Interstitial Cystitis Advice

If you have IC chances are that you also experience urinary frequency, in other words you are peeing a lot more then you may have ever in you life (sans perhaps pregnancy and or urinary tract/bladder infections). For some people this number isn't over-the-moon high, but for others it’s an extremely large number. (It’s worth noting however that in rare cases a patient can have IC without a marked increase in urinary frequency.)

Peeing constantly doesn’t rank very high on anybody’s list of favorite activities, and rightfully so, it’s tedious work. The average person voids less then ten times daily, assuming they are not ill or consuming large quantities of liquids. If that number doubled it would be troublesome but perhaps something you could “work around”, but when 8 times a day becomes 58 times a day or even more, peeing goes from being something you never really gave much thought to, to something that now consumes a great deal of your time, during the day and at night.

Have you ever wondered just how often you are voiding though, and how much? In diagnosing numerous bladder and prostate conditions physicians will use what is typically referred to as a “voiding diary” to help them access the patient’s urinary habits and fluctuations. Many doctors and urologists use voiding diaries to help determine the output of fluid that you void daily (and sometimes impute taken in to the body as well). It’s really a great tool on the surface level, but of course further diagnostic tests/procedure will need to be done to determine if IC is present.

If you are like me though, you are curious for your own sake. You know you are voiding umpteenth times a day, why not record just how many. This isn’t to depresses you or send you running for the nearest tub of ice cream (or your favorite comfort food), on the contrary. This is to inform. If you are still on the (elusive) hunt for a great doctor (or doctors) or if you are among the lucky few who have a wonderful physician it’s in your best interest to be as accurate as possible when describing you symptoms, and voiding excessively is certainly a serious symptom. It’s one thing to ball park it and say oh-in the neighborhood of 35 times a day, 6 of those being at night. But wouldn’t you like to know for your own peace of mind, if that number is really more like 28 or even 50? Some times we are voiding so often we lose track, one trip to the bathroom fades into another.

A voiding diary doesn’t require a lot of effort on your part really, I mean you are already doing the key thing, voiding!

Some doctors require that you track the quantity of urine that you void, some also ask that you record the about of liquid that you drink, this can be important, because if you are drinking a lot but not dispelling propionate amounts of fluid you could have problems with organs such as your kidneys. If you are keeping this record just for yourself the choice of recording the quantity is entirely up to you, but if you have never kept a voiding diary or if it’s been a number of years since the last time that you kept one, I recommend measuring, at least initially, say for 5 to 7 days, in order to get a rough pattern (chart) establishes.

If you want you can use a measuring cup and or a set of measuring of spoons to accurately measure how much urine you are voiding. This isn’t the most fun of ideas but it will help you be able to estimate how much you are actually voiding. If you don’t want to ruin your good Pyrex, (okay technically it won’t be ruined, but I guarantee you won’t ever look a that poor little measuring cup again the same, even after it’s been sterilized) try scooping out the local dollar-store or second hand shops, it doesn’t need to be fancy, just accurate and the more measurement markers it has the better! If you want to get even more accurate then the garden (or rather kitchen) variety, many hobby, medical and science equipment store sell measuring cups/bottles/tubes with very small increments. Another option is to stock up on as many of the plastic cups (with the screw on lids) as you can from doctor, and use them as you would a measuring cup as most nowadays have fluid measurements printed directly onto them.

You’re not only tracking how much you void and when, this is also an awesome way to help record pain (if applicable) when you void, and also not if you seem to experience ant urine leakage between voids. This could be a sign of incontinence or vestibules (such as in the urethra), as leakage is rarely a symptom of IC. You might also want to note how you are feeling that day in general and any strong (predominate symptoms that you are experiencing).

There is no “best” place to keep your voiding diary, but a notebook or binder with ruled sheets is good idea, or alternatively you could create a spreadsheet on your computer (say in Excel). You want to be able to give each day it’s own page (or two if you feel your situation calls for it), and have ample room to write and record your information.

Divide your page in to columns, starting on the left-hand side it’s best to put the date, say Friday or April 18th, whatever you like, just as long as you are always able to know exactly what day your record corresponds to.

Next is the time of the day (or night) when you voided, you could write 11:30pm or 23:30, whichever you prefer. The amount of urine voided comes next, this can be an exact measurement (if using a measuring device) or a rough estimate, you could say 55 milliliters or ½ cup, it’s a good idea though to keep the measurements all in the same format (cups/milliliters/etc). If your not accustomed to guessing at volumes of liquids it’s probably a good idea to measure at first, this will help you begin to realize the difference in how it feels to pass say ¼ cup and ½ cup of urine.

If you are opting to record your fluid intake as well it’s a good idea to do so either in the column directly before or directly following the voiding one. Record the time in one column and the amount (and type of liquid) in another or all in one depending on how much room you have allotted. I find it helpful to try and put the closet time voided to the last amount of fluid that you drank, so let’ say you voided at 10am and you had ½ cup of pear juice at 10:15 I would line these two events on the same line of the page. If you like though you can record what your drink and not try to align it to voiding time too, or if you are keeping a separate page or journal for your dietary intake you could record fluid levels there as well.

Next you’ll want to record your level o pain/discomfort in one column and any symptoms or abnormalities in another column if space permits. That’s it. If you don’t want to draw out the columns time and time again you can make one hard copy, say on white paper with a ruler and black ink and then photocopy and hole punch the copies, keeping them all together in a binder.

Here is an example of what your voiding diary could look like, please feel free to copy the layout.

Every person’s voiding diary will vary. You may be startled to see how little or how much you really void at a time or per day, or perhaps you will just have your thoughts and inclinations confirmed. The longer you keep a voiding diary the more it become second nature. If it doesn’t run thee risk of being damaged (eg. kids deciding tear out the pages and flush them or being used to mop up spilt aftershave) to you can keep it in the bathroom (look for a notebook with a plastic type cover or use a vinyl binder). It’s portable and can travel anywhere you can, if you can’t take the notebook with you for some reason you can always jot down the information someplace else and transfer it when you get home or have the time. Likewise it may not always be possible for you to take a measuring device with you into the bathroom (such as at work or school), which is why it’s handy to develop your ability to gauge relatively accurately how much urine you have voided.

Keeping a voiding diary is something that I recommend every IC patient do at least some of the time. It will provide you and your doctors with a realistic and accurate portrait of your voiding habits, which may lead them to try new treatment options or adjust existing ones. Also, you may see patterns emerge, for example perhaps you realize that you void twice as much in the morning as you do in the afternoon, or you are actually waking 10 times not 6, to void during the night. As well many women ICers notice (what they might have already assumed or suspected) that they are prone to voiding more often then their regular IC level during their period. Male and female IC patients often see a drastic or serious increase in the amount they void during an IC flare.

This really needn’t be a daunting task, if you forget to write down a trip or two to the bathroom, don’t worry, the idea behind this activity is really to get a clear view of the bigger voiding picture. So why not give it a try: Dear voiding diary…