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  • trying to halt midstream ... trickling continues

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    Old 05-18-2019, 12:10 PM   #1
    aphid
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    trying to halt midstream ... trickling continues

    I really hope someone can answer this question for me! I'm a woman in my mid-40's, never been pregnant, never had bladder problems. Last month, I tried to squeeze my pelvic floor muscles midstream while urinating, and the stream stopped for a second, then trickled for several seconds before finally stopping. It's gotten worse over the last few weeks, so now, if I try to stop urinating midstream, it just slows to a trickle and continues to trickle until I relax and allow it to start again. So, it's like incontinence, but I don't see anything like this described in articles about incontinence.

    This is kind of ironic, because for the last couple years, the muscles on the sides of my rectum have been permanently seized up, so that my stool comes out flattened on the sides (leading to jokes about wombat poo, since wombats make rectangular poop cubes!). I recently told this to my gynecologist, and she said it's levator ani syndrome, and she offered to refer me to a pelvic floor physical therapist. I declined, because according to Google, levator ani syndrome is painful, and I don't have any rectal pain at all.

    So what would cause one group of muscles to not tighten properly and another group of muscles nearby to not relax properly? I'm afraid that if I tell my gynecologist about this, she'll definitely diagnose it as psychogenic, stemming from some long-forgotten childhood trauma, and refer me to the pelvic floor specialist again. I have other neurological problems, like intention tremor, possibly now also essential tremor, hypnic jerk myoclonus while awake and sitting up, narcolepsy, dysautonomia-but-maybe-just-vasovagal-presyncope, possibly meralgia paresthetica in both legs, and various other symptoms that I've forgotten because of brain fog. I saw a general neurologist last year for my laundry list of symptoms, and she ordered MRIs from head to tailbone. The MRIs showed that I had had an ischemic stroke the month before (so that's what that mild headache and slight double vision for 4 days was!), and I have some damaged areas in my lumbar spine and cervical spine, which might be the cause of my lower back and neck pains, but the spinal cord itself was all clear, as was the rest of the brain (minus the ischemic stroke spot).

    I was really hoping to not have to add "urologist" and "proctologist" to the growing list of specialists on my medical record. I'm in a university teaching hospital system, where they hand out referrals like candy, so I get bounced from specialist to specialist with all of my oddball, but mercifully mild, health problems, but I don't seem to get a lot of answers. When I saw the movement disorder specialist, he diagnosed intention tremor, but he didn't offer any suggestions for what caused the tremor or how to stop it, so it was just added to my symptom list. I saw an endocrinologist/rheumatologist when both of my thumbs developed trigger finger out of the blue, and we did lots of blood tests, but they were all negative, so I just had weird thumbs for several months. I saw neurologists and had an EEG for the myoclonus, which ruled out epilepsy, but didn't find any other cause for it, so myoclonus was just added to my symptom list, and my whole car bounces when I stop at traffic lights and lean back and relax and start to jerk like a jumping bean. My thighs burn in pain when I lie flat at night, and there's a visible dent in each of my quad muscles where the pain is worst, so I had EMGs and nerve conduction studies on both legs, and they were all clear, so we did an ultrasound and a cortisone shot to test for meralgia paresthetica, but the shot didn't work, so we did a pelvic MRI to see if there was anything wrong in the iliac crest area of my femoral nerves, but the MRI found nothing but uterine fibroids, which is what landed me in the gynecologist's office, but the legs remain undiagnosed, and I'm not looking forward to the burning agony of having to lie totally flat and perfectly still for an hour when I have my PFO, which they found after the stroke, repaired with a septal occluder, which they have to insert by way of my femoral artery. Before I saw the gynecologist for fibroids, I had already seen a GI doctor for the wombat poo problem, and he did a sigmoidoscopy and said I had signs of past internal hemorrhoids, but nothing severe enough to cause wombat poo, so nothing came of that delightful procedure except my very first external hemorrhoid, which led me to buy Preparation-H and latex gloves, which is how I found out that the sides of my rectum were completely rigid at all times, even if I tried to relax them (no, it never occurred to me to stick my finger up my butt before this experience). And that's why I told the gynecologist about my poo problem, and now I'm dreading telling her about my pee problem!

    Wow, sorry for the rant! I'm just tired and frustrated from having weird (BUT MILD!) symptoms for so many years without getting answers about what's causing most of them. But this symptom -- the "midstream incontinence" one -- is embarrassing and puzzling enough, and I already have enough embarrassing problems on my medical record that gets read aloud to me by nurses at every appointment -- the latest was a man who read "Caya contoured diaphragm" on my list of prescriptions and I had to explain to him what that was, because I had to stop taking my beloved oral contraceptives after the stroke, and the gynecologist had to write a prescription for my pharmacy to get me a newfangled one-size-fits-most silicone diaphragm (which is available OTC everywhere except in the USA!), and somehow the medical software that they use listed it as a medication -- and so I'm hoping somewhere who reads this post knows exactly what's wrong and how to fix it!

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    Old 05-18-2019, 12:48 PM   #2
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    Re: trying to halt midstream... trickling continues

    Dear aphid,

    This female issue maybe based not on age so much as gravity. Not sure why you resist a pelvic floor specialist, esp since you can request a female therapist. It's not something we enjoy but it is important to rule out worst case scenarios. It is most likely just that your pelvic muscles need some professional therapy. We then how then to do it ourselves. If that doesn't work there may be a surgery you need.

    At the very least do find out what is going on, hon. I'm not sure what you are fearing. I have had the exams and while not fun it also was not a big deal. You really need to make sure there is no benign or other kind of tumor.

    Never let anyone bounce you around like a specimen. Get established with your own doctor that can order referrals and express what you want.

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    Old 05-18-2019, 06:05 PM   #3
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    Re: trying to halt midstream ... trickling continues

    Hi there. This sounds exactly like Levitor Ani Syndrome and no- it doesn't have to hurt... Mine doesn't.

    You do need a pelvic floor specialist and at your age, you want to address this now or you will be having major problems in another few years. A pelvic floor specialist is usually a woman and will teach you exercises to do or prescribe you medication if need be- don't ignore this, it only gets worse.
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    Old 05-21-2019, 12:57 PM   #4
    aphid
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    Re: trying to halt midstream ... trickling continues

    Thank you, yayagirl and MSNik! Your responses have won the day; I will ask my ob/gyn for that pelvic floor therapist referral.

    Last edited by aphid; 05-21-2019 at 12:59 PM. Reason: wasn't logged in at first... couldn't see the "say thanks" option

     
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    Old 05-21-2019, 02:06 PM   #5
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    Re: trying to halt midstream ... trickling continues

    Those icons don't work for me and I am logged in. You are very welcome! Let us know how things go for you.
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    Old 11-09-2019, 07:11 PM   #6
    michaelc45
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    Re: trying to halt midstream ... trickling continues

    If the possibilities raised in the other replies don't pan out, consider that I had the same symptom with a urinary stricture. The muscles that cut the stream off were working fine, it just took a while for the pee to empty out, due to the narrowing.

    Usually strictures happen due to a trauma to the urethra, and it doesn't sound like you had one. So it's unlikely, but maybe keep in mind just in case.

     
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