Wednesday, June 30, 2010

Conquering Urinary Incontinence -- The First Bladder Infection of the Year

Last year my mother had five bladder infections. This is a common occurrence amongst people suffering from Alzheimer's disease and dementia....
By Bob DeMarco

Beginning in 2008, I came upon a solution that not only allowed me to detect my mother's frequent bladder infections, it also allowed us to cut down her urinary incontinence to near zero.

In 2008, I made a simple observation, my mother seemed to be warmer when I held her hand. I also noticed that she seemed to be perspiring a bit.


At the end of one of her regular doctor appointment I brought this up to our personal care physician Dr. Carlos Chiriboga. He decided to test her for a bladder infection and hydration right on the spot.

Hydration no problem. She did have a urinary tract infection. In my discussion with the doctor, I learned that is was possible to have a bladder infection without pain. I now refer to this as the silent bladder infection.

Prior to this new understanding, I was under the impression that when a woman had a urinary track infection she would experience pain, or have an irresistible urge to pee all day long. I learned that older women knew immediately from the symptoms that they had a urinary infection.

When I learned that it was possible to have a bladder infection without the typical symptoms I started to discuss this with my sister and other women. Most of them were surprised to learn what I was learning.

On top of the above, it is now impossible for my mother, who suffers from Alzheimer's disease, to tell me when she is sick, feeling pain, or when she has a headache. I usually notice these symptoms from her non-verbal behavior before she tells me. For example, if she starts rubbing her head I have to ask, do you have a headache? Most times she will say something like, I am OK. After I ask her the same question a few times, very gently, she tells me she has a headache and where it is located.

My mother has never once told me she has a urinary track infection. In fact, if you ask her right now she will tell you she never had one. On top of that, if you ask her if she has incontinence she will tell you no. NO pee pee pajamas, no pee pee underwear, no pee pee pants.

I should interject, my mother was suffering from incontinence since 2000. I know this because she started to have "accidents" in public places. The flood.
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After I had the experience I described above with our doctor, I started to wonder why a doctor didn't detect my mother's bladder infections with ease. It soon dawned on me why.

My mother's normal body temperature is 97.6 to 97.8.

So, when she went for her typical three month check up and they took her temperature at the doctor's office they would not detect a problem when my mother's temperature was 98.4. This is part one of the solution.

I started taking my mother's temperature every day or two. Sure enough, once her temperature reached 98.4 she had a bladder infection. Every time. Five times last year and once already this year in January.

So here is my first piece of advice. If your loved one is suffering from urinary incontinence start taking their temperature and establish a baseline temperature. It is not unusual for an older person, suffering from dementia, to have a body temperature well below the commonly recognized 98.6.

If you are experiencing the dreaded pee pee underwear, pee pee pajamas, or pee pee bed, get on the stick. Get the baseline temperature established and get rid of the silent bladder infection.
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Here is something you might find interesting. This last time around within hours of getting the 98.4 temperature reading we had the flood. The big dreaded pee pee flood in the sky. I already thought my mother had the bladder infection and this "event" convinced me it would prove to be true. Unfortunately, it was Saturday and we couldn't do anything about it until Monday.

As a sidenote. It use to "piss" me off (lol, pun) when I would try to tell the woman on the phone that I needed to see the doctor because my mother has a bladder infection. Usually, they want an explanation of how you know this. Of course, when I explain the 98.4 they automatically assume I don't know what I am talking about. I say this use to bother me, no more. I am use to the drill, and I am confident in my diagnosis. I know I am not a doctor -- I am an observer of patterns. And there in lies the solution, look for patterns.
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In November, 2009 I finally got around to writing -- Urinary Incontinence -- How We Beat Alzheimer's Incontinence -- The Solution. Now, I am feeling a lot more confident, probably cocky, so I am not afraid to use the word - conquered.

Conquering urinary incontinence requires two things. The first I already described above. Establishing the body temperature baseline, and catching the silent bladder infection and killing it.

The second thing you need to do is to establish a pattern of pee-peeing. In other words, you have to incorporate the scheduled pee pee into your own already established pattern of behavior.

I describe how I did this in Urinary Incontinence -- How We Beat Alzheimer's Incontinence -- The Solution.

The bottom line is this. I have to make sure my mother pee pee's every two hours. Of course, she says all the time, I don't need to pee pee. I sometimes try to explain to her in a very low calm voice, when you have to pee pee its too late. To be honest, I have all kinds of things I say, in a calm low voice, to get her to pee. Things like, come on, its time to pee and then you'll have a snack. Come on, its time to pee pee and then we will eat. Come on, its time to pee pee and then we will go out and have some fun.

I say all these things to my mother not because I believe she will remember them, but because I want to establish a pattern of behavior.

If you got this far consider this. No pee pee in the bed. None. No need to change the sheets. My mother does not wear diapers, or for people that find that word objectionable -- briefs, depends, or socks.

Sometimes a little pee pee in the pajamas. Sometimes a little pee in the panties or pants. Often-- NO pee pee.

This is my belief. If I don't get my mother to pee pee at least once every two hours, and she pee pees on herself that pee pee is on me.

One of these days I am will get around to writing the Magic Poop Solution. Yeah, I conquered that problem also. It only took around four years to figure that one out.

Feel free to share this article by emailing a friend or caregiver that is going nuts with the dreaded pee pee. Somebody push this up to Stumble Upon, Digg, and Facebook. Use the share button at the top of this article.

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Original content Bob DeMarco, the Alzheimer's Reading Room

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