If the ICN has helped you
Please Read Our Disclaimer
Revision January 18 2001
Created: June 1999
and/or given you comfort
during those difficult nights,
we hope that you will become
a subscriber.
Diane Manhattan & Jill Osborne
Jill Osborne
Pain Management and IC
Coping with Flares
Many IC patients have periods of flare and remission. Why? We're not sure. Some patients report flares after eating foods that irritate their bladder, such as coffee or diet soda. Men and women with IC often experience flares after driving in a car or having sex. Many women experience flares when they ovulate and/or right before their period.
For many, flares can be the worst at night, when there are fewer distractions and it's much harder to ignore our bladder symptoms. Often, flares at night follow a typical pattern. A patient may go to bed at 10PM and by 11PM they've been awakened by a need to urinate. They then get out of bed and void, usually a small volume of urine. They return to bed, to awaken at 11:45PM with another intense need to void. Their bladder may feel very full, but when they try to urinate, only a teaspoon or so of urine comes out. They then return to bed, and sometimes within minutes, have yet another sensation that their bladder is very full. But, when they actually urinate, nothing comes out.
This is a very confusing sensation. Your bladder feels full, but it's hard to urinate. Sometimes patients strain, trying to push urine out. That is a mistake. Remember, the bladder can only communicate with one language: frequency, urgency and pressure/pain. So, whether you have a UTI, or an IC flare, or even a bullet wound to the bladder, you would still feel an intense need to urinate.. but that doesn't always mean that your bladder is full. Try to resist straining because that can severely strain your pelvic muscles. If you've gone to the bathroom just 10 minutes ago, then you know that you bladder isn't full to capacity.
The Secret To Handling Flares
Here's an example that we often use in our phone support. You walk through your living room with a glass of water and see a flicker of flames at the bottom of your drapes. You walk out of the room and come back ten minutes later with that same glass of water, and see that your drapes are a raging inferno. At what point of time would that one glass of water stopped that fire. Early! The same is true for managing IC flares and pain. The earlier you catch them, the easier it can be to stop them and the less it takes to stop them. Veteran patients often recognize their early warning signs (such as a specific type of pain) and then immediately begin using their IC tool kit. Often, this can stop the flare in its tracks.
Other patients, though, feel that if they stop and rest, they are letting IC win. And so they push and push through the pain. They don't use their pain medications until it's a desperate situation. They wait much too long and often hurt themselves more.
Try thinking of your IC as an injury. Your bladder wall has tiny wounds in it. So, how would you care for any painful wound on your body. You'd clean it with water. So make sure that you're an adequate amount of plain water. Moderate your diet. You certainly wouldn't pour coffee or tea on a wound on your hand.. so why are putting it on wounds in your bladder. You would also rest. So, don't try to run a marathon on your aching bladder. When your IC symptoms start to flare, give yourself permission to stop and rest.
A List of Flare Coping Tips
Here's a big list of what patients often find helpful when they are having a flare.
Use a heating pad or cold compress, laid on the belly and over the bladder.
This can be very comforting right before you go to sleep. If you prefer
heat, try using a microwaveable pad or an electric pad that has an automatic
shut off. The ICN
Marketplace has special shaped microwaveable pads that fit right
over the bladder. These can be very comforting.
Some find that a warm, soothing bath is comforting. No bubble bath or
strong soaps, please! Soft soaps, perfumed soaps, bath salts & bubble
baths can be very irritating to an IC patient. However, you can put baking
soda in the tub for extra comfort.
Ask your doctor for a TENS unit. A TENS unit is believed to work by providing
another source of stimulation to "divert" the brain from paying
attention to your bladder. It's based on the spinal gate theory. Some
patients find TENS very helpful while driving, or in situations when a
pain medication isn't appropriate.
Use your pain medications as instructed by your physicians. Remember,
the earlier you catch a flare and pain, the easier it is to stop and the
less medication it can take to stop it. So, don't wait until you are crying
and desperate.. because that allows that pain cycle to get firmly started.
Try to catch your pain early!
Rather than laying in bed, get up and walk around the house. Some patients
distract themselves by doing work around the house or by watching TV (yes,
we admit that there is really bad TV in the middle of the night). Do what
feels comfortable to you. Don't push it.
Create a library of videos for late night diversions if needed!
Ask for a foot massage from your spouse or partner.
Get onto the internet and visit the ICN web site to look for other patients
who can't sleep that night. Post in the message boards and/or visit the
chat rooms! Helping someone else often helps you just as much!
Listen to a guided relaxation audio tape to relax your body. Commonly
available at book stores, we recommend the tapes by Potential's Unlimited
(Barry Konicov). If you can't find those, try the Health Journey's series
of tapes.
Use the pain constructively by writing a letter to your congressperson
or senator demanding more money for IC research! Pour out your heart and
your pain to a constructive purpose! Tell them just what IC feels like.
Request more research money! Emphasize the need for more education for
primary care providers who don't know enough about IC! Read the ICN
Activist's Corner for more information and ideas!
Some patients like to work on a craft or project during flares so that,
after the flare is over, they can cherish what they have accomplished
during that difficult time. (Editors Note: I designed and made stuffed
rabbits during the six months that I had heart problems. To look back
at that scary time and see that I was able to make something special is
gratifying and comforting. I know exactly what I'm going to do if it happens
again! More rabbits or, perhaps, painting!)
Practice cookie therapy! If you're having a pity party (which we all have
had at times), try sharing a special kindness with someone else. Make
something special, like cookies, for your family to let them know just
how much you appreciate them! These aren't for you to eat! They are an
expression of your love for your family! Give them a surprise gift of
warm cookies and a house filled with love.
If you need help or are thinking of going to the emergency room, wake
up your family and ask for help!
Call the doctor and/or visit the emergency room if you need to.
During flares, IC patients should NOT:
Take extra medication above the dosages that a doctor recommends. Talk
with your physician and pharmacist first to check for medication safety
tips, contraindications, safe dosages, etc. etc.
Drive or operate a motor vehicle while heavily medicated. Please preserve
the safety of yourself, your family and others on the road by not driving
when you are impaired.
Use medication that was prescribed to another member of the family.
Read even more flare suggestions in the ICN Survey Center. We surveyed IC patients for their best flare coping strategies. Read their suggestions here!