Wednesday, March 12, 2008

Bladder blather

Lucky me, someone else cancelled their Interstim procedure, so I'll be getting mine April 7 instead of some time in July. That's good news, because the more I think about it, the more it seems as though I'm a hostage to my bladder.

I've been perusing some of the patient information/promotion materials I got about the device from my urologist, featuring accounts from patients who've gotten an Interstim. Many of them describe how their bladders were essentially ruining their lives, causing constant anxiety, preventing them from doing things they wanted to do, and leaving them isolated and grumpy. That sounds familiar. I spend a lot of time and energy thinking about peeing: Where's the nearest bathroom? How far away is it? How soon am I likely to need to use it? Can I make it there in time? If not, will I be able to put on a new pad? Do I have a new pad? Did I remember to leave some in this car?

Here's a frinstance: before I get the Interstim, I have to get an ultrasound of my kidneys and bladder. I'm having it done on Friday morning. The instructions are to fast for 12 hours before the ultrasound, and to drink 32 ounces of water an hour or so before going to the clinic. Drinking the water is supposed to help me arrive for my ultrasound with my bladder "uncomfortably full," according to the friendly people at the lab who called yesterday. It didn't really occur to me until after I'd hung up that I haven't really had an uncomfortably full bladder for a number of years, that my bladder tends to empty itself long before that point. So now I probably need to call back and bring to their attention that the reason I'm coming in for an ultrasound is that I'm more or less incontinent.

If this thing works, it will be very interesting to see just how different life becomes when I don't have to worry about pee and peeing.

Friday, March 07, 2008

Worm eggs for MS?

I think I blogged on it a while ago, but my neurologist is conducting a teeny tiny study of whether ingesting the eggs of itty bitty worms can help MS patients. According to this newspaper article, a similar study in Argentina had encouraging results:
The eggs hatch into larvae, the size of an eyelash, that stick to the inside of the intestine. In killing the larvae, the body unleashes an extra dose of regulatory T cells, which dampen overactive immune cells. Existing multiple sclerosis treatments, all of them injections, also try to block overactive immune cells. But with the worm therapy, "instead of knocking down the bad parts of the immune system, we're pushing up the good parts," Fleming said.
A study in Argentina backed up that hunch. It compared a dozen multiple sclerosis patients who were naturally infected with a similar worm with a dozen worm-free patients. Over four years, those with the worms had 90 percent fewer flare-ups and brain lesions.

Wednesday, March 05, 2008

What's new, what's old

Hello, again. I've been on hiatus for a while because over the last five months or so, I've either not really had anything interesting to say (often) or I've been too wrapped up in the business at hand to step away from it and blog (much less often).

It won't really take that long to catch up. Since last October, I stopped smoking pot and started baking and eating pot brownies, my dog developed Addison's disease and almost died, we broke a record for total snowfall in a season, and my mother-in-law was diagnosed with, and had surgery for, breast cancer.

What brought me back was this morning's visit to the urologist. Over the last couple years, my bladder symptoms (urgency + frequency) have gotten worse, although it's happened so slowly that it almost hadn't registered. Today, though, the urologist told me that he's pretty much used every pharmaceutical trick in his bag and doesn't have any new drug options for me. Instead, he said he thinks I'm a good candidate for getting a gizmo called Interstim (a.k.a. "the bladder pacemaker") implanted.

Interstim delivers a contant, mild electric charge to nerves near the base of the spine. What good will that do? The urologist explained that Insterstim fixes bladder function similar to the way a good hard smack fixes an old TV: it's not clear why it works, but it does. Here's how the process goes: First, they would implant the wires in a procedure during which I'd be sedated but awake. There are 4 wires, and they go in near some nerves at the base of the spine. After that, I'd go thru a two-week trial period during which the wires would be connected to a pager-sized control gizmo. The control gizmo can turn each of the four wires on and off independently and, I think, change the polarity of the charge sent to each wire. For two weeks, working with someone at the hospital, I'd go through different settings on the gizmo while keeping a pee-pee diary. After two weeks, they look at the results. If I've gotten at least a 50%benefit from the gizmo, they replace the pager-gizmo with a device that would be permanently implanted under the skin just north of my behind. If I haven't gotten a 50% benefit, the wires come out and I go back to my non-bionic bladder.

Cool, huh? There's a waiting list right now, so I wouldn't be able to get hooked up until July, but I told them to put my name on the list. The urologist says there's about an 80% chance that I'll see a dramatic improvement and a 20% chance that it won't do a thing for me. There's slightly larger than an Oreo under my skin, but not nearly as much as the Botox injection. And supposedly, my HMO will pay for it with minimal fussing (we'll just see about that).

So now we're all caught up. That wasn't so bad.