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INTERESTING STUFF – 24 March 2018

Urinary Incontinence is No Joke

Incontinencecartoon

There is an amazing number of icky things our bodies can do to us and they seem to increase as we get older.

In general, we don't talk about this stuff but since my pancreatic cancer diagnosis and Whipple procedure nine months ago, any embarrassment I felt about discussing pee and poop is gone.

It was the post-surgery nurses and doctors who taught me all about that acceptance and, in time, ease with the topic. On the first morning I was lucid following the surgery, a nurse popped into my room and with a big smile on her face asked, “Have you pooped yet today?”

A little later, another asked, “Have you farted yet?” And another minced no words at all: “Have you shit this morning?”

Healthcare professionals talk about pee and poop the way you and I discuss the weather. Over my 11 days on that post-op floor, I got used to their most frequent talking point and a good thing that is because since then they have never stopped.

As one nurse answered my question about all the poop and pee talk, when someone has had abdominal surgery, it is important afterward for them to know how well – or not – food is being processed as it moves through the patient's body.

So they don't just ask “if” but also want to know size, shape, color, density, etc. And these queries have continued long after my recovery from the surgery so that, like those nurses and doctors in the hospital and clinic, I'm as comfortable with it now as they are.

But that wasn't always so.

I first wrote about urinary incontinence in these pages back in 2009 because it had been plaguing me and I know that if it's my problem, so it is for many other people.

When I'd finished, it seemed to be a useful blog post but I couldn't bring myself to hit the “publish” button. It just wasn't something I was comfortable talking about in public and thought that was probably true for you too.

It took three days for me to work up the nerve to post the story and surprise, surprise – the response was quite large with a lot of readers recounting their leaky pipe problems, many of them with a great deal of humor. You can read that post here where you will also find some useful links to good information about dealing with urinary incontinence.

My own leaky pipe problem disappeared when I lost more than 40 pounds five or six years ago but that is not always a cure and now I have the problem all over again.

Since the surgery, I no longer have any warning when I need to pee. The urge comes on suddenly and it means NOW (as I had to learn the hard way). No waiting until I finish typing this sentence or being polite to wait until you finish telling me a story. If I don't go immediately, there will be a puddle.

A few days ago, I ran across a useful story at AARP with “10 things you didn't know about urinary incontinence”:

”For something so shrouded in secrecy, urinary incontinence affects a staggering number of people — a quarter to a third of men and women in the U.S., according to the Maryland-based Urology Care Foundation,” reports AARP.

“That’s not a third of seniors or a third of pregnant women. A third of all people, regardless of age or sex.”

Here are a few samples of the information compiled in the AARP piece. Go to the website for the full explanation of these and the other six items.

One Cause? Blame Winter
“Cold weather affects the bladder muscle by making it contract harder and sooner than it ordinarily would, even if the bladder is not full...”

Reducing Liquid Intake Won't Help
“Cutting down on your water can result in dehydration, constipation and even kidney stones — urine flushes out the bacteria in there — which will only worsen the symptoms.”

Botox for Incontinence is a Real Thing
“Botox has become an increasingly popular fix for incontinence — and if you’re like us, that news probably made you wince and ask, 'Wait, they want to put a needle where?'”

(Ronni here: Botox for this also has some serious side effects so if you are interested, do your research. Here is a start.)

Peeing in the Shower Might Help
“It sounds nuts (and more than a little disgusting), but there are health benefits to using a shower as your personal toilet, at least for women with incontinence.”

If medical fixes are not for you or behavior adjustments don't work, there are the growing numbers and types of incontinence products which I'll write about soon.

Meanwhile, feel free to discuss this in the comments below or anywhere else. After all, actors like Samuel L. Jackson and Kate Winslet have done so on television as has writer Stephen King, among others. Even I've learned to be at ease with it.


Comments

Wow, I was shocked to read the article about the actors who openly talk about incontinence! Good for them...and you, Ronni. I don't have the issue. Yet. But I have to pee every hour and a half and I worry that someday I will. This is nothing new with me, though. even as a kid I had to go frequently and my parents took me to a doctor about it. He suggested "bladder stretching" which involved making me hold my urine until I cried from the pain of doing it. Needless to say, it didn't work.

I can really relate to this subject. June of 2016, I was rear-ended while stopped at a red light and ended up in the hospital 5 days. I was able to get up to go to the bathroom but when I had a bowel movement, was unable to wipe myself. Most of those days I had a male attendant so I just told myself to put my modesty aside and had him wipe me.

When I got home, my son came to care for me (for 6 weeks until my daughter who had hurt her back, was able to take over). My son had to help me get dressed including get my panties on over my feet and put on socks. He said it was no different than when he dressed his grandkids.

Since then, I have the same problem about urgency as mentioned in this post. When I get the first indication I have to head for the bathroom immediately whether it's pee or poop. I've learned the hard way that finishing that sentence isn't the wise thing to do.

This is a subject with which I am intimately acquainted. In 1999, I had surgery for a "bladder sling", which involved a huge incision and the propping up of my bladder so it could empty fully, rather than remain sideways and always be partially full. The medium used to prop up the organ was cadaver tendon! It worked for about four months, until I fell on some ice and ruined the surgery. I buy $50 a month worth of incontinence pads and it isn't going to be long before I have to start wearing Depends. Even the "overnight" pads aren't doing the job, because my incontinence takes the form of leakage that I am often not aware of because of loss of sensation in my nether regions. There isn't any "cure" for what I'm going through, other than the possibility of Botox injections which I'd rather not even think about. I get enough injections with my cortisone shots in both knees and my wrists!

I'm 72 years old, and after 70 years, I'm back in "diapers" !! Not fun.

Doesn’t everyone pee in the shower?? When I feel a sneeze coming...I need to prepare my body...so I won’t pee. When I am with my friends, I say loudly...prepare to sneeze....and everyone laughs....they know exactly what I mean. Far more comfy with pee than poo!

Looking forward to more info. on this! I'm only 63 and have to wear thin pads due to leakage all the time...not fun! Been doing more exercise and kegels and hoping. Thanks for your post on this!

The manufacturers of those mini-trampolines claim that using them is better for incontinence muscles than Kegels. I asked a friend who is a natural healing guru and she says it's true. She says you don't need to jump on them, just bounce up and down without even moving your feet.

I don't know if it's true, but I had one gathering dust in my garage, so I just brought it in and put it by the TV. I figure it's worth a try for 5-10 minutes a night. I would love to avoid/delay my mother's fate. She was in diapers for the last 10 years of her life, which caused her to stop traveling to visit grandkids.

Wait a darned minute !!! You say that some persons can actually inject a bit of humor when talking about (their) incontinence ? I'm trying, I'm trying.....

What gets me is that youngish doctors today do not use words such as urinate or BM. Color me a Senior, an ancient senior at that.

I actually do manage a smile when (driving out of town) I spot a truck with the business name in bold letters ...... P and P Septic Services.

I had a 15 foot fall about 20 years ago (I’m 75) and in the resulting recovery, had a catheter for 2 weeks, which the visiting nurse pulled out immediately, saying I would have problems with incontinence when I was older. She was right. Sometimes it is worse than other times, but in the morning especially, I stay near the bathroom. I can cross my legs in public and often make it, but saying to myself “you will NOT leak” is useless. I do the exercise when I think of it, like now, and I stay active, but this problem is not going away. Another of the aging things we seem to share. Yippee.


Started wearing a pad in my late 50s or early 60s. Since they are cheaper, I just bought the monthly pads rather than the incontinence pads. Then, several years ago, I discovered that I could greatly reduce the stress incontinence by cutting way back on caffeine. Now, I have 1/2 of a Diet Dr Pepper every week or two or three (down from the 2 per day that I consumed during my working years), drink de-caf tea, and am rewarded by having to wear only a "panty liner" that is totally sufficient for the drop or two that may be exuded every couple of days. Except, that is, when I get a cold.

I had a cold during the first couple of weeks of March. That sent me back to using "maxi-pads" (which, fortunately, I had not discarded). I can prepare to sneeze (as someone mentioned, above); but, I've found no way to shut off the valve for a big coughing fit.

As to the words we use: I once (in the 1970s) chided a health-care professional for the coy way he referred to feces (in a questionnaire he referred to them as "floaters" or "sinkers"). It seemed totally weird.

It was with a huge sigh of relief that I waved goodbye to sanitary napkins along with all their paraphernalia many years ago.

It was with a huge sigh of relief that I welcomed them again - thankfully with far less paraphernalia - a few years ago.

'nuff said.

I've made a game whenever we take a road trip; I keep notes on my phone on how many Dairy Queens we've visited for my very excitable bladder. If you know anything about Texas, you know that it could be 75 miles between towns with no good landscape to hide behind for a "squat", and that nearly every little rural town has a Dairy Queen.

There are pilates classes that specialize in strengthening the pelvic floor. Our class also has learnd about different ways to go to the bathroom to make things flow better. I had an operation through my stomach in my late 30’s and am a good candidate for leakage as time goes by. My physiotherapist recommends these pilates classes rather than kegels, although I personally believe everything helps. (Both my parents suffered from the indignities of fecal incontinence and it is very unpleasant and humiliating.)

Praise be for the Tena women's incontinence pads. No longer dread the laugh, cough or sneeze out of the blue.

I'm very glad you've reintroduced this theme Ronni. Much too important to get coy about and or ignore. It only takes a few brave souls to be public about it and we all jump on the uninhibited roundabout. xxx

Oh and: anyone caught short on a long journey in a car, get one of those thingies for women. Men have their bottles, so much easier, but they do a good design for women too. Also, the front and rear doors can also be opened and squat in between. At the end of the day, when you're desperate, you're desperate.

I learned during my chemo that there are charts out there showing the various shapes and consistencies of poop. I think I was even given one for reference. Each type had a name, and my doctors always wanted to know which one I was experiencing. That was also when I learned how very useful adult diapers can be.

Cutting back on caffeine definitely helps. I've also found that using the bathroom leaving a restaurant or stopping at a public bathroom in a park before walking home also helps a lot.

My husband and I resorted to the extreme several years ago. As two old people living in Seattle who love Starbucks and had only one bathroom, we hired a contractor to add a second bathroom. It wasn't cheap, but it fixed the one bathroom issue and increased the value of our house.

I wrote on the last post on this subject that I used mini-pads. Then I fell and they were no longer sufficient so I now use maxi pads.

When I was bed-fast my daughter put a porta-potty next to my bad and bought Depends for me. I really didn't need them as the maxi-pads did the trick and it's a good thing because I am allergic to the adhesive they use in Depends.

My doctor kept recommending incontinence medication and when I was no longer able to go anywhere without a bathroom close by I succumbed and am now taking it. It helped with incontinence in the daytime, but I still have to get up every 2-3 hours in the night. I t did a great job of drying up other bodily fluids and there are times when I can barely talk due to dry mouth.

After my last fall I lost most sensation in the pelvic region and have to wait for a second flow to make sure I have gotten rid of all the urine in my bladder. Oh woe - just one more aggravation to make old age interesting.

All the women in my family have incontinent issues which start in our 50's. My mom has had problems for a long time and refused to deal with it and now at 95 it is not pleasant for her. So I had a bladder fix about 5 years ago and it really made a big difference. I have gone from wearing an overnight pad all day to just a panty liner just in case. Of course my husband has his prostrate issues so we know where all the Starbucks and McDonalds are when we travel any distance by car.

As usual a great topic and wonderful comments

Oh what fun we are having! I've been rocketing along with near perfect health, and I'm still healthy, BUT I've got the old lady voice all of a sudden, and when I get up to pee in the middle of the night, I leave a little wet trail between bed and bathroom. My accidents are still limited to when I'm home. Though more and more, laughing and sneezing are dangerous. . .

Fabulous to know I have so much company! At 80, I've finally started wearing a pad all day every day. Not amused, but--even just reading over all these comments--it could be so much worse! (Just think--what did the elderly do before the advent of even the earliest sanitary pads??)

As long as we are on the subject, I was driving one day behind a plumber's truck , which had a plaque on the rear bumper which read, "Your s**t is our bread and butter". Quite pithy, don"t you think?

After juggling pads number 4,5, and 6 for years, I have gotten down to 5 and 6, and hopefully will stay there until the end. One never knows!!!

Once upon a time my mom was gifted with a mini trampoline.

She was in her eighties at the time.

In other words- a senior.

Mom was all excited about that mini trampoline.

Sounds cool so far, right? Wrong! Mom jumped on the thing, got dizzy and decided she'd rather walk than jump.

Guess who she called?

Ghostbusters?

Nope.

Yours truly.

I raced over, walked in and there it was.

Mom said "go ahead, jump on it."

Ok.

Looking back, I think it was a set up. Mom knows darn well what happens to me when I laugh TOO HARD.

Which us what happened. One look at mom watching me bounce up and down like a drunken pinball, well, that was it.

The more I jumped, the more I laughed.

"BOING BADINGGGG HEE HEE BOING PING HEEE HAW BOING HEEEEEEEE STOP HEEEEEEE HEEEEE MOM QUIT MAKING ME LAUGH HAW HAW HEEEEE HAAAAA."

"Oh
Nooo."

I don't know what happened to the thing.

Yes I call it "The Thing."

Mom never mentioned it.

Stuff like this usually ends up in mom's garage.

"In case someone wants it."

But the mini trampoline disappeared like a fart in a tornado.

I should ask mom about it, but you know exactly what will happen if we get on that subject.


I am similarly afflicted. Part of my problem is waiting too long to go to the bathroom because I’m watching something on tv or my computer. I am learning to heed the call sooner and avoid the trail of droplets. The other problem responds to Imodium.

The shower? What’s the shower suggestion?
I read all the comments too, in case one of your other readers knew about that fix.

I’ll keep reading. Thanks!

Several years ago I took one of the incontinence companies up on their offer of some free products, even though I wasn’t having problems yet. For some reason, they continued to send me products for about six months. I saved them, knowing one of these days I’d need them, and I did when I had very serious bronchitis earlier this year and the coughing got so bad that I peed all the time. I used my whole free stash, some of which were rather attractive panties and surprisingly comfortable. Last week I bought some because I never know when I’ll need them again

So glad of this post as of now with a terrible coughing cold I'm a mess. I usually wear washable pads that I bought on line, they last for years and pay for themselves over and over and ENVIRONMENT. But at night I wear those huge ungodlies (Walmart) incontinence pads. But they protect the bedding.

Question: I was in the incontinence section of my drugstore today -there is such a thing and it gives me hope for us all - and I spied tampon like things that are inserted into the vagina to alleviate the problem. Has anyone tried these?

XO
WWW

I've worn "light days" pantiliners for years and so far, so good. Can't "hold it" as long as I once could though, which probably wasn't healthy even back then. I think one answer to Kate's question about how elderly people managed before the advent of basic sanitary pads is that many people just didn't live that long! (Longevity is definitely a mixed bag.) Botox sounds too extreme (and risky) at least for now. I've never heard of the tampon solution. . .

I became used to the language associated with all bathroom body functions when I had my first child. Those actions, describing them, etc. were a primary focus with the newborn and when they were little. I learned monitoring them for health’s sake was important as it is for us, all our lives., though I recalled my mother stressing that to me as a child. I just didn’t allow myself to think, “This is yucky, disgusting.” — a language mindset to keep me from becoming nauseated with some of the most gross excretions.

Years later when I began working in medical settings, primarily with adults of all ages, my exposure to and use of language for body parts, functions, descriptive terms became greatly expanded. The language became as ordinary as saying, “I have a hang nail.” Jokes were even made to lessen the tension after the fact and out of earshot of others who might not understand the levity at serious times.

I noticed that some patients often became so relieved at being in a setting where it was not only acceptable but desirable to report, describe and discuss all their most intimate body functions with any non-judgmental lab coat-wearing staff that they freely did so seeking solutions to their problems. Some often injected humor into their accounts making the whole business more comfortable for them.

Pads for leakage have finally become readily available in stores. There shouldn’t be any embarrassment in purchasing them, as there once was with sanitary napkins, but I noticed a TV ad the other day promoting the need for secrecy in their pitch to sell their product. Leakage isn’t always an age related problem. So, some of us leak sometimes — we can do something about it, use pads, or whatever — just like I use a tissue when my nose congestion runs.

Unfortunately, some people experience the opposite of incontinence as did one of my family loved ones. Other medical issues prevented her from surgery to correct the problem. With her bladder not fully emptying she became subjected to constant urinary tract infections (UTI) and finally had to use catheters constantly.

Been there - done that!
Oh the problems we ladies and gents have with aging waterworks (and non aging ones as well)
I get those little (and big) leakage problems over and over again.
My causes are winter time coughs and colds - Asthma coughing- sneezing - seasickness (why is it impossible to heave over the toilet and not pee ?) doing crunches on the floor at the gym yet funnily not running/jumping on the mini tramp.
I love the little teardrop chart on the liner packets - similar to the monthly loss description on the sanitary towel packets. Needless to say I have packets of various 'sizes' in my drawer. Ready to use in my drawers 😊
When he decided it might be time for a little protection during long haul flights I found some mens products for 'drips and dribbles' - what a lovely description for a male complaint lol

Incontinence is the single worst problem I have as I finish my 80th decade. I have high blood pressure and kidney problems, but incontinence is the one thing that affects my quality of life.

I first experienced it when I was in my thirties - doing the Mexican Hat Dance during a night of exuberance. It's no laughing matter now, though. It keeps me from traveling - how many days pads can I pack and will they actually last through the entire trip. I even dread going to see my son and his family. (I think if I had a daughter it would be easier.) I take a couple of platic trash bags to hold the pads and try to sneak them out to the trash before I leave.

It's depressing.

I don't have much of a problem in this area myself yet, now that the days of perimenopause are behind me and real menopause has freed me from a reliance on all kinds of feminine hygiene supplies. I have had extensive experience with this, though, while taking care of my mother-in-law a few years ago during her last two years of life with Alzheimer's. I tried every brand of pads and adult diapers I could find, and found, later in the game than I would have liked, the best source for the most comfortable forms of both...the Alzheimer's Store (that's its name) that can be accessed online for all sorts of supplies for dealing with dementia.

One of the worst aspects of Alzheimer's disease is incontinence, first urinary and then the other. The person has no awareness and their caregiver gets to clean up as long as they can stand it. Then $10,000/month cash for so-called "Memory Care" where someone else gets to do this for a floor filled with similar cases. As long as you are aware of the problem, you are ahead of several curves.

Had a loose connection to keyboard (after I vacuumed it) so couldn't comment until now...my daughter, 52, has a genetic bladder disease that causes her to be unable to completely empty her bladder. She sees a urologist and takes a medication to do that for her, I forget the name of it but it is usually prescribed for men. She has pressure to urinate frequently. If I wait too long, and get home with a full bladder I have to park the car and pee under the avocado tree, can't take a chance of getting inside to the bathroom.

I do not yet have any leakage, but have done keagle (sp?) exercises for years, and also use a premarine vaginal creme a few times a month for comfort during sex. The reports of hormones on leakage are mixed, and not substantiated. I am not overweight and have never been overweight except the year after my first child was born at age 21, and I imagine weight has a lot to do with pressure on the bladder.

As to what women used to do, I remember my elderly piano teacher used to smell like urine, poor dear, guess she didn't use a pad.

Genetic hypermobility issues, where the tissues are very stretchy, can be both a blessing and a curse. Three quick, almost pain-free births were the blessing for me, now my bladder has breached the wall of my vagina and is peeping out saying; "Hello Sunshine!" or at least "Hello World," as there's little chance of sunshine down there. And with it has come what I call "Bi-Polar Aggravation Syndrome", which is both incontinence and/or the need to pee so bad I'm going to pop and *can't* because the full bladder is wedged against my urethra, preventing the urine from escaping. The cure for the latter is gloving up in surgical gloves and lifting my bladder off my urethra. So fun.

But a very funny story happened to us on a trip many years ago. We were driving across West Texas when a sudden illness made us seek help at an ER in a small town. We were there three or four hours, the only people they'd seen all day and talked and talked. They'd never met Canadians for one things, so we talked health care systems, meds until lab tests came back, antibiotic was prescribed and it was deemed our little one was safe to go.

One of the nurses, surprisingly (and beautifully for a tiny Texas town in 1984) was an openly gay male, and obviously loved by the staff who worked with him. I only mention he was gay because you have to imagine that he told this story with such an exuberant flamboyance that it was not just a story but a performance none of us will ever forget! He was the most compassionate and sweet caregiver with our little one, who was very ill, but none of us, even the five-year-old, have ever forgotten his "pee" story.

With a deeeep drawl this nurse described how he took his "water pill" just before he left work every day at 4:30, and then the drove 80 miles to an adjacent town where he lived. But he said he'd get about half way home and his pill would start to work and he'd need to "go tinkle". "There's not a bush or a tree or a clump of long grass between here and home," he said. "Not a single place you can get out of your car and take a wee. But," he went on, "I have worked out the perfect plan. I pull off the side of the road, put my hazards on, then I put my hood up. I stand real close to the car - and I just let my radiator boil over!"

We laughed until we were all in tears and then we laughed some more. <3 I think we all hugged and kissed everyone in that ER as we left. What a wonderful bunch of people.

WWW - The tampon things are for stress incontinence, so if you wee when you laugh or sneeze they might be useful. If you're a dribbler it's unlikely they'd help. They come in different sizes, as we come in different sizes, but there's a starter pack which has all the different sizes. You start with the smallest and work your way up. Walmart carries them, in the aisle with incontinence products.

As for peeing in the shower. Urine is sterile unless you have an infection. If you pee on your legs, wash it off and be done with it. Unless you have spent your life squatting, like African women, Continental Indians, and women in associated cultures, few of us are capable of squatting at 70-80. Don't start trying now unless you are under the tutelage of a professional physiotherapist after having been assessed by your FP. I have trouble with my hip dislocating when I walk too far!

What a fabulous story, Deb. And thank you for the good incontinence information. too.

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