How to cope with soiling and wetting 7 year old

[MrsLeoTolstoy]

I've name changed for this as I am currently sitting weeping at the hell of having an incontinent 7 year old DD. She returned home today with her pants in a bag having withheld a poo because she was too busy playing and then sat in the messy results for at least 4 hours. She changed at the childminders.

We've had four long years since she toilet trained - except she didn't. She sees an incontinence nurse, renal nurse, poo consultant. She is on medication for constipation, urge incontinence, and to stop recurrent UTIs. Thr medication has made a big difference, but for the last month she's been wet and or dirty everyday.

We've been to see child mental health services and it didn't seem to help. We've done all the reward strategies going, given her a reminder watch for the past 2 years to get her going to the toilet frequently at school. She has two bottles of water to drink everyday. We have a toilet routine. We've done everything we can, but it's not working.

I dread her coming home. I've yelled, cried, and pleaded with her. I've tried to understand it so I can help her, but I'm broken. Our family life is under massive amounts of stress. DH is great but he's at a loss too. I just don't know where to turn too.

The odd day she has been clean and dry have been so carefree and lovely in comparison to the days spent cleaning up after her and washing yet more wet, soiled clothes. I've thrown out 100's of pairs of pants.

I don't know how to cope. It's having a really negative impact on how I feel about her, which makes me feel even worse. I want to be the mum who just shrugs and says never mind, but I just don't seem to be able to. I know she is anxious about it, I know she understands I am angry and frustrated.

I'm worried I've damaged our relationship for forever and that she will be increasingly shunned and teased at school by her peers.

How do I cope better? Everyone just seems to think she'll grow out of it, but I'm not sure I can wait that long.

Don't laugh at me but have you seen a physiotherapist? DD (age8) who has Aspergers was referred to one by our consultant. She had very similar issues to your DD.

It was a lightbulb moment. DD has severe hypermobility, she is far too flexible & her muscles don't work quite right. That includes muscles you clench when you need the toilet.

A bit like "what happens when you have a sneezing fit having forgotten to do your pelvic floor exercises" as it was explained to me.

When did you see CAMHS? Can you get a referral back? IME they need dynamite under them to actually get moving & do something useful.

I don't want to put much more info on a public forum but please PM me if you have further questions. I might not be able to help, but I can certainly listen.

Thanks Kippersmum. I'll PM you in a bit. I've called the continence nurse and CAHMS this morning and left messages. I feel the problem is me and how I cope. Hadn't even considered physio but might very well be worth a shot DD doesn't appear to have hyper mobility but I'll try anything to help here.

We got a hypnosis CD from Lynda Hudson - we're not woo in the slightest- and it worked really well by somehow re-programming DSDs brain to respond to the physical sensation of needing to wee, which previously she had been ignoring, sometimes consciously sometimes not. In our case it also helped to shift the attention- seeking aspect to the positive thing of having not wet, whereas previously the "inability" to stay dry had gained her lots of fuss and attention at her mother's house which she wasn't keen to be without.

Like you it was the entire focus of family life and caused huge stress for everyone - we had tried everything before we got to this, and had the CD not worked we were intending to go to Lynda's clinic in Kent.

hope this works as well for you as it did for us. And no, I am nothing to do with the clinic, this is a genuine post!

Has she seen a urologist? A bowel specialist? Can she feel when she needs to go? I'd be pushing for further investigations. Has she had an mri?

I think this is the sort of situation where you need to twin -track. Carry on seeking out long-term solutions (that's the "easy" bit, ironically) but in the short term accept that this is how it's going to be for a while. This bit isn't easy but if you can accomplish the necessary mental gymnastics it will take some heat out of the situation and let you build a positive relationship with your dd that doesn't focus on whether her pants are clean or not.

I have only lived a pale shadow of the situation you describe and I recognise exactly the pressure and fear it puts you under and how it infiltrates everything and (in my case) lead to huge anger and angst, much of which I passed on to ds (also 7). In our case constipation was the first problem - he couldn't feel when he needed to go but the second was a fear of soiling that made him just 'blank' the situation (and so made the soiling worse).

To counter that, I just had to stop getting stressed and angry (so easy to type, so difficult to do). We put ds in charge of the elements of self-care (shower, changing, soaking affected clothes), administered movicol and otherwise feigned complete nochalance. It really helped cause as much as he pretended he didn't care he was desperately anxious, poor kid and the improvement in stress levels at home were (eventually) matched by more suiccessful toileting.

3 things I'd ask. Could your dd be constipated now (despite the medicaton)? Or too loose because of too much? (we did this [shame]) And how does she feel about the school toilets (ds hated his which was a major stumbling block - as was the '5 min off playtime if you need the toilet in class time).

HTH

Thank you all for responding. I wouldn't wish the hell of this on anyone but it helps to talk to others who understand it. I'm on my iPhone so can't name check everyone.

DD hasn't had an MRI. She sees a bowel consultant and has had an ultrasound of bowel and kidneys. We are seeing a renal nurse but not a consultant.

I don't believe that this is physical now. The symptoms are but I think this is about DD being massively anxious about how I react. I feel like I have completely failed her and agree that I need to back off so we can repair our relationship, I am finding it really hard to do.

She maybe constipated again due to withholding. I discussed that with the continence nurse today.

Our childminder has texted to tell me she had an accident at school today because she ignored her vibrating watch and wet herself in a maths lesson. She goes to the toilet at school and doesn't complain about them. I think she just hates having to go the toilet full stop. It gets in the way of what she is doing and is all too inconvenient.

I wish I could just be taken out of the equation but that's not possible. We have a DD2 and the very thought of toilet training her makes me sick with anxiety and stress.

I try really hard to take one day at a time but after 4 years it's taking its toll on us all and with no end in sight it's hard to be hopeful.

hrpufnsuf can you tell me more about the hypnosis. We are 100's of miles from Kent so way we could visit. DD1 stopped sucking her thumb overnight by me just asking her to, but she's still wet almost every night and still uses pull ups. Which CD did you use?

It sounds like it could be due to anxiety. You know some kids have this with eating.

She might have developed anxiety over toileting? I'm no expert at all except my oldest was selective mute at school for a brief period.

I completely understand why you feel frustrated and blogs are a great way to get that out - bless you. If she picks up on the stress it makes her anxiety greater (if that's what's causing this.)

She needs a child psychologist to rule it out.

Hi Mrs LT, we used "I am dry at night" because overnight was our main challenge - my DSD was also still in pull-ups (aged 9) and although she clearly had some control when she chose to have, she more often chose not to...

You play the CD to them as they fall asleep (you can also download it for ipads I think) and they take it in both consciously and sub-consciously, to the point where DSD could recite it almost word perfect after a couple of nights! For us it was a bit of a miracle, worked within a few days, and then we had a bit of a relapse for a few nights before we had a long spell of it working which seemed to get her out of the habit.

Such a relief - we live a long way from Kent too, but that would have been our next plan if the CD hadn't been enough. The re-programming of the brain is sub-conscious so it wasn't something DSD could "outwit" if that makes sense; like you the anxiety/attention issues had got tangled - I do sympathise, and completely understand, I was at the end of my tether as it was ruining every day - and it got to feeling like she was doing it on purpose, particularly when sometimes, when it suited her - going on a brownies trip for example - she had no problems.

It's got to be worth a try I think - we had also ruled out all the physical issues - and I really hope it works for you like it did for us. Don't be hard on yourself, you deserve a break too xxx