To be embarrassed by going to the continence clinic at 30?!

[ScarletFaced]

Posted on Health but I don't know if anyon actually reads there. Sorry for the embarrassingness of this!

I'm currently having some investigations which were triggered by issues I'm experiencing with bladder and bowel control

I don't know (and I assume won't know for a while) what is causing it, but the hospital have put a referral through to the clinic so that I can speak with them about managing the issues.

I don't really have any idea what to expect, so I was wondering if anyone knows:

What kind of things they are likely to ask?
How horrendously embarrassing will it be?!!
Will they do any physical examination?
Is there anything I should probably prepare in advance, like some kind of diary?
What might they suggest?

This has come on for only a few weeks and I've been experiencing urgency with both the bladder and bowel - like, needing to go to the toilet very suddenly and not being able to hold on.

I don't have any infections, signs of diabetes, it's not caused by recent childbirth or pregnancy and I'm not experiencing any bloating or stomach pain. I've just lost the ability to hang on when I need to go to the toilet - and I need to go a lot!!

Please stop overthinking this and try to get your embarrassment under control. The clinics are fabulous - they’ve seen everything before and it’s literally all in a day’s work for them, even accidents. I’ve spent hours in a urology department with each of my parents and have seen people of all ages and stages seeing specialists. They treat it just like when any other bit of you stops working properly.

You will need to be prepared to answer questions properly without being squeamish so they can take a proper history from you and have the best chance of working out what’s going on, so I’d begin by writing down as much as you can - this will also get you used to thinking and talking about it. They won’t bat an eye at anything you say. They might need to examine you if that helps them understand the issue. They might refer you to another sort of specialist, eg neurology if they think it’s an issue with nerves rather than the mechanics of your urinary or bowel function.

Just take a deep breath and relax. It will all be fine, and they will do everything they can to get you better - so it’s worthwhile going through whatever it takes to get there.

Thank you! I really appreciate your reply. I know that I shouldn't be embarrassed but I'm sure I'm just going to wimp out of saying anything. So writing down is a good idea.

I'm already seeing neurology as they do think it is a nerve-related issue. So I think that hopefully there will also be treatments to sort it out, further down the line!

P.S. it is literally ridiculous to be embarrassed at the thought of an examination when one has given birth, had smear tests etc. But for some reason it feels more embarrassing!

Name changed for this as although I’m not embarrassed about the issue, it is potentially outing when added to my other posts!

I’ve had issues since my early 20’s. For me, the continence team have been brilliant.
To answer your questions. At my first appointment I was asked about lifestyle, activity levels, sexual health, pregnancy/childbirth and diet. Attention was paid to caffeine intake and the amount of fluids I actually drunk. They were keen to hear the impact incontinence had on my life. I was also assured this wasn’t just an old persons problem and that they saw people of all ages.
Making notes beforehand may help you. Think about the total number of toilet trips (day and night), if you have accidents/near misses or are woken up at night with a need to go. Note any food triggers for bowel issues and amount/type of fluids drunk. A diary would also be helpful but they normally provide one for you to complete for your next appointment.
Embarrassment wise, it wasn’t too bad. I felt a little uncomfortable initially but both the consultant and nurse put me at ease with gentle humour and kindness.
At some point I had an internal exam to check I could grip/feel my pelvic floor muscles. I’m not sure if it was my first appointment but it was early on during my treatment, as were my bladder and bowel scans. I was also referred to a dietitian, gynae physio and urodynamics.

My treatment plan was tricky as my issues weren’t just due urge/stress/overflow incontinence but a combination of them (close together pregnancies, large birth weight children, loss of sensation, neuro issues and anxiety/overthinking).
Bladder wise; physio exercises, retraining my bladder and brain (stopping the ‘just incase’ toilet trips), cutting caffeine and drinking more fluids have all helped. I tried medication and also learnt to self-catheterise but decided that for now, both options weren’t for me.

For peace of mind, I wear lighter/thinner pads if I am out close to home and the thicker ones provided by the continence team for long car journeys or when I know toilet access may be tricky. I carry a RADAR key in my purse and usually spare underwear, leggings etc in a small bag. I also permanently keep some in our car.

Excluding the advised foods, trying to relax (bowel issues were in part due to worry about it happening - a vicious cycle to break!), physio and making regular toilet trips have thankfully assisted the bowel issues. My longer pads cover my bum and have assisted on the very rare occasion needed!

I know I’ve been chatty (and probably haven’t helped that much) but I do hope I’ve helped a little!

@ScarletFaced so understandable to be nervous and embarrassed, there's so much shame with struggling with bladder and bowel control because not everyone does vs a smear which everyone with a uterus is supposed to have.

Please know lots of women have these challenges, sometimes related to birth and sometimes other things.

They will probably get a history especially related to onset and what the situation is like now. As well as neurology as you mentioned. There can be many reasons. Maybe try speaking to the Bladder & Bowel trust as they will fully understand what you are facing, will be able to offer support and may have some added information.

www.bbuk.org.uk

Oh. There were meant to be paragraphs in that massive chunk of text. I previewed it and everything...

Very common OP and I agree with the advice given above. Any time I feel embarrassed about sharing things like this I picture my mil in my head and pretend I’m talking about her. I don’t know why that helps me but it does!

Thank you so much for the supportive messages. It makes me feel a lot easier about it!

The bladder issues I actually find easier to discuss than The Other Thing. I've had a LOT of bowel accidents lately and it's not having an upset stomach or anything, it is just that I don't feel the urge until it's already basically happening. Even though it's the same with the weeing, I do usually get a bit of warning and it's not quite so desperate if you do have an accident. Added to that, waking up 5+ times a night. I am so fed up with it!

I have been diagnosed with crohns recently so discuss my bowel habits regularly with health professionals, it’s hard but they are used to it, it’s their job. I also have extreme urgency to pee and on meds for that. Waiting to see pelvic health team also. They know you’ll be worried/embarrassed it’s not uncommon to feel like this when discussing things that that but hopefully you’ll be out at ease by the staff and well looked after. Try to remember as much as you can and be honest with them. Take care op & hope it improves soon it’s not a nice thing to have

This isn't something I have personal experience of, but my mum had issues due to nerve damage in later life.

Although the hospital and kidney specialists knew all about her issues, in order for her to have the support she needed (including things like incontinence pads on prescription-making them affordable) she had to be assessed for her need by the continence team (we used to laugh about the name: surely incontinence team more accurate…). The team were great. They see this all the time for multiple reasons and were able to put my mum at ease. I can understand why you feel embarrassed but at the same time, I know (as no doubt you would say to anyone suffering) there is nothing to be embarrassed about. I saw your original thread and I know this is all very new for you. I wish you well.

Thank you!

I am really hoping it will improve soon, too! I suppose it will partly depend on what is causing it.