When you hear the phrase “quality of life,” it usually drums up some sort of terminal health scenario.
When my grandma’s cancer advanced, her “quality of life” was in the forefront of our minds as we made decisions and next steps.
It’s something you hear on prime time medical dramas as doctors stand over unresponsive patients, or on the floor of Congress as they debate and decide such serious issues as Death with Dignity legislation.
It’s a heavy phrase.
It’s a phrase that doesn’t usually make you think about peeing your pants.
I walked into every doctor’s office as a mother first, a woman second, and then somewhere way down the line after 1999 senior class vice president and maybe-wiccan, I allowed myself the title of patient.
I want to talk about this, I mean really talk about it, because this is a huge part of my life.
This is me.
You are probably wondering if this picture was taken after I ran down the driveway to get the mail, or jumped up and down on a trampoline, or had some sort of coughing fit?
No. This photo was taken halfway through brushing my teeth.
When I say I peed my pants a lot, I don’t mean when everybody else pees their pants: during a sneeze or of high impact activity.
I peed my pants when I walked, I peed my pants when I lifted clothes out of the dryer, and I even peed my pants pulling my leggings back up in the bathroom after peeing.
If you asked me to list all the times in a day I peed my pants, it’d be easier for me to tell you when I didn’t: in the shower, because technically, I didn’t have pants on. Boom.
I even peed during sex, which is, as you can imagine: awesome, if that’s your fetish.
If it’s not, well, waterproof pads and goggles help.
Incontinence and urgency are billed first as old people issues, second as punchlines, and lastly as quirky byproducts of having kids.
And as a result, it took me a crazy long time to escalate my concern about peeing my pants to anything other than, “haha motherhood and bladder leakage amirite, haha.”
It took my gynecologist sitting on a stool in front of me, asking what my quality of life was, to realize my quality of life kinda sucked, and even though I wasn’t elderly or terminal, that still actually mattered. Me- enjoying life, experiencing things, doing things not in a diaper at age 37– mattered and was a thing I was allowed to want and advocate for.
I’ve talked about this before, and after meeting with my gynecologist, my primary care physician, two urogynecologists, and trying both pelvic floor therapy and medication, we came to the decision to move forward with a mid-urethral sling and medication to address my two main issue: stress incontinence and urgency.
First let me define them.
Stress Incontinence: Leaking urine when performing some sort of activity (coughing, running, laughing, whatever). This can be remedied with surgery.
Urgency: Sudden urge to pee, and not being able to make it to the bathroom in time (it happens so fast, and I can’t stop it). Fun fact, this could actually get worse with surgery, and I am currently successfully treating this with Ditropan.
Second, I want to tell you that this is a personal medical decision I made for myself with the help of four doctors I trust. If I had a dollar for every person who heard me say the word “sling,” and immediately parroted back to me every class action lawsuit commercial they heard on television, or spammed me with internet articles, I’d have a nice stack of McChicken sandwiches in front of me right now.
This decision was about me, my body, and weighed against the quality of life I was experiencing versus the quality of life I deserved. Got it?
Alright, in the most layman’s of terms, my urogynecologist made two incisions on my mons pubis, and one inside my vagina, to place a small sling around my urethra to stabilize it, with the hope that scar tissue forms around the sling, further holding my weak and shaky tube in place so that I don’t leak anymore.
I think of my urethra as a super drunk lady stumbling through a party in high heels with a glass completely filled to the rim with wine, and it’s sloshing all over place the every time she bends down to talk to someone, or trips over herself. The sling is like her less-drunk friend just trying to get her to sit down and sober up for a while, and maybe not scream-sing the lyrics to Whatta Man by Salt N’ Pepa so loud.
Barring any complications, this would normally be an outpatient procedure, followed by 6 weeks of pelvic rest. However, my account of this surgery is somewhat skewed, as I had a hysterectomy at the same time, and that sorta took precedent in the whole pain, discomfort, and recovery department.
I left the hospital with the reminder to not expect miracles right away, but that my incontinence should improve in the coming weeks as scar tissue starts to build.
Best case scenario: I stop experiencing bladder leakage. Worst case scenario: it works so well, no pee comes out at all.
The first time I coughed, I was walking down the hall 10 days post-surgery, and it was so sudden, I didn’t even have time to reflexively cross my legs. And nothing happened.
I mean, I fucking screamed because, dude, abdominal hysterectomy 10 days ago.
But no pee. No leaks. No wet underwear or pee running down my inner thighs.
“Andy come here right now!” I screamed leaning up against the wall holding my stomach.
He bolted out of the kitchen to find me lifting my nightgown above my panties,”I didn’t pee my pants, can you even believe it?” I was beaming. “My intestines might have fallen onto the floor, I think, but like, completely dry otherwise!”
I stood in that hall fake coughing over and over, and nothing. No pee.
Tomorrow I head in for my 6 week post-op appointment with my urologist, and then Wednesday I’m visiting my gynecologist for my final post-hysterectomy check, and I’m feeling a mess of things. I’m scared for an internal exam, as I’ve had nothing (no dicks, no sticks, no licks) inside of me for 42 days, and I’m terrified it’s going to really hurt.
But between us, I am also desperate to be released from pelvic rest and the aforementioned 42 days of celibacy.
I honestly didn’t think it’d effect me this badly, but between my hormones shifting all over the place and Andy walking around here in grey sweatpants looking like sex, I’m basically leaning in to the washing machine every afternoon, just trying to control myself.
But most importantly, I’m excited to experience my renewed quality of life. I want to be able to run and hike again, play with my kids, brush my damn teeth and not need an outfit change, or leave my house without pre-scoping out every bathroom I’ll be near.
If you are reading this and thinking: um, this sounds like me, wtf do I do?
- Talk to your doctor. Explain that your bladder leakage has escalated from fun party trick to actual inhibitor of your daily life, and then ask what you can do about it. I made a list of all the times I leaked urine over the course of one day, and brought it with me to an appointment. Don’t let the conversation end until you feel like you’ve been presented with a next step.
- Know your options, because you have a lot of them! I am not a commercial for mid-urethral slings, nor do I suggest you get one, unless you need one, then let’s compare vagina scars! You actually have loads of other options that can happen before escalating to surgery, and even with surgery, there are so many different types and options. But for real, talk to your doc about physical therapy, medication, diet changes, and make sure to get yourself some Icon undies, trust me on this.
- Stop being too embarrassed to bring this up to your physician. Listen, to even get to be a doctor, they had to do a whole buttload of way grosser things than listen to you talk about peeing your pants. I mean, in the grand scheme of things, it’s really one of the more sanitary conversations they get to have with a patient. Bear Grylls drank his own pee on television- I mean- you’re fine, talk to your doctor.
- Ask me. I didn’t meet a single person who experienced what I experienced until I said out loud that I was experiencing it, and then I was met with a chorus of: me too! This shouldn’t be an embarrassing secret. Peeing your pants isn’t taboo. Incontinence isn’t just an old person problem. It’s a woman problem, and we gotta talk about it. So let’s give that a try, eh?