WWYD re:accidents

LSU628

To give you a little background, DD was very difficult to PT and had a really big regression after DS was born. After months of complaining about her tummy hurting, multiple trips to the pedi (dx with constipation), it resulted in DD having a ton of pee accidents and finally blood after wiping from a BM. We went to the dr again who sent us for an xray. Turns out DD was full of poop and had a pretty serious impaction. The pedi believed the impaction was pushing on DD"s bladder causing her to not be able to empty it fully and causing the accidents. DD FINALLY passed the impaction but is still having TON of pee accidents. I've tried everything from taking away tv and the Leap Pad b/c she wouldn't stop watching to go, to now we are going back to the way basics of sticker chart and M&Ms for dry panties but unless we remind her or strongly encourage her to go, she isn't going pee on her own. Even more disturbing, she will stay in wet panties and not tell us. I'm not sure if she is afraid of losing her Leap Pad or tv but she will seriously sit in wet panties. She is going back to school in a few weeks and I am terrified they are going to send her home for excessive accidents or she is going to wear wet panties all day. I'm going to call the pedi b/c I'm concerned that maybe there is something going on medically (although they did a urine sample and there is no UTI), but how would you handle this? I'm trying REALLY hard not to get angry with her b/c I know she knows how to go, but I"m tired of doing laundry, am concerned about her giving herself a UTI, and I"m worried about her going back to school. Any advice would be greatly appreciated.

LSU628

PS- sorry for the run on sentences, but I'm frustrated  and just venting.

mommymegan831

DD has been having more accidents recently.  I've also told her how upset I am with her, when we're home I make her stop what she's doing to bathe.  I've just gone back to very frequent reminders and insist she goes before we go out anywhere.

ali0608

Is the constipation still ongoing?  Becase my DS has severe constipation.  He holds it because it hurts and it hurts because it holds it.  When we started PT, he did great with pee until he had a lot of poop.  He was trying so hard to hold his poop that he was also waiting forever to pee.  This would cause many accidents (pee and poop).

It just sounds like these are still tied together.

I could be completely wrong though.

krusso511

I would recommend a book called "It's no Accident" by Dr. Steve Hodges. He is a Pedi GI and explains this problem really well. I also had constipation problems with my DD but fortunately never any peeing problems. If I can summarize what he says, basically the bladder is a muscle which has been stressed by the constant pressure from the impaction. Once it was cleared the pressure let up but the muscle is still stressed much like your legs feel after you run for a very long time. Basically the bladder muscle has to be sort of retrained to work properly and the "accidents" that child has are not really under her control. They result from the involuntary spasms that the bladder is having. I don't know how well I am explaining it but again if you take a look at this book he explains it much better as well as giving some tips to cope and help the bladder muscle regain its tone if you will. I hope you are able to solve this issue soon, I know how frusterating wetting and soiling problems can be.

LSU628

krusso511:

I would recommend a book called "It's no Accident" by Dr. Steve Hodges. He is a Pedi GI and explains this problem really well. I also had constipation problems with my DD but fortunately never any peeing problems. If I can summarize what he says, basically the bladder is a muscle which has been stressed by the constant pressure from the impaction. Once it was cleared the pressure let up but the muscle is still stressed much like your legs feel after you run for a very long time. Basically the bladder muscle has to be sort of retrained to work properly and the "accidents" that child has are not really under her control. They result from the involuntary spasms that the bladder is having. I don't know how well I am explaining it but again if you take a look at this book he explains it much better as well as giving some tips to cope and help the bladder muscle regain its tone if you will. I hope you are able to solve this issue soon, I know how frusterating wetting and soiling problems can be.

Thank you, thank you, thank you! I think you hit the nail on the head. I'm going to look for that book today. 

LSU628

ali0608:

Is the constipation still ongoing?  Becase my DS has severe constipation.  He holds it because it hurts and it hurts because it holds it.  When we started PT, he did great with pee until he had a lot of poop.  He was trying so hard to hold his poop that he was also waiting forever to pee.  This would cause many accidents (pee and poop).

It just sounds like these are still tied together.

I could be completely wrong though.

She actually has been doing great with the poop lately. Such a relief!

LoveEeyore

LSU628:

To give you a little background, DD was very difficult to PT and had a really big regression after DS was born. After months of complaining about her tummy hurting, multiple trips to the pedi (dx with constipation), it resulted in DD having a ton of pee accidents and finally blood after wiping from a BM. We went to the dr again who sent us for an xray. Turns out DD was full of poop and had a pretty serious impaction. The pedi believed the impaction was pushing on DD"s bladder causing her to not be able to empty it fully and causing the accidents. DD FINALLY passed the impaction but is still having TON of pee accidents. I've tried everything from taking away tv and the Leap Pad b/c she wouldn't stop watching to go, to now we are going back to the way basics of sticker chart and M&Ms for dry panties but unless we remind her or strongly encourage her to go, she isn't going pee on her own. Even more disturbing, she will stay in wet panties and not tell us. I'm not sure if she is afraid of losing her Leap Pad or tv but she will seriously sit in wet panties. She is going back to school in a few weeks and I am terrified they are going to send her home for excessive accidents or she is going to wear wet panties all day. I'm going to call the pedi b/c I'm concerned that maybe there is something going on medically (although they did a urine sample and there is no UTI), but how would you handle this? I'm trying REALLY hard not to get angry with her b/c I know she knows how to go, but I"m tired of doing laundry, am concerned about her giving herself a UTI, and I"m worried about her going back to school. Any advice would be greatly appreciated.

I cannot speak to the medical involvement here, but if she is never going on her own but will successfully when told, I would bet there is a behavioral component to. It may be emotionally tied to the stress of the poop issues, but I'll put $$ down on the fact that if she can successfully eliminate in the toilet on command, then there is some behavioral component at play here too.

Because there seems to be a major medical issue too, I would stay away from punishment and taking away the BIG rewards for accidents. I would flip it around, and every time she initiates and at a minimum goes through the motions independently, give her 30 minutes on the tv or leappad.  Let the natural consequence of being taken away from fun be the punishment.  If she has an accident while watching. playing, do not reset the timer for her while she is getting cleaned. 

The goal is to teach her that initiating is what you're going for.  After a week of rewarding this, or two solid successful days of her initiating and actually peeing 50% of the time, pull the reward- tv or leappad back to ONLY hen she initiates AND eliminates.  I would continue to do dry checks and reward with an M&M- especially during tv time.  (If she initiates during TV time, I would allow her too pause it and add on to the timer what she earned.  Don't worry if she masterminds and figures out if she initiates after 20 mins that she'll get more time.  That will fade after she only gets rewarded for elimination.

Definitely restrict all other screentime.  Except for what may be your family routine (ie bdtime show) I would have absolutely zero screentime.  Except hen she initiates potty.

ali0608

LSU628:

ali0608:

Is the constipation still ongoing?  Becase my DS has severe constipation.  He holds it because it hurts and it hurts because it holds it.  When we started PT, he did great with pee until he had a lot of poop.  He was trying so hard to hold his poop that he was also waiting forever to pee.  This would cause many accidents (pee and poop).

It just sounds like these are still tied together.

I could be completely wrong though.

She actually has been doing great with the poop lately. Such a relief!

Can you get my kid to poop?  The other suggestion of the book sounds perfect and exactly what has happened.  Good luck!

LSU628

LoveEeyore:

LSU628:

To give you a little background, DD was very difficult to PT and had a really big regression after DS was born. After months of complaining about her tummy hurting, multiple trips to the pedi (dx with constipation), it resulted in DD having a ton of pee accidents and finally blood after wiping from a BM. We went to the dr again who sent us for an xray. Turns out DD was full of poop and had a pretty serious impaction. The pedi believed the impaction was pushing on DD"s bladder causing her to not be able to empty it fully and causing the accidents. DD FINALLY passed the impaction but is still having TON of pee accidents. I've tried everything from taking away tv and the Leap Pad b/c she wouldn't stop watching to go, to now we are going back to the way basics of sticker chart and M&Ms for dry panties but unless we remind her or strongly encourage her to go, she isn't going pee on her own. Even more disturbing, she will stay in wet panties and not tell us. I'm not sure if she is afraid of losing her Leap Pad or tv but she will seriously sit in wet panties. She is going back to school in a few weeks and I am terrified they are going to send her home for excessive accidents or she is going to wear wet panties all day. I'm going to call the pedi b/c I'm concerned that maybe there is something going on medically (although they did a urine sample and there is no UTI), but how would you handle this? I'm trying REALLY hard not to get angry with her b/c I know she knows how to go, but I"m tired of doing laundry, am concerned about her giving herself a UTI, and I"m worried about her going back to school. Any advice would be greatly appreciated.

I cannot speak to the medical involvement here, but if she is never going on her own but will successfully when told, I would bet there is a behavioral component to. It may be emotionally tied to the stress of the poop issues, but I'll put $$ down on the fact that if she can successfully eliminate in the toilet on command, then there is some behavioral component at play here too.

Because there seems to be a major medical issue too, I would stay away from punishment and taking away the BIG rewards for accidents. I would flip it around, and every time she initiates and at a minimum goes through the motions independently, give her 30 minutes on the tv or leappad.  Let the natural consequence of being taken away from fun be the punishment.  If she has an accident while watching. playing, do not reset the timer for her while she is getting cleaned. 

The goal is to teach her that initiating is what you're going for.  After a week of rewarding this, or two solid successful days of her initiating and actually peeing 50% of the time, pull the reward- tv or leappad back to ONLY hen she initiates AND eliminates.  I would continue to do dry checks and reward with an M&M- especially during tv time.  (If she initiates during TV time, I would allow her too pause it and add on to the timer what she earned.  Don't worry if she masterminds and figures out if she initiates after 20 mins that she'll get more time.  That will fade after she only gets rewarded for elimination.

Definitely restrict all other screentime.  Except for what may be your family routine (ie bdtime show) I would have absolutely zero screentime.  Except hen she initiates potty.

I think you're right that there may be a behavioral component as well. She is resisting going, even when we ask her to go. She seriously values her screen time, so I think if she earned time by going we would see progress more quickly. Thanks!

Asquared

Is she on miralax now to make sure that doesn't happen again?

 

LSU628

Asquared:

Is she on miralax now to make sure that doesn't happen again?

 

Yes- we had to do a cap 2xs per day at first to soften and clear the impaction. Now we are on a 1/2 cap a day along wiht a high fiber diet to try to make sure it doesn't get to that point again. I"m not sure if it is the Miralax working, or DD"s fear of the suppository and enema again, but either way she's not holding it and is going at least once if not more per day. 

regenab

A little late on this, but I went through the same thing. We did the big clean out the week before this past Christmas. It took about 2 1/2 - 3 months to retrain her bladder so it would no longer spasm and have pee accidents. Bascially to retrain her bladder you will need to work on filling her bladder and having her empty it all day long. I don't know how this is going to work if she is not a stay at home kid. But basically I when my DD got home from Pre-K at lunch time every day, I would start by giving her about 5 oz of juice/water and then 20 min. later have her sit and empty her bladder. I did this all day long until about 1 hour after dinner. This also helped to keep her constipation at bay because for miralax to do its job you must be sure to have them drink enough everyday to move things through. In the beginning we had many panty changes throughout the day. Just kept a level head and told her we are working on her bladder and she will get better. Finally at 2 1/2 months she stopped having the constant pee accidents. We still are dealing with pooping accidents, meaning she has starts in her pants. Basically her nerve endings in her colon and rectum were damaged from the prolonged constipation and the colon being over stuffed with poop. So we are now just trying to keep her cleaned out all the time and in time the nerve endings will heal themselves. Last month we had a 2 week period where she had no accidents and it was great, but then she stayed with a friend of mine while DH and I had a night away for our anniversary and her diet got messed up. So I spent a week trying to get her back to daily pooping and the soiling started again.

Just keep reminding yourself that it is not her fault, she does not feel it. It is a medical condition she cannot prevent. I had to tell myself that every day because I would become frustrated and think I should give her a consequence, but when I took a breath and reminded myself it will get better, I just need to give it more time, I would get through the day. So don't beat yourself up, it really will get better, it just takes a little time. Oh and the book It's No Accident, really is a blessing to have. It helps to put thing into prespective.

Good luck Mamma and keep your chin up, it will get better.