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Guest post: Stress incontinence - 'Fallen fanjos are a feminist issue'

259 replies

MumsnetGuestPosts · 21/05/2014 10:55

Doorstep piddling wasn't unusual for me - you know how you're okay right up until you get the key in your lock? Well, my poor neighbour caught me as I was wresting small kids and shopping with a post-coffee-bladder. She chatted away as I tried to disguise that I was bursting (standing on your tip toes works by the way, for a time).

Our relationship was mostly based on exchanging gardening tips and accepting parcels for each other. So, washing her down the driveway in a giant tsunami of my steaming piss was a bit, y'know, socially awkward.

And I had no excuse. I knew exactly what pelvic floor exercises were, how to do them, and why I should bother because I'm a physiotherapist.

No excuse, but, there was a good reason – I was awfully tired. I lived with hundreds of tiny kids who were always trying to maim themselves, and each other, in ever-more inventive ways. I could barely remember my children's names, let alone remember to clench my nether regions.

But the great Dribbly Doorstep Disaster was the motivation I needed.
"Make it a habit" is the advice, so, I did them every time I shouted at my kids' (effective), every time I craved a glass of wine (remarkably effective) and every single time I thought an evil thought about my husband (dry in three months).

Here's the sciencey bit:

One in three women aged 35-55 wet themselves, and, about 50% of women over 55.

70-80% of stress incontinence can be cured with pelvic floor exercises within four months.

Read that again. At least a THIRD of your peers use pads, and MOST of them can be cured.

The exercises are cheap to teach, free to do and don't have any side effects. Unless you count toe curling, panting, blaspheming orgasms as a side effect (ask me how I know).

And it bloody MATTERS. Incontinence quietly disempowers women by interfering with every single thing they do, and yet, few complain. It matters because wetting yourself in the front row of Zumba, means you are unlikely to go back to Zumba (again, erm, ask me how I know), and we know that diseases of inactivity kill people. It matters because being "a bit leaky" is a big deal that can have a huge impact on your long-term well-being.

We silence ourselves. It’s as if we are so ashamed of having less bladder control than our toddler that we'd rather continue to suffer in silence than seek help. I suggest we try being angry and vocal instead, because that’s how taboos change.

Even more silent are the one in ten people who leak poo, or the 50% of women over the age of 50 who have vaginal prolapses. Some wait until they are practically dragging their cervix behind them before seeking help.

It's common to be a bit disengaged with your "down below" because, well, you can't see it. We know that many women find the exercises difficult to do correctly, and that energetic eyebrow wiggling is not an effective alternative.

So, set the scene: You're in a tiny lift with your boss, your MIL and someone you've got a massive crush on. Imagine you can feel a fart brewing. A really nasty one. You know that bum-ole squeezing you do to hold in the mortifying toot? That's you working your pelvic floor. Hold it for a count of 10. When you let go you should feel a "drop" down into your pants. Or you could do 10 quick flicks and relaxes in a row - try doing them in time to the beat of music.

The important thing is to keep breathing and to relax your muscles in between the exercises. Do these three times a day, every day for four months, and then, once a day, every day, until you die. If you get pain, stop and take your bits to a GP or pelvic physio.

And, I'll even remind you via twitter - when I tweet, you twitch your twinkle. Midwives and physios are collaborating with #squeezeandlift. If you see it, do it!

Basic lifestyle changes – like reducing caffeine, citrus and alcohol (so, at least cut out the 'slice' from your rum and coke), controlling hayfever or asthma coughs and (even small amounts of) weight loss can make a huge difference to the amount of leaking you experience.

As with all things, the best place to start is with good information – there are brilliant blogs out there, like Evidently Cochrane, and lots of useful stuff from the CSP and the Bladder and Bowel Foundation. Or, you could even watch me, on a really bad hair day, doing about pelvic floors.

The bottom line is that any leaking at all is abnormal. It is not an inevitable consequence of ageing or parenthood, and you don't need to put up with it.

Watch Elaine's alter ego Gussie Grips take the Edinburgh Festival by storm over on the - and don't forget to subscribe - lots more brilliant videos coming very soon.

OP posts:
PacificDogwood · 22/05/2014 23:12
gussiegrips · 22/05/2014 23:14

Pacific am awfully glad I was nice about GPs...phew.

Your wonder about "doing them right" is why the NICE guidelines recommend doing an internal when you teach pfexs. Which is fine, for the one, consenting woman you have in front of you...but, the millions of them wandering around outside...? Every one of them, a slip hazard.

There's clearly a need to 1. educate women that ANY leaking is abnormal 2. that most cases can be improved if not fixed 3. that they are not alone (actually, that should be #1) 4. that they don't need to put up with it 5. that they should be on MN. ok, #5's pushing it, but, honest, I've got a big MN crush going on because of this thread!

So, yep, feeling like something's going to drop out is a symptom of prolapse. And, seeing as how the States (I can't find the reference, I'll have a dig) allegedly regard it as normal for a woman who's had 2 vaginal deliveries to have a G2 prolapse, well, you fit the criteria.

If it were me, and my bits, I'd be looking for a good urn-gyn person. But, that's mainly because showing my bits to people is practically a hobby of mine.

What's the negative about having an assessment? Worst scene scenario is being told "That is normal for someone of your age with your maternal history. Please do x, y and z to keep it that way"



Go and show off your bits. They'll have seen worse (probably mine)

Oh, and, stealth boast about the orgasms duly noted... and that you DIDN'T say "probably outing myself here" with THAT nugget

rosypsypuddingandpie · 22/05/2014 23:29

gussie, i have had 4 dcs, and generally the pelvic floor is holding up pretty well (i do my exercises), however i definitely do have a bit of a vaginal prolapse. I am not prepared to go to the drs about this as i had a very bad experience with gynaecological surgery many years ago.
my only problem is when i am galloping and jumping my horse, sometimes i wee myself, and if i am on my period i cannot wear a tampon as it literally falls out mid round. (fine the rest of the time) do you think i should try the incotampax thing you refer to whilst going cross country?

PacificDogwood · 22/05/2014 23:29

Grin

gussie, you've always been nice to me even though I did not make it to your Fringe show and me feelings (personal and professional) are not easily hurt (and I am very nice and would never/have never said to any woman "Ah, well, love, you've had kids, wadda'ya expect")

Your threads are always a joy and a laugh and an education

gussiegrips · 22/05/2014 23:30

Oooh, Bunny, I can can't hold my pelvic geek back much longer...

It's not that the French stats are the same as ours. It's that the measurements here are wildly different from theirs. For a start, theirs are great, ours are rubbish.

I can back that up.

UK estimated spend on managing incontinence? £288 million.

Australia's spend on managing incontinence? $43billion (from memory, I'll check. Either $43 or $46. I'll find the reference, it's a Deloitte study done in 2010)

See, UK government only really add up the cost of pads and surgery.

Australian's are smart. They include the cost of managing the secondary depression, the obesity, the heart disease, the hip fractures, the loss of tax from folk having time off from sick leave, the cost of welfare payments due to families who have split up because sexual dysfunction put the tin lid on the relationship...etc.

Australia has a HUGE government funded campaign to drag this stuff into the light. Have a look at this video. It's brilliant. 30 seconds of genius. On their tellies. Let's be honest, it's funded because their government realises it'll save money, but, it REALISES! Our assorted politicians don't seem to notice me yet



Acksherly, whilst I geek out about numbers...

I did a Companies House search to see what the post-tax profit was of pad manufacturers...one company makes more than twice our national NHS spend. One company.

About £180million a year is spent in supermarkets by people buying pads.

50% of sanitary towels (estimated) are destined for bladder management (hint, if you are 65, you're kidding no one in That Aisle)

I have no problem with companies making a profit. But, I DO have a problem with companies making more than twice the NHS funding WITHOUT ANY HEALTH PROMOTION ON THE PACKAGING!

It wouldn't be expensive to put #doyerblardyexercises on every incontinence pad.

You wouldn't forget then.

woodja?
bodo2 · 22/05/2014 23:36

Thanks gussie. The NHS physio I saw suggested that the nerve damage was permanent, but pleased to hear that nerves can heal. I'm going to ask to explore other avenues before TVT surgery. I absolutely can't stop the flow of urine (which always seems to be the suggested way to identify the PF muscles) but encouragingly, I have recently started running again and can do so without leaking. Maybe there's hope for me yet... It's so difficult to judge the severity of ones symptoms when no one talks about it openly. At my last appointment I felt like I was being pushed down the TVT route but perhaps although I do have symptoms that I shouldn't have to put up with, it's good to know that perhaps there are other options to try first. I've got an electrical stimulation device which I bought on advice from a private physio and used a bit between DD1 and 2 and a little bit after DD2 was born but that was 3 years ago... Sounds like I need to reacquaint myself with it again!

gussiegrips · 22/05/2014 23:37

Oh, and yes, yes, yes to posture - but, really tricky to do remotely.

Easy to fix if you have one person in front of you - well, not easy, but, easier than online. People are weird, I can say that because I've seen a few in a state of undress. Honestly, it's amazing most of us can stand, with our creative posture.

Less sitting. More standing. More activity.

Would do me the power of good.

gussiegrips · 22/05/2014 23:38

yep, WH have done PF stuff.

Twice a year, by my reckoning.

If you're relying on external prompts to remind you to #doyerblardyexercises, Women's Hour is not clinically effective.

Shame.

They totally could be.

PacificDogwood · 22/05/2014 23:41

Less sitting. More standing. More activity.

Me too Blush

Then again I have this theory that almost all human illness could be solved if we all ate less, moved more, did not smoke, drank alcohol in moderation and were not overweight.
I have hundreds or no studies to back that up (depending on how you look at it) Wink



How about swimming? Is that any good? I must do something…. the middle-aged state of me is ridiculous.

PacificDogwood · 22/05/2014 23:43

In word of one syllable, what do I have to do to join The Dark Side Twitter to have you tweet me??
That might actually work for me…

I am thinking of going off to see Dr Karen Guerrero/a (?) at the Southern General in Glasgow - do you happen to know of her?
Sorry, I am shamelessly taking advantage of you good nature now. Feel free to ignore me, honest.

gussiegrips · 22/05/2014 23:48

TeWe TBH, I'm not sure how to spell vajisheemush either. I never, ever use it in scrabble.

Nerve damage isn't common, but, isn't a shocker in clinic. Glad you're good now, and, I hope the vayjaychimooch is well and truly resolved.

If not, you're going to see your GP and get a referral, aren't you?

I totally know how to spell it

gussiegrips · 22/05/2014 23:50

TeWi it's Much Better Now, that was a preview where I rambled on a bit. I blame Commander Hadfield and a bad hair day.

I have since MET The Commander (wanted to lick his face, resisted. Proud of myself) and, found my hairbrush.

Must make another video...

gussiegrips · 22/05/2014 23:52

Bunny are you kidding? If I have my way, this thread Will Never Die.

The only person who listens to me in real life about this is my stupid budgie...why do you think I landed up spending a month of my life in basement bar wittering on about vaginas? Self indulgence.

Keep posting We. Must. Keep. The. Thread. Alive.

PacificDogwood · 22/05/2014 23:53

You made me look up who Commander Hadfield was - result or what?!

gussiegrips · 22/05/2014 23:54

Pacific so, you wouldn't go with a big, juicy procidentia image, then?

Probably for the best.

PacificDogwood · 22/05/2014 23:58

No, IME big procidentias are v rarely juicy Wink - definitely stay with a astronauts Grin. Who's the new guy? Luca?

Are you doing this year's Fringe?

gussiegrips · 23/05/2014 00:07

Ooooh, Rosy you're not going to like what I'm going to say, but you can guess what it is.

Horse riding's tough on your prolapse. I'm sorry you had a bad experience in the past, that can be really traumatic.

I'm guessing (and, clearly, it's a guess seeing as how I can't see or prod about in your fanjo) that your bits must be in Quite Good Nick considering your big brood (congrats) and that you only leak when your cuddy's* in 6th gear.

So, from that guess (am being careful incase I say anything less professional than my usual) then, I suppose you could surmise that an incostress might be helpful.

Pros:
You can try it without examination
it's about 30 quid, so, not cheap, but not horrific
it's not going to do any harm
it might do a lot of good

Cons:
You can try it without examination

Thing is, the incostress could well be the answer, but, if you have wee niggly muscle spasm up there, well, that could be treated and fixed. Then you could use the incostress as a preventative thing, and have bespoke education about how to best look after your bits so you can keep galloping

TeWiSavesTheDay · 23/05/2014 00:21

Mmm commander...

Yes worry not, there is a whole treatment plan thing. I have a lovely GP.

gussiegrips · 23/05/2014 00:35

Pacific I am always nice to you - but, I can turn...

Twitter's an odd thing. I never understood it until someone said it's like being in a busy pub, with loads of conversations going on round you, and you're listening in to two or three at a time.

So, sign up. Follow me @gussiegrips. Find someone you like (like, say, @Cmdr_Hadfield) and see who HE likes (note the absence of @gussiegrips there. I should have licked him) and follow the ones that appeal.

When someone tweet something you like, you tweet it to your folk. etc.

Busy pub.

but, it's totally underestimated as far as health promotion goes. Some good work amongst diabetes nurses - if it's an actual person doing the tweeting, well, you'll read it. An app, spitting out reminder-bots, maybe not.

Anyhoo, not doing a run in the Fringe - am working on trying to get funding to tour Gusset Grippers as a means to getting a research project going. Hoping to be ready in time for the Glasgow comedy Festival next March, then Edinburgh Festival, then the O2...ish.

gussiegrips · 23/05/2014 00:40

swimming - yes, lots of it. aqua-aerobics - seen as beign for little old ladies, actually, an excellent workout (and, good biofeedback if you're in a council pool and you're jumping about. A chilly cervix reminds you to #doyerblardyexercises)

Southern's got a great reputation. Gwan, gwan, gwan. Gwan, gwan, gwan. Gwan. Gwan.

gussiegrips · 23/05/2014 00:42

Who asked about Astronaut Luca? He's been and gone, some Japanese and Russian blokes up on the ISS now.

@Astro_timpeake goes up in a few months. Well, as long as the whole Crimea thing settles down. He's British. A British Astronaut.

I shall have a crush on him as soon as he hits zero gravity.

NASA has physios, you know. But, I only found that out last year. Dammit.

gussiegrips · 23/05/2014 00:49

Bodo nerves can heal - but, sometimes they can't. It's always very, very slow and there is a point past which the nerves can't recover.

Sounds like you need some answers - or, that you've been seen, but, still have questions requiring answers.

There will be reasons why TVT has been offered, and, it's important that I don't say "#squeezeandlift will cure all" because, that's just not true.

Make a list of what you know, what you wonder, and what you're worried about. Take it to the clinic/physio/GP and tick off their answers. Insist on having an appointment to go through your questions, informed consent means that you need to have information.

You don't have to put up with it, true, but, sometimes, that means understanding the problem as much as getting dry with exercises. Good luck.

gussiegrips · 23/05/2014 00:54

Tewis having inappropriate thoughts about Actual Astronauts is not compulsory. But, if I can get funding to do some research, well, sign up...

nooka · 23/05/2014 01:28

Thank you for the advice gussie, I'm having a smear tomorrow so I'll ask then. I definitely don't want UTIs!

OhBabyLilyMunster · 23/05/2014 06:53

I pretend one day Gussie shall be in the queens honours list for Services to Fannies

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