[give_form id="19690"]

But You Look So Good

A Guest Blog Post from Alice Thomas: In the early days of my MS I regularly heard ‘But, you look so good.’ While I have always been happy to have my good looks admired, rather than feeling like a true compliment, this statement often came across as one of disbelief that there could possibly be anything wrong with me; Discover the challenges of living with invisible struggles.

Invisible Struggles – Living with a Condition You Can’t See

I have even been skeptically asked ‘Are they sure you have MS? You don’t look sick.’ To which I am tempted to reply ‘You don’t look ignorant’. Because the question is inherently impudent and compels us to provide proof we actually have a disease. As patients, we don’t want pity but we do wish to be understood and we shouldn’t have to explain. So, what’s the answer?

One of the barriers to negating this confusion is that invisible symptoms can be difficult and even socially unacceptable to talk about. Amongst the many aspects of MS (Invisible Struggles) that aren’t obvious to the casual observer, bladder and bowel dysfunction are some of the most distressing.

During my own looking so good days, this may have been the most troubling of my symptoms. I didn’t understand it so how could I talk about it and furthermore, why would I want to? It didn’t seem right to answer the old ‘But, you look so good?’ raised eyebrow with the truth that actually I was up all night doing laundry and crying because I’d peed the bed.

Adding to the frustration and confusion that looking good doesn’t necessarily equal feeling good, is that we as patients already question this ourselves and sometimes we are the most unforgiving accusers of all. We too can’t clearly see our own fatigue, nerve pain, numbness, muscle weakness or heat sensitivity. Consequently, we repeatedly set ourselves up for failure by not recognizing or respecting these unseen forces and then feel angry and defeated when we can’t accomplish what we’ve set out to do.

We are the unwilling soldiers in our bodies’ civil war and it is a physical battle but also an emotional one. The physical struggle might be about the strength of our legs on any given day but the mental one is often an argument to simply will ourselves to do that which, based on how we look, we think we should be able. What we need to tell ourselves is the same thing we need to hear from others. MS is real. MS is hard.

Expand on the mental health implications of living with an invisible illness.

The answer to the dreaded ‘looking good’ statement isn’t to defensively list off every manifestation of the nasty disease that exists within us. You don’t owe anyone an explanation of something as intimate as your health. Nor should you have to prove your condition. But the question isn’t going away. Determining what is caring inquiry and what is idle curiosity can inform your response in these interactions.

I’ve often found myself uncomfortably blurting out more than I wanted with someone who didn’t really care anyway. Rather than referencing my latest MRI, I’ve learned to point to some resources. Now when someone remarks on my striking countenance I say ‘Thanks, I inherited my mother’s flawless skin. MS is a complicated illness. If you want to know more, may I suggest checking out the MS Society website?’.

We are all curious from time to time. Let us act out of compassion and before we glibly assess the state of someone else’s health, of which we actually know nothing, pause a moment and instead of saying ‘but, you don’t look sick’ admit that we don’t really know much about the problem and ask how we could find out more.

Alice Thomas lives in Toronto with her husband and dog. She is an avid traveler, an arts enthusiast and a cheese fanatic. She is the author of the blog Tripping on Air - My trip through life with MS.

Alice Thomas lives in Toronto with her husband and dog. She is an avid traveler, an arts enthusiast and a cheese fanatic. She is the author of the blog Tripping on Air – My trip through life with MS.

Comments

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Related Articles

An older couple walks hand in hand on a forest path, smiling at each other. Sunlight filters through green trees, creating a peaceful, natural setting. Thanks to reliable bladder leak pads, they enjoy their stroll with confidence and comfort.

Ask The Expert: Can You Live Without a Bladder?

Are you or someone you love scheduled for bladder removal surgery (cystectomy)? While it can be a surprise to find out you’ll need a cystectomy, whether partial or radical, know that you aren’t alone. 

In fact, bladder cancer is listed among the top 10 most diagnosed cancers worldwide.

We sat down with Aleece Fosnight, MSPAS, PA-C, CSC, CSE, IF, MSCP, HAES, to ask whether you can live without a bladder, how long you can live without one, why you might need a cystectomy, and more. 

A confident woman in a suit sits at a desk, embodying the role of a health advocate, with text about a podcast offering tips for managing urinary incontinence at work. The Life Without Leaks podcast logo and Listen Now message are also visible.

Showing incontinence who’s the boss in the workplace

Managing urinary incontinence is challenging enough, but bladder leaks, sudden urgency and frequent trips to the restroom can be especially stressful when you’re trying to get through a busy workday.

In this episode, we share practical strategies for managing bladder symptoms on the job, whether you’re commuting to an office, sitting through a long meeting, working from home or navigating a packed schedule. We’ll talk about bladder training and bathroom planning, hydration and potential bladder triggers, keeping a bladder diary, preparing for unexpected leaks, choosing incontinence products, staying active and more.

A group of six smiling adults takes a selfie outdoors in a grassy area, with trees and a road in the background. Everyone appears happy and relaxed, enjoying each other’s company—there’s no sign anyone is worried about a UTI, just laughter and good times shared among friends.

Why Bladder Health Matters More as We Age

Aging and the Bladder: What Changes?
As we grow older, the urinary system naturally undergoes changes that can affect bladder function.
Common age-related changes include:
Reduced bladder capacity
Increased bladder sensitivity
Changes in pelvic floor muscle strength
Hormonal changes, particularly after menopause
Enlarged prostate in men
Increased prevalence of chronic conditions such as diabetes, stroke, and neurological disorders
These changes can contribute to symptoms such as:
Urinary urgency
Frequent urination
Overactive bladder (OAB)
Urinary incontinence
Nocturia (waking at night to urinate)
While these symptoms become more common with age, they should never be viewed as something people simply have to live with.
The Hidden Connection Between Bladder Problems and Falls
One of the most overlooked consequences of bladder symptoms in older adults is an increased risk of falling.
Many falls occur during urgent trips to the bathroom, particularly at night. An individual may wake suddenly with a strong urge to urinate, rush through a dark room, become dizzy when standing, or trip over furniture, rugs, or other obstacles.
Research has shown that urinary urgency, frequency, and nocturia are associated with a higher risk of falls and fractures in older adults.
For seniors, a fall can have life-changing consequences, including:
Broken bones
Head injuries
Hospitalization
Loss of independence
Reduced mobility
Increased risk of future falls
In many cases, addressing bladder symptoms can be an important part of a comprehensive fall-prevention strategy.
How Nocturia Impacts Healthy Aging
Waking multiple times each night to urinate is more than a sleep disturbance.
Nocturia can contribute to:
Daytime fatigue
Reduced concentration
Memory difficulties
Mood changes
Increased fall risk
Lower overall quality of life
Older adults who experience frequent nighttime bathroom trips often report feeling less energetic and less able to participate in activities they enjoy.
Protecting sleep is an important part of protecting overall health.
The Emotional Impact of Bladder Leaks
Many older adults quietly manage bladder leakage without discussing it with family members or healthcare providers.
Unfortunately, untreated bladder symptoms can lead to:
Social withdrawal
Anxiety
Depression
Reduced physical activity
Fear of leaving home
Loss of confidence
Some people stop exercising, traveling, attending social events, or spending time with friends because they worry about finding a bathroom or experiencing leakage in public.
The result can be a cycle of isolation that negatively affects both physical and mental health.
Healthy Aging Includes Bladder Health
The good news is that many bladder conditions can be improved or successfully managed.
Treatment options may include:
Pelvic Floor Muscle Training
Strengthening the pelvic floor muscles can help improve bladder control and reduce leakage.
Bladder Training
Scheduled voiding and urge-suppression techniques may help reduce urgency and frequency.
Lifestyle Modifications
Small changes can make a meaningful difference, including:
Managing constipation
Maintaining a healthy weight
Limiting bladder irritants when appropriate
Staying physically active
Monitoring fluid intake patterns
Medical Treatments
Depending on the cause of symptoms, treatment options may include:
Medications
Neuromodulation therapies
Vaginal estrogen for postmenopausal women
Prostate treatments for men
Surgical interventions in select cases
Fall Prevention Tips for Older Adults with Bladder Symptoms
If urgency or nighttime bathroom trips are a concern, consider these safety measures:
Keep pathways clear of clutter
Use nightlights between the bedroom and bathroom
Wear supportive, non-slip footwear
Install grab bars when appropriate
Rise slowly from bed to avoid dizziness
Discuss medications with your healthcare provider
Seek evaluation for persistent bladder symptoms
Addressing both bladder health and home safety can significantly reduce fall risk.
A Conversation Worth Having
Too often, people assume bladder leakage is simply the price of getting older. The reality is that while bladder problems become more common with age, they are not an inevitable part of aging.
National Senior Citizens Day reminds us that healthy aging means more than managing chronic diseases—it means preserving independence, confidence, mobility, and quality of life.
If bladder symptoms are interfering with sleep, daily activities, or peace of mind, don’t ignore them. Talk with a healthcare provider and explore your options. Effective treatments and management strategies are available.
Because aging well isn’t just about adding years to life—it’s about adding life to those years.

An older couple walks hand in hand on a forest path, smiling at each other. Sunlight filters through green trees, creating a peaceful, natural setting. Thanks to reliable bladder leak pads, they enjoy their stroll with confidence and comfort.

Ask The Expert: Can You Live Without a Bladder?

Are you or someone you love scheduled for bladder removal surgery (cystectomy)? While it can be a surprise to find out you’ll need a cystectomy, whether partial or radical, know that you aren’t alone. 

In fact, bladder cancer is listed among the top 10 most diagnosed cancers worldwide.

We sat down with Aleece Fosnight, MSPAS, PA-C, CSC, CSE, IF, MSCP, HAES, to ask whether you can live without a bladder, how long you can live without one, why you might need a cystectomy, and more.