Yesterday, I connected with a new physical therapy studio. My wife found it on the web somewhere; unlike my other Health Care Providers, it's a long fifteen minutes away from home (and that's if I don't make the signals the right way); and unlike many places I've been recently, the doors to things like the building and the bathroom seem to have been set up with wheelchair-users in mind. The doors don't push back at you. They just open, or close. But they don't push back. As fun a zero-g-simulation as such things might be, on paper... Trust me, they're not always. If ever. So, two up-checks in their favor, immediately!
The "initial visit" assessment outstripped my experience with the therapy company my insurance company sent me to a couple of years ago (I quit going because it wasn't worth the money they were charging me and not reimbursing me for, I have no idea why, plus midstream their rates went up and the company rebranded, not a winning combination). They seemed honestly distressed by the logic of my explanation of why I have nothing to do with Western MS drugs (short story: it's not possible to tell you whether they've helped you or not, given the inherent pseudo-random variability of MS itself; and the only thing the manufacturers do promise is that you're definitely gonna feel awful. On which promise, I've heard, they deliver 100% of the time).
But, one thing they did suggest, which I think is worth sharing with my fellow MSers, is that there are such creatures as "neuro-bowel" doctors and "neuro-urologists," people who are specifically interested in the neurology of those systems and how to assist people who (like many of us) have ... issues... in those areas. They told me to ask my own doctor first, but that if any questions arise, just call the MS society and they'll help. So, if I can connect to one of those folks, I'll also report here.
The physical-therapy person gave me some great tips just on standing up and sitting down; very Alexander-Technique-esque, in many ways. One of her tips for me was to keep my back straight when I was doing that... My own investigation/experimentation suggests that the improvement in part is related to improving mechanical efficiency; when the back is rigid, inelastic, the "standing up" energy is more effectively put to use in standing up, rather than dissipated by the "bouncy" rounded back.
And for those of you who might struggle with the whole "make your back straight" instruction, here's my own personal favorite trick: don't think of your back at all. Move the top of your head to be as far as it can be from the floor (when standing) or from your sacrum (when sitting). "Straight back" happens automatically. But the "visualization" road to the straight back is much simpler, plus it has "unintended side-effects" of straightening parts of your back that actually are your back but that you may not have thought of as being part of "your back." "Get the top of your head as high/far as it can go" fixes the back below the neck, and all the bits of the neck, and your head alignment on top of your spine. I've had vocal teachers and my kyudo teacher tell me that this way works (and some have asked to "borrow" that trick for their own work). As a choral conductor, I've seen it work on choristers of all ages, instantly and effortlessly. If you have spinal/neck issues, your mileage may vary, and if you're received specific instruction to the contrary, of course follow it! But if it's safe for you do do so, experiment with it... Who knows what you'll discover?
So, in a matter of days (perhaps weeks, depending on their schedule) I'll be on a new program, specifically designed for me, to address the issues I'm having here and now.
Custom care; no negative side effects. Can't beat that in the MS game, can you?