APAD Day 48 …. Showing my ass….a little

Why do so many people think that freedom of speech means freedom of consequences? For the record, it doesn’t.

I’ve been on social media a lot this week, posting status updates about my mom, going through and responding to emails about too many topics to cover, etc. To be honest my first impulse is to scream shut the fuck up you spoiled self indulgent assholes, but that would make me no better than the ones whining, tweeting, or whatever else they are doing to show their asses.

The airline example:

Almost everyday I see an article about someone getting being thrown off an airplane for being loud, disruptive, or refusing to wear a mask. What the fuck is wrong with you? What gives you the right to cause so much stress to other people. Can you take a second and be grateful that we have the ability to fly? For the people that refuse to wear a mask, the answer is simple…don’t fly. I don’t like masks, I don’t think anyone really does. I honestly don’t think they can prevent the spread of covid…maybe they help, maybe they don’t, but the law is the law. Standing up and whining that you don’t like it is childish, but more importantly it causes so much discomfort for other people. Please sit down and shut up!

I read another article about a woman who wants to sue the airline because they serve nuts on airplanes and she is allergic to them….so don’t fly?!?!?!? Why do so many people think it’s ok to assholes?

This week I have been overwhelmed with phone calls, inconsistent information etc. When I couldn’t handle it anymore I removed myself from the equation. “I’m having a bad day today, can we do this another day, please?” usually followed with TY, Have a good day! It’s really not that hard people.

I’m not saying that people don’t have a right to get upset or vent, but please take a minute to think about the consequences of how you are doing it. Is there a more effective way that doesn’t suck other people into your bullshit?…(says the girl who wrote a post about how much insurance sucks)

Let’s look at that for a minute. I wrote a post about something I am struggling with. A Post! I didn’t call anyone names, I didn’t burn or destroy anything. I asked people to be aware. I asked for advice. Maybe I’m not doing it right either, but I’m trying. I’m trying to respect others. I’m trying not to be an asshole. I’m trying not to be part of the problem.

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APAD Day 38 $1.72 to pee

Have you ever heard of a foley catheter? It is an indwelling catheter that is a attached to an external urine collection bag. If you have ever been hospitalized and needed a catheter this is the kind they used. Not fun right? RIGHT! Fortunately, they also make one time use catheters. They are individually packaged. When you need to urinate, you insert the single use catheter while sitting on the toilet. Your bladder is emptied, then you remove it and discard it. YAY!!!!…. or not.

Single use catheters are expensive! $1.72 each to be exact. So if I have to pee 10 times a day that’s $17.20 a day to pee or $516.00 a month. WHAT THE ACTUAL FUCK?!?!?!

The reason this comes up is because I have Medicare and they have decided that I am allowed to pee free of charge 6x a day but no more. If I have to pee more, I’m gonna have to pay for it. $206.40 a month to be exact. Yeah that’s not going to happen. I do have other choices though

  1. Reuse the single use catheters ( Mind you the box they come in, the patient information, and just about every website that sells catheters STRONGLY insists that they are not to be reused.) Medicare even has a commercial on tv that a person should be able to use a new catheter each and every time they urinate. (Then why the hell won’t you pay for it?!?!!?)
  2. I can use a foley catheter (walk around with a bag of pee strapped to my leg everyday) for a couple weeks a month when I run out.
  3. Try to spread awareness of this issue, hoping it will make a change.
  4. Try to enlist others to spread awareness as well.

I’ve chosen to do all four of the choices that I feel I have. I am also going to attempt to contact Cure Medical to see if they have any patient assistance programs. https://curemedical.com/contact-us/

If you are able, please share this story or blog, tell someone the story, something. It would mean a great deal to me if you would.

Do you have any other thoughts on how to work around this problem?

Living with Interstim 3 months post op

Back in August of this year, I had the Interstim bladder stimulator placement surgery. In September, I wrote about my journey with Bladder Incontinence in a post called, Being a Human Guinea Pig. A few days later, I wrote a sarcastic, yet honest post about what I was going through mentally after having the surgery. At the end of that post, How did your Interstim implant surgery go, I said that the device was already in my body, so I should at least give it the benefit of the doubt. I have, and I would like to share.

Did the Interstim Device “fix” me?

NO

Did it help reduce my symptoms more than 50%?

Absolutely!

Do I regret having the procedure?

No

Would I recommend the Interstim device to someone suffering from Incontinence?

Honestly, I don’t know. ( Not very helpful am I?)

Maybe this will help

On a day to day basis, I don’t even realize that I have the implant anymore. By this I mean, I don’t really notice it unless I am looking for it. I don’t feel any pain at the incision site while I am sitting, driving, walking, bending over, etc. I use a leg press machine for physical therapy and have not had any issues with that amount of pressure against my back side either. I have to admit that I do miss the “ass pats” (spankings?) that Einstein used to loving provide, but to be honest we are both a little nervous about that experiment.

I did not die in the MRI

I was very anxious about having my quarterly MRI last month, (another story for another time) but after finding a location that had the equipment and experience to perform MRI’s on patients with implanted devices, my anxiety about my body being ripped apart while in the tube has been relieved. As a bonus, the pictures from the MRI model that they have to use are 1000x better than any of my previous 100 scans!!!

Going through Airport Security with an implant

I am pleased to report that I also did not die while going through airport security at O’hare or Denver airports. (I did this two times just to be sure.) Medtronic supplies you with a card stating that you have an implanted device and can not go through the metal or magnetic detector. You can also always ask to have a pat down from TSA, but I had no trouble standing in the usual “stand still here and put your arms above your head” scanner.

Other horrible things that did not happen

The above list had me terrified, but to date I have done the following and have had no issues:

  1. Driven a car without turning it off
  2. Operated power tools including a drill and a saw while standing on an aluminum ladder
  3. I carry my cell phone in my back pocket (over the device) for 90% of my waking hours
  4. Operated all household appliances including the washer, dryer, dishwasher, microwave, vacuum cleaner, freezer, computer, television, security system etc
  5. I have been to the dentist with my 2 year old grandsons, not as a patient

What HAS happened after having the device implanted?

Most of the time, I am able to hold 400-500 ccs of urine before leaking. (pre interstim and without Botox surgery, the number was closer to 150 ccs) I still have to use a catheter to empty my bladder completely, but am actually able to “pee a little” on my own (if that’s a thing). *Drinking Alcohol changes those numbers. Beer seems to run right through me. The carbonated or hard selzer drinks ( Vizzy, white claw, corona) seem to move a little slower, but still increase frequency and decrease retention.

The only other change

I have to “recharge” the device once a week.

As you can see, the recharger is about the size of my hand. Also in the picture is an elastic belt that you can put the charger in to wear while you are moving around. The Medtronic website shows a woman gardening while wearing her belt. Yay her! (This doesn’t work for me.) I have found that I have the best results and shortest charging time, if I sit at the computer, put the device under my underwear and don’t move for a half hour or so. For some reason, when I am re-charging, my right foot (the one that has that all the titanium in it gets very warm)

While uncomfortable, its not incredibly painful. Maybe it’s a coincidence? Maybe that is where the nerve that is being stimulated ends? I’m not sure. I could also turn down the charging speed, but it takes twice as long to charge and sitting still IS difficult for me.

If you are reading this because you or someone you care about it considering getting the Interstim, I wish you the best of luck. Only you can decide if it’s right for you. DO YOUR RESEARCH!

How did your Interstim implant surgery go?

GRACE : I can’t tell you.

Wonderful friends: What do you mean you can’t tell me? Weren’t you there?

GRACE : Yes.

Wonderful friends: Have you noticed any difference?

GRACE : Yes, my back hurts and I am supposed to do nothing for the next two weeks.

Wonderful friends: What do you mean nothing?

GRACE : I don’t know the drug rep said don’t bend, twist, or lift anything over 10 lbs, no driving, no sex, don’t touch it….. So basically nothing!

Wonderful friends: Well what do you expect, you just had surgery?

GRACE : Yeah yeah, I’m gonna go do nothing…Thank you for asking, ttyl

Two days later

Wonderful friends: Are you feeling better today?

GRACE : What do you mean? It doesn’t hurt as much, but I can’t really do anything so I’ve been kind of grumpy.

Wonderful friends: Do you notice any difference with your symptoms?

GRACE : Nope! I don’t feel anything. I’m still waking up soaked. I don’t know if the device is on or what it is supposed to be doing. The doctor hasn’t even called me back to tell me if I can take a damn shower….grrrrr

Wonderful friends: When do you see the doctor again?

GRACE : TWO WEEKS!!!!! I’m gonna go, they sent me home with all these books to read and I should probably get started on that.

An hour later

GRACE : Incoherent mumbling

Wonderful friends: Why are you crying, did you try to do something you weren’t supposed to?

GRACE : BECAUSE I DON’T KNOW WHAT THE FUCK I JUST DID!!!! I feel like I have a fucking alien inside my body! I am terrified to move wrong so I don’t break or disconnect anything, what if I end up paralyzed?!?!?!

An MRI is like the biggest magnet we are ever gonna come into contact with right? So If it’s MRI approved, I should be good right?!?!?!?!?

Why does this book tell me to AVOID ALL MAGNETS…stereo speakers, computer disk drives, keep everything a minimum of 4 inches away from the implant!!!!! So I can’t carry my cell phone in my back pocket?

OH! And I have to shut it off before driving?!?!?!?!?!?!?!?

What the hell did I get myself into?!?!?! Why wasn’t this information available before surgery?!?!?

OH and it says NO skydiving, or things that could jostle the impant. Does that mean NO Horseback riding?!?!? High Altitudes should NOT affect the device?!?!??!

Can we just say I had a really bad couple of days? Maybe even a couple more melt downs. I FELT tricked, lied to, deceived….you get the point. How could I go in an MRI (remember really big magnet?!?!?!?), but I had to be afraid of a stereo speaker?!?!?!?

Once I calmed down enough, I came to the conclusion that this device was already in my body, so I should at least give it the benefit of the doubt. I went through each of the books that they had given me marking each page with questions. (I ended up with 2 pages)

Finally the time came for my post op appointment. I knew that the drug rep would also be there and even though, doctors weren’t allowing patients to bring anyone with them to their appointments ( smh covid) I NEEDED Einstein with me, so HE WAS COMING IN WITH ME!!!!!

I’m not sure if it was the xanax I had taken, the fact that the office didn’t fight me about bringing Einstein in, or the fact that while we were waiting to see the Dr.we began talking to another patient that had also had the same surgery, (but for different reasons) but by the time we were shown to the exam room, I began to relax.

So far I have written about my emotions concerning this surgery. Emotionally, I did not do well. Do I regret getting the Interstim? Honestly it is too soon to tell. I DO however, regret that I didn’t meet with the Medtronic Representative BEFORE surgery. I WISH, I had seen the device, and all of the equipment that comes with it…but that’s on me.

Our conversation with the doctor and the representative lasted over an hour. I will continue to write more about my experience in the future, but I don’t want to leave you with any misconceptions…. Here are some points that were explained to me.

  • The interstim leads were NOT placed in my spinal cord, but by my sacral nerve. (meaning the device should not paralyze me, if I do get a shock)
  • The warnings concerning magnets is that they could turn the device off, but will not cause it to pull out of my body
  • Flying in an airplane is safe (I hope) and I am allowed to go horseback riding after I give everything more time to “settle”.

I’m am still nervous and anxious, but I’m no longer terrified. As I mentioned before, this device is already in my body, so I should at least give it the benefit of the doubt.

Being a Human guinea pig

A quick search of Google defines A Human Guinea pig as “something you experiment on. When someone calls himself a human guinea pig, he means he tested a theory or method on himself.” When someone allows themselves to be a human guinea pig in the medical community, they allow doctors and/other so called experts to experiment on them.

Why would anyone allow themselves to be a experimented on?

While I can not speak for others, I can tell you the reason I DID was out of desperation. I have never been good at taking no for an answer, or hearing there is nothing else that can be done. When I was in my mid thirties I had reached my breaking point regarding urinary incontinence, urgency, and retention.

A little bit of history

My bladder issues began when I was around 28 years old. I would have the urge to urinate so strongly that I would leak, yet I would end up sitting on the toilet unable to void even a drop of urine on my own. After trying for several minutes, I would stand up, begin to redress myself only to start leaking again. These leaks were not small drops. Next came wetting the bed. (Ironically this occurred at the same time I was potty training my daughter) grrrr

Time to see a urologist

The doctor came in to the room, literally shrugged his shoulders and muttered, “You have MS, and you’ve had a hysterectomy, what do you expect?” He said, “there is nothing that can be done”, and left the room. I was shocked and outraged.

Urologist Number 2

After “licking my wounds”, I made an appointment with another urologist who I immediately lied to. I purposefully omitted the fact that I had a hysterectomy and MS when filling out my patient forms. After the doctor performed a post-void residual, (a test that measures the amount of urine left in the bladder after urination with an ultrasound.) and they questioned why I had no uterus, I was “busted”. The tears that I had been holding back for months rushed from my eyes as I began to choke out my apology and an attempted explanation for my omissions. Thankfully he was very understanding of my desperation. He sent me to an office at the hospital to learn how to self cath.

I have been doing this ever since. I have tried every Anticholinergic on the market with limited success from each. I’ve have had urodynamics testing performed numerous times. I have gone through bladder retraining and pelvic floor therapy. I have restricted my fluid intake to the point of dehydration. All of these things “helped a little” but not enough, and not for long. Finally, urologist number 2 referred me to a specialist at Loyola University Medical Center in Chicago.

Introduction to being a guinea pig

After meeting with this specialist and undergoing urodynamics testing again, she informed me that I had exhausted all forms of approved treatment for my conditions. Fortunately though, the hospital was currently seeking patients to enroll in the study of Botox treatments for Urinary Incontinence. I would even be paid to participate in the study if I was interested.

I can, and may at a later date, write an entire post about my experiences while being involved in the study, but at this time I am simply going to state the the treatments were approved.

For the last several years, I have been receiving botox injections in my bladder. During the trial, and for the first year or two afterward, every three months, I would drive an hour and a 1/2 into Chicago to have this performed . The procedure was done in the doctor’s office with the whole thing taking a little over an hour. Here is a link to the drug company if you are interested…. Botox treatments for bladder incontinence.

I was on top of the world! I still had to self cath, but I was rarely leaking anymore and I could go hours in between bathroom breaks!!!!!!!! No more poise pads, wearing depends or constantly feeling that I smelled like urine!!!! Botox worked great for me, until it didn’t.

The doctor at the university told me that most of her patients could go 9 months between treatments, and she refused to do them any more frequently than that. Research from the drug company stated that recommended time between treatments is 6 months although, they could be administered as frequently as 3 months. Feeling “normal” for 3 months and then “regressing” to leaking, pad and depends wearing was not an option for me. So the search for a new doctor began.

It took me more than a year to find a doctor that was willing, and able to perform the injections more frequently, but even he was not comfortable with doing them more frequently than at 6 month intervals. Also, he could not perform the procedure in the office, like I was able to at Loyola. I would have to receive botox at the hospital in an outpatient surgical procedure. If you would like to read my vent about it having to be surgery, please bookmark, “you’re getting botox where?”.

During my initial visit with my current urogynecologist, let’s call him Dr. S. , he informed me about a ‘newer’ treatment that was being used to help manage OAB or overactive bladder called the Interstim by Medtronic. The problem was, the device was not safe for use in MRI’s. (Until recently, I have had to have MRI’s yearly to remain on Tysabri. Now I have to have them every 4 months, but that is another story.) So having the Insterstim implanted was not an option for me BUT….

The same company that developed the Interstim, developed a treatment called PERCUTANEOUS TIBIAL NEUROMODULATION or PTNS. Their website provides this information about the procedure if you are interested.

MEDTRONIC BLADDER CONTROL THERAPY DELIVERED BY THE NURO™ SYSTEM

  • Known by doctors as percutaneous tibial neuromodulation (PTNM)
  • Targets the tibial nerve above the ankle
  • Does not require a programmer
  • In-office therapy
  • Starts with 12 weekly, 30-minute sessions followed by maintenance treatments every three to four weeks
  • Used to treat the symptoms of OAB but not retention
  • Does not cause unpleasant side effects like oral medications can2
  • Ideal for people who can’t tolerate surgery

I’ve also posted this video on my Youtube channel showing how PTNS is performed.

So again for the past several years I have been somewhat successfully able to manage my bladder issues, with a combination of PTNS, frequent self catheterization, and surgery to receive botox injections every 6 months. Some time during the last year though, I have begun waking up soaked almost every night or having to sleep with an indwelling catheter, in spite of having all these treatments.

In October of last year, Dr. S told me that Medtronic had come up with an Interstim device with Surescan MRI SAFE leads and was just waiting to be approved by the FDA. In February, it was still not approved, so I had botox surgery again. Maybe this is the last time?

Each month when I went in for PTNS, I asked Dr. S if the FDA approved the device. Each month he told me, “not yet but they are close.” I would grit my teeth and tell him I would see him in 4 weeks. When I was at my appointment in July, Dr. S surprised me when he came in to the room and announced, “We are going to go ahead and schedule you for surgery next month”. “Seriously?!?! It’s really been approved?!?!?” No, not yet, but they are saying any day now.

Surgery was scheduled for 8 am on August 19th.

I got a call from their office on August 12th, stating that it had finally been approved and surgery would go on as planned. Talk about nerve wracking!

On August 19th, 2020 I had one implanted.