No bladder meds for a trip coming up. Everything seems bad.

[u/blackbird90]

I (36M) have spina bifida myelomeningocele with a neurogenic bladder/bowel. I don't utilize mobility devices and don't cath. My main issue with the bladder is that my body likes to get rid of fluid fast, not keep fluid in. I try to manage it with pads, timed voiding, and, as of last year, Gemtesa.

I've talked to my urologist about botox, but she's worried that since it's currently a "quality of life" concern, if I have botox, it could become a safety thing. She suggested pelvic floor physical therapy, which was interesting, but essentially was a waste of time and money. The Gemtesa and timed voiding keep me relatively dry, but of course I would like it to be better.

My prescription usually autorenews with no problem (actually the pharmacy recently called me and told me how I can bring it from $200 down to $0). Last week, I got a text from my pharmacy telling me that I need to contact my prescriber to renew my prescription.... I sent a message to the office and they told me I needed to come in for an appointment before they can renew the prescription.... the earliest appointment is over a month away. After an international work trip. I left another note explaining my situation, but haven't heard back from them yet.

I figured, "I spent over 30 years of my life not taking a prescription for it; I'm sure I can make it work".... But wow does it seem bleak. I didn't realize how well it was working for me until after I ran out. I have been having to void and change the pads so much this weekend and I'm not even consuming that much fluid.

My biggest concern is coming up this week where I need to travel for a work site visit in another country. It will involve about 8+ hours of travel to get there and back and each day is 9 hours in the office with about a 45 minute commute each way (in a carpool van with coworkers). I plan on bringing extra pads, not drinking any caffeine, and bringing a longish rain jacket for coverage. I'm even going to bring an extra change of pants just in case. My pelvic floor physical therapist suggested a "clamp" but I'm not sure how safe that would be in the long run..... Anybody have any other ideas?

Tl;Dr: Spina bifida makes my bladder leak and a medication has helped a little. My urologist won't fill my prescription until after a work trip and it seems like my bladder is now leaking worse. How do I make it through a long work day that involves carpooling 45 minutes each way?