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bedwetting information

What Can I Do About My Child’s Bedwetting

Dr. Wendy Glaberson’s April 10th, 2018 article in the Miami Herald, “What Can I Do About My Child’s Bedwetting?” is well intended, however, it is filled with myths that we at the Enuresis Treatment Center have seen all too often.

To be brief, here are Dr. Glaberson’s errors and our responses to them.

  1.  Enuresis most common cause is constipation leading to “dysfunctional elimination syndrome” that causes bedwetting.

ANSWER: Enuresis Treatment Center has successfully treated thousands of bedwetters throughout our forty three years of work.  A very small percentage        of our patients, regardless of their age, from five to fifty, also report constipation.  Our treatments 97% success rate is directed toward ending the underlying deep sleep/arousal disorder that is at the heart of the problem.  Patients suffering from constipation either remain so after the bedwetting is ended or no loner suffer from the problem due to the “fluid challenge” impact of our treatment program.

Our 43 years of treatment of enuresis has shown us that constipation and enuresis are not clinically related.  Constipation does not cause bedwetting.

  1.  ADHD or anxiety are causes of enuresis.

ANSWER:  Many of our patients present with one or both of the difficulties.  However, we have found that hyperactivity symptoms disappear when the underlying unhealthy deep sleep is treated, resulting in a return to more healthy sleep.

Also, many of our patients, regardless of their ages, experience anxiety which does not cause the bedwetting, but instead is the psychological result of the many stresses that the bedwetting produces – fear of discovery, feeling of failure, low self-esteem.

  1.  Enuresis can happen in the daytime.

ANSWER: Enuresis, i.e. bedwetting occurs only at night.  It is the involuntary release of urine during sleep.  Children who cannot control their bladder while awake are experiencing daytime accidents usually resulting from the bladder sphincter muscle’s weakness due to its frequent opening during sleep.  The bladder sphincter cannot remain closed during the day because it has not been kept closed automatically during the night.  Those bladders do not develop the strength to remain closed during the day when the urge to urinate first arrives.  Daytime accidents result.  They are a major source of anxiety that results from bedwetting, not the cause of it.

  1. Enuresis is caused by making large amounts urine overnight and having a bladder that does not relax properly to fill and store urine.

ANSWER:  Someone who wets the bed almost always has a very small bladder.  A small amount of urine can trigger the sphincter to open since the enuretics’s deep sleep cannot be aroused enough for the brain to send the “stay closed” signal to the sphincter.

As a result, the bladder does not grow or cannot hold the “large volume of urine” that Dr. Bladerson reports. Someone who wets the bed does not produce any more or less urine than non-bedwetters.  The difference between them is the brain-bladder connection with the deep sleep.

  1.  Dr. Glaberson recommends: 1) regular bladder emptying during the day and before bedtime, 2) use of laxatives to aggressively treat the underlying constipation, 3) behavioral therapy and positive reinforcement as methods to treat bedwetting.

ANSWER:  Regular bladder emptying can make the bed wetting problem worse.  Emptying bladders lead to the bladder’s failure to grow and retain urine.  The bedwetting process is accelerated by the proposed method and daytime accidents are much more likely to happen.

We have found that only by treating the underlying deep sleep/arousal disorder, regardless of constipation, if it presents at all, can bedwetting be permanently ended.

Behavioral therapy and positive reinforcement only works with difficulties that can be brought under the patients control.  Bedwetting does not respond to such treatments because it occurs when the bedwetter is not awake. It is involuntary.

Dr. Glaberson is correct when she opines that medication used to treat bedwetting “does not cure the problem but helps control the symptoms”.  Ending the medication often leads to a return of the bedwetting.  Should the medication be used lifelong?

  1. Dr. Glaberson recommends the use of pullups inside of a sleeping bag for enuretic children who attend sleepovers.

ANSWER:  While this method can work in the short term, it does very little to decrease the possibility of discovery and the shame it can bring.  The “logistics” of the recommended method are daunting.

Dr. Glaberson’s article remains a repository of the myths and misconceptions that the medical field unknowingly promotes.  Physicians can be wrong. Her article supports this opinion.

Author – Dr. Lyle Danuloff, Staff Psychologist, Enuresis Treatment Center

Dr. Glaberson’s article

What can I do about my child’s bedwetting?

BY WENDY GLABERSON, M.D.

April 10, 2018 04:06 PM

Enuresis, also known as “urinary incontinence” or “bedwetting,” can be extremely distressing for both parents and children. It can lead to lower self-esteem in children, frustration among caregivers, and disruptions in sleep for both.

Enuresis is a common problem in the United States with approximately 5 million children affected, with boys experiencing it three times more often than girls do. Enuresis can run in families — often times a parent will come to the office and say that he or she also “wet the bed” when younger. In most children, it will resolve by the age of 6 years. When it persists much past that age, particularly when a child begins sleeping outside the home, at sleepovers, is typically when it becomes most distressing.

There are some known risk factors for enuresis. One of the most common ones is dysfunctional elimination syndrome. This syndrome represents a collection of abnormal urinary patterns associated with constipation. For example, it can mean your child is holding his or her urine for too long and overstretching the bladder, or having difficulty relaxing the bladder outlet during urination, straining the muscle. Other risk factors for enuresis are breathing problems such as sleep apnea, or neuropsychiatric disorders such as attention-deficit hyperactivity disorder (ADHD) or anxiety. Constipation and sleep apnea should be treated by your child’s pediatrician or another specialist. Children with ADHD should be reminded to empty their bladders every few hours.

Enuresis can happen during the daytime, but it is more common overnight. There are two forms of enuresis, primary and secondary. Primary enuresis is more common and means that your child has never been completely dry. It can be caused by making large volumes of urine overnight, having a bladder that does not relax properly to fill and store urine, and lower than normal levels of a hormone which causes water retention by the kidney. With secondary enuresis, your child was previously dry for a period of at least six months and is now experiencing symptoms. Causes include bladder infections, things that cause large volumes of urine such as diabetes, and emotional stress or trauma in a child’s life such as a family divorce, bullying at school or the loss of a beloved pet.

If your child is experiencing enuresis, see your pediatrician first. He or she can likely make the diagnosis with a simple history and physical examination. In addition, your pediatrician may want to screen your child’s urine for infection or excess glucose. Imaging studies are rarely needed to make the diagnosis.

Most parents recognize enuresis but don’t know what to do to treat it. Parents should understand the natural history of the problem — that it’s developmentally appropriate in young children, and that most children will “grow out of it.” If enuresis is a stressful problem in your household, here are some of the available treatments to discuss with your pediatrician:

  • Minimize the amount of fluids your child drinks after dinnertime.
  • Encourage your child to empty the bladder regularly during the day and before bedtime.
  • Treat constipation aggressively with laxatives such as polyethylene glycol. Stool should be soft like a banana and come every one to two days.
  • Some families find success using a bedwetting alarm: a device which is placed in the child’s bed and will activate if it becomes wet. This type of device is used every night and improves arousal from overnight bladder filling and storage of urine, through repeated conditioning.
  • There are also formal programs developed by pediatric psychologists that use behavioral therapy and positive reinforcement —often in conjunction with bedwetting alarms. These programs are more successful when implemented consistently.
  • If your child is over the age of 6, your pediatrician may refer you to a specialist with advanced knowledge in medications to treat incontinence such as a nephrologist or urologist. These specialists can prescribe medications which are taken every night to help keep your child dry. These medications do not cure the problem, but they help control the symptoms. One type of medicine called desmopressin leads to decreased urine in the bladder, another type called imipramine causes the bladder to retain urine overnight, and still another called oxybutynin relaxes the bladder muscles allowing it to fill more normally and empty completely with regular voiding. These medicines are often successful.

What can you do for your older child in the short term who wants to stay at a friend’s house without suffering embarrassment? One suggestion is to send your child with a pull up inside of his or her sleeping bag. This technique offers a little more housework for a parent, but allows your child not to miss out on fun with friends. Finally, a closing note — if your child or your family dynamic is suffering from incontinence, we can offer hope — 99 percent of cases spontaneously resolve without the use of medications.

Dr. Wendy Glaberson is a pediatric nephrology fellow at the University Of Miami Miller School Of Medicine. For more information or to find a doctor, contact the UHealth Pediatric Nephrology department at 305-585-6726. 

Read more here: http://www.miamiherald.com/living/health-fitness/article208490119.html#storylink=cpy

 

Bedwetting Option

Bedwetting – A Good Problem

Why Is Bedwetting A Good Problem To Have?

I have been searching for answers to my son’s bedwetting for seven years.  Yes—seven years!  He is a freshman in high school and would be horrified if he knew I was writing about his “dark secret”, the one that almost strangled the life out of his self-esteem.

Once I understood what was really happening to cause the bedwetting, it completely changed my perspective, as well as my commitment to finding the best treatment for my son.  My background is in process management and root cause analysis.  I wonder why it took me so long to apply this knowledge to my research for my son’s enuresis!

Every night my son slept with the real problem.  However, my husband (the engineer) and I could only focus on the morning failure.  This is what my husband began calling it when our son turned seven.  Then my son began calling it The Failure.  Every morning we tried not to make a big deal of the wet being contained In a diaper, then a pull-up, and then the wet mat.  Even when we did nothing but remove it and throw it away, my son would look at me with sad eyes and even apologize.

I am sure the struggle is the same for parents of an aging bed wetter:  You turn to the pediatrician who dismisses it from the very first time you bring it up – when your child is about to enter first grade, and every visit thereafter until they are tired of hearing you ask, beg, complain; demand a solution.  Next comes a prescription for DDAVP, which I later researched and learn it is called Desmopressin and the side effects are extensive.  My son has always been active in life and active in sports.  We also live year round in a hot climate so hydration is essential.  The physician never explained that dehydration is one of the side effects of this drug.  How crazy is that?

We were directed to another doctor in the building, a urologist.  He explained the steps he needed to take to rule out any internal issues.  I asked about the chances of bedwetting being caused by a physical problem, and was stunned to learn how small the percentage was – less than 2%.   He said he would not make any recommendations until he was satisfied with his test results. In addition to the nighttime wetting, my son was experiencing some daytime issues.  I explained to the urologist that it appeared as if my son was waiting until the last minute to go to the bathroom, and would have some very small accidents if he could not make it to the bathroom in time. At nine, he did not soak his underwear, but he often came home from school and from soccer practice with damp underwear that had a faint odor.  It would be enough for anybody to notice.  If other children were to find out, there’s no telling what would happen.

The urologist told my son an ultrasound was an easy test, and that the results would help him solve the problem.  My son asked if it would hurt.  The urologist was very patient and told him the bladder ultrasound is painless.  All he might feel is a slight pressure as the little flat wand about the size of a cellphone is moved over his stomach.  He explained that he would need to lie down and be very still during the procedure so the sound waves could produce a picture of his bladder and help discover what was happening to cause the bedwetting.  The technician told him I would be in the room with him at all times.

I was thrilled with the explanation and reassured my son. What he failed to explain was the need to drink a great deal of water before the exam so that you arrive in the room with a full bladder.  Sounds simple enough.  Except my son had a history of urgencies and leaking, which the urologist knew from the history, but apparently forgot to place any significance on when it came to being able to hold a full bladder from the time you drink the water until the time you are taken into the technician’s room for the ultrasound.  They failed to tell him about the gown he would have to wear, which he ended up needed to change twice because he kept leaking urine.  This turned out to be a very embarrassing and challenging experience for my little boy.

In the end, the urologist diagnosed a small bladder as well as an inability to completely empty his bladder.  He then proceeded to tell us that this is what was causing all the problems.  He prescribed Ditropan, another drug, of course,  and wanted to set up a timed-voiding program. He told us to purchase an interval watch that would need to be set at two-hour intervals during the day.  He turned to my son and said he could have fun picking out his favorite color, and would be able to wear his colored watch for the next six weeks.  He also told us to make him drink more water during the day.   How do we gauge that while he’s at school…and how much we would considered “more”?  We ended up purchasing this special watch online, and shared with our son that this would fix the bedwetting problem.

Unfortunately the watch drew a great deal of attention and questions from his classmates.  Questions such as why he was wearing a watch that went off all the time.  Why did he need to go to the bathroom during class rather than waiting, etc.  My son ended up not wanting to wear the watch.  He seemed to try to break it, in fact.  Regarding the Ditropan, my son developed a lack of trust in that as well, and every dose given was a struggle.  Fourth graders are way smarter than we give them credit for!

I must confess we stopped trying and simply told our son—parroting the pediatrician—that his body would eventually outgrow this and he would not be wetting the bed as a teenager.  Reflecting back on this, I cannot believe we continued to feed him this type of unfounded reassurance. Even though he continued with the sad eyes every morning he wet the bed, he stopped calling it The Failure, and thank goodness, so did my husband.  In my mind, this meant it did not bother him as much.  How wrong we were to assume something as insidious as waking up wet was the first thing to greet you in the morning was not bothersome.  How is it possible to expect anyone to simply ignore this and simply wait for it to go away?

The bedwetting dragged on, and during the spring of my son’s sixth grade year, he came to us one night and begged us NOT to allow him to go to the sport’s summer camp his friend was attending.   We had avoided discussing summer camp for several years trying to avoid putting any pressure on him.  I was sad to see him miss the childhood joy of sleep away camp.  He told us he was terrified of what anyone would do to him if they found out he wet the bed.   It was an absolute heartbreak for us.

All of that devastation explained….why would we think bedwetting is a good thing?

Because it led us to the truth behind so much more of what made up my son’s experience of life.  The more he turned into a little man, the more we started seeing changes in his mood like irritability.  He wasn’t nearing puberty, and he said he wasn’t having problems at school, so we weren’t sure what was going on.  And as we started to hear from two of his teacher’s that he appeared to be daydreaming or distracted, we were beside ourselves.

The miracle came when we discovered that bedwetting is actually related to sleep.  So it turns out that my son’s style of sleeping was at the bottom of his bedwetting.  And by recognizing that the sleep is actually not good for him, it made things crystal clear to us.  Everything in our son’s life was starting to be challenged by not sleeping well!  So in that sense, bedwetting was good…because finding a company that works with bedwetting and targets sleep to end it, my son was given the opportunity to flourish and function at his best.  There is no better feeling.  From heartbreak to full on joy!  Persistence to find the truth of something is so important.  You have to learn to go beyond what everyone tells you is true or right or wrong or good or bad.  You gotta go for it based on all signs, symptoms, and gut feelings as a parent.  And as a determined and resourceful parent, you find what you need.  Fortunately, you don’t have to figure out how to make the change.  A determined and resourceful mom has already found the solution.  We are ever grateful to the Enuresis Treatment Center for curing my son and liberating him from his cage.  Thank you also to the “mom”, Barbara Moore.  Truly, we cannot thank you enough!

Cheryl Evans,  January 2018

mom talks about son who wets the bed

Go After The Real Bedwetting Problem

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“First of all, I can’t pull this part to I say thank you to the whole team over there. I think it’s only those families who are in the same situation as we were What a huge relief it is for everybody really to get to this point to have a child who is not wetting the bed anymore.

I can say now that I have a happy 10 year old boy who is highly intelligent and proud and confident and happy! For me to be able to see my boy going to a birthday party and sleep over night and have no fear of wetting the bed at someone else’s house is the most important to me.

There was a time when I thought maybe we would maybe never get to this point, but we did it. It’s only because we got into this program, which i think is wonderful. I had Claudia –wonderful Claudia–all the way supporting us.

I had my moments when all the family found it difficult to keep on going and do the practice and do everything that we were asked to do, but it was worth it….more than worth it.

I would encourage all the families in the world to try this method–to go after the problem– because bedwetting is not something that will just disappear by itself. This is something we are told; that it will disappear through time. I think this is the biggest problem–that we believe in it–and we keep waiting and waiting.

I just couldn’t understand why we didn’t find the program sooner.

I’m glad we found it. It’s so logical.”

Miriam G

Sarasota, NY

Our whole team thanks you for sharing your experience with the Enuresis Treatment Center for Bedwetting.

To listen to additional audio testimonials click here

To watch videos click here

 

Research All You Need to, But You’ll End up Coming Back to This Program Because it Works.

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“Hi, I’m Charity, and my little boy is Jack, and he’s nine years old.

I had done a lot of research. We worked closely with our pediatrician and a urologist to try to make sure that I could find something. I didn’t want him to suffer without a program.

I actually looked at the references or the testimonials of other parents, and they had mentioned that their children had ADHD. People from all over the country and world were able to be successful in the program, so I thought I’d give it a try.

He has been diagnosed with ADHD since he was four, and he’s been on a constant regiment of different medications. We’ve tried melatonin at night to get him to sleep He has definitely had sleep problems since he was born.

He ended up on medication called Quantity. We’ve basically been on that medication throughout the program.

You were fabulous, and I mentioned that to you when we graduated us that I felt really blessed to have you consistently stick with us, and I didn’t feel judged when I couldn’t feel I could do it anymore with this long process. You provided a lot of information that was tailored to him, and it worked.

I felt supported, and it was definitely something that each and every time I talked to you, you would make things specific to him. You also gave me encouragement about how you had other parents and clients going through certain things as well.

It was just really nice knowing I had you the whole time.

LORI: What has been the best thing for Jack as a result of not wetting the bed anymore?

MOM: Probably his self esteem. Just something as simple as wearing the same underwear up to the next morning without having to take a shower every single morning because he wets. He can go to the next evening and shower because he feels like it, and not because he has to.

Of course, I get to sleep during the night now if I don’t have to worry, and it feels like a weight has been lifted off our shoulders. He is looking forward to going to friends’ houses that he hasn’t been able to go to because he was worried about wetting.

So the sense of freedom and his self esteem… those are probably the big things.

LORI: Have you seen any difference in his behavior?

MOM: He’s acting a lot more mature and independent. I would honestly think that his behavior has changed because he slept better, and maybe it has even effected his grades. He’s always done fairly well, but just being able to get a good sleep pattern has made a difference in that.

I would encourage any parent to go through this bedwetting program.

Research all you need to, but you’ll end up coming back to this program because it works. It’s tailored to you and your child, and it’s successful. I wouldn’t waste any time whether they are three years old or 12 years old or older. Just start this program and you will have amazing results. I just wish I had found it earlier and started earlier than I had.”

 

To listen to additional audio testimonials click here

16 Year-Old Continued Wetting the Bed – Why Trust Us?

Bedwetting counselor, Claudia, works at Enuresis Treatment Center

 

We are always grateful when a family wants to share their experience with other parents searching for help for their child, especially a teenager, to stop wetting the bed.  Here is the written version of this mom’s conversation with her counselor, Claudia, as they were completing treatment.

MOM: I’m so unbelievably grateful, and also just to this company. Words can’t begin to describe how truly thankful we are for all it has done.

After so many years of dealing with this problem, I can’t believe it’s no longer an issue in our house. I have a very healthy, happy, dry teenager, so we just want to sincerely say thank you.

Our previous experience was with a company called Pacific International. It was a very long and draining experience that we had, and it was also unsuccessful. We started the program when my son was nine years old, and were very optimistic that it was going to help him.

We tried on our own, but knew we needed help at that point.

I’m sure as anyone knows who is dealing with this problem, it’s very heartbreaking to see your child wake up wet every morning.

Pacific International told us that the program should work anywhere between one and two months to six months to a year at the longest.

My son was on that program for four years. At that point we said that that was enough, and we asked for a refund. They pushed off that request, and asked if we could try a couple more things.

Of course we did. We wanted to try more things because we wanted our son to be dry more than anything. The money wasn’t that important; we just wanted to get him dry.

The things they asked us to do were things we had already done and that hadn’t worked the first time, but we still tried.

After another long period of time–probably more than six months at least–we called it quits. To this day, we never received a refund that was promised, and I know we never will.

But we stayed with that program for so long–probably over the course of six years–because we wanted for our son to be dry.

We honestly didn’t know what else to do at that point. We just had no other answers. We were hoping and praying that he would grow out of it on his own, but he never did.

So for about a year, we just did nothing. Sometimes he would have long stretches of dry periods, and sometimes he would have long stretches of wetting. At this point, he was approaching 16 years old, and we knew we needed help, and that’s when we found the Enuresis Treatment Center.

CLAUDIA: Wonderful! So why did you trust us? What made you trust us?

MOM: First of all, we loved how the company began…by a woman looking for a solution to help her daughter. Gaile was wonderful on the phone. We knew a lot went into finding and researching solutions that worked, and we were just very impressed by all the people we spoke to.

I’m going to be very honest with you. We were very skeptical about this program –as you can only imagine — after all we had been through. We were also very tired and drained from working so hard at this for so long with no results.

As much as we were hopeful and optimistic that this was finally our answer, we went into this without that brand new excited energy that you might have when you start something new, but something felt different, and we knew that we were going to give it a shot.

CLAUDIA: Do you have any difference you want to share with us?

MOM: There were a lot of differences to the program actually that we found. While some of the methods were actually similar in nature, ETC had a lot of positive differences. For one, just the equipment in general. It was so much more comfortable for my son and so much easier to use. Also, a couple of the simplest exercises that he did on your program were so effective, and he had never done that before in the past –they were never presented to him. That was a great step, and obviously that worked.

One other big difference that comes to mind. On the other program, the only communication we had with our caseworker was through the mail. If we had problems or concerns, we would call, but it was not on a regular basis. Only as needed.

Here with you, we were assigned a wonderful caseworker who I spoke with every two weeks. It was wonderful; so personable. I was able to ask questions–even the smallest ones– regarding my son in particular. It was personal in nature, which was great. It was a great process.

Listen to the audio version of this conversation here https://nobedwetting.com/testimonial-audio/