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Wondering what your experience has been. This and botox are the two options being recommended. We are hesitant to try either.

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I had to google it to see what it was! It sounds like a relatively simple procedure if your doctor feels it would help in your mom's situation. I always figured that urinary incontinence at 90+ just seem to be inevitable, certainly most of us on this forum seem to be dealing with it.
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Thanks, cwillie. Yes, it sounds simple. Just wondered whether anyone had a parent who'd done it. The success rate is 70% from what I have heard.
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Medicare won't cover either one. When insurance companies balk, there is usually a poor record of success.
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Got to google it never heard of it. My Internet is about to go down so may comment latter.
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After some research, as a nurse, I would recommend the botox over the pacemaker mainly because it is not covered by Medicare, it is mostly more successful in women and it hasn't shown much improvement in men. However, I have had botox for migraines injected at the base of the skull and frontal regions and it seemed to help with my frequent urinations. The best course to take is first try something that is non-invasive. Your father can bleed at the site of implantation, it is painful at the site and it may not work. Before you subject him to a surgery, try the botox or meds that can reduce the vagus nerve from overacting. He could also learn Kegel exercises to strengthen the floor of his bladder. Good luck!
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Intersteim (to help control bladder)...battery died & my Dad has demenita he didn't even know...nurse ran test & discovered. So in the beginning it worked good but when your mind/brain doesn't work correctly..NO at 90 unless the person is really in great health & mind wise, I wouldn't recommend it. My Dad's urologist wants to do surgery to replace battery & remove bladder tumor..Dad is on warafin & is a free bleeder & 89 yrs old..Dr won't be administering anesthesia just surgery..piece of cake he says..where will he be when we need 24/7 care or my dad dies on the table???????The Dr has to make a living so I'm the bad guy with POA so no was my answer. But the Dr. ran a guilt trip with my Mom so then, I had to step up & say NO..NO..NO. The Dr. still argued his point with us about pain as well as death sooner or later...My Dad could die naturally & I think that would be better..He is in no pain or doesn't even know how to express pain even if he was in pain. Demenitia is cruel as it is. Oh & the younger dentist where my folks have been going for years (not the usual dentist because guess what? he retired) pulled a tooth without my Mom's knowledge or permission & evidentally without checking my Dad's chart to find out before he pulled it that my Dad should have taken an antibiotic as well as been off his warifin for 4-7 days. Older people trust their doctors..go figure. When he realized what he did he immediately came & got my Mom & tried to play it off with her so she wouldn't sue him...but she had to take him home & watch him & she is 86 yrs old...Our medical staff is great in the fact that they have been able to extend our parents lives but at what cost later in life. I am really having a terrible time making my Mom realize that my Dad has checked out & she is dying trying to do all the same things she could have done over 20 yrs. ago & she is burnt out as a caregiver still trying to care for my Dad. She is also a breast cancer survivor struggling to get the prostheaic on & doing everything for my Dad also. And trying to get help at home...not as easy as one thinks especially if the Dr.'s won't help because of all this health care change & their position where they work..which system pays their salary & all the rules they might break just to help me help their patients.
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Thanks, pam, ferris1, and tvidos for your comments. Actually the botox was suggested to my mom by her urologist as the first option before trying the sacral neuromodulation (bladder pacemaker), and Medicare does now cover the botox, and we were told it would cover the pacemaker as well, if that was the option mom wanted to take. My worry with botox is that while the success rate is good, there is a small chance that the patient would need a catheter for 3 months to a year, and frankly, I am not up for that, which sounds awful I know, but I just can't envision myself dealing with that. More important, I am hugely concerned about UTIs. Mom had one over the summer that almost killed her. Her general practitioner is against the botox idea, and not too enthused about the pacemaker, but says it is up to my mom and her feelings about her quality of life. In the past few years, mom has tried loads of meds, but none have helped much. She tried the Tibial nerve stimulation which helped slightly but no real change. At 90+ I know this is all to be expected. I know that I would have to be the one to adjust mom's intersteim as needed, as I know she (while still pretty sharp) would not be able to stay on top of it. Personally I am okay with mom not doing either. I just hate to see her doubling up on diapers, and tripling up on pads. She is paranoid about leaking. We are definitely helping to put Proctor & Gamble's execs' kids through college.

tvidos, sound like you are really in the thick of things. Don't know how you do it. I don't think I could. I agree with your comment that "Our medical staff is great in the fact that they have been able to extend our parents lives but at what cost later in life". I think about that a lot. And I wonder where the world is headed.
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You know I am not the full time caregiver. I couldn't do what my Mom does. That is what scares me. I am afraid & I've told my Mom please don't leave me with my Dad. Of course, with dementia he realizes nothing but thinks he does. He can't stay by himself if something were to medically happen to my Mom. I'm not even sure he could call 911. She has sugarcoated everything to her Dr/Internist. As I write this, I'm writing a letter to their Dr. hoping it will encourage him to understand that my Mom is so emotional & in denial about my Dad's health as well as her own that he will help me by signing off on the evaluation form so we can figure out what type of help she can get to help with my Dad. He is so tired most of the time & begs not to go. I've been working on this for over 2 yrs. & I'm getting really tired of trying to reason that she can't continue to do everything she does when she can't. For a long time I just read all the messages other people were writing-mine could be sounding desperate but all of us seem to be struggling one way or another & even though my Mom says how she appreciates my help & loves me very much I still feel desperate for her. My siblings live so far away & all these people who want to help find assisted living, etc. they really don't get it. I was really sorry that I ever reached out to them because they don't get it. I am not really a negative person but these agencies are so not helpful. My Dad was told at 65 when he had open heart surgery that he had 5-10 yrs probably..same thing with prostrate cancer & 2 heart pacemakers later he has lasted far longer than the mortality rate the financial guy planned his future by. Right now the pacemaker is the only thing that is really keeping his heart beating. I feel so bad for him but he really doesn't know. But the chances of him lasting longer than my Mom are great. So I spend as much time with both of them doing whatever I can but it isn't good for marital relationships. Venting is so helpful. Thanks I wish all of you a great Thanksgiving with your families.
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After 8 years of dementia, my
Mom died of a brain bleed. The neurosurgeon in the hospital said he could do surgery to stop the bleed. Her neurologist asked me the million dollar question after discussing the surgery with him. " Can they do surgery, the answer is yes. Should they do surgery, is what you need to think about. What kind of results will you get? What are you exposing your mom to, infections, pain, more time in hospital, etc. is it really for you or mom" We chose not to do the surgery .
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I hit the button too fast

My mom died 2 weeks later, at home with her husband and family there. It was peaceful and pain free, we couldn't have asked for anything better .
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For the UTI problems, I use a mixture of herbs available at the local health food stores. Don't know if this would help in this situation or not. The one I use is called "Kidney Support" I think. It has corn silk, horse tail, usa uvi. and cranberry extract.
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I am just getting into this bladder thing. I had the bladder sling surgery, and not much as changed except I don't squirt anymore when I sneeze or laugh, which I don't do much of right now. I have read all of your writings and must confess I thought it all very scary. I too have been offered the Botox, and the bladder pacemaker. I am wearing pads & diapers and I am also quite sore from wearing them. I don't know any other way to protect myself. I am only 75 instead of being the age of your parents, I hate to think of what lies ahead. Oh, forgot to mention that I still take Vesicare now because I pee so much & so often. I am taking it because it was the only way to get some control. I was taking 5mg before surgery, now I am taking 10mg. I go back to have another Urodynamic study in Dec, and then I will find out what is all available, and try to make a decision. Good luck to all of you, and thanks for posting all of this information. Bunny
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My Dad got an intesteim unit implanted but still takes medication. It worked good for awhile. His memory started fading & he wouldn't let my Mom help him adjust it to a higher level. This is done with a little unit from outside & he claimed it hurt. Now, the battery has died & he wears men's adult pads. Sometimes he forgets to change them so now it is a real sticky subject. At his age, since he didn't even know about the battery being dead, when the people checked of course, they wanted to replace the battery..another procedure. We declined. He had just had a new heart pacemaker & that is probably what helps him live now. My Mom had a bladder sling done yrs ago & she got really sick & coughed a lot & she thinks it didn't hold & she wears extra long panty liners & has for yrs. I wish you luck & you are a lot younger so maybe it will get adjusted & so will you to it.
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Hi Tvidos, thank you so much for sharing your problems. I think you might be telling me that I might be very blessed to be a little younger than your parents!
I do have memory problems, but I hope I would remember or notice if the battery went out.
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My mom at 90+ had Botox, which didn't work, so they did more tests and concluded also that a higher dose of Botox would also not work (they start with a small dose and increase for more effect). Also note the Botox if it does work, wears off. ...so knowing how long it took to get the appointment 6-10 weeks you would be back in Depends waiting for your next Botox, twice a year, that's a good portion of year to be wet! So they offered the interstim, and honestly, mom was so NOT into having invasive (her perspective) exams "down there" she just gave up.
I myself have a bit of stress incontinence and wear a thin liner, and wonder what & when I will be like my mom, some day.
I just wish the Depends didn't cost a buck apiece. And nothing washable/reusable is out there.
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I agree, Patrice2oz, re: "Can they do surgery, the answer is yes. Should they do surgery, is what you need to think about." If this were 4-5 years ago, I do think I would back mom if she wanted to try the implanted pacemaker as she was much stronger then and mentally more together. She is so frail now; I can't imagine her going through any invasive procedure that is not absolutely essential. I was really annoyed last week when I took my mom to the dermatologist for a suspicious growth (looked melanoma-ish to me), only to find it was not suspicious at all, but while there, the PA could not help but find a few little things to quickly freeze off (not invasive, I know, but still--was it imperative?); did not even ask mom whether she could freeze them off. Had she asked, we probably would have said no (The GP said not to worry about anything but melanoma at this stage).

My advice to all of us 'yungins' is to do our Kegels. I think they can have great benefit at any age.
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I agree, Samara, that there needs to be a better solution than the dollar Depends. Mom likes the Tena overnight ultra/max pads, and the Poise hourglass ultra/max pads, but they are sometimes hard to find. When I shop they are often sold out.
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The alternative to the Depends is the Walmart brand. It ends up costing about half as much as Depends. It's generic. The color is lilac rather than peach. Mother seems to like them better than the Depends.
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Thanks, sherry1anne. We'll give that a try.
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Hi I received the bladder pacemaker about two weeks ago if you have a good doctor I totally recommend it I go normally now but mine was done by the number urologist in Canada
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