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Welcome...Bladdernewsissue #9Welcome to issue #9 ofBladdernews. We wish all ourreaders a very happy andhealthy new year!In this issue, we have twofeature articles written byhealthcare professionals. Thefirst from nurse Kathy Costellotitled “Gotta Go!! MS andBladder Problems” where shefocuses on connections betweenMS and the bladder, describesbladder problems that can occurin patients with MS, and offersadvice on ways to be proactivein treatment and diagnosing.The second article is written bynurse Jake Klein who addressesthe topic of “Potty Training andDysfunctional Elimination”. Herelates how the coordination ofpotty training steps is crucialto successful voiding and theoverall establishment of optimalbladder habits.Attention all LoFric kids! We arefeaturing an exciting coloringcontest with an iPod Shuffl eand iTunes gift card grandprize! Get out your crayons andstart coloring, entries must bereceived by June 1, 2009. Thewinning picture will be featuredin our next issue, ,good luck!Happy Reading!FEATURE ARTICLE #1Gotta Go!!MS and BladderProblemsKathleen M. Costello, RN, MSNearly everyone has had atleast one occasion when theyexperienced bladder urgency– that feeling that you mustempty your bladder RIGHTNOW! Sometimes this mightoccur while on a long car ride,or on a long flight. But usuallywe do not consciously “think”about our bladder on a regularbasis.With a diagnosis of MultipleSclerosis (MS), the bladderand its function may becomean annoyance or even a majorissue. To learn why thishappens in MS and what canbe done about it, let’s lookat normal bladder functionand then what can happen tobladder function as a result ofMS.The bladder is really a flexiblecontainer for holding urine.The walls of the container aremuscular. When we drinkfluids, they pass through thekidneys and the liquid wasteflows from the kidneys intotubes called the ureters andthen into the bladder. Thebladder stretches as more andmore urine flows in. Whenthere is about a cup of urine inthe bladder, nerve endings inthe bladder wall are activatedand send signals up to thebrain. The brain then decidesif it is an appropriate time toempty the bladder and sends asignal back down to the bladderto either wait or contract.When the bladder contractsit squeezes the stored urinetowards the opening known asthe sphincter. The sphincter islike a valve that must open toallow urine out of the bladderand into a tube known as theurethra. Once the sphincterrelaxes, urine is able to flow.Most all of this activity isautomatic, although we usuallyhave the ability to “hold” urineif a bathroom is not available.So what happens in MS?Bladder symptoms are verycommon in MS, affecting morethen half of those diagnosedwith the disease. Bladderproblems in MS range inseverity and type of problem.They result from disruptionin the messages going fromthe bladder up to the spinalcord and to the brain or thosemessages coming from thebrain and spinal cord to thebladder. This disruption inmessages generally causesone of the following bladderproblems:1) Failure to store urine2) Failure to empty urine3) Both failure to store andfailure to emptyThe inability to store urine isthe most common bladder issuecaused by MS. The bladderreceives an inappropriatemessage to contract when it isnot really full. A bladder(contd. on pg. 8)3