Incontinence Close to Home
by Angie Littlefield
I have been out on daily walks since my gym shut down due to COVID-19. Fortunately, I live in a suburban area near Lake Ontario where the streets are wide and currently deserted and where there is a beautiful waterfront trail. There are lovely hour-long routes to walk and five very distinct ways back to our house. I know the number of routes because I purposefully started to mix them up once I suspected that my bladder and bowels had learned to read. I would get near to any one of the street signs on the home-bound stretch, and an uncontrollable urge would cause me to step lively back to our home’s porcelain facilities. The signs for Stotts Terrace, Broadbridge, Baronial Court, and the tree configuration near two ravine openings became my Pavlovian bell, but not for salivation. I decided to investigate the new reading phenomenon, before my bowels and bladder turned to War and Peace or Moby Dick.
Who knew? Search engines turned up learned articles in response to “Pee close to home” or “Poop close to home.” Dr. Phillip P Smith, associate professor of surgery and clinician in the University of Connecticut’s Health Center for Continence and Voiding Disorders, had received a $600,000 grant from the National Institute on Aging back in 2016 to look at the brain-bladder connection. I read more articles and discovered that the condition dubbed “latchkey incontinence” was a real thing. The urge, it turned out, came from sensory input the brain perceived as permission or triggers—à la Pavlov’s experiments.
Simply put, my eyes signaled my brain, upon my taking whatever route to return to my home, that I could relax the appropriate muscles. Relief was on the way! I believe now, after my research, that my eyes simply acted too hastily about getting home appropriately and not because of defective or overworked plumbing. The experts agreed, however, that physical problems had to be ruled out first, before any further course of action.
In my case, there were no physical issues. I had to learn to exercise control over my hairpin trigger eyes. The experts’ suggestions were to practice forethought or maybe even diversion. For example, I could start whistling “Dixie” or recite the Rubaiyat of Omar Khayyam upon my approach to those street signs. Other experts recommended the practice of incremental “toileting delays,” meaning home warm-up exercises to prepare for the outside world. I considered that these delays might constitute cruel and unusual punishment, but, then again, I had practiced early morning urinary delays with success. I decided I would give toileting delays a try, willy-nilly, as I figured it would be good for me in the long run. For the walks, however, I decided I’d go with outright deception. I would bob, weave, and feint like a professional boxer. Those eye signals would never get a shot at my brain.
“Me going home, Miss Bladder? Hell, no! Where did you get that idea?”
After a while, and more research, I decided that I didn’t need to go exclusively with lying to my bladder and bowels. There were other comforting ideas to assist me. Foremost was the knowledge that it takes three hours for the bladder to fill completely. I knew that the pee urges within the time frame of an hour-long walk were bogus. I also knew from experience that it was best to void whatever I could before setting out on my walkabouts. That prep helped only to the degree that my toilet habits complemented my walk routines.
Ironically, this meant that, as in my toddler days, I had to go back to toilet training. I was not at all dismayed by this. I had forever taken my toileting habits for granted and had no awareness of what I did when. I decided I would log my habits (as suggested by several experts) and then work out a training routine. I had been toilet trained once, and I could do it again. Heck, Jack Gilbert, a professor in the Department of Surgery at the University of Chicago, went so far as to say that he felt he could train a human to pee at the smell of peppermint. The article, “There’s No Toilet Like Home,” in which Gilbert was quoted, had appeared in The Atlantic in November 2017. Strangely, Gilbert’s peppermint comment gave me hope. It was a good to feel in charge of what at first had seemed like a runaway train. (Don’t go too far with that image!)
I have subsequently laid out my training regimen as well as a few books for my bladder and bowels, just in case they do want to read. For the first book, I thought they might like Nick Haslam’s Psychology in the Bathroom.
Photo by Justin Groep @justin_groep (South Africa).
Angie Littlefield is an author, curator, educator, and editor. She has written three books about Canadian artist Tom Thomson, the most recent of which is Tom Thomson’s Fine Kettle of Friends. Her eclectic interests include curating art exhibits in Canada and Germany and working with children from Nunavut and Tristan da Cunha to produce their books. Her other books include Ilse Salberg: Weimar Photographer, Angelika Hoerle: Comet of Cologne Dadaists, and The Art of Dissent: Willy Fick. She co-created www.readingandremembrance.ca, a website with lesson packages for Ontario educators. Angie lives in Toronto, Canada.