Bedwetting Dicussions With Your Doctor
Enuresis, more commonly known as bedwetting, is not the easiest topic to discuss, especially when it comes to people outside of the family. So despite the fact that your doctor holds some key answers for you regarding bedwetting, he or she just might be the last person you want to talk to. With a little preparation, however, you can enter this important conversation with more anticipation than hesitation and walk away with a better understanding of enuresis.
The first step in talking with your doctor is deciding when to have the conversation. Renee Mercer, MSN, certified pediatric nurse practitioner at Enuresis Associates in Maryland, says that in a perfect world, all health practitioners would ask about bedwetting during general check-ups.
If your provider has not broached the subject, then it's up to you to make the first move. But how do you know if the wetting your child is experiencing requires medical attention?
"The tolerance for having a bedwetter will dictate the age at which medical advice is sought," says Ruth London, M.D., a pediatric nephrologist at Mount Sinai Hospital in Chicago. "However, children 6 to 12 are more commonly brought to medical attention."
Mercer adds that "between 6 or 7, if the child has never had a dry night in their life," you should talk with your doctor.
If a well-child check-up is in your immediate future, plan to discuss the matter with your doctor. If not, call the office and ask for an appointment to discuss your concerns.
It's natural to be nervous. You are not alone. "It's very rare for a parent to make a special visit about bedwetting," Mercer says. In fact, many parents make appointments for other matters and interject the bedwetting issue as an aside, but it's to your advantage to be forthright with your healthcare provider. If your doctor knows that bedwetting is your concern, he or she can set aside the proper amount of time and provide any pamphlets and printouts on the subject.
As far as whom to talk with, your family physician or pediatrician is a good place to start. He or she is qualified to discuss and set up a treatment plan for bedwetting. On occasion, your doctor may refer your child to a specialist, Mercer says.
Your child should be present for the conversation. There will be questions asked that only he or she can answer. Mercer says that the child should know why they are going to a medical professional to discuss the bedwetting issue, and the child should know that you all intend to work together in order to help.
"It's always good for the child to anticipate what's going to happen," Mercer says. And that goes for moms and dads, too.
Once you and your child are face to face with the doctor, it helps to be ready for the questions your doctor will ask. "[A healthcare provider] would ask about any ... problems," Mercer says. These problems can include leaking on your way to the bathroom, urgency and frequency of urination. You can also expect questions like this: "Out of the seven nights, would you expect to wake up wet seven out of seven?"
It would be wise to brush up on your family's medical history. "The physician needs first of all to ask questions aimed at ruling out rare disorders of the urinary tract or central nervous system leading to urine incontinence," Dr. London says. "Examples include urinary tract infections, conditions with high volumes of urine (such as sickle cell anemia or diabetes), inborn anomalies of the ureters and bladder, urologic disorders like spina bifida and the like."
When you're through answering your doctor's questions, it's your turn to get some answers. You may be interested in treatment options. Mercer says it's beneficial to ask your healthcare provider what has led to success in other children with whom they have worked.
Making a list of questions before the meeting will help you remain focused, so you can efficiently make use of your time.
Taking the Step
This might be one of the most difficult discussions you will ever have with your doctor, especially if you and your child are experiencing feelings of blame and embarrassment over the condition. That's exactly why this is such an important discussion.
A part of you might be thinking that bedwetting goes away on its own, that you can avoid bringing up the topic. If so, you're partially correct. Dr. London points out that the occurrence of bedwetting, or nocturnal enuresis, does tend to decrease over time. She cites that "while 15 to 20 percent of 5-year-olds wet the bed at least twice a week, only 2 to 3 percent of 12- to 14-year-olds have the problem."
Many times, enuresis is part of the child's natural developmental process. But, especially for older bedwetters, a treatment and/or management plan, which may include using products like disposable absorbent undergarments to get through it, can aid in recovery.
And there is something even more important. Not only will talking with your doctor give you valuable answers about the condition and arm you with a plan for dealing with enuresis, it will also help you and your child let go of any shame or worries you might be experiencing and give you the tools you need to work together toward a positive outcome.