IMRT--strategy for keeping a full bladder

I start my IMRT on Monday and I've been instructed to show up each day with a "comfortably full" bladder. I'm mildly concerned about getting this right since following my HDR brachytherapy, I've found that when I need to go, I really need to go.

I'm having my treatments at UCLA and it's likely to be a minimum of 90 minutes from my door to when I begin treatment. I'm thinking I should leave the house with an empty bladder and once I get about 45 minutes away I can begin drinking water in the car. UCLA had suggested 24 ounces of water, but nothing more specific than that.

I know everyone's response to drinking and filling up your bladder is different, but hoping to get some feedback as to whether or not this is sensible for a starting point. I presume after a few days I'll have a better feel for this and can adjust my routing as needed.

Michael

Michael:

I had 36 IMRT treatments and at first the timing of when to drink water before treatment was hard. It took me about 1/2 hour to go from work to the treatment center, I would empty my bladder at work and when I got on the road I started to drink a bottle of water, 16oz, I believe, and by the time I got to the center I was starting to Bust from holding my bladder. Sometimes I would get changed and go right in for the treatment and other times I had to wait because they were backed up. When I had to wait, it became hard to hold it, only one time did I go relieve myself and try to just let a little out, try to stop peeing once you start!!:) After a couple of days you will get a feel for the timing of when to drink, just remember that you won't always go right in.

Good luck on your treatment.

Joe

Check my sig - in the IGRT journey thread there is a lot of what now appears to be humorous now about my trials with water, pads, and getting the drivers seat shampooed and the electrical parts replaced.

Eventually I got it to 500ml at 40 minutes out, and I always tried to arrive well before my appointment so that I wasn't "shaking the bottle" so to speak.

Michael -

You've gotten good advice so far. I would emphasize what has been said: every man is unique, and you need to tailor whatever advice you do get to your own situation.

Just a couple of other points from my own experience:

(1) I actually mastered the art of going into the mens' room adjacent to the radiation waiting room and letting out just a little while keeping the rest of it in, thus relieving pressure but still keeping my bladder pretty full. Yes, I know this is a challenge, as you say, but if you keep doing it session after session, as I did, you may wind up exercising the muscles involved to the point that they get built up to the point where, after a while, you can really do this kind of "partial unloading" without a huge amount of discomfort. At least that's what it felt like was happening with me, and it worked out for me. Worth trying, anyway.

(2) please remember this one: when you're laying on the table under the machine, that is, laying in the plastic body mold they made for you, do NOT worry if you just lose it once in a while, and a whole bunch of pee comes flowing out of you because you just couldn't hold it in any longer. This is exactly what happened to me four times out of the 45 sessions I had, early on, before I had mastered the technique described in (1). DON'T be embarrassed, because the techs have seen it all before, and it will be no big deal to them. In fact one of my techs, a delightful young woman named Marie, playfully yelled out "Clean up on aisle 1" one of the times I lost it. Your techs will be OK with it, believe me. The worst that can happen after losing it like this is you may need to go back out to the waiting room, drink some more water, fill up your bladder again, and then go back in later for a slightly delayed treatment.

Getting through radiation is largely, as has been said, a matter of patience, a sort of endurance contest. You can do it. Personally, I made up a treatment calender, and marked off each day as I competed a session. This gave me a sense of accomplishment.

One other thing comes to mind. You will probably discover that there will be a group of three, four, five or so other patients who will always be there in the waiting room at about the same time as you every day (assuming your place has its patients reporting for treatment at the same times every day, each for his own appointment). You will see then every day. Get to know them. Chat with them and be friendly. It will help pass the time in the waiting room, and you might even learn things from them. I know I did from my "waiting room colleagues." There were five of us in my similar-appointment-time "club": four PCa guys (including me) and a woman with BC. We had our own little group over in a corner of the waiting room, and getting with those folks every day and talking and laughing with them, and learning from each other, definitely made the waiting easier.

On a bit of a darker note, you may be aware that one of our list brothers here, Purgatory, had a terrible experience with getting radiation doses on an empty bladder. If you read some of his posts, you will understand how awful the outcome of that is. So whatever you do, never let them treat you while you have an empty bladder. If they're a competent group, this should never happen. But if as you're getting on to the table one day, if you just "feel" that your bladder isn't full enough, bring up the subject, and see what they say.

Once more, patience is really the best quality you can have for this. So, good luck with your treatments!

I drank 20 oz. of water 30 min. before my appointment time and I always brought a bottle of water with me. Quite often they were running late and I'd do the same thing 81GyGuy did, use the bathroom and release just enough where I was comfortable, go back to the waiting room and drink more water.

A couple of times I had to wait an hour before being zapped. Toward the end I got into the habit of calling ahead (live only 20 min. away) to see how backed up they were.

Thanks Michael and all the responders. I'm starting Monday as well! I've been wondering the same thing. A few days ago I emptied my bladder, drank 16 oz, and held it 1:15, figuring that will be enough. So my plan is to drink 16 oz 45 mins ahead of time.

I've had a lot of aches and cramps in my back and groin thus week. I think it's a virus. Glad it was this week or Id be blaming the radiation.

Good luck and let's keep each other posted.

I bought enough 20 oz bottles of low-sugar gatoraide to have one for each session and put them in my trunk. I had a 25 minute drive from my office to the center. Before I left I would pee and chug 8 oz of water. When I got to the car I would grab a bottle of gatoraide and drink it as I drove, looking to have two or three oz in the bottle when I arrived. When I got there I would count the patients who were ahead of me for the machine. If there was more than one I would go pee again and drink the last couple of oz. It worked pretty well but most days I did have to stop at two grocery stores to pee on my half-hour drive home.

One added benefit was that when I opened the trunk I could see how many bottles were gone and how few were left. It helped give me a sense of making progress through my weeks of treatments. It was a good feeling to pull out that last bottle on the last day.

I had about a half-hour journey to the hospital. I made sure I arrived around 30 minutes early and I never drank until I got there - I even had to forgo my morning cup of tea to make sure I set out "empty." Even with these precautions I still had to learn the locations of all the farm gates/fields I passed en route which I could, in extremis, pull into for a quick slash - i.e. those where there were convenient bushed to hide behind ! Towards the end of the treatment I couldn't drive home without having to stop either......

The problem with their instructions is that you only know for sure when you over do it.
You don't get an empty fuller fuller Fuller Full gauge.
Comfortably full for me gave just enough time to dress in street clothes before needing a stop. That meant, of course, that if they were running late I'd couldn't make it to street clothes. I admit, too, that there were times I questioned whether the extra pressure from leaning over to tie my shoes was worth not being barefoot in a public restroom.

So is a full bladder more to prevent colon issues then it is to prevent bladder issues?

I only had two treatments this week because of a flu delay but I found a good way to time the water. I stop drinking 2 - 2 1/2 hours before the radiation. Then I make sure my bladder is empty an hour before radiation and begin drinking 16 oz 45 minutes before radiation. That ensures there will only be 16 oz going into the bladder, which is its capacity. It's uncomfortable but I was able to hold it as much as 1 1/2 when I had an unforeseen delay (I hit the emergency shutdown switch by mistake).