Desperately seeking advice!!

[Vicky_Wells]

My husband has been having some bladder problems but his doctors tell him that nothing is wrong with him. His urine tests for illness, infection and diabetes came back normal. I was hoping that you guys had some idea's? We are getting frustrated and doctors are expensive!!

 Medical Incontinence Issue

• Thirsty all the time; blood sugar is normal
• I have to pee all the time
• Started with having to go but able to hold it but know I don't always make it to the restroom
• Urge hits quickly and strongly but little comes out (a weak stream/dribble)
• Wet bed, sleep through morning pee on meds (on amitriptyline for treatment of the symptoms of TBI)
• Sometimes hurts when pee
• Sometimes leak out when I fall
• When not on sleep meds I'm up a lot to pee
• Drink about 6-8 cups of water a day
• Urine often dark
• Cold tempature makes him have to go pee
• Pee smells funny (bad) 
• Don't always make it to bathroom 
• Cyst on/in testicals 
• Testicals are tender  

[SeattleDoug]

Has his doctor checked for an enlarged prostate, or run a PSA test? That would seem to fit most of the symptoms that you listed. If those are negative I would ask if he is having any saddle area (around the rectum between the legs) pain or numbness. The sacral nerves that serve that area also control bladder and the area around and including the penis. If he is having any erection problems it could be the nerves.

Amitriptyline is nasty stuff. I'm not surprised he is sleeping through the need to go. How much does he drink before bed, and how long before?

It could also be stress. Stress can manifest itself in many ways.

Good luck. I hope you and your husband figure it out quickly.

[Vicky_Wells]

He had a prostrate check in 2008 but nothing recently.  As for erection problems, well he gets hard and erect but it takes him awhile to climax, not that I'm complaining!  The amitriptyline is to treat the minor traumatic brain injury which he suffered in Iraq in 2005.  It is being used to treat the TBI symptoms; his headaches and dizzyness.  They also want it to replace his sleeping medicine which he uses to treat his PTSD.  As for how much he drinks before bed, well he has cut back his drinks and I worry that he's dehydrated but he's only worried about not having an accident.  He tends to cut it off two or more hours before bed.  As for it being stress, well he's already taking Fluoxitine (Prozac ?) for his TBI and any more anti-depressants and he'll be a zombie!!

[SeattleDoug]

Please tell him "Thank you". I was in the Army in the early 90's. I messed my back in the service. Sorry to hear about his PTSD. That is no small issue. Thank you for caring enough to stay with him.

If everything else is in order your husband may be having mixed reactions to the medications. I hope you two find something that helps.

He should be drinking about 60 to 80 oz of water per day. Have him try to stop drinking 3 to 4 hours before bed and see if that helps. My PCP recommended me doing that and it didn't help, but that is a different issue for me. The more water he drinks the less the less the medications will show their side effects. Being thirsty all the time is a common symptom of dehydration. If he gradually increases his intake he should see some improvement in reducing the "got to go now" feelings. More water will also help dilute his urine so it doesn't smell as strong. He may have increased incontinence but it will only be until his body starts regulating the water balance again. Been there. Done that.

Tell him not to be ashamed. When I started having problems at night I struggled with the emotional baggage that diapers were for babies. I quickly learn the truth when I first tried them for bed wetting. Both my wife (now ex) and I had the first uninterrupted night of sleep in months. It was a lot of trial and error to find something that worked and diapers were it.

Doug

[Vicky_Wells]

Doug,

    I will tell him "thank you" but he gets very uncomfortable and says that he only did his job.  He was in the Army for two tours in Iraq as an infantryman.  As for his PTSD, well he feels guilty about doing his job as his squads designated marksman.  I agree though, PTSD is no small issue!  As for staying with him, well I signed up 'for better or for worse' and I meant it! 

As for the potential for this being a pure drug interaction, wellthat has been ruled out already.  I think that the amitriptyline may be part of it but not ALL of it because his meds have been tweeked a lot lately to no resolve.  Obviously I too hope that we find something that helps!!! 

Anyway, I know that he needs to drink more water but after he began having issues he cut back to prevent leaks.  I have encouraged him to get to a doctor ASAP because I imagine that denying himself water will only make it worse.  As for the night accidents, well we deal with that so that he can keeping his TBI medicines so night diapers don't bother him because the TBI symptoms are worse!  As for drinking more, well it is definitely important to protect his liver and kidneys from his sustainment medicines.  I do think that the urine smell could be his medicine but I'm encouraging him to brave the uncomfortable talk with his doctor. 

Vicky

[SeattleDoug]

Vickie,

He will have more frequent urination if he's not drinking enough water. Too much and not enough can both be dangerous.

I will keep you both in my thoughts.

Doug

[Vicky_Wells]

Thank you for your information, but I really think that it is more than pure liquid intake. That said, I will keep that in mind!!!

[SeattleDoug]

Yes, it can be more than just liquid intake, but you need to eliminate the possibilities so you are not chasing symptoms so you can find the cause. Process of elimination.

Please keep us posted on his progress.

Thank you again for your service Vickie's husband. My father was a first recon marine in Vietnam. He can relate to the PTSD. Some things he still refuses to tell me about. I know he feels guilty about some things, but he was following orders. Sometimes the orders given conflict with human morals. We have all made mistakes we don't feel comfortable with.

We can't change what has been done, only what will be done.

Best wishes to you both.

[Vicky_Wells]

Good news, he has a consult at the VA on November 2nd where he finds out if the VA or my civilian insurance will handle the bills which is a step forward. Let me tell you, that was no small feat of convincing on my part!! LOL, baby steps!!!

[SeattleDoug]

Great to hear!

Since my back problems are service connected the VA bills my private insurance then pays my copay amount for me. That is because of my income level when I'm working.

Doug