Potty training - Left hemiplegic Cerebral Palsy

[MABS]

Me again asking you for help , don't seem to be able to help anyone else these days!

As you may know, my ds aged 3yr 8 months has a mild left hemi. His hand is virtually unaffected and his foot is very mild - he say piedro boots and various other splints depending what mood his physion seems to be in!! He walks ok with a limp and generally gets around well. But, he is totally incontinent. He wants to wear pants but anytime we put them on , he has no idea how to control it and he gets upset. We don't react at all and yesterday he said that he only knows he wants to wee wee when he feels it on his leg. He is, i'm told, a bright child and i don't know what to do . His ot and paed (neither great) just keep telling me to leave it til he's ready. His physio said she feels it could be related to the cp but can't elaborate!! Any experience, advice or knowledge of this girls? btw i've bought every type of potty going recently !

[dottee]

Hi MABS - my dd is r. sided hemiplegic.

I'm trying to cast my mind back to when she became t-trained. I think it was around her 4th birthday. I remember sort of putting it of until the mainstream nursery she was attending suggested I should try and she took to it straught away.

It was a long time ago - she's just turned 12 - but I remember not bothering much with potties as was not 100 % keen on them. But she was lead on regular intervals to the nursery toilet or my toilet at home with a little step to it (I had an child's 'insert?' (forget the proper name)) and it seemed to click with her. In fact, I think I started at the beginning of the Easter holidays and she was dry by the time she was due to return to nursery (and that included overnight). So calculating back, she was ready on her 4th birthday.

She still has the odd dribble, especially when she's too preoccupied (lazy) to get up and go.

Hope this helps. ((()))

[dottee]

Sorry about typos.

[lou33]

Hi mabs, potty training here atm, 3y2m, so in a similar situation.

You probably already know this, but CP can affect sensation, in as much as ds may not have enough nerve endings "awake" enough to tell him it is time to go , just yet, so that could be a contributory factor.

Have you spoken to OT about the different types of potties and potty chairs available? Also the types of pads you should be able to get for him (i believe it is from age 3)? You might be able to get hold of something that can slip inside pants. Because ds2 is unable to sit on a toilet, as he is too unstable, and he is too big for a run of the mill potty, we have a commode style chair by Smirthwaite. It has really helped him get the training under way , although we are a bit hit and miss on some days (esp with poo). It might be worth getting an ot out to assess him for something similar.

Hope this helps!

[MABS]

Thanks Lou, i feel like i'm banging my head against a brick wall with the medical lot round here. The ot and the paed said , leave it to the summer and remember he's a boy!! I felt so patronised and said that's what we were told last year...

He seems to have abosolutely NO sensation that his bladder , bowels are full - has your little one? Over one year he has NEVER succeeded even tho he is 'happy' to sit on potty/loo with someone holding him. D'you know if i can actually buy these commode things as i stand little chance getting one 'prescribed'. Have been told locally that they don't look at nappy issue til he's 4 yrs. As you can gather i'm really stressed about it - but no - he's not ware of that . Many thanks

[lou33]

Hi Mabs. The link to the website menu is here . We have the Birchwood one. It has a potty seat and a commode style add on for when they get bigger. The good thing about these chairs, is that they have a little woodne bar that can go across the front, so if you have to leave him, he can't get out/fall out. They have lap belts too.

Ds2 is 50/50 about doing wees, but not too hot about poos. He doesn't acknowledge he has done one as of yet, hence the reason I was cleaning a four foot trail of it off my white rug yesterday! He is normally extremely constipated, again not helped by his lack of mobility, and we have him on lactulose and pico sulphate atm to help unbung him. 30mls of lactulose a day didn't help, so 4 days of the pico wotsit did, but he didn't realise it was coming.

Let me know if I can help any more.

[rsv1000r]

We have had, and still have, this problem - I think it is more common in boys with cp. My son is 5 and still wets himself although he has good days and bad - still not dry at night and has to wear nighttime nappies.

His physio says it is because he is not receiving signals early enough that he needs to go, and again doesn't seem concerned. The only thing that seems to work is regularly reminding him to go - even if he says he doesn't need it. Every 2 hours seems to do the trick - it is a pain though having to keep an eye on the time - particularly for his teachers at primary school.

[MABS]

just an update... Last Friday at nursery he told them to take his nappy off! Since then we have only had 4 wee wee accidents and he is so proud of himself, poo is another matter. I'm so delighted with him, particularly that he's sort of 'cracked it' before he gets an Afo splint next month. Many thanks for all you advice and support.

Lou, many thanks for your advice re the 'baby commode' we got one 3 wks ago but then went away and i forgot to thank you.

[coppertop]

Awwww! Well done, Mini-Mabs. :

[lou33]

I'm glad it's all worked well for you Mabs