Category Archives: behavioral health

Coping With Nocturnal Enuresis (bedwetting)

With five kids, it is probable that we’d have a bed wetter. Our son C is six years old and for most nights of his life, has wet the bed almost every night

We have tried the following things to cope with this problem:
•pull-ups, rubber pants, cloth pants for older kids
•limiting fluids after a certain time
•waking in the middle of the night to use the bathroom
•chuxs and or bed pads
•resignation

I was beginning to think that he would be wet until high school. It was highly embarrassing to him (particularly since his twin is dry all the time). We are just beginning the age of sleepovers and boy scout camp outs, and I didn’t want him to have to be ashamed. Unfortunately, my friends didn’t have any enlightening answers either. I also didn’t want this to become a millstone such as the 12-year old who wets the bed. My stepson was such a child, and it was painful for him. I figured that if we could fix it now, all the better.

One day while perusing Amazon for pull ups (again), my search engine directed me toward some new items. One of these articles was the TheraPee program. I tend to trust Amazon reviews, especially the reviews that did not receive money for their evaluations. I was blown away by the price tag (it’s over $200.00), but the reviews were fantastic. I filed it onto my wishlist.

Time passed, we went through more and more dollars of pull ups, laundry and reusable bed wetting pads. I had some Amazon credits and a recent VA back pay, so I bit the bullet and purchased the Therapee program. I DID NOT receive money or this product for free. To say I was nervous is an understatement, especially after spending so much money.

Here’s how it works:

For the price tag, you get the Therapee alarm pad. It looks like this:

therapee

There is also video coaching in which a therapist talks to your child. This is bi-monthly, and although it is prerecorded it is related to your child’s progress.

Additionally, there is an online progress chart that we complete nightly.

Screenshot 2016-09-08 13.15.08.png

The Therapee alarm goes under the bottom sheet. It’s a pretty sensitive signal, and the sensitivity can be adjusted. At first, we had it going off when C was sweating, but we changed the sensitivity. The monitor (displayed in the photo), sits on his dresser next to his bed. The device allows for setting alterations.

But it’s not about the alarm alone.

First, the doctor had C work on controlling his urine stream. He practiced stopping the flow during urination and then releasing it again.

He also works on opening and closing his eyes rapidly. This helps to modify his Spinal Galant reflex. I had no idea that vision therapy could help bedwetting. Here is an article describing vision therapy.

This program has been a complete game changer!

We are in our second month of treatment.

The difference is evident in the charts.  Blue stars represent dry nights. Red stars occur after three consecutive dry nights. What you can’t see in the image is the nights without stars (wet nights) have an expandable menu that you type in the hours period of wetting, the wetness measurement and if the child woke on his own. Every two weeks we check in with the therapist and get a new assignment to practice.

My son feels he can now proudly sleep away from home. I see such a difference in his confidence. To me, that is priceless!

Some caveats:

  • This program is not for children younger than 4.
  • You have to follow the program. Use the online chart daily.
  • Children older than 12 might not be as excited by the rewards system visual as my 6-year-old. I believe there is an older child program. Contact the program for more information.

This post contains an affiliate link. An affiliate link is a link to a product I like and trust on Amazon.

Stop With the Veterans’ Push-Up Campaign Already!

If you are at all active on Facebook, no doubt you have seen the campaign of people doing push ups to raise awareness for the need for mental health resources for veterans.

If you haven’t, people are posting photos of themselves doing push-ups for 22 days and tagging a different person to challenge them to the same campaign and so on…

This campaign does nothing for veterans except to prove that the person posting the photo can do a push-up.

Studies vary about the actual rate of veterans suicide, and it depends a lot on which population you examine. It’s a statistics issue and an extrapolation discussion. However, there are some common themes that we should take a look at:

  1. The number of younger veterans seeking mental health services is higher than it has ever been in history. The veterans we see today in therapy do not have greater issues than veterans of other conflicts. As a culture, there has been a growing public awareness about the importance of seeking therapy. Additionally, we screen our veterans at every turn (pre-deployment, post-deployment health screenings, for example). If you are on or have been on Active Duty for the past five years, you can’t turn around without receiving some screening questionnaire every six months. Our younger veterans, in many cases, have been taught about the value of mental health services and expect to use them.
  2. In spite of the Department of Defense’s constant efforts, some Service Members and veterans still perceive accessing mental health services as a weakness. Many people are taught from the beginning to “tote their own ruck” and asking someone to share in their burdens is a sign of weakness.
  3. We are a military force that is overly reliant on medications. Please don’t take this as a rally against the use of antidepressants, anxiolytics, antipsychotics or any other psychiatric medication. My psychiatrist friends will always talk about the need for therapy IN ADDITION to drugs. However, most soldiers started on medications during their tours on Active Duty have learned that medications are partially the answer to reducing physical or emotional pain. As with the civilian population, prescriptions don’t mix well with recreational drug, and alcohol use. While we may try to institute one prescriber programs while the service member is on Active Duty, life sometimes requires multiple prescribers in the civilian world and overdoses, and medication interactions occur, sometimes with catastrophic outcomes.
  4. There are just not enough skilled civilian and military resources to meet the current demand for mental health treatment. Skilled is the operative word. Over the years, I’ve heard Service Members recount some hair-raising stories on the range of behavioral health providers they’ve encountered in their quest for treatment. Good providers are frequently booked for months out and for many if they get care, it is the luck of the draw on what they can access and most importantly, afford. Many therapists do not take third party insurance, and so it becomes an access issue waiting for an appointment at either a military treatment facility that accepts retirees (many do not) and waiting for a VA provider.

Doing push-ups does nothing to provide services for veterans. All it does is makes the poster feel better about themselves.

Here are ways you can really help.

  • If you are a licensed behavioral health provider, consider donating one session per day to a veteran in need. Service matching programs such as Give an Hour match providers with patients who are in need of services. If you are not a mental health provider, you can still volunteer your services to help or pay for a session as a charitable donation..
  • Support services such as the Veterans Crisis Line. Consider sharing their services as a Facebook meme, a banner on your blog or in your twitter feed.
  • You can save your arms. Donate twenty-two dollars to services mentioned above, the USO, the VA or to any other vetted program that serves veterans. With more funding comes more access to providers which translates to access to care.
  • Reach out to the veterans in your social circles. People may not always tell you they are struggling in conversation but if you notice their social media posts seem sad, angry or detached, message them and check in.
  • Take time to listen and be present. Do not constantly look at your phone, watch or any other distraction. Listen. Ask reflective questions. Check in. It’s okay to ask if they know how to access care. I can’t tell you how many clients over the years were turned around by one real conversation with someone who they felt cared.

Be brave, reach out, support our veterans.

Service Members need more than words, selfies and push ups to get through this crisis, they need action.