2021-05-26

Keeping your bladder in check as you hit the travel trails, post-COVID

For people with over active bladders (OAB) and urge incontinence, the road-trip season is fraught with worry and logistics challenges. Mapping out all the toilets along the route, and the time it takes to get from one to the next, is just part of the deal.

Emergency clothing changes, extra absorbent pads, tactical dehydration - this is road trip planning for many people, even if it's just to visit their sister in Tatamagouche.

For all of you in this unfortunate boat, here are some tips which might make for smoother sailing.

Start your bladder training early

There are many causes of OAB and urge issues, and not all of them can be easily remedied. This post isn't meant for situations in which underlying problems such as MS, Parkinsons, radiation damage and other deep medical issues are at work.

When it's caused by increasingly garbled signals over time (often), retraining can make a difference and is generally the medically-recommended first line of defence. It can take six to 12 weeks to see a significant improvement, so starting early is critical. It won't all be progress. You'll have set-backs you'll need to plough on through over months.

Changing the pattern

Your toilet patterns have probably been decades in the making. Some of it has been self-inflicted, through "just in case" peeing habits and such. Some of it has happened because of physical deterioration in the neuromuscular control mechanisms. Your bladder says it desperately needs to go, but there's not actually much in there.

Bladder retraining involves learning how to resist or inhibit the feeling of urgency, postponing voiding, and peeing to a schedule instead of on demand, until such time as the demand becomes a true signal.

Keep a voiding diary so you can understand your starting point and track progress.

When you first feel the need to go, in a safe place try to postpone it "by the clock." For example, hang on for one to two minutes initially and gradually increase this by five to 15 minutes over weeks. The goal is to gradually increase the time between the initial urge and going to the toilet, aiming for an ultimate toilet interval of three to four hours.

This is not the same as "holding on as long as you can" each time, which you should avoid. Only postpone by the amount of time you've decided on for that day and week.

You can use these urge suppression strategies to improve your sense of control and allow the initial urge to fade:Stop and be still. If possible, sit down.Perform several quick pelvic floor muscle contractions, which inhibits the messages sent to the nerves in the bladder; don't fully relax between contractions.Take several slow, deep abdominal breaths to relax the rest of the area.Use mental distraction such as counting or spelling words backwards.Wait until the urge fades and try to wait for a minute or two (the set interval) before going to the toilet without rushing.

Pit stop tactics

You'll still have to plan where you're going to stop. If you're at the point of successfully being on a voiding schedule, try to just go once at the pit stop. No rushing in, then having a bite to eat, then going again just in case. That just further entrenches old habits. When you go, take your time to make sure you void as fully as possible.

Don't dehydrate

Bladder management through dehydration is a favourite tactic of OAB suffers everywhere, but it ultimately does more harm than good. Drinking less creates more concentrated urine, which can be irritating to the bladder and creates a greater urgency to get rid of the offending fluid.

Drinking water - only water - is one of the best things you can do. Slow and steady is the aim; when you hydrate by frequent sips, it gets to the cells where it can do good, rather than delivers a tsunami to the urinary system that can't be processed and must therefore be eliminated. Guzzling large quantities after dehydrating for hours simply overwhelms the system.

What not to drink and eat

There are plenty of drinks and foods that are natural diuretics or just plain irritating. Figuring out which ones are your bladder's kryptonite is essential when packing snacks. Leave the kryptonite at home if you want your bladder to behave better.

Here are some of the offenders:Tea (including herbal) and coffee (caffeinated or otherwise)AlcoholChocolateCaffeinated soft drinks and anything fizzyCitrus juices and fruitsApples and apple juiceTomatoes and tomato-based productsSpicy and acidic foods and drinksCucumbers, watermelon, pearsFoods and drinks that contain artificial sweeteners

Natural remedies

Valid research is typically scant when it comes to supplements and herbal treatments. A naturopathic doctor would be the best person to recommend what might be right for you, but some things showing promise are:· Pumpkin seed extract· Magnesium hydroxide· Gosha-jinki-gan.· Hachi-mi-jio-gan.· Buchu (Barosma betulina)· Cleavers (Galium aparine)· Cornsilk (Zea mays)· Horsetail (Equisetum)· Ganoderma lucidum

The big fix

All of these cost-free management approaches can help. If you still find yourself dreading the travel season, it's worth exploring other options, such as Emsella treatments, which utilize High-Intensity Focused Electromagnetic (HIFEM) technology to stimulate deep pelvic floor muscles and restore neuromuscular control. The treatments have worked for many others.

Shelagh Meagher is the owner of SheSpot, a pelvic area wellness centre in Halifax offering BTL Emsella technology. She is a self-described "entrepreneur, science geek and author," with decades of experience in health technology.