Emily Dawson

Stop the Urgency at the Source. Naturally.

My daughter took her mother-in-law on the trip we'd been planning for six months. I found out on Facebook. There they were outside the hotel, holding drinks. Rachel had on the green dress we'd picked out together. Under the picture she'd written, “Birthday weekend with my favorite travel buddy.” That used to mean me. I looked through the rest of the pictures. They'd gone to the restaurant I'd sent her. There was a shot of the river from the boat we'd talked about taking. Her mother-in-law, Susan, had commented, “We need to make this a tradition.” My phone rang while I was still looking at it. “Did you see the pictures?” Rachel asked. “I did.” She started telling me about the hotel. I let her talk for a minute before I asked why she'd taken Susan. “Mom, I asked you.” “You asked if I thought I could go.” “And you kept saying you'd see. I had to book it.” I knew I'd said that. At the time, I'd meant I needed a few more days to work out how to manage it. When I didn't answer, she said, “You don't really like doing this stuff anymore. I didn't want you to feel you had to come just because it's my birthday.” I told her I had something on the stove. The kitchen was dark. I hadn't made dinner. For a while I sat there with the picture open, trying to decide whether to leave a heart under it. ===== I'm 61. Rachel is my only daughter. When her dad worked weekends, we'd get in the car and go somewhere. Sometimes it was the mall an hour away. Once we drove three hours to an outlet store and bought two things we could have found at Target. She still brings that up. We kept doing it after she got married. A weekend for her birthday when we could afford it. Lunch and a movie when we couldn't. Then, a few years ago, I started saying no. Whenever Rachel asked, I blamed my knee, the long drive, or something around the house I needed to finish. She would offer to drive or suggest another day, and I'd find a new reason. There was nothing wrong with my knee. I was leaking urine, and I couldn't bear the thought of it happening in her car. At first it was a little when I coughed. I'd change my underwear and tell myself I'd had a baby. Plenty of women had the same thing. The sudden urges came later. I'd be fine until I stood up to leave somewhere. Then I'd have to get to a bathroom right away, even if I'd used one half an hour earlier. Most of the time I made it. On the days I didn't, I'd stand at the sink afterward, pulling paper towels out of the dispenser and wondering how to get back to my car. I could hide that when I was alone. A whole weekend sharing a hotel room with my daughter was harder. She'd hear me get up at night. There would be pads in the bathroom trash, and I couldn't keep claiming I'd spilled something if I had to change my clothes halfway through dinner. So when she brought up her birthday, I asked about the drive and whether the boat had a bathroom. The hotel looked nice, I told her. Let me check a few things. By the time I was ready to talk about it again, she'd stopped asking. ===== I hadn't told my husband either. Paul knew I got up at night. He'd sometimes ask if I'd slept, and I'd say, “Not much.” He thought that explained why I didn't want to go anywhere. On our last drive to visit his brother, I'd asked him to stop three times. The third time, he pointed at the water bottle in my door. “You haven't even opened that.” I said I must have had too much coffee before we left. There hadn't been any coffee. I'd been thirsty since breakfast. After that, when he went to his brother's, I stayed home. Being home was easier. Nobody asked why I was in the bathroom again. I could put a load of laundry on without having to explain what was in it. Eventually Carol stopped asking me to walk with her. Paul started going to things alone, and Rachel found someone who would give her a straight yes. I understood all of that while I was looking at those pictures. It still hurt. ===== The stupid thing was, I could talk about almost anything else. I'd spent 24 years doing payroll. If your paycheck was wrong, I'd call whoever I had to call until someone fixed it. When it came to this, I sat in my doctor's office and called it “a little trouble sometimes.” She asked if I did pelvic floor exercises. I said I could be better about them. That was easier than explaining that I'd been doing them while the coffee brewed, at red lights, and through whole episodes of whatever Paul was watching. Months of squeezing, with no idea whether I was doing much of anything. She gave me an exercise sheet and said we could look at other options if it kept bothering me. I folded the sheet and put it in my purse. It was bothering me enough to miss a weekend with my daughter. Somehow I hadn't managed to say that in the room. Later, I bought a pelvic floor trainer. The instructions were easy enough to read. Using it was another matter. I'd lock the bathroom door and try to follow along. Paul would knock to ask where the clean towels were, and I'd shove everything back in its case. That case ended up under the sink. Beside it were two half-used bottles I'd bought after reading reviews late at night. Neither had made a difference I could notice. I quit coffee for a while and used the bathroom twice before leaving the house, just to be sure. The next thing I bought was a bigger pad. ===== Rachel came over the Sunday after her trip. She brought me a small tin of cookies from a shop we'd talked about visiting. I thanked her and put them beside the kettle. We got through most of a cup of tea before she said, “Are you mad at me?” “I wanted to go.” “Then why didn't you say that?” I picked at the paper tag on my tea bag. She waited. “I'm having trouble with my bladder.” Her face changed, but she let me finish. I told her about the pads, the stops on the way to her uncle's, and the hour I'd spent studying pictures of the boat to work out how far the bathroom was from the dining room. “That's why you asked me to call them?” I nodded. She put her mug down. “Mom, I thought you were finding reasons not to come.” “I was. I just didn't want you to know why.” She asked how long it had been happening. “A few years.” “How many?” I had to think. The first leaks had started before I'd retired. “About four.” Rachel looked toward the hallway, then back at me. “Does Dad know?” “Not really.” She reached for her phone, put it down again, and asked what I'd already tried. For once, I told the whole story. ===== Rachel helped me find a women's health clinic. I nearly put off calling because I knew I'd have to say all of it again. This time I wrote everything down before I went: getting up two or three times most nights, leaking when I coughed, and sudden urges when my bladder barely had anything in it. At the bottom I wrote, “I've stopped going places.” The nurse practitioner was named Janet. She read the page, asked about the medicines I took, and went through when each problem had started. There were questions about pain, infections, and whether I felt I'd emptied my bladder. Then she asked about menopause. “That was years ago,” I said. She wanted to know whether I'd noticed dryness around the same time the leaks became more common. I had. I'd bought something for that too. Until then, I'd thought of those as separate problems. Janet explained that lower estrogen can change the tissue around the bladder and urethra, the small tube urine passes through. That tissue helps the urethra stay closed until you're ready to go. When it becomes thinner and drier, a cough or lifting something heavy can put more pressure on it than it can handle. I asked where the exercises fitted into that. “They work on the muscles,” she said. “Those matter. We also need to look at the tissue and the urgency you're describing.” I'd assumed everything down there worked by how hard you could squeeze. She explained that the bladder has its own muscle, which squeezes to empty it. Sometimes it contracts before it needs to, creating a desperate urge even when there isn't much urine inside. That was the part I'd found hardest to explain to Paul. He'd see the unopened water bottle and wonder where it was all coming from. There often wasn't much coming out. I just felt as though there would be. Janet also explained that the bladder has a thin protective layer on the inside. It helps keep urine from irritating the tissue beneath it. She called it the GAG layer. I asked her to write that down. Hyaluronic acid was one of its natural building blocks. I'd heard the name on face creams, but I hadn't known the body already used it to hold moisture. The tissue around the urethra and the lining inside the bladder had different jobs. Both were things I'd never considered while I was trying to squeeze harder. For the first time, I had more to ask about than whether I needed a stronger pelvic floor. Janet went through the options with me, including guided exercises, bladder training, and treatment for the dry tissue. As I was putting my notes back in my purse, I asked what she thought I should start with. “Let me text you something to look at,” she said. Her message came through later that afternoon. At home, Rachel wanted to know what Janet had said. I put my notes between us on the table and told her everything I could remember. Then I opened Janet’s message. It was a link to Elavie. Hyaluronic acid was the first name I recognized from our appointment. The label also listed pumpkin seed, soy germ, and magnesium glycinate. Rachel and I looked up the other ingredients at the kitchen table. I understood why they were together. Whether they would make any difference for me was another question. Rachel offered to order it. “I can buy my own vitamins,” I told her. She laughed. “I know you can, Mom.” I ordered it myself. ===== For the first couple of weeks, I couldn't tell any difference. The pads stayed in my purse, and I was still getting up at night. When Rachel asked whether anything had changed, I told her no. I kept taking Elavie and doing what Janet had suggested. A few weeks in, I woke one morning and realized I'd only been up once. The following night I was back to two trips, so I didn't say anything about it. Then the better nights started coming more often. I'd get through a morning at home without dropping what I was doing to hurry down the hall. I still had bad days. They just weren't every day anymore. The first change Paul noticed was at the hardware store. He was looking for a part, and I was halfway through telling him where I thought it was when he said, “Don't you need the bathroom?” Usually I'd leave him with the cart as soon as we got inside. I'd walked straight past it that day. We found the part, picked up a few other things, and went home. Later that evening, I told him about the clinic and Elavie. He wanted to know why I'd gone without telling him. I said I was embarrassed. “It's me,” he said. I knew. That had been part of the problem. We'd been married for 36 years, and I still wanted him to see me the way he always had. ===== Rachel started asking me to do things again. The first time, I suggested she come to the house instead. The words were out before I'd thought about them. She said we could do that. I looked at the clock. It was barely ten, and I hadn't been to the bathroom since breakfast. “Actually, where did you want to go?” We met for lunch. I used the bathroom before we left the restaurant, then went shopping with her. She needed shoes. We tried three stores, complained about the prices, and ended up buying the first pair she'd tried on. On the way home, she asked whether I wanted to stop for something to drink. I said yes without checking how far we still had to drive. After that, we went out more often. Some days I still packed more than I needed. It took time to leave the house without going back to the bathroom door and wondering whether to try once more. But I was staying out longer. Paul and I visited his brother, and I spent the ride home talking about his new puppy instead of watching for an exit. By the time Rachel brought up a weekend away, I'd already been thinking about it. ===== We went in October. I packed pads and spare underwear. Four years of worry didn't disappear because I'd had a few better weeks. Rachel offered me the bed closer to the bathroom. “Either one's fine,” I said, and put my bag on the one by the window. The first night, I woke once. The next morning she was drying her hair when I opened my eyes. We spent most of that day walking around. At lunch, she asked if I'd mind going to another store before we went back to the hotel. I wanted to go to one myself, so we did both. That evening we sat down for dinner later than we'd meant to. Rachel ordered, then handed me her phone to look at the pictures she'd taken. There was one of me trying on a hat I had no business buying. She said I should get it. I told her she just wanted something to put on Facebook. We were still laughing about it when our food came. I hadn't thought about my bladder since we'd left the hotel. ===== I used to think about the picture of Rachel and Susan whenever I opened Facebook. For a while, I was angry with Susan, which wasn't fair. She'd been invited on a trip and she'd gone. Rachel knew I'd missed out. She hadn't known how much I wanted to be there. On the drive home from our weekend, I told her I wished I'd said something sooner. “I would've understood,” she said. She meant it. My bladder still has its days. When it does, I deal with it. One rough morning no longer costs me a whole week. Elavie is still part of my routine. I also kept the notes Janet gave me that day. For the first time in years, I understood that weak muscles were only one part of what was happening. If you want to read about what I chose, I've put it here: https://elaviedaily.com/products/elavie-bladder-support P.S. Rachel called about her next birthday while I was making dinner last week. I asked where she wanted to go. She started telling me, then stopped and said, “So you're coming?” I'd already gone to get my calendar.