Thursday 19 April 2018

'I feared I was the only one living with incontinence'

Claire Reid suffered in silence for 10 years before finally going to her GP about her incontinence issue. Now on medication, the mum of three is urging other women out there not to be embarrassed as she was by the common condition

Claire Reid is urging anyone who suffers from incontinence to go to their GP. Photo: Fergal Phillips
Claire Reid is urging anyone who suffers from incontinence to go to their GP. Photo: Fergal Phillips

Ailin Quinlan

IImagine having an uncomfortable medical condition which affects your social life, curtails your fitness regime and keeps you in a state of anxiety - but which you endure for over a decade because you're embarrassed to talk to the doctor about it.

Wicklow mum Claire Reid experienced pelvic floor weakness - which causes urine leakage - when she was 31 and pregnant with her first child, now aged 15.

The pelvic floor, explains Wicklow GP and medical expert on Operation Transformation Dr Ciara Kelly, is like a sling which sits across your pelvic area, holding your organs - bladder and uterus for example - in place.

"What happens to some women following childbirth is that their pelvic floor becomes stretched and lax," says Dr Kelly, emphasising, however, that women who haven't given birth can also experience the condition.

Pelvic floor weakness is mainly caused by pregnancy and childbirth, menopause, being overweight or as a result of a hysterectomy.

Symptoms can include accidentally leaking urine when you laugh, sneeze or cough; a frequent need to go to the toilet; reduced vaginal sensation or difficulty emptying your bowel or your bladder.

At the time Reid thought what she was going through was an inevitable part of pregnancy - in fact, according to a new survey, 'Being a Mum in 2015', some 41pc of women are not even aware that a solution exists - so when the problem continued through the births of her second and third children, she didn't do anything about it.

In fact the Greystones, Co Wicklow woman endured the discomfort and stress for more than 10 years before eventually seeking help at the age of 43.

"I went to see my GP about it three or four years ago," she says, adding that by that stage she was utterly fed up of the restrictions the condition imposed on her lifestyle.

"I was able to exercise but I couldn't go for a really long walk without needing to go to the bathroom for instance.

"I restricted my intake of coffee and water. Socially, it also affected me; if I was going into a restaurant or a bar I'd immediately need to know where the bathroom was, and of course the last thing I always had to do before I left home was go to the bathroom - there would be a sense of urgency," says the office administrator and mother of three.

So she reluctantly sought a consultation with her doctor, believing, she recalls, "that I was the only woman in the whole world who'd ever gone to the doctor about this.

"However, I was sick and tired of it, and fed up of not having the freedom even to go for a long walk."

To her surprise, the world didn't cave in - instead her GP simply observed that it was a common problem. And it is.

The latest Irish research has revealed that more than 70pc of women surveyed have experienced accidental leakage from everyday activities, such as walking, running, exercising, jumping on trampolines, laughing, coughing or sneezing. TV presenter Bláthnaid Ní Chofaigh recently revealed her own battle with incontinence and urged people to speak out about it.

Pelvic floor weakness is also a huge problem globally - one in three women worldwide experience pelvic floor weakness, which can cause some concern - or be completely debilitating.

The Irish research also revealed that 65pc of women including mothers and mothers-to-be wouldn't discuss pelvic floor weakness with their healthcare professional.

"We forget that GPs hear so many personal problems that they don't think anything of it," observes Reid.

"For me I was quite embarrassed, but when the doctor said it was very normal, I immediately took comfort from that. I really had felt I was the only one - even with your friends you wouldn't feel comfortable talking about the subject."

The doctor recommended medication to take away the sense of urgency around urination - characteristic of the condition - as well as special exercises to strengthen the pelvic floor.

Reassured, Claire felt emboldened to speak about it with friends - some of whom confided in return that they too had experienced it - and to carry out some research on the internet.

Within a month of starting on the medication and doing the exercises, she noticed an improvement.

"That sense of urgency was gone and I felt that if I needed to go to the bathroom I could wait - I had that confidence [with] the new regime."

There's a huge lack of public awareness about the fact that pelvic floor weakness is a problem which can be dealt with, says Dr Kelly:

"I have written about this and have spoken about it on television and radio. I regularly get feedback from women saying they didn't know there was help out there."

The research, which was carried out among 600 women during October and November 2015 in order to gauge awareness of pelvic floor weakness among women, mothers and mothers-to-be throughout Ireland, shows that 87pc of women surveyed would use a clinically proven, non-invasive solution to prevent pelvic floor weakness from reoccurring.

According to Dr Kelly, there is a variety of solutions to the problem, ranging from pelvic floor exercises to physiotherapy, neuro-muscular stimulation, drugs and surgery.

"We'd prefer to avoid surgery or medication so the first line is exercise, physiotherapy or neuro-muscular stimulation, where you use a machine that passes an electrical current through the muscles of the pelvic floor.

"This stimulates them to contract more strongly than they would do otherwise," she explains.

"Too often, women think that pelvic floor weakness is a condition they have no choice but to put up with, when really there are solutions out there," says Dr Kelly.

"Women aged from 30 to 45-plus frequently visit my practice with signs and symptoms of pelvic floor weakness. It can have a huge impact on their lives with their family, with their partner and at work," she explains, adding that she's also seen younger women who are experiencing the condition.

"I see women in their 20s who have never had children, having issues. This is not exclusively a problem for older women or women who have had children.

"Younger women often think it's a problem for older women, which exacerbates their reluctance to do anything about it. You're not alone - there are loads of people like you - so come forward and you will get help," she exhorts.

"I really don't see enough of this coming in the door. People are not talking about it."

Don't suffer in silence

Don't feel embarrassed - visit your GP to get a diagnosis and to discuss the many different options for tackling the problem. These include:

• Special exercises to strengthen the pelvic floor

• Neuro-muscular stimulation

• Practice bladder drill - look at your fluid intake

• Medication can remove the uncomfortable sense of urgency around urination

• Surgery, which involves inserting a sling which is like a hammock support for the bladder. This procedure is done under anaesthetic and requires an overnight stay in hospital

• Botox injections - helps relax the bladder, enables it to hold more fluid

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