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September 17, 2021  
UTERINE NEWS: Feature Story

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  • Brain Injury Leads to Urinary Incontinence

    Traumatic Brain Injury Leads to Urinary Incontinence – Part Two

    September 20, 2006

    Part One |Part Two

    Part Two

    By: Jean Johnson for Uterus1

    In the first half of this series, Jody Willer of Portland, Oregon, shared the details of a Friday afternoon car accident that left her facing an uncertain weekend. While the symptoms of the traumatic brain injury she incurred seemed slow to emerge at the time, in retrospective she is not sure if it was the actual symptoms that took their time, or simply her own fuzzy perceptions that left her not entirely certain as to what was happening and when it happened.

    Certainly that was the case when in came to the urinary incontinence Willer suffered. While it seems as though a person would know right away that they had a problem, Willer says she was distracted by so many things at the time that she didn’t realize a real pattern had developed until it became pronounced enough to get her attention.
    Take Action
    The American Urogynecologic Society (www.augs.org) assessment can be helpful in evaluating urinary incontinence problems:

  • How long have you had a leakage problem?
  • How often do you urinate?
  • How many times at night do you get up to urinate?
  • Do you wet yourself when you cough, sneeze, or stand up?
  • Do you have to run to the bathroom to avoid wetting yourself?
  • Do any foods or fluids make the leakage worse?
  • Do you use pads to absorb urine leakage?
  • If you use pads, how many do you use each day?
  • Do you have burning pain when you urinate?
  • Do you have pain in your lower abdomen or back?
  • Have you recently seen blood in your urine?
  • Does your urine stream dribble and have no force?
  • Do you have any problems with bowel movements?
  • Has your condition gotten worse since it started?
  • Have you been evaluated or treated before?
  • Are you sexually active?
  • Do you smoke?

  • “I didn’t notice the incontinence at first because a lot was blurry. But after awhile I would start to go to the bathroom and just couldn’t hold it. I just couldn’t wait,” said Willer. “I don’t think I mentioned it to my doctor until the third time I was there. There were bigger issues for us to discuss. It just seemed like another way in which I’d aged.

    “Instead I went online and read about Kegel exercises to strength your pelvic muscles,” she added. “But eventually when the doctor was taking care of the damage on my neck, pelvis, and back, I finally told them. They said, “this is because of the accident.’

    “Their explanation to me was that the brain gets signals that the bladder is full. In turn it sends signals that tell the person to go to the bathroom,” Willer said. “Normally, they said that you get these signals several times over a half hour, and that you tend to know where you are in the message train and how much time you have.

    “They said what was happening with me was that I was only getting the last message. I wouldn’t rush because I thought it was the first one. So what would happen is that on my way to the bathroom I would lose control of my bladder. I went through underpants and towels, and it was happening all the time,” said Willer.

    “There was no problem going out because I wasn’t driving. I normally dance several times a week, but that all had come to a halt. So what I learned to do once they told me what the problem was, was to bring my brain to the idea that whenever I got a warning it meant I had to go right away.

    “What it means is that if I’m reading something and get a message, I cannot even finish the paragraph. I have to go now,” said Willer. “It was the same one day when I got a ride to the store. I was standing in the checkout line when I knew that I had to go. I got out of line and when and found a bathroom right away – and made it in time. Believe me, I know where all the bathrooms are in the stores.”

    Willer says that she eventually started driving short three-mile radiuses around her home. “Once I started driving again I learned to say to myself before I’d leave a store: ‘do you have to go to the bathroom?’ Often I went just to be on the safe side even if there was very little need to go.”

    It didn’t always work out like peaches and cream for Willer, although because during her younger days when she spent quite a bit of time outdoors she was able to roll with the punches. “Yes, there was one time I was driving at night, and knew I could never make it home. So I stopped in a church parking lot and went behind the bushes. I was hidden, but I felt so very vulnerable and didn’t know if I was breaking the law or not. My car was the only one in the parking lot, and I was so worried a police officer would come by.”

    We’re happy to report that in addition to her other problems, Willer did not have to endure being hauled off to jail. More, she notes that over the months things gradually got better as she learned to keep a stock of underpants and towels easily accessible and respond to any urges in an exceptionally timely fashion. “When I learned to ask myself if I needed to go to the bathroom and then got the towels and underpants I need near by, I felt like I had some sense of control.

    “I still respond very quickly,” she said. “Yesterday I was with a friend, and we stopped to get a submarine sandwich. We were sitting there talking, and I knew I didn’t even have time to politely wait while she finished the end of a sentence. I felt rude - as I have many times before since the accident last November – but I just got up and said, ‘I’m sorry, but I have to go.’”

    Willer still feels she has no time to shilly shally when it comes to getting to the bathroom. “My guess is that even though the incontinence really has gotten better and maybe is close to being back to normal, I still have a shorter time frame or I wouldn’t have all the nervousness I do around it. I don’t know it’s all so hard to judge.”

    At the very least, Willer observes, she was able to navigate the nine months of urinary incontinence that dogged her after a car accident that caused traumatic brain injury without resorting to pads – a place she definitely did not want to go. “All those things were my way of doing it without getting diapers and stuff like that.”

    Control. It’s something many of us so often take for granted. Control over our environment to some extent. Control over our home lives. Control over our bladders.

    But control is something that’s not always to be in the larger scheme of things. We at Uterus1 hope Jody Willer’s story helps those living with urinary incontinence to keep the faith and work to be as proactive as possible in managing the problem, be it a temporary condition or one that accompanies the privilege of aging. At the very least the image of Willer hunkering down behind a churchyard bush might give rise to a tender smile. We hope so.

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    Preserving Continence As We Age

    Last updated: 20-Sep-06

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