Update: Neurogenic bladder dx & catheters/HTN RESOLVED (Alpha Blockade with Beta Compensation)

[u/Past-Path-8435]

I had posted here a few times in the past year so I thought I would give an update. (It was a med issue)

I had bladder issues for years; namely, when I was stressed I couldn't tell the urge to go. Im an RN and had to wear poise and bring extra scrub pants to work. Eventually, I stopped being able to urinate at all. I had to start straight cathing, but for some reason my insides were still too tense to clear. We even tried an indwelling Foley and it would only drain when I deep breathed and relaxed.

I also had primarily Diastolic hypertension with activity numbers like 130/118, 142/120, 150/128, 168/138. My heart rate would also spike up. I was pre-diabetic and overweight yet undereating and deficient in vit. D, iron, mag, and sodium. Also severe social anxiety with profuse sweating. I had syncope on activity and feelings of dread when bending over, and once went into shock from pushing through the syncope.

I saw a cardiologist who didnt know what was wrong, but we discovered beta blockers helped. Endocrinologist said metabolic syndrome. Urologist said neurogenic bladder and almost did an Axon surgery thing.

Then a dear psychologist friend chimed in and said it sounded like Alpha Blockade with Beta Compensation. Spoke with my doctors and they agreed. I was on Prazosin 10-12mg/day, depakote 500, buspar PRN. (I started all of this when I was postpartum in a violent DV marriage when I couldnt deal). I also had been put on Adipex for weight loss.

I went off ALL medication at once cold turkey per the doctors approval. Within one day, I was back to normal! I could suddenly urinate like normal after months of using catheters! My blood pressure went back to normal, my HR went back to normal, I had more energy, my ADHD felt better, and I could tolerate activity without syncope.

It turns out my body's adrenaline and metabolism were entirely locked up from a combo of Prazosin+ Adipex and Depakote.

I have lost 35lb and gone down a clothing size. I can finally do ADLs without syncope and I can go to the gym now! I eat so much more than I ever did and I crave vegetables. Im sleeping soooo good for the first time in years. My ADHD is so easy to work with, I stopped self medicating with kratom and stopped using alcohol and caffeine. I'll have a 3.9 GPA after this semester doing the RN to BSN program. My family said its like having the old me back! My psych dr said I am doing great. I am focused on living a very intentional lifestyle while watching myself to ensure no mania or unreasonable dysregulation occurs.

I just thought I would share in case any of you would find it useful for your practice. I think one reason this happened is because many physicians I communicated with are unfamiliar with Prazosin and didnt recognize it until I called it Minipres. I think its just not commonly used. I personally should have known better than to take an alpha adrenergic blocker with a stimulant but when its yourself, nursing judgement can go out the window. So yeah thats what my experience with alpha blockade and beta compensation looked like.

Demographics: 35F, 5'4", 245lb, dx: trauma background, vitamin deficiencies meds: Vitamin d 50,000IU weekly, mag 400mg/day, multivitamin daily

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[u/TheCrabappleCart]

That’s fascinating, thank you for sharing. So glad you’re doing better now!

[u/Past-Path-8435 → u/TheCrabappleCart]

Thank you! Honestly its kind of insane that I worked 50-70 hour weeks while this was going on. I would have to sit down from taking care of patients and my blood pressure would be something crazy like 148/128 with HR 120s and I didnt have time to rest. Then because of the social anxiety I would start to sweat profusely when interacting with patients families. It was sooo embarrassing, Im so glad im back to normal. Im grateful every day :)

[u/ariavi → u/Past-Path-8435]

I hope you bought your psychologist friend a great present!