Cough Cough Whiz Whiz - Oh What a Relief It Is

Bladder cancer. So much fun. So many new things to experience and enjoy.

I’m a five-year “survivor” of stage 2 high-grade bladder cancer after chemo and surgery. They removed my bladder and prostate (had a bit of cancer there too) and installed a neobladder. Quick description of a neobladder in case you’re just now jumping into this site mid-stream (pun intended). A neobladder is one of the diversion options you can request(?) when you get a radical cystectomy (removing your bladder). It involves creating a new bladder from your ileum, attaching it inside your abdomen and connecting to your urethra for voiding. From the outside it all looks normal. On the inside it is all new equipment.

Training your neobladder

One of the things you have to do with a neobladder is “train” it. Yep, I said train.

What that means is that since you don’t have your original equipment you don’t have all the same muscles that normally hold back your urine. You still have some - but the ones left over aren’t designed to do the entire job that you need them to do now. Therefore, you have to “pump them up” and do kegel exercises to strengthen your pelvic floor muscles do what used to be done with muscles around the prostate and bladder. Over time, many who have neobladders will gain the same level of continence as before their surgery. Others don’t regain that level of continence and must wear pads and such to keep the urine from leaking all over. I am pretty lucky. I’m continent during the day almost 100% and at night about 90% if I get up every 3-4 hours to void.

What they don't tell you

But all of that is pretty boring run-of-the-mill bladder cancer stuff. The doctors, nurses, and communities like this all tell you that same thing. Training is critical. Your mileage may vary. There are no promises.

What they don’t tell you is this.

The MOST frustrating part of a neobladder diversion is… wait for it…

The common cold.

Yep - a cold. The scourge of humanity. They can put a human on the moon but they can’t cure the common cold (and cancer - that too!!!)

Here’s the deal with a neobladder. In order to push out the urine from your new “ileum-enhanced” urine receptacle you need to use your abdominal muscles. You contract them like you’re doing a sit up and that compresses the neobladder and pushes the urine out through the urethra. Normally, your made-from-scratch bladder has a muscle around it that contracts and does the squeezing for you.

Now, when you have a cold, with a nasty cough, your new custom rig doesn’t work quite like the your old one. First, your muscles for holding in urine are much weaker even with training, and the muscles you use to cough with are the same ones that push out your urine.

I’ll let you puzzle that one through for a minute....

You got it!

The perils of coughing

Every cough not only clears your throat and lungs, it also clears your bladder too.

Hence the title of this post.

With almost every cough, a little bit of urine gets jettisoned. While most people cover their mouths when they cough I have to cover my groin too!

And while I’m getting more comfortable with small amounts of dribble now and then, when you get a bad cold it gets intolerable. To the point that either you resign yourself to changing underwear every 20 minutes or so, or you reach back into your supplies from the “old days” and put on a pair of adult diapers.

The rock-star life no?

Truth - I’d choose this over the alternative any day.

Excuse me while I sneeze and cough my way into a new outfit.