No Longer Controlled by an Overactive Bladder

As a young girl, Donna Howell couldn’t step into a department store without making a beeline to the restroom.

“My mother would take me to Belk’s to go shopping and the first thing I’d have to do is go to the bathroom,” said Howell, who grew up in Beaufort.

As an adult, it was the grocery store that would trigger a quick dash to the ladies’ room. The older she got, the more often the urges came.

“When I had to go to the bathroom, I had to go right now – and there better not be anyone in my way,” she quipped. “Sometimes it was just a dribble, but I couldn’t stop it once it started.”

Ignoring the call of nature could lead to unpleasant outcomes.

On one occasion, she was in a meeting when she felt the need to urinate. Unable to break away, she held off until it was too late.

“I wet my pants,” Howell said. “It was so embarrassing. I don’t know if anyone noticed but it ran down my leg.”

For years, Howell lived with the problem, coping with the sudden urges as best she could. To avoid a repeat of the meeting incident, she started wearing mini pads anytime she had to go out in public.

Although she had spoken with her health care provider about her overactive bladder, it wasn’t until this spring when she and her husband, Bob, were preparing to take a six-month trip across the country in their 40-foot motorhome, that she decided to do something about it.

“I wanted to be able go on our trip without worrying about having an accident,” the 73-year-old Sun City resident said. “There aren’t always bathrooms along trails.”

In March, she made an appointment with Beaufort Memorial physician assistant Stephanie Lovato, PA-C to discuss the worsening condition.

Urinary incontinence, which affects 25 million adults, is especially prevalent among females, with one in four women over the age of 18 experiencing episodes of urine leakage.

Read More: Loss of Bladder Control Could be Uterine Prolapse

“It’s a very common problem, especially as you age,” Lovato said. “Up to 75 percent of women older than 65 report urine leakage. But less than half of women who experience involuntary leakage discuss it with their physician.”

Lovato recommended the least invasive treatment for Howell’s condition. She referred her to Beaufort Memorial occupational therapist Jaime Patillo for pelvic floor therapy.

A highly experienced therapist with more than 20 years’ experience, Patillo received special training in pelvic floor therapy and now specializes in the treatment.

“Most people who come to me were referred by their physician,” she said. “They have no idea what pelvic floor therapy is.”

Pelvic floor therapy worked on strength, urge control and dealing with triggers.

The goal of the treatment is to improve the function of the pelvic floor muscles that lie at the base of the pelvis and support the bowel and bladder, as well as the uterus and vagina in women. In addition to urinary leakage, pelvic floor disorders can result in bowel incontinence, sexual dysfunction, pelvic pain and pelvic organ prolapse.

At the first therapy appointment with Howell, Patillo spent time explaining the relationship between bladder function and the pelvic floor. She listened as Howell explained the history of her issues and how it affected her life.

The next appointment focused on evaluating the abdominal muscles and the range of motion, coordination, endurance and strength of her pelvic floor muscles.

“Typically, it’s on the second visit that I assess the patient’s anatomy and, with consent, I perform a physical exam that includes external and internal assessment of the pelvic floor muscles,” she said.

Due to the limited amount of time before Howell’s scheduled trip, Patillo used biofeedback with external sensors to show her how to properly contract and relax her pelvic floor muscles, ensuring she would get the most out of the exercises she performed.

“As she followed my cues, she could see the visual representation of the contractions on the monitor,” Patillo said. “It’s like watching the line graph on an EKG.”

Patillo asked Howell to keep a seven-day bowel and bladder diary that chronicled everything she ate and drank, how many times she went to the bathroom, the size of each void, and the strength of the urges.

Before starting any exercises, Howell learned diaphragmatic breathing to help lengthen and relax the pelvic floor.

Read More: Bladder Control Treatment for Women

Over the next several weeks, Patillo taught her strategies to stretch and relax her pelvic floor, techniques for urge control, and how to deal with common triggers that can cause you to feel an urgent need to urinate, like running water or putting the key in your door when you arrive home. She helped her work on endurance and control of the pelvic floor muscles and build up the strength in her deep abdominal muscles, glutes and thigh muscles.

“The exercises started out simple and got more complicated with each passing week,” Howell recalled. “But I was gung ho. I would do them before I got out of bed in the morning and then several times a day.”

By the end of the sixth or seventh week, Howell noticed a significant improvement.

“I still have to go, but I don’t have the urge that I had before,” she said. “I try to hold it now and wait 30 minutes.”

Nearly four months into her trip out west, Howell continues to do her exercises on the road.

“You have to train your bladder and your mind,” she said. “I don’t want to let my bladder control my life.”

If you’re having difficulty with bladder control, make an appointment with your primary care provider. 
Don’t have a primary care provider? Find one who is accepting new patients.