Question:
My son
and his wife got divorced 18 months ago, after a marriage made in
hell.
My grandson
came to live with us.
He has
been staying with us for the past 18 months and is still wetting the
bed, there is a slight improvement, but I am worried, he has a problem
getting along with friends.
He says
there is nothing wrong with his bladder.
It could
be so many things, as we do not have a medical aid, and I do not have
the money to spend on going from one doctor to another, I need to
find help for him.
This
must be very embarrassing for him and could cause even more problems.
Elsa
Answer:
Dear
Elsa,
Nocturnal
Enuresis (bed wetting) is a relatively common disorder fraught with
emotional physical and social effects.
The occurrence
of bed-wetting in children is: 26% at 4 years,7% at age 5; 3% at age
10 ; 1.5% at age 14 and 1% at age 18 (Yes! even at 18).
Probably
one of the most currently popular theories as to why children wet
the bed is that they lack a certain hormone vasopressin.
More
support for the idea that a major cause of bed wetting is something
physical comesfrom research that demonstrated that if both parents
of a child wet the bed that childhas a 77% chance of being a bed wetter
too. If only one of the child's parents wet the bed the probability
drops to about 44%. The idea that something physical causes bed wettingis
the driving force behind many of the medical treatments available
for bed wetting.
What
Can he Do?
Limit
his drinking of liquids to three hours before getting into bed or
only allow two ounces of liquid after 6:00 p.m.
Avoid
foods and drinks that contain caffeine.
Educate
himself. Read as much as he can on nocturnal enuresis. The more he
knows the more comfortable he will feel with the situation.
Remain
calm. Often easier said than done remaining calm is of primaryimportance
to him.
Be supportive.
Your grandson is probably experiencing a great deal of shame and self-ridicule
during this time.
It will
help to reassure him that you still love him .
Reward
consistently. Dry nights and cleaning up after accidents are deeds
worthy of being rewarded every time.
Inconsistent
rewarding often does not accomplish much.
Help
him feel secure. Offer thick underwear and/or pajamasfor nighttime
wear.
Try Every Treatment.
Hypnosis
is sometimes effective in treating enuresis . This option is usually
less expensive and has fewer side effectsthan most medication; recent
research suggests that many bed wetting people respond within four
to six sessions. Hypnosis can give to your grandson the power to treat
himself so it can also help build the self-confidence and self-esteem
that may have been lost through the bed wetting experience
Support
groups may be of help to him.
If all
else fails medication is sometimes found to be helpful -- especially
in older children. Imipramine is often prescribed; it is a powerful
antidepressant that has also been found to be effective for about
30% of bed wetting children. However it can have serious side effects
and has not generally been shown
to be effective over the long term.
Desmopressin
acetate is another drug that is widely prescribed to treat nocturnal
enuresis. This is an artificial version of vasopressin (the natural
hormone that helps the body concentrate urine so it doesn't fill the
bladder during the night). Side effects are not often reported with
this drug but headaches runny nose pain in the nostrils and stuffiness
are sometimes experienced.
Desmopressin
is available as both a tablet and as a nasal spray.
While
there may be a medical condition that is causing the problem, and
every child should be tested to rule out such conditions, only 1-3%
of enuresis cases have an organic cause that is identifiable by Western
medical tests.
The bed
wetting alarms help by alerting the child or the adult that there
is time to get up and go to the bathroom, this alarms being offered
throughoutthe web and many local areas.
One in
50 teenagers still wet the bed and almost half of 19 year-olds who
have the problem are wetting the bed every night, according to research
published in the May issue of the urology journal BJUI International.
How your
grandson can Stop Bed Wetting?
Stop
1-Drinking caffeinated beverages. These drinks cause people to urinate
more than juice and water do.
Teenagers often drink a lot of soda. Cutting out soda, tea and coffee
is a great way to help stop bed wetting.
Step
2-Stay him away from drinks once dinner is over. Your grandson should
try sucking on ice pops or chewing on ice cubes if you get thirsty.
This will reduce the amount of urine you produce during the night
which will keep the bladder from getting full and causing you to wet
the bed.
Step
3-Start his night with an empty bladder. He should go to the bathroom
just before he goes to sleep. He should go this even if he doesn't
feel like he has to go. Teenagers often don't think of going to the
bathroom before bed if they don't feel the urge to go. The object
is to release even the smallest bit of urine to give his bladder more
room during the night.
Step
4-Set his alarm to wake up in the middle of the night to use the bathroom.
Many teenagers and adults get up and use the bathroom at night. Bed
wetting teenagers just don't wake up to go. If he utilizes an alarm
clock
he can get himself up in the middle of the night to let the urine
out and go back to bed with an empty bladder.
Step
5-Have hid doctor prescribe DDAVP or Ditropan. DDAVP will stop his
body from making a whole bunch of urine at night. The Ditropan relaxes
the bladder so that it doesn't feel the need to urinate so much. If
he is really struggling with bed wetting he may want to consider one
of these two options.
Step
6-Make sure your grandson gets nine hours of sleep each night. The
more tired the teenager is, the more likely he will be to sleep deeply.
This will cause him not to be able to wake up when he has to go to
the bathroom. The result is bed wetting.
Step
7-Purchase a sensor alarm . These alarms are designed to wake him
up so that he uses the bathroom instead of his bed. There are a few
different kinds. Some have an attachment that goes in the underwear
and sets off an alarm when it begins to feel wet.