I HAD A LYMHOMA/29. NOCTURIA

UROLOGIST CONSULTATION.

One big side effect of my Cancer has been the increased visits required in the night time to the toilet for urination. At least it is now considered that the cause is because of a reaction to the Chop Chemotherapy Treatment undergone. That essentially was the conclusion of my second visit to the Urologist last week. I have been asked for more on Nocturia as the condition is termed and have done some research as below.

NOCTURIA EXPLAINED

The definition of Nocturia is that of being awakened at night one or more times to pass urine. It can occur at any age, but people like me, males over 60 ,are most susceptible.The number of trips can often increase with age.It is now classified as a condition not merely a symptom as previously with two main types.

1. Nocturnal Polyuria. This is an overproduction of urine during night hours, giving an increased volume of urine of 20/30% more than in the daytime.

2. Global Polyuria. This form affects both day and nighttime urine volume.

Urine is produced via the kidneys which pas urine to the bladder for storing prior to ejection from the body of the filtered waste products. This is done via the urethra ,this being the tube that connects the bladder to the outside of the body. Urination takes place when the detrusor muscle contracts and effectively squeezes urine from the body.At the same time as this occurs the urinary sphincter relaxes and opens the door to allow urine to exit the body.

SO WHAT CAUSES THE CONDITION?

Quite often in male Prostate Cancer is a potential cause, but scans and direct examination have proved this not to be the case. In both men and women 6 main areas need consideration as follows:

1.Behavioral Patterns. 2. Diuretic Medications.3. Caffeine. 4. Alcohol. 5. Excessive fluids close to bedtime. 6. Diminished nocturnal bladder capacity. Fluid Redistribution. This caused by horizontal sleep position which reabsorbs fluid into the blood stream from the legs in particular where it has been accumulating in daytime. Excess fluid in legs, ankles and fingers can signpost this cause.

Underlying causes however are: Diabetes, High blood pressure, Heart failure and disease, Vascular disease, Insomnia and other sleep disorders and Restless leg syndrome. As can be seen pinpointing the exact individual cause is no easy matter and, as my Urologist explained at our first meeting, whilst many potential causes can be eliminated quite easily ,it is still trial and error in other cases. It is however important to seek diagnosis by referral to a Urologist, sleep expert etc as the GP determines and progress from their. It may be a simple cause or warning of a more serious problem developing.

CONSULTATION.

At my consultation, I had brought a 4 day measurement record of my fluid intake as per time consumed and the same for toilet visits over each 24 hour period. Amounts of both intake and ejection were also calibrated by ourselves at home as requested. I arrived, as requested with a full bladder to perform a flow test which simply involves urinating directly to a machine which takes calculations of content and volume to assist the Consultant as it computes them directly. Immediately before and after that, a scan of the full, then emptied bladder is taken to check on volume and performance. For example, full, I was carrying 448ml and after 63 ml. These figures showed, apparently that all was well in terms of capacity, performance and residual amount remaining.

From the above data, the Consultant is able to calculate and eliminate certain potential causes of the problem. He had put me on one nightly tablet of REGURIN taken around 10 pm each night. I was able to confirm, as my chart indicated, namely that it had made some, if not startling improvements, reducing night trips generally to 1/2 per night. As a result, the Consultant determined that in all probability it was a reaction to Chemo which had caused my earlier many nightly trips to the toilet. He determined I should finish the course of tablets, then lay off for 2/3 weeks to see if any alteration took place and if adverse to get more tablets prescribed by my GP.He would then arrange a further appointment in 2 months and if adverse reaction obtained, I could arrange earlier with his office.

So, some improvement and a lot more information gained on what for me turns out to be a minor problem but also underlines the importance of seeking expert advice at an early date. I feel we are all guilty of not doing this and by acting as we do could be storing up big problems for a bit later on.

A Friend of mine has just received Treatment for Prostate Cancer, revealed when his PSA figures rose a bit. Thanks to early action he is recovering well, but who knows what could have been the result had he ignored it and only gone for help a couple more years down the line. I,through sheer chance, had an early enough diagnosis of my T-Cell, had I not gone in for emergency bowel operation, who knows when it would have been found, as there were no symptoms at all and may not have been until far too late. As It is I still face the vexed dilemma over High Dose which keeps us awake at nights since the consultation with Prof Linch. Alongside that NOCTURIA is now something I can take easily in my stride, at least for a couple of months or so.

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