No Longer Controlled by an Overactive Bladder
November 2021 Issue
by Marie McAden
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 Donna, 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,” Donna said. “It was so embarrassing. I don’t know if anyone noticed but it ran down my leg.”
For years, Donna 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 Palmetto Medical Group 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. “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 Donna’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 are referred by their physician,” she said. “They have no idea what pelvic floor therapy is.” Pelvic floor therapy works 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.
“Pelvic floor therapy can be effective for a lot of people and make a considerable difference in their quality of life,” said Patillo. “Even if a patient does not reach 100% continence, they will gain a better understanding of their anatomy, other influences on continence, and how to train their muscles. There are other treatments, such as medications and surgery, however, many patients express wanting to try pelvic floor therapy first.”
At the first therapy appointment with Donna, Patillo spent time explaining the relationship between bladder function and the pelvic floor. She listened as Donna 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.
Due to the limited amount of time before Donna’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.”
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,” Donna 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 and seventh week, Donna 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.”
Now nearly five months into her trip out west, Donna 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.”
Is an overactive bladder controlling your life? If pelvic floor therapy sounds right for you, talk to your provider about a referral.
Pictured Above: Donna Howell can now enjoy hiking the great outdoors in places like Sand Canyon Pueblo in Colorado. “I wanted to be able go on our trip without worrying about having an accident,” she said. “There aren’t always bathrooms along trails.”