Louise Chang, MD
Eloine Plaut has had problems with an overactive bladder for years. Now 59, she's fought back the urge to urinate while lecturing marketing classes at a university, flying back and forth on business trips between Chicago and New Mexico, and presenting at bank business meetings.
"I've never had an accident at work or in public," she says. "But I live in chronic fear of that occurring."
As many as one in four adult women experience episodes of urine leaking involuntarily, according to the National Association for Continence. And about 17% of women and 16% of men have continuing problems with overactive bladder (OAB).
If you have OAB, you know how difficult and embarrassing it can be to manage your overactive bladder at work. How can you keep things dry and professional? Many experts will advise you to try behavioral therapy, and if that fails, seek medical or surgical treatment. All that can take time. Here are some tips to help you manage OAB at the office, at the shop, and on the road.
You may think you should restrict beverages so you'll urinate less, but fluid restriction can be counterproductive.
"The bladder sometimes squeezes with no relationship to how much is in there," says Pamela Ellsworth, MD, associate professor of Urology at Brown University and the author of 100 Questions & Answers About Overactive Bladder and Urinary Incontinence. "And concentrated urine actually acts as a bladder irritant." Instead, maintain a healthy fluid intake throughout the day.
Scheduled fluid intake and urination are the keys to managing OAB. If you know you'll have a big presentation at noon, stop drinking fluids at about 11 a.m., and then take a bathroom break right before stepping into the room.
That's how Patty Meek, a retired Army aviator who spent years as a maintenance pilot, kept her OAB in check. "I made sure I went to the bathroom before we went out and tried to make sure that the aircraft was not going to take that long," she says. "If it did, after a couple of hours, I'd say, 'I need to go back in.'"
Familiarize yourself with all the restrooms on your floor, especially when you're on a visit to a different office or at a conference.
"The power spot at most work meetings is at the front of the room, but I give up the power spot," says Plaut. "I sit as close to the door as I can." Sit in the back of the room and at the end of the aisle for presentations.
Stay away from obvious OAB triggers in work situations -- coffee and anything else with caffeine, acidic drinks like orange juice, chocolate, and spicy foods.
"Save them for at home when you have more control over when you go," says Ellsworth. In addition, many people with OAB have noticed other factors that trigger the urge to urinate -- like cold weather. "Pay close attention to these triggers, especially on days with more hectic schedules."
Choose airline seats ahead of time if at all possible so that you can have an aisle seat near the restroom.
Solicit help from flight attendants when traveling. For example, explain your situation, and ask if they can let you know ahead of time when the seat belt light is about to come on so you can go to the bathroom first.
If you're making a fast connection, flight attendants or gate agents may be able to help you speed to your gate in time for a bathroom break.
Most supervisors will be reasonable about scheduling regular bathroom breaks.
"You don't have to go into detail," says Ellsworth. "Just explain that you have a bladder condition that requires that you go to the bathroom every two hours, or whatever your schedule is."
Ellsworth and most doctors who treat patients with OAB will write letters confirming the condition so that the boss doesn't think it's just an excuse to get another break.
The pelvic floor contractions called Kegels are a great way to keep your bladder muscles strong in general, and you can do them without people noticing.
Even if you haven't been doing Kegels regularly, if the urge to urinate hits, a quick series of pelvic floor contractions can sometimes abate that sensation until you can get to the bathroom.
If you know you're going to be having a horribly hectic day, wear a pad or other protective undergarment that day. For men, there are "condom catheter" devices, such as the Liberty, that can collect urine until you can change. "It allows a little more control so that in the worst-case situation, you're not going to have a visible accident," says Ellsworth. "Sometimes it's the better part of valor."
You don't have to live with overactive bladder, at work or at home. People wait an average of seven years before seeking professional help for continence issues, but there's no need to suffer in silence.
Start with your family physician. Your doctor may refer you to a urologist or urogynecologist, who can discuss your options for medication, behavioral therapies, or surgery.
SOURCES:Eloine Plaut, Chicago.National Association for Continence, Charleston, S.C.Pamela Ellsworth, MD, associate professor of urology, Brown University, Providence, R.I.Patty Meek, Fort Worth, Texas.
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