Pelvic Floor Problems?? Could someone help me out with this?

[emeralds333]

I don't know much about this at all. It's kind of a "new set of symptoms" for me.

It started a few months ago when I noticed I was doing alot of "pushing" to urinate - and when I mentioned it here, everybody said that's a big "no no!" so I tried to watch it.

Well, my pain management dr put me on two new meds a few weeks ago and I ended up with horrible retention on them. I almost went into the emergency room because I was having such a hard time urinating - but I held out (with the flu going around I didn't want to go in and be around more germs than my 5 kids bring in) but I had to strain alot for several days.

Well, that ended up in extremely sore pelvic muscles and suddenly nothing quite wants to work right down there. I read through one of the books on IC that suggested bending forward and resting your stomach against your thighs when you urinate and that seems to help hopefully get me using the right muscles and not straining but my pelvic muscles are still really really sore - sometimes sharp pains. I think it's all from that retention but I'm scared. Can anyone give me any advice? It's scary when you "can't pee". Those things are supposed to work naturally. I know I've always had to go to the bathroom about 8 times as much as everyone else but "not being able to go" and the muscles working wrong really scares me.

The urologist called in a muscle relaxer that I"m taking at night and that seems to be helping a little but can anyone else clue me in on some suggestions or what to do next with this to at least get it back to normal? Is this pelvic floor disfunction?

Thanks so much. I really appreciate any help anyone can give.

Kellie

[havingsuccess]

Sounds like it could be PFD to me. Never ever strain. I take valium 2mg three times a day and that helps. I also have my husband massage my pelvic area when it acts up. When I used to go to the PT she showed my husband how to do it. Lye down with a pillow under your head and sorda spread your legs out like a frog and start at your hip bone and just massage diagonally downward on both sides. It also helps to sleep with a pillow between your legs, this keeps your pelvic area open, at least that's what I've been told. If you still retain you could always self cath, it's not good for all that urine to stay in your bladder it could cause a nasty UTI. Hope some of this has helped.

Success

[ICNDonna]

If you haven't learned to cath yourself, I suggest you ask your uro about learning this skill --- it can be a life saver if you ever again come up with a retention problem.

Another thing you can do to help get your bladder empty is to clasp your hands together and place them just above your pubic bone and push gently --- then lean over, still pushing gently. I was taught this after I had surgery and it worked very well.

You may be just sore from all the straining. You might give it a few days to see if it calms down, but please --- don't ever strain.

Warm healing thoughts,
Donna

[emeralds333]

Thank you both so much. I've even printed your responses so I can try them both. I've never had this problem and it's kind of scary - worrying about if you're even going to be ABLE to pee - and I'm just floored at how bad my pelvic muscles hurt. They're so sore.

I've never learned to self-cath, though I've heard many people on here talk about it. I'm going to make an appointment today and make sure this is in my next appointment. Doesn't it hurt to do it? It's always hurt when the nurses have done it when I've given birth. :( It really sounds kind of hard too. Please tell me it's not!

[ICNDonna]

The first time you cath yourself it might hurt a little. But it's far easier for me if I do it myself than it is for somebody else to do it.

Sending an encouraging hug,
Donna

[havingsuccess]

Same for me. I use small catheters (size 10 french) Squat down over a mirror, use some lubrication on the tip and slowly insert the catheter. It really only has to go a couple inches, once you see urine you don't have to go any farther. It's not painful at all just a little funny feeling for me but it's better than having all that retention. Good Luck!

Success

[queenbeemig]

Anything that will relax your muscles should help you somewhat. Try warm baths (2X daily) if possible and i also use heating pads. Heating pads are my magic elixer!!! The muscle relaxants should help you too. I use 2.5mg of klonopin and it seems to help me when my urine stream seems slow and my bladder achy! I NEVER strain....hurts more!!! Good luck. I hope you start feeling better.

[queenbeemig]

Oh and i forgot....constipation makes it worse!! Whatever you do...make sure you have regular bowel movements. Take sennokot if necessary or make sure your diet includes something to help you go daily. I use flaxseed (2tbs) in my cereal every morning. It helps a great deal. My doc said something about the bowels pressing on the bladder when they are impacted and that makes matters worse.

[emeralds333]

Thank you so much everyone. I've written down the names of some meds you mentioned to ask about and I'm trying the heating pads and the baths and putting my hands on my pelvic bones when I go to try to use the muscles right.

The constipation is a BIGGIE. Boy, you're not kidding. It happened the other day and there was just no way I could go if I had to push. My pelvic muscles hurt terribly and I'm getting sharp pains every now and then.

When you strain them, how long does it take for them to "get back to normal"? I think part of the problem is that I WAS pushing for quite awhile without realizing I was or paying attention to it. Just anything to get it out.

I am going to learn to self cath. Just don't want to have to go to the emergency room for something like that. ~sigh~

[ICNDonna]

Constipation can be a real problem, especially when we have to take medications to relax the muscles. I take Colace stool softener, make sure I get plenty of fiber in my diet, and drink at least 6 - 8 cups of water a day. If you are having a continuing constipation problem, I do think you should discuss it with your doctor. I keep Fleets enemas on hand just in case, but don't need them often.

grouphug
Donna

[emeralds333]

Donna,

I can't tell you how many times you've helped me, calmed me down, made me feel like I'm not alone. You are a true angel on this board. Should you ever feel like you're not appreciated, please know you couldn't be more so.

One last question about the pelvic floor disfunction and muscles........I'm getting ready to see a new gynocologist (because I felt my old one just wasn't answering my questions or might not have known enough about it). Is it the gynocologist who would do the exam to check for it and see how the muscles are doing or is it the urologist? I'm confused on who handles that part. Also......if there's a chance my bladder has dropped (after 5 kids, re: the leaking), would that be the gynocologist or the urologist?

And then, a huge hug for you.....and for everyone else who gave me some helpful tips and reassurance. I"ve never been so scared to death, with this first episode of retention. You give me the strength to handle it. And I appreciate that so much.

Kellie

[ICNDonna]

Either your gyn or uro can evaluate your pelvic floor, and either can repair a bladder that has "fallen." I had surgery in November to put my pelvic organs back where they belong --- I chose to have my urologist do my surgery. I made the choice based on the fact that he has cared for me for all of my 29 years with IC, compared to a very few gyn visits. My old gyn retired two years ago and I had to choose a new one.

And I thank you for your post. It gave me a warm feeling that will last all day.

Gentle hugs,
Donna

[Arizonian]

I developed a similar type of problem with slowness in urinating which developed over the past 6 months. I met with my urologist last week and told I thought I had PFD. She agreed and prescribed physical therapy for me and referred me to a terrific physical therapist who is skilled in treating IC patients with PFD. I've had one session and already feel better. She gave me a number of exercises to do daily and they will help me over time. You may want to see your urologist to explore the possibility that you have PFD. It develops with chronic pain which I had this past year. It is diminishing with my DMSO treatments.
Good luck!

[skershner3]

Kelley,
I have just gone through the same thing with the straining. About three months ago I was straining every time I went to the restroom. I just couldnt get any urine to come out, just dribbles. I would be up at night, almost asleep on the commode in terrible pain and straining to go to the bathroom. I would go back to bed and right back up again, doing the same thing. I went to my urologist, did the routine "pee in the cup" and had an ultrasound done which showed that I still had 700 cc's of residual (urine left in the bladder)urine. He had me go back and do another urine, emphasizing "not to strain" and I had 500 cc's of residual. He discontinued my Ditropan for now and had me watch a film on self catherization and then had the nurse show me how. We started out on the commode and ended up on the exam table with a mirror. He told me to do the self catherization every four hours for three months and keep records of my output and on my own I have kept records of my residual from time to time. I started out on the bathroom floor with an emesisis (sp?)basin (to record the cc's), a warm soapy wash cloth, catheter, KY Jelly and a mirror. It takes practice, at first it took me forever, now I have moved up to doing it on the commode (which is much better after you learn where all of the "parts" are). I have started using baby wipes instead of the wash cloth which is much more convenient for me, you can use it to wipe the area. I am using Xylocaine Gel (you have to get an RX for this from your urologist and I recommend it highly) to put on the end of the catheter and when I insert it I push it in the urethra slightly and let the gel do its job and then insert it further until I get the stream going. The most pain I get is when the stream stops, you will get a little tugging feeling and then when you take it out it hurts some. With the Xylocaine it helps this alot. I was having terrible, terrible lower back pain. This was from the bladder being so full that it was lying on my spine and this has improved a great deal. I also dont have the distended abdomen because I was retaining so much urine before. I was still having some problems at night and had to get up one night to go to the bathroom and got back into the straining thing and finally did a catheter and got 800 cc's of residual so I called my doctor and we cut my Imipramine doseage back and that hasnt happened anymore. It is more of an inconvenience for me than anything else but is well worth the comfort that I get from it. I have a follow up on the 12th with my urologist and will see at that time if I have to continue. Even if he says that I dont, I am definately going to keep catheters, etc. around to do a self catherization if I need to because it does give you relief if you are retaining that much urine and it sounds like you are in the same boat I am in. The one thing is that I have had increased bladder spasms after removing the catheter. Everybody is different so who knows. My residual urine outputs have come down so I am hoping that this is all medicine related and not damage to the bladder which is suspected by my urologist. Although the residuals are down, I still have alot of high outputs most of the time. If you have any questions just give me a yell and feel free to email me. It is scary at first and a little difficult to do the self catherization but you will get the hang of it quickly and will be a pro at it and in my case it was well worth it to get rid of the back pain. My best to you. Susan PS. I am sorry for the long post, I have a tendency to get a little "wordy."

[Peta]

Thanks, you have all helped me by reading your posts. I am having a real tough time at the moment not being able to empty my bladder. The last two night I have been up every 20 minutes or so to try an relieve the pain by peeing. I think I will give my dr a call.

Thankyou
Peta

[emeralds333]

Susan,

Thank you so much!!!!!!! I NEEDED that to be lengthy!!!!!!!! Honest! That has to be the most detailed description of what to expect and I honestly did need that.

I've got an appointment for the urologist next week, as I'm still "not working right" and I can tell that after I urinate as soon as I stand up, I feel like I need to go again and have a hard time not straining to get it out. This happens about 5 times in a row sometimes and then of course you're "back in the bathroom" ten minutes later. It's just so frustrating sometimes and my husband is sick to death of hearing about it.

But you know, if this were HIS problem, I've a feeling he'd be shouting the house :rolleyes:

down.

I feel a little less scared about it after reading your post. Thank you so much for that.

Kellie

[skershner3]

Kelly,
I am glad that I could help. It always helps me when I can get on the message board and find help and I have done it many times. I have to go back on Monday to see the urologist and I am afraid that even with the low residuals I might still have to do the self catherization since my outputs have been up and down. I did the catheter the other night and got 1,000 cc's of urine which is way, way too much. They are usually about 300 cc's but sometimes as high as 700 and that is bad but the 1,000 cc's really scared me so I dont know what to expect on Monday. I have been keeping records of my outputs and have already mailed my urologist the records that I had all but this weeks so he will have some time to go over them. Battling with the IC and being so tired all of the time (some of this from medicine I am sure) really gets the best of you sometimes. Anyway, I am sure that you will do fine with the catheter and believe me, it will give you relief if you are having back pain. I cant believe the difference in the back pain - much, much better. Susan

[Teri]

Susan~I am like you. I have unbelievable bladder capacity. And I retain ALOT of urine. I was finally taught to self-cath about 5 years ago and it's been a total blessing. One of the greatest advantages is that if I cath at night before I go to bed, I will only have to get up once to pee blink And, I can cath before going shopping and KNOW that no matter what my bladder is saying, it can hold alot more pee than it's holding so I can ignore it.

When I was taught my uro had a home nurse come to the house. She drew me a picture and sent me off to the comfort of my own bathroom. I was so proud because I got it on the first try. There are times I do have trouble finding that little guy cuz it does move around but it's something that I wish I would have been taught to do years ago.

Wishing you the very best~

[skershner3]

Teri,
Do you catherize on a regular basis or just when you need to? I had a terrible night, I went to bed at 11 and was up until about 4 AM trying to go to the bathroom, etc. so I finally did a catheter and got 500 cc's of residual. It must be the Imipramine that I am taking at bedtime. I look for the urologist to discontinue it when I go in for my follow up. I dont know but I am having nights when I can cath before I go to bed and do pretty good at nights and other nights when I am up trying to go to the bathroom until I cath. My back definately thanks the catheter. That has been the biggest help for me. I was having terrible back pain, still have it but nothing like it was before. I am curious how many people cath on a regular basis and how many catherize when they need to. Thank you Teri for your reply. It helps to talk to someone who "has been there." Susan

[Marigold]

Emeralds, something I have learned that helps me keep my bowels moving effortlessly is to drink a warm liquid on an empty stomach when I first wake up and then wait 20 min before eatting. It helps me keep pelvic tension down.