A just-in-case wee might be something that your mother encouraged you to do before you left the house as a child. It might be something that you still do, or tell your children to do. But what if this piece of advice creates habits that are at cross purposes with good continence practice? Here’s how:
Women who are practising the just-in-case wee may be unintentionally shrinking their bladder size. The smaller the bladder size, the less urine it is able to hold, the more often you need to go to the toilet. However, training your bladder the right way means that you are able to enjoy adventures without the need to know where every nearest toilet is located.
Here are the real stories of two women (their names have been changed). However, over my many years as a Personal trainer working exclusively with women, I heard numerous variations of these stories.
Perhaps these stories resonate with you too.
Linda was in her early 60’s when she came to see me at my private mishfit® PT studio. Linda had a social life that many would be jealous of. She looked after grandchildren several times per week and loved to craft. It was Linda’s goal to travel to Europe with a group of sewing girlfriends later that year.
However, Linda shared with me that her life was dictated by where the toilets were located. Yes, Linda had incontinence. But more than that, she had anxiety about her incontinence.
Linda’s biggest fear was to not make the toilet in time and disgrace herself in public.
Going out for Linda was carefully planned around where all toilets were located. Linda knew every public toilet at her local shopping mall. In fact, she knew every public toilet as part of all her routines. This meant that experiencing new places was a secret source of worry. Instead of admitting the shame of her inability to hold her bladder to those around her, Linda was more likely to make excuses and opt out and stay near to a toilet.
Linda shared the example of going with her family to the beach where after the picnic, there was always a walk. For many years now Linda had been opting to stay and keep an eye on their things, rather than join them. She wanted to go on that walk, but the fear and anxiety around how long the walk would be and if there was a toilet nearby was too debiliating for her to go. And her family had stopped trying to convince her to go.
Linda worried that if she did get to Europe with her girlfriends, that she would miss out on all the walks and end up only seeing the inside of her hotel.
Linda’s incontinence anxiety was making her inactive. Which in turn, further decreased her confidence in living her life to the fullest.
Mary was in her early 30’s and came to see me after the birth of her second child.
At our initial consultation I asked her about her toileting habits. Mary told me that she had suffered from Light Bladder Leakage (her words) after the birth of her first child. Mary had started being very careful about emptying her bladder before she left the house, whenever a public toilet presented itself and most certainly before she exercised.
Mary believed that she was minimising her risk factors of leaking.
When I asked Mary to count up the number of times she went to the toilet, she admitted that she had never really given it much thought. Mary counted at least 12 toileting times over a 24 hour period. Mary admitted that she did not wee very much each time. And with often forgetting to drink water, her urine was usually dark in colour.
Mary was habitually going to the toilet just in case.
The normal range of having a wee is between 4 – 8 times in a 24 hour period. And our bladders can hold up to 400-600 ml of urine (with the sensation of needing to empty starts at around 200-300ml’s).
Mary was actually a younger version of Linda. Linda had also started her just in case wee habit after her postnatal incontinence. Linda did not suddenly wake up one day and find that her life outside her house was dictated by the proximity of a toilet. This behaviour had thoughtlessly become her normal over time.
Both Mary and Lynda had not really given much thought about their toilieting habits. Or just how much these habits might be influencing their continence.
Mary looked at me and she said that Linda reminded her of her Aunty.
A just-in-case wee is a learned toileting behaviour. However, a habit can also be un-learned.
Our bladders, if not allowed to experience fullness, will shrink in size. Keeping your bladder in healthy proportions means that we need to monitor our toileting and ensure that we are not emptying it until it is full (or near to it). The bladder system, complete with a valve system, works best when it is in the right position (so hence can be misplaced with a bladder prolapse) and when it is allowed to be full and then emptied. When there is only a little urine in the bladder, the urine can become very acidic and thus further irritate and cause more issues and / or pain.
It is never too late to change your habits!
Here are 3 tips to improve your toileting behaviour:
- Toileting Inventory. Start a taking a note of how many times you go to the toilet in a 24 hour time frame. If you are are going to the toilet more than the normal range of four to eight times in a 24 hour period: Stop and ask yourself each time you feel the urge, do you really need to go? Or is it your just-in-case-wee habit. Can you wait a little longer? Decreasing the amount of times that you go to the toilet will take time and effort. But it always starts with awareness.
- How full is full? Recognise the feeling of a full bladder. One way to quanitfy a full bladder is to count in seconds how long it takes you to empty your full bladder. This will probably be the first wee in the morning (if you are able to not go during the night). This number can then become the bench mark of your full bladder. Count your wee at other times of the day and compare.
- Self talk and good breathing techniques. Monitoring your self talk is also very important. If you are repeating the mantra; “I’m going to wet myself. I am going to wet myself” as you rush to the loo, there is a very good chance that you will be a self fulfilling prophecy! A better mantra would be to breathe deeply to settle any anxiety and repeat ” I can do this. I am in control of my bladder.”
The place where women most often feel anxiety around not making it to the loo in time, happens at the front door! This is actually so common, that it has the name keyhole incontinence!
So, if you find yourself with your arms full of groceries, hunting frantically for your house keys while desperately trying to keep your bladder under control…
Here is the best trick of all:
Perform a series of quick pelvic floor contractions – we call these flicks. Flick your pelvic floor on and off as strong as you can muster. With practice and with accompanying positive self talk you will give yourself some time to calmly find your keys, unlock the door and get to the toilet on time!
Doing a just-in-case wee may be something that you have been told as a child, or perhaps you have used it as a strategy to deal with your incontinence. That’s ok. But it is not the best one to ensure that you stay active and enjoy life to your fullest. And sometimes your urgency to wee is a symptom of other issues. Investing in a pelvic health professional will ensure get the right help for you. And you deserve to live full of adventures.
And, I am very happy to report that Mary mindfully changed the direction of her continence habits and Linda went on to enjoy a much anticipated European trip with her sewing girlfriends!
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