Dealing with Your Pediatrician

pediatrician

Your pediatrician will be an important part of dealing with bedwetting. However, since medical health professionals are so busy today, you will want to make sure that you approach your child’s physician in a way that ensures maximum cooperation. Here are some tips that can help you communicate with your child’s pediatrician in a way that will ensure better treatment options for your child:

Keep a diary

One of the best ways you can help your doctor treat your child is to keep a diary of your child’s bedwetting. Starting from the time your child seems to be bedwetting more frequently, keep notes in a small notebook. In this notebook note:

  • When your child wets the bed (dates and times, if possible)
  • Any family history of bedwetting
  • Any results of bedwetting (crying, problems at school, teasing)
  • Any medications your child is on or any medical problems your child has had or is having
  • Any questions you have about bedwetting
  • Any questions or comments your child makes about bedwetting
  • Any comments that your child makes before bedtime that may indicate a problem (aches before bed, emotional upsets during the day)
  • Any bedwetting products (disposable liners, moisture detectors) your child is using and how effective they seem to be
  • Any other symptoms your child seems to be experiencing
  • Notes on any resources or information about bedwetting that you encounter that seems helpful

Health care professionals are busier than ever today and keeping such a diary can be a big help to a busy physician. Go over the notebook with your doctor and together look for patters, and possible causes. Get answers to the questions you have written down.

Keeping a diary can also be useful for you and for your child. If your child shows improvement (wetting every few days rather than once a night) you can show your child this improvement. If you yourself have any questions, you can easily refer to the resources and information you have collected in your notebook for more information.

Explain any underlying problems

Sometimes, doctors will not pay attention to bedwetting once they have ruled out an underlying condition, because they assume that it is not a very threatening situation.

If your child’s self-esteem, grades, or social development is affected by bedwetting, you need to let your doctor know because at that point bedwetting has moved from a non-threatening problem to a problem that is affecting your child’s development. Discuss with your doctor the steps that must be taken to stop bedwetting or at least cope with the problems your child has developed as a result of it.

Did your child’s bedwetting develop at the same time as other symptoms?

If your child has developed bedwetting and snoring or extreme fatigue at the same time, you should mention this to your pediatrician.

In rare cases, something called Obstructive Sleep Apnea (OSA) may contribute to bedwetting. OSA means that some blockage – such as enlarged lymph glands called adenoids – block flow of air to the lungs.

In some cases, this problem causes snoring while for some children OSA causes brief periods where breathing is entirely interrupted. OSA is thought to cause enough to seriously interfere with breathing. The most common cause of OSA is restless sleep, early morning headaches, and fatigue.

Some researchers have also linked this condition to bedwetting. Bedwetting caused by OSA is very rare, but can be treated, usually by removing the tonsils or adenoids. Your doctor can run a special test to determine whether your child’s bedwetting is related to OSA.

Get a Second opinion

If you are not happy about your doctor’s response regarding your child’s bedwetting, don’t be afraid to seek more help, possibly from a specialist. Get the care for your child that makes you feel comfortable. Every doctor has a different approach to child bedwetting. If your doctor is satisfied that your child will overcome the problem while you want some form of treatment, you may seek a physician who will help you.

Many parents are reluctant to seek a second opinion, even though they are not satisfied with a child’s care. Many doctors are reluctant to recommend a child see an urologist or other professional because bedwetting is a problem.

However, you are the parent and you should take responsibility for your child’s health. If your instinct tells you that something is wrong, seek a second opinion. Consider the following problems that can easily be mis-diagnosed or overlooked:

  • Bladder reflux – This illness can contribute to bedwetting and can require surgery to correct
  • Constipation – If your child does not empty his or her bowels regularly or completely, remaining waste can press down on the bladder and cause bedwetting.
  • Malfunctioning of the urinary sphincter – The sphincter muscle is responsible for controlling urine flow. In those people who do not have a functioning sphincter, bedwetting is chronic and will not go away by itself.
  • Kidney diseases – Some kidney diseases cause bedwetting as well as other symptoms. Without resolving the kidney problem, there is not much chance in successfully beating the bedwetting problem.
  • Undiagnosed underlying problems – Some children may wet the bed due some serious problem such as abuse, diabetes, epilepsy, OSA, or other problems. If medical avenues are not carefully explored, these conditions will remain undetected and untreated, putting the child at risk.
Build a team

There are many people in your child’s life that can help ensure that bedwetting is a solvable and un-stressful problem:

  • Teachers: You do not need to tell your teachers about your child’s bedwetting, but you should be in contact with your child’s instructors to make sure that your child’s grades or social development is not suffering. An alert teacher can also often be your first alert of bullying or teasing that is taking place.
  • Pediatrician: Your child’s doctor should be one of your first stops when bedwetting becomes a problem, as your child’s pediatrician can run tests to determine whether there are any physical or underlying causes behind the bedwetting.
  • Therapists/Child Psychologists: If your child’s grades, self-esteem, or social skills are affected by bedwetting, you may need to help your child develop a team of emotional support. Therapists and others can discuss your child’s feelings with him or her and can help your child develop coping strategies for teasing and other problems.
  • Pediatric nephrologist or urologist (kidney or urinary system specialist): In some children, a medical problem such as a badly working urinary sphincter can cause bedwetting. Kidney specialists and urologists can tell you whether your child’s urinary system is fine or whether there is some underlying medical problem or physical problem behind the bedwetting.

If bedwetting persists very late (such as into adolescence) or is a nightly problem even by age eight or so, medical or physical reasons should be explored very carefully as they are a likely culprit.

Work with your team

You should choose the specialists who work with your child carefully, choosing those who seem to see the problem in the same light as you, and choosing those whose treatment options agree with you. When looking for health care professionals to treat your child’s bedwetting, you will also want professionals who listen to you and your concerns.

Once you have found a team you trust, however, it is just as important that you work effectively with them. This means following instructions to the letter (asking for clarification when needed) and being very frank about other treatments you are using and about which treatments seem to be working and which do not.

Do Your Own Research

While a doctor can be very useful in helping you deal with your child’s bedwetting, health care workers today are busier than ever and no one doctor can keep up with all the research and new information coming out each day. You may want to contact organizations such as the National Kidney Foundation or the American Academy of Pediatrics for more resources and then raise the information you find with your doctor.

You can contact some key resources about bedwetting yourself:

The American Academy of Pediatrics (AAP) provides lots of useful information, and pamphlets about a variety of conditions, including bedwetting…

American Academy of Pediatrics (AAP)
141 Northwest Point Boulevard
Elk Grove Village, IL 60007_1098
Phone: (847) 434_4000
Fax: (847) 434_8000

Alternative address:
The American Academy of Pediatrics
Department of Federal Affairs
601 13th Street, NW
Suite 400 North
Washington, DC 20005 USA
Phone: (202) 347_8600
Fax: (202) 393_6137
Email: [email protected]
Web Address: http://www.aap.org

The National Kidney Foundation has recently launched a number of resources about bedwetting. Their website has lots of information and even video clips about the subject. Plus, if your child’s bedwetting is caused by a kidney problem, this group can help you get information on that issue, as well.

National Kidney Foundation
30 East 33rd St., Suite 1100
New York, NY 10016
Phone: 1_800_622_9010
Web Address: www.kidney.org

The National Kidney and Urologic Disease Information Clearinghouse provides all sorts of information about conditions that affect the kidneys and urinary system. Not surprisingly, they have several resources just about bedwetting.

National Kidney and Urologic Disease Information Clearinghouse
3 Information Way
Bethesda, MD 20892_3580
Phone: 1_800_891_5390
Web Address: www.kidney.niddk.nih.gov

The American Academy of Child and Adolescent Psychiatry helps in distributing information about childhood psychiatry. It can be a useful resource if your child experiences undue upset because of bedwetting or if your child is experiencing secondary Enuresis caused by emotional trauma and needs treatment to overcome the problem.

American Academy of Child and Adolescent Psychiatry
Web Address: http://www.aacap.org

Look for resources that can help you and your child understand what is going on.

There are a number of resources that are useful for parents:

Pamphlets

Doctor’s offices, clinics, hospitals, and even pharmacies have pamphlets about various conditions – including bedwetting. These pamphlets can give you a general introduction to bedwetting, outline some commonly-used treatment options, and generally help you understand bedwetting.

Since you will already have lots of information from this ebook, keep your eyes open for pamphlets about bedwetting that are designed for children. Written for children, these pamphlets tend to explain that problem in simple terms.

Videos

Pharmacies and some doctors or specialists have videos available that clearly discuss bedwetting. These videos use understandable language and plenty of visual information to inform parents and children alike about how the body works. It is sometimes useful to see pictures of the urinary system and to see the actual bedwetting treatments – seeing something visually can help with understanding.

Clinics or Specialists

Health care professionals can answer your specific questions about bedwetting and your child, and so should not be overlooked as possible sources of information. Medical professionals also often have access to all sorts of information and resources. Asking your medical professional “where can I get more information about this?” will generally give a treasure trove of reliable and accessible resources.

Articles

The media writes about health issues all the time, and there is plenty of reason to pay attention. First, the media will often report on new treatments and products that may help your child. It may also help your child to see that a subject is written about and that others suffer from the same problem.

Online sites and groups

Online resources are not always reliable, and so should be treated with some caution. Although some online resources about bedwetting are written by professionals, some are written about ordinary people who may know less about bedwetting than you do. Trust online information only from sources that you have confidence in.

On the other hand, online resources are very plentiful and are easy to look up. One type of online resource that many parents have found helpful is the online forum or chat. In this online area, parents can discuss health problems and health solutions.

Although, again, you have no way of knowing who you are speaking with and so need to exercise caution, many parents find that the sympathy and support they get from online groups helps them deal with a child who is wetting the bed.

Online speakers can also have some ideas about bedwetting and suggestions for specific problems (such as the best cleaners to use to eliminate odor or thrifty ways to save on sheets). As long as you use your common sense and some caution for online chat, you can find online forums informative and supportive.

Other parents or relatives

Many families have at least a few people in the family who wet the bed. Talking to other parents about bedwetting often brings plenty of support and even some useful advice.

You should never discuss your child’s bedwetting with another person without your child’s knowledge. However, if your family is already aware of the problem you can often get useful information about what methods worked for children and what doctors or professionals in your area seem to have a high success rate in treating Enuresis.

Often, other parents and relatives will tell you information that others cannot know – the fact that a certain alarm is too high-pitched to work or that a certain brand of absorbent underpants has a special feature that make them useful. Those in the know often have great insights.

Pharmacists

Pharmacists have plenty of information about all sorts of ailments and treatments. If your child is taking any medications for bedwetting at all (including herbal or all-natural medicine) then you need to talk to a pharmacist to see whether the medication will interfere with any other medication (including over the counter drugs). Your pharmacist can help keep your child safe while he or she learns to control bedwetting.

Be cautious when evaluating bedwetting resources

There are many sources out there about bedwetting. Unfortunately, there is also plenty of myths and misinformation about the subject, too. Make sure that you consider the following about any bedwetting resource you look at:

1) Who wrote it?
Was the author someone who knows about bedwetting?

2) Why was it written?
If something is written to convince you to buy something (an ad) you need to consider the claims more critically than if you were reading an article meant to inform rather than influence.

3) Can the facts be verified?
You should be able to look up the facts in the resource and find that other reputable bedwetting resources offer the same facts.

4) What is the publication date?
Older material may no longer be valid. New information is emerging all the time, so if you are using an old source, you are looking at information that may no longer be true.

5) Is there anything suspicious about this information?
If someone has basic facts wrong or seem to be offering a miracle cure that cures twenty illnesses, proceed with caution. Double-check the information the resource contains, at the very least.

Know what to expect.

Knowing what to expect when you take your child to the doctor with a bedwetting problem can make the trip less stressful for both you and your child. The first thing that the doctor will likely ask is about the bedwetting itself.

You may also be asked whether the child can control the bladder during the day (an answer of “no” means that the problem is not bedwetting per se but a problem controlling the bladder). Parents will also be asked whether the child has experienced any stress or changes lately and what the bedwetting is like (whether it is constant, when the child wakes up, etc.).

Finally, parent history and medical history will be taken, as some medical problems cause bedwetting, as do genetics (children with two parents who were bed wetters as children have a more than 76% chance of having a problem with wetting the bed themselves). Your doctor will likely check to see whether any medication or medical treatment your child is getting may contribute to the problem.

Once your doctor has evaluated the problem through questions and answers, he or she may decide that your child’s age and medical history indicate no cause for concern and that waiting is the best solution. He or she may also order further testing.

One very common test is to determine whether the body can hold 200cc’s of fluid. To determine this, the child is asked to hold urine for as long as possible and then have whatever urine is produced measured (often this is done by having the child urinate into a container so that the urine can be measured).

If the child cannot produce 200cc’s then that is an indication that the bladder simply may not have developed enough. Doctors may also order urine or blood tests to see whether any underlying cause may be the problem.

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