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Questions for those with medical knowledge


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So, a little bit about me:  I had a spinal cord injury in the upper lumbar when I was younger, in my early 20s.  Initially, much of my bodily functions "shut down" as I was left without sensation in certain areas of my lower body.  Fortunately, much of it came back rapidly (I think this is common with spinal cord injuries).  I was catheterizing for about 1.5 months, as I recall, until I finally regained the ability to void on my own, albeit with a weaker stream than most men and occasional partial retention (seems like it comes and goes... maybe based on how much caffeine or other irritants I have in my system).   Once in a while I'll dribble a little bit - just enough to dampen my underwear/diaper - which, again, seems to be the result of irritants, exhaustion (this is common for whatever reason), or a cough/laugh.

So I have a couple questions:

1.  If I was to carry on with 24/7 diaper-wearing and an unpotty-training program, would it be believable to a physician that my incontinence was actually the eventual result/deterioration of my existing injury and bladder issues?   This seems like a preferable outcome compared to admitting to a doctor that I purposely became incontinent.  Perhaps I would even have an outside chance of having my diapers covered by insurance - I don't feel too bad about this as I pay plenty of premiums and taxes as it is.  I know many people here are of the opinion that you should never lie to your physician, which I respect, but I'll ask that you keep those opinions to yourself for the purposes of this discussion.

2.  As mentioned before, I have occasionally had minor issues with weak voiding and urinary retention.  Apparently the issues aren't too serious as they have not resulted in UTIs, etc.  But it's probably safe to say that I have to focus on voiding as much as possible each time I use the restroom or my diaper.   So my question is this:  As unpotty training involves relaxing muscles as much as possible rather than bearing down to urinate, would my retention issues be likely to get worse?  Could I be setting myself up for health problems down the road?

Thanks in advance for your help!

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Given your medical history, i think Drs would be concerned if you started having accidents after being accident free for a long time. Incontinence is a big red flag for people with spinal issues. So at a minimum I think you would get a lot of questions about the injury and any other symptoms. That said, if you just lie about it and they can't find anything else, they will eventually let it go I would guess.

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All I can do is relate my own situation- I have no medical training but I've researched this deeply online and with a few Medical Professionals. My own decreased control is probably due to a furthering of deterioration in my spine (L5 and going down to L3 now). While they can see spinal deterioration, they cannot tell what is going on inside where the nerves are except by empirical methods (assessment of what you tell them is happening and the effects they see). I do not advise lying to your medical providers, but it is a plausible scenario for you and me which they could not disprove ;) If you are OK with diapers as a solution they would probably leave it at that. Were I able to get some financial assistance via insurance I might go that route myself, but since I can't the point is moot for me. It's a question of your own morality levels and what you feel is right and proper.

As best I can tell, the usual 'untraining' process has no other implications involved save that it sometimes also lessens bowel control. So no worries there :)

Bettypooh

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Thank you both for your input, it is very much appreciated.   What each of you is telling me sort of reinforces what I was thinking.   Bettypooh, what started your spinal deterioration, do you know?  Also, were you ever asked to do a urodynamics test?  I had to do that a couple times shortly after my injury.   Not comfortable!   And I'm thinking I would need to be well into my untraining program before I agreed to one of those, as it would identify if my bladder muscles were working properly.

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I had a lifting accident in my late 20's which was never correctly repaired, and that got me a case of Scoliosis when the bones healed wrong. Since then I've been prone to back problems at L-2 and L-3. In my mid 40's a full examination and a back X-ray revealed that L-4 was now becoming involved and that all the discs were degenerating with the Lumbar area being the worst. On top of that all the bones had become arthritic and were degenerating too. I was given a prognosis of 15 years at the most before I could no longer work (which I've surpassed) as well as the ever-present danger that a fall could pop things out of place and damage or partially sever my spinal cord, leaving me in a wheelchair. A Maternal family history of bad backs indicated that at least some of this was likely genetic in nature. I have the world's greatest Chiropractor and she has kept me going, plus now I do nothing which might injure my back in any way.

I've always had bladder control issues since birth which they concluded were caused by a nerve or brain dysfunction (bladder spasms, OAB, SI, and UI). As my back got worse so did my bladder control which was attributed to the Pudenal nerve getting chafed or irritated at where L-4 and L-5 have been mis-aligned. I never had a urodynamic study done, however my bladder capacity and function were tested after a Colon surgery which had caused my digestive and urinary systems to shut down. It turned out that while I have a normal-sized bladder, it had always emptied at half-full which was the cause of my frequent urination needs to that point. Not having insurance made a urodynamics study unfeasible so they went with all the info they did have which they deemed was enough.

So while my back problems do contribute to my bladder problems, both are separate but now related issues. I've spent several hundreds of hours doing my own research online about how all this comes together and it seems they have me diagnosed correctly. I guess that it's fortuitous that I have strong DL tendencies as that made going into diapers quite easy for me, with the outcome being that now my only concerns are for my back- nothing else is a problem to me anymore.

Bettypooh

 

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  • 3 weeks later...

babypat80,

one needs an intact, and functioning spinal cord to have normal bowel and bladder control. The reason for this is that the signal to tell your brain uses the spinal cord as the pathway. Also, the brain has to tell the relevant muscles to relax or close. Damage in the pathway does not mean one is incontinent, NOR does no damage mean one has full bladder and/or bowel control since there is so many other factors that determine bladder/bowel control.

As a result, no doctor can state, with absolute certainity, why one person has bladder/bowel control and another person has not. In your case, all a doctor can state is an educated guess why you have / have not got bladder/bowel control.

With that information, you can chose to deal with your doctor how you wish, but in my opinion, I think that if you wish to be incontinent, tell your doctor. You are giving your doctor less work - for example, if the time comes that a decision needs to be made that would extend your quality of life but the side effect is incontinence, most here would choose the incontinence. Your doctor, not knowing your true wishes, might not even tell you of this option and chose a different medication in order to protect your continence cause s/he is doing the best for you in your interest. There are some medications that have side effects that lead to incontinence, these group of medications can be stronger for a specific patient yet doctors are reluctant to prescribe same due to the side effects. I do not know your indept medical history nor am I your doctor so I can not state for definite that your doctor would prescribe same, but it is always better for your doctor to know all the information.

PS I hate the word normal as it sets a standard for all to follow. We are all different and unique. As a result, there is not, and can never be a normal.

 

 

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