the burning and much of the pelvic pain has lessened, however, I 've always had a bit of hesitancy(especially if people are waiting for me), but now it's becoming a real drag...Any thoughts? Is this what everyone is calling a spasm? Could the Emiron be a cuprit? Just started 10 days ago. I do take it out of the coated capsule. I also take Cymbalta and Wellbutrin, fish and flaxseed oil, and pyridium if needed. I run the water, try to relax... but it's quite impracticaland time consuming Could use some advice or tricks.

Many thanks


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[Baba Yaga]

My opinion: I think it's the Cymbalta. Did you know that Eli Lilly was pursuing approval for Cymbalta as a drug for incontinence? It has some sort of effect on the bladder neck and sphinctor (?), increasing their tone.

I am on it now, and it has felt like I have had more of this hesitancy you speak of, not to mention a sense of fullness at most times -- or something I have trouble describing, but I feel is sort of related to frequency and urgency. I was not feeling this before the Cymbalta and may eventually go for another drug.

I plan to ask to try Vesicare or Enablex when I see my uro next week. I had been helped by Detrol and Oxytrol, but had not tolerated their side effects well. I am not sure in Cymbalta's actions on the bladder are "opposite" of OAB meds', or independent.

Anyway there is my two cents. One other ICN poster I know of had some retention while on Cymbalta -- we can't be sure if it was attributable to the Cymbalta, but it makes sense to me. Maybe she will chime in.

Please let us know what you learn about your case in the future -- it may be helpful to others, like me. :)

[ddemos]

Wendy,
How long have you been on Cymbalta, and if you don't mind, what dosage? I have stopped many antipressants over the years because this retention would happen immediately. Now I get good relief from 90 mg of Cymbalta and 300 of Wellbutrin. Helps the pain of a recent hand injury and also depression. Been on it for about a year. It's hard for me to tell because the hesitancy is always somewhat present, but really annoying lately. It might be starting the Elmiron...? Perhaps stirred up more from a recent flare? It seems I have to give any and all drugs a longer experimental phase than other people, as everything seems to aggravate the retention.

I am seeing my doctor tomorow, he's good with meds., and will ask him about your Cymbalta theory... didn't know about that at all. Thanks for the info. I was also going to ask for Atarax and Enablex as well. I 'll let you know. I think part of the confusion on this site is that we may all give the same experience/symptoms different labels. This feeling we have may be the spasms that everyone keeps talking about?
I will update as I learn.

Cheers, Diana

[ChrissySunshine]

Hi Diana, I think the terminology is rather confusing as well. I have some of the same problems you have, periodic retention, and pain, pain, pain (for me anyway!). I have also experience seperately what I could actually FEEL was spasms. These spasms were HUGE, (kinda hard to explain), it was my whole pelvic floor muscle, (around urethra, vagina, rectum, thighs, low low back....I thought I was in labor. It felt just like that. If I put my hand on the outside of my vaginal/rectal area, I could actually feel from the outside the uncontrollable spasms! They would actually come UNCONTROLLABLY around every 5-20 seconds or so.!! Felt just like labor to me!!!!Now I KNOW those are spasms...FOR SURE!

I do however, question if some of the every day pelvic muscle pain I experience is spasms...in that case I don't feel the strong "labor like" pains, just constant pain. I was Rx'd Levsin S/L, (antispasmotic), and that seems to help alot with the SEVERE LABOR LIKE pains I mentioned above. I was taking it only for the bad spasming, but I think I should take it more regularly, I felt better when I did. When I let up on it, I have more pain. So I'm guessing some of that everyday pain is indeed "Spasms". That's MY experience anyway, like you said, I think everyone's terminology is a little different. I hope I cleared it up for you in how I think of it anyway!

There's alot of great advice on here about dealing with retention. (I would write more, but can't tonite, as I'm in ALOT of pain sittin here!) You can "search" the forums...just hit the button right near the toolbar that shows your private messages, type in "retention" and threads that deal with retention issues will pop up.

I hope you feel better soon!

[ddemos]

Thanks for the explanation Chrissy, wow I don't think I've ever experienced a spasm then, and may I say,I feel extremely lucky. I hope the Levsin continues to work for you. I have pain during a flare...the burning and irritated feeling. I always have that nagging "headache in the pelvis" feeling, that really is alleviated with the diet.and also the frequency, which for me diet doesn't fix. The retention is like a mini non- painful spasm...and let me reiterate mini...I have to flex to start to urinate, and then keep flexing to empty. I think my urethra is the most powerfully strong organ in my body! It takes me awhile to go, which can be a real bother, I was hoping that maybe there were some tricks out there to help. I am in the process of researching better insurance, when I get it, I think I will try to do some pelvic phys. therapy...I feel like some of it must be retraining muscles etc.

I need to ask the gyno about vesicare/enablex...because Detrol made the retention much worse. Perhaps the more intense retention was brought on by this latest flare, alot more intense than I usually have. Or perhaps it was starting on the Elmiron. As I mentioned, any new drug seems to increase this. I just think I need to take something to relax that area.

If anyone has any thoughts.

[Sarojini]

I agree... that sounds like hesitancy or retention, and it may well be the Cymbalta causing it. A spasm usually is very painful, as Chrissy mentioned (I've had a number of them... ugh.)

In addition, have you been tested for pelvic floor dysfunction (PFD)? This is a condition where the pelvic floor muscles become continuously tight -- ICers often get it along with their IC; it's possible it happens because we tighten up all the time, trying to hold urine, or because we are "guarding" against pain. Regardless of the cause, it can increase painful symptoms and cause hesitancy and retention.

If it turns out not to be your Cymbalta, you may want to check into it.