Three Bladder Tablets In Two Years. Nobody Ever Looked At My Bladder Wall.
Two years, three bladder tablets, a dry mouth I could not get rid of, and I was still up to pee at two and again at four. I am not against the tablets. I am still on one. I just wish somebody had told me what they were aimed at.
I want to say at the start that I am not writing this to have a go at my doctor. He is a good one. He did what the book says to do and I would probably have done the same in his chair.
But I have been up two and three times a night since I was sixty-five, I have been through three different bladder tablets in two years, and not one person in all of that ever looked at the inside of my bladder or told me what the tablets were actually aimed at. I found that out from an article. At sixty-seven.
So this is the two years written down, because when I was in the middle of it I could not find a single account of it anywhere and I would have paid money for one.
The first appointment, and the first tablet
I mentioned it almost as an afterthought at a check-up. Twice a night, sometimes three. He asked the right questions, sent me for an ultrasound and a urine test, and both came back completely normal.
That is when I got the first prescription. He explained it as calming the bladder down, which I took to mean it would fix it. I want to be fair here: he never promised that. I heard it that way because that is what you want to hear.
The dry mouth, and the first six weeks
The first fortnight was genuinely better. Once a night instead of three, twice if I had a beer. I told my wife it was working.
Then came the mouth. Dry is not really the word. I was waking up with my tongue stuck to the roof of my mouth and drinking water at four in the morning, which as you can imagine did not help the original problem. By week six I was back up twice most nights, with the dry mouth on top.
The second tablet
We swapped to a different one. Same class, he said, different molecule, some people tolerate one better than the other. That is a completely reasonable thing to do and it is what I would want a doctor to try.
The dry mouth was better on that one. The nights were not. I was up at two and again at four, which by then I had stopped mentioning to anybody because I was tired of hearing that it happens to everyone at my age.
The pelvic floor sheet, and the word pads
I got a photocopied sheet of exercises. I did them. I am not going to pretend I did them every day but I did them more than most people would.
And then somebody used the word pads. Kindly, in passing, the way you mention something you have decided is inevitable. I am sixty-seven. I went out to the car and sat there for a while.
What it was actually costing me
Not money. The money was nothing, a few dollars a month.
It was the caravan trip we did not book. It was sitting at the back near the door at my grandson's school thing and leaving halfway through his bit. It was my wife saying, without any edge in it at all, that she had forgotten what a full night's sleep was like, because I wake her every time I get up.
The third tablet, and the honest conversation
The third one was a different class again, the newer kind. Less dry mouth, a bit of a foggy head instead, and about the same at night.
To his enormous credit, my doctor was straight with me. He said this is roughly what the medicine can do, and that for a lot of men it does not do much more than this. I asked him what was actually causing it and he said, honestly, that at my age the usual answer is the bladder muscle and the prostate, and mine had both been checked and were fine.
So we left it there. Nobody had a next step.
The article, and the thing nobody had said
My daughter sent me a piece by a urologist. I nearly did not read it because I assumed I knew what it would say.
It said the tablets work on the nerve. That is what they are for — they turn down the message the bladder sends the brain. And it said that in most men over sixty the message is not the problem. The wall sending it is.
I read that three times. Two years of medicine aimed at the messenger, and not one person had ever looked at what the message was about.
| What I was given | What it cost | What it did |
|---|---|---|
| Bladder tablet #1, eight months | Covered | Two good weeks. Then a dry mouth that woke me up, and back to twice a night with it |
| Bladder tablet #2, five months | Covered | Less dry mouth. Same nights. Two and four, most nights |
| Pelvic floor sheet | Free | I did them. They are for leaking. Leaking was never my problem |
| Bladder tablet #3, still on it | Covered | A foggy head instead of a dry mouth. Nights about the same |
| Cutting water after 6pm | Free | Woke up thirsty and still got up. Worst advice I ever gave myself |
| Going just in case, before everything | Free | Trained myself to go on a quarter of a bladder. Took months to undo |
| The pads conversation | Nothing | Sat in the car park for twenty minutes |
Look down that last column. Every single thing on the list is aimed somewhere other than the bladder wall. The tablets are aimed at the nerve. The exercises are aimed at the outlet. Cutting the water is aimed at the tap.
Nobody was aimed at the wall, because nobody had looked at it, because none of the tests I had look at it.
If that list looks like your last two years, this is the part of the article that changed how I think about it.
See what the article was aboutWhat The Article Actually Said
I am not a medical man so I will say it the way I understood it.
A bladder tells your brain it is full by stretching. That is the whole mechanism. It is a bag, it fills, the wall stretches, and at a certain amount of stretch a signal goes up the nerve and you get the feeling.
The urologist's point is that after fifty or sixty years of ordinary urine, the inside surface of that bag is not clean. Minerals and acid settle out and bond to the lining in a thin pale film. He showed a photograph of it.
A wall with that on it cannot stretch properly. And if it cannot stretch, it hits the amount of stretch that sends the signal when there is far less in there than there should be — about a third, he reckons.
So you get the feeling of a full bladder on a third of a bladder. Twice a night. Then you go, and there is hardly anything there, which is the bit that always confused me most.
“Most of the bladders I scope are not weak. They are coated. We have spent thirty years drugging the nerve and leaving the wall exactly as it was.”
— Dr. Alan Reeves, MD, urology
That sentence is the whole thing for me. The tablet turns the volume down on a signal that a coated wall is sending. It is not a bad medicine and it is not doing nothing. It is just not aimed at the film.
He said getting that surface back takes three separate jobs and that they have to happen in order, which is why he thinks one-ingredient products disappoint people.
CranShield
Standardised cranberry extract at 30 per cent, with astragalus root. He was clear that cranberry genuinely does this job and that most people are taking a fraction of the dose the research used, usually as juice.
Sedraclear
Chanca piedra, horsetail and java tea. This is the one he says almost nothing on the shelf attempts, and it is the reason my cupboard full of things half-worked.
UrsiCalm
Uva ursi, buchu, goldenrod and nettle. Under the deposit is a lining that has been irritated for years and is calling full early out of habit.
All three are in one bottle, two capsules of a morning, and he was particular that it is not a water pill. That mattered to me more than anything else on the page. Half of what gets sold for this makes you go more and calls that success. I already go too much.
I take it with the third tablet, in the same organiser, on the same windowsill. My doctor knows.
What I Would Say To You
If you have just been handed a prescription for this, take it. I did, I still do, and the fortnight it bought me was real.
But ask the other question at the same time, because nobody asked it for me for two years: what is on the wall that is sending the signal, and what is anybody doing about that? If the answer is nothing, then you know what the tablet is and is not going to do, and you can plan around it instead of waiting for it.
I am sixty-seven. I got two years into this before anybody explained the mechanism to me, and it took a newspaper article and my daughter. You should not have to find out that way.
