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Mama needs dipes too!

A mama recently emailed us about her situation, seeking your thoughts and experiences:

Ready for the whole diaper story in our house?  The babies and toddlers aren't the only ones wearing 'em.  There is also a stack of what the kids and I call "run dipes," which I must wear when I go running if I don't want urine soaking my pants, trickling down my legs and into my shoes.  And even when I dutifully wear my dipe, sometimes I need two!  And yes, I pee RIGHT before I leave the house.  I will NEVER know where it is hiding, why it waits until I've just left the driveway to come out.

I've always someone who wet my pants laughing, jumping rope, sneezing - aerobics was totally out.  But after two kids, my, my....  My sister-in-law (3 kids) just had surgery as it was so bad for her (and she's not the type to take that lightly), and another friend made the very fortunate, accidental discovery recently that those menstrual cups (diva?) seem to serve a double purpose and stop the urine, too.  Does anyone else share this predicament?  Whta do you do?  Mamas, I need ideas, tips, tricks, to keep the urine right where it belongs.  I'd rather it were just the kids in this house who wear the diapers.

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I don't have this problem but have you tried Kegels? I had heard so many problems about this that it was something I was very concerned about while TTC and talked to my doctor. She said Kegels were the first line of defense. I did my Kegels and didn't even have problems with leakage while I was pg.

If you don't know how to do them, start while you're sitting on the toilet, going pee. Start and stop, start and stop. Once you isolate them muscles, then it will be easier to do them when you aren't going to the bathroom. As you do them, see how long you can squeeze before you have to release.

Try doing them during sex. Not only is it good for you, but I've yet to hear of a man that didn't enjoy them.

If you have a hard time remembering to do them throughout the day, when you're driving your car, do them at every red light until it turns green.

I haven't had this problem (yet!) myself, but I am familiar with it and I have a friend who seems to be famous amongst many women for helping with this sort of issue. Check out Tami Kent in SE Portland. Here is more info on her...

http://www.wildfeminine.com/

I had this very same problem. Get to Tami Kent right away! The kegels may help; the surgeon I consulted with in discerning whether to do the surgery was surprised how strong my muscles were, so it's not just kegels. Over the years, I have found great help from internal work by Tami Kent and more recently, have had "miraculous" results from giving up caffeine- I was shocked that such a simple thing could make such a difference, as I only had 1 -2 cups of tea per day of caffeine intake previously. Since giving up caffeine, the only time I leak (requiring a panty liner, NOT a maxi pad, is the week before my period. And to me, that's fine, since it is SO much better than before. Other bladder irritants (which is what I think the caffeine was for me) include carbonated drinks, alcohol- I am sure there are others.) I also went the traditional physical therapy route, which was somewhat helpful but not nearly as helpful as the work Tami Kent does.

I would love to hear about your sis-in-law's experience w the surgery. I had a hard time finding out about it from people who had it when I was looking into it and at some level, I want to be prepared -if the no-caffeine cure is temporary- to make an informed decision about the surgery.

As luck would have it my sister-in-law is coming to visit this weekend and I plan to pepper her with questions - which I'll share here in the comments section. While I am overjoyed to think there is an easy solution ot there (caffeine), wow that would be a big thing for me!! Not as big as surgery, of course. I, too, ahve noticed that the week or so before my period is the worst - what's the link there? Hormones? This is great advice - I shoudl have sent this question in many diapers ago!!

Tami Kent! She's the best.

In spite of daily kegels during pregnancy a forceps delivery meant that I couldn't even do a single kegel afterwards. Incontinence was making me cry daily! I got a referral from my midwife to the Providence Physical Therapy Clinic and they really helped me out. There are two types of urinary incontinence - many post partum women can have both. Along with exercises (mostly kegels - if you can't do one, or many DON'T try to practice them sitting in the bathroom - this was one of the no-nos) they had lots of helpful advice (many food/beverages can irritate the UT), training yourself to "go-before-you-go" can backfire and make managing incontinence worse, etc. It took a couple of months but with constant practice, biofeedback, and some behavioral changes things are sooo much better!

I am in the same wet boat....pelvic floor physical therapy has made a big difference for me as well as acupuncture. There is a fantastic woman at the MIississippi health center (beth)who does acupuncture and is a specialist in women's pelvic floor health, her work, along with herbs and the PT has improved my situation at least 60% - since i am not that into surgery if i can avoid it.....good luck, it seems like it is a long road that may never be EXACTLY as it was before but there are some options...

I had this problem after delivering my child and now go to PT at Providence St Vincent's. Woman named MJ there specializes in it. She is great-booked out months though. I am a runner and have been for 20 years-did marathon and everything. She talked to me about not running and doing alternate exercises that aren't as high impact. I was very sad about this and went through a grieving period, but I am now okay with it. My reasoning is that I want to do all I can to avoid surgery. I also have rectocele-which is prolapse which did not emerge until 10 mos post delivery..triggered by running! Reason incontinence is worse week before period is because of all the pressure in the uterus pushing on all the organs making incontinence more pronounced during that time. I know b/c I asked my PT that same question. Kegels are good but you definitely are not supposed to do them while peeing as someone else wrote. I would get checked out by PT that specializes in this, not regular PT. They can offer so many helpful suggestions! Good luck.

Can those of you who've gotten treatment describe the PT process or the work that Tami Kent does? I guess I picture the sort of PT that I've known people to get for sports injuries, and it's hard to picture being comfortable working on something this intimate and embarrassing with my stereotypical gung-ho, sweaty, male PT. Are we talking about something equivalent to a pelvic exam every time you go? How does this work?

Go see Tami Kent!

I did 2 rounds of PT one after each kid - the first was with bio-feedback, i.e. sensors hooked up down there to help me watch a screen and see how i was moving my pelvic floor, since i had lost much of the feeling down there i needed to re-train my brain to understand how to contract for a kegel, it was really interesting...then i saw a PT at OHSU (Sandy Gallager) and she was also awesome, exercises, relaxation techniques, even meditation to gain control of that part of my body again. no sweaty men,just focus and work on your pelvic floor. PT made a huge difference not just in leakage but in discomfort w/intercourse (which was such a bummer!!!). Find a good PT and try it, you will be surprised at how much better you feel!

I spoke to Tami today. She seems great -used to be a PT at Providence, 3 young-ish kids. Yes, therapy is "down there," bit since that's where the problem is, makes sense to me. It's not a sexual thing at all, though people can get that impression. I'm willing to try, but first I have to discuss the whole thing with my surgery sister-in-law this weekend! Stay tuned.. and thanks, everyone, for this great advice! I just wish I had known earlier - I wonder why no-one in the medical community mentioned it, b/c I sure talked about it!!

i also don't know why the medical community don't talk about it- esp before birthing; I was SHOCKEd the first time it happened to me; I even had my midwife (who are s'posed to be more ...something... tell me I might have to use drugs or just get used to it for the rest of my life...that was VERY disheartening- until my chiropractor referred me to Tami Kent, who does internal myofascial release and othe types of work. I have also gone to Prov Portland PT (covered by insurance)and improved- focused on kegels, biofeedback, which was helpful, and lifestyle changes. I have found that the internal work has been most beneficial to me. Good luck!

I don't have leakage or peeing issues, but I do have a cystocele (bladder prolapse) and rectocele. After having my second child I felt like I was "falling out." I never really notice it now unless I run, which I don't do for excercise anymore. I hike and bike instead, if I do anything that is. Regardless, it is there and I was told I'd probably need surgery when I'm much older.

I too had heard NOTHING about this before the births, and I am the queen of research. I never ran across it at all!

The PT thing sounds good. I wonder if my insurance will cover that sort of thing.

I plan to ask my insurance next week,which is Kaiser. I'll report back...

Pants Wetter and anyone else,
FYI- There is an excellent PT at Kaiser Sunnyside named Amy who specializes in women's pelvic floor issues...incontinence, pain, etc. She does all the above mentioned type therapy. Your ob/gyn practioner may be familiar with her, if not request a referral to be see by her specifically. For more "run of the mill" incontinence issues, Kaiser has classes run by Amy and another good PT but if I were you, I would try and see her for an individual appt. Good luck. She should be able to help you out.

Just an FYI, there is a whole specialty within Ob/Gyn that deals with these types of problems called Urogynecology.

Just wanted to report back that I signed up for Kaiser's class with Amy the fab PT and will let you know how it goes. THANK YOU SO VERY MUCH for this resource. It feels really good to be taking steps to solve this issue!!

So I went to the Kaiser class -it was really informative and I'm so glad I went. Of course I was the youngest pants wetter by like 20 years -at least! The class was free to Kaiser members (no co-pay), and seemed like a necessary first step to getting an appt. One thing that seems promising is a pessary - a hard rubbery plastic ring that you insert much like a diaphram - it puts pressure on the bladder wall, supports it somehow so the pee doesn't come out. pretty quick and easy solution while you're simultaneously exercising up a storm. on beyond kegles. anyway, i feel like i'm on my way to improving this situation adn it's covered by my health care provider. thanks again to all. if i get the pessary -on my list - i'll report back about that, as well.

Your article is extremely impressive. I never considered that it was feasible to accomplish something like that until after I looked over your post.

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