Yes, I have a physical disability. Sometimes I don't feel that great but I try to make the best of my life. I want to be your cheerleader: to let you know that after taking care of your body there is still time to laugh and live a good life. Many people ask me about incontinence and think because I have both bowel and bladder incontinence that it must be a death sentence. I am here to remind you that it is not and despite some hassles, life goes on.
Because we are so shy to talk about our toileting issues and there is so much mystery I thought that for today I would give you folks a little lesson to pass on to the "Nay-Sayers" in your life, so that our disability will seem less shocking to them.
Here it is:
There are all kinds of incontinence. I know the many types can be confusing, so I have compiled a short explanation of each.
I have Urinary Retention. I do not feel the urge to urinate at all. In fact I stay dry until I use a catheter to pee. Some people are not being able to pee because of a blockage in their urethra and others have a urinary sphincter bladder muscle that refuses to contract. I am unsure of the cause of mine. It was not discovered until my kidneys became distressed. Retention of urine can be caused by anything from mental illness or other any number of other neurological disorders to physical injury of the brain, spine or urinary system dysfunction, even kidney stones, if they prevent the normal operation of the bladder, especially if they block the neck of the urethra.
Sometimes people who have Urinary retention can experience Overflow Incontinence. When the bladder is way too full, sometimes urine pushes past the sphincter muscle and dribbles out. This is a rather common problem, but I do not experience it.
Fecal Incontinence - because my sacral nerves are not very effective, I experience fecal incontinence. As I have said before I am not sure why, but it can be for any number of reasons such as spinal cord injury, multiple sclerosis, or from surgical procedures, such as a vaginal hysterectomy (which I had). My bowel does not move, for the most part -- the muscles do not push things along. Because it is so sluggish, I need stool softeners to help things move along more easily. Most of the time all is well, but sometimes my meds get out of whack. When I was in a biking accident and broke my hip last year, I had weeks of inactivity. As a result, I became extremely constipated and my usual stool softener did not help at all. I was in pain and I needed a little help from my friends. I put out a shout to a group that I am a member of and they gave me great suggestions to get things moving. Another and probably more correct option for help would have been to contact my doctor. I am sure she would have helped, as well. Fecal incontinence is common for people with crohn's disease, ulcerative colitis, uncontrolled diarrhea, and cognitive disabilities.
These next two types are much more common:
Stress Incontinence is the diagnosis when a physical exertion results in the inability to control the bladder. For instance, if a person sneezes, lifts a heavy object or just cracks up and they just cannot get to toilet in time. Oftentimes it is caused by muscles and tendons that are stretched out due to pregnancy and childbirth; the muscles have become weak and over-stretched. It also can be caused by a neurological disorder or even surgery.
Urge Incontinence is the condition when a person just cannot get to the toilet in time after the urge to relieve him/herself is felt. Some women have painful bladders and the urge can be constant, causing the sufferer just to dribble a little at a time. Sometimes a large amount (a full-fledged flood) of urine is lost when women with urge incontinence need to urinate right NOW! This type of incontinence can be the result of bladder spasms or strong debilitating contractions or cramping; whenever it hits, the sufferer has little time to reach the toilet. I know when I have a bladder infection sometimes even I feel the urge to urinate, which is a bit surreal because as I said I am unable to urinate without a catheter.
Functional Incontinence- or Reflex Incontinence is often paired with a cognitive disorder such as autism or a developmental disability or neurological complication following surgery. As a result, the person may not even feel the urge to urinate; it just happens to them without any warning, feeling or urge.
Mixed Incontinence is some combination of any of the above. I personally know there are women out there who feel so isolated because they are afraid to even leave their home due to an intense fear of having an accident. You are not alone! Reach out to others who share your condition; it really helps!
Nocturnal Enuresis or bedwetting is suffered particularly by adolescent boys, but adults as well, who as a result rely on overnight protective products, which can help significantly. Bedwetting can caused by anything from a childhood trauma, mental illness, or the inability of the body to produce an anti-diuretic hormone that slows the production of urine at night. In other words, there can be emotional and physical factors leading to this type of incontinence.
I hope this helps take the mystery out of the condition that many of us have in varying degrees and presentations . . . It is manageable, when you stay on top of it, though and understand how to tackle it.
Now, Go enjoy your day!