Road Warriors, Mount Up!

Wanna feel like Thelma and Louise on their roadtrip but toilet anxiety is holding you back? Let's talk about how you can hit the open road armed with strategies to make you feel wild and free! Knowledge is power, ladies!

First of all, this very common concern. And not just with aging women. I have many a pregnant or postpartum patient or friend that has this very same concern. Hell, I can't recall the last time I wasn't thinking about this very thing myself. In fact, I started writing this blog a couple of week's back while on a roadtrip to from LA to Vegas. The previous weekend I had water restricted HARD while driving Arizona to LA as we were on a time crunch to get back home after Thanksgiving weekend (read, trying to minimize potty breaks) and it took me days to rehydrate and feel recovered. Why? Because I didn't follow my own advice.

I have treated many the over-the-road truck driver but I was a super young therapist (a bit more shy than I am now) and these patients were seen in my pre-pelvic health provider days. I never asked these men how they managed such long trips with few bathroom breaks, but I sure wish that i could now! I suspect empty soda bottles and, if my partner is any indicator, breaks behind road-side bushes. Something that is much more challanging for we ladies to muster. Brb while I go research prostate health issues and professional truck drivers. But now...I've got something much better for you!

Road trip anxiety and toileting is an excellent canvas to use to discuss different types of incontinence. Did you know that incontinece affects over 25 million adult Americans? While it can happen at any age, it is most common with women over 50.

Let me introduce you to the types of urinary incontinence.

Stress incontinence. This is the most common type. It is the leakage of urine that happens when we cough, sneeze, laugh, lift things up or do anything else that increases our interabdominal pressure (IAP). While increased IAP is normal with all of these activities, if it puts more pressure on the bladder than the pelvic floor can support, we can leak.

Urgency incontience: This is the strong, sudden urge to urinate with the inability to hold urine long enough make it to a restroom.

Functional incontience: This is urine leakage due to difficulty getting to the restroom in time due to injury, arthritis, or another disability.

Overflow incontinence: Leakage because the quantity of urine being produced exceeds what the bladder can hold.

*I am skipping over types of fecal (poop) incontinence for the purposes of this blog. Please send me a message if this is a topic you'd like to see in the future!*

Of the above types, stress and urgency incontinence are the most likely to affect your road trip, however, they certainly could all raise their ugly heads as I don't think it is heard to imagine when you read back over the above definitions.

Let's talk about what can make our bladders more irritable and worsen the need for speed (in peeing, I mean). If our bladder are more irratated, we are going to feel the need to go faster and more often. Both are bad for roadtrip success. Did ya'll know that the foods and beverages we consume can create bladder irratation? These aren't the same for everyone, but caffeine and acidic foods can be up at the very top of that list.

Coffee (caffeine +acidic) or energy drinks (caffeine +acidic+ bubbles) are a good couple of drinks to avoid if you are often car-uncomfortable. As is that morning orange juice (acid). I am a big bubble-water fan. Did you know that the citric acid in bubble water can also be a bladder irratant? I was so bummed when I learned that this was a trigger for me and is a must-avoid on road-trips. I hope that no one here is drinking and driving, but the alcohol you enjoyed the night before your trip could also contribute to your number of bathroom stops.

Good old plain water is your best bet for hydration success.

Let's talk about strategies.

🧻 Preload: Our bladders tend to fully empty within about 2 hours of drinking. Try preloading your daily water intake before a trip but cut off water/beverages 2 hours before you start your drive. Avoid bladder irratants leading up to and during your drive.

🧻 Know where you can go: Look at your roadtrip route on a map or use an app such as Google-Maps where you can search for restrooms along your way. Look for Starbucks, rest-stops or larger gas-stations where they are likely to have public toilets. Nothing worse than getting to an out of order or inaccessible toilet.

🧻 Sip: During the drive itself, sip water to "wet your whistle" but try to restrict until you are close enough to a stopping point or your destination that you have a toilet close at hand.

🧻 Gum or mints: Chewing gum or sucking on a mint can trigger salivation and keep your mouth feeling moist without you needing to drink.

🧻 Avoid salty snacks: Everyone loves a road snack. And so many are so salty and delicous. However, they are also THIRST TRAPS. In the interest of our cause here, attempt to pick satisfying snack that wont make you crazy thirsty.

🧻 Distractions: Starting to have that pressure building? Getting a little fidgety? Look for distractions to keep your mind off of the discomfort so that you can get to a toilet. Do not pass toilet after toilet. Just use this to get you to the nearest one. This is where "the potty dance" can literally help.

🧻 Perineal pressure: Ever wonder why crossing your legs helps? Its because pressure into the perineal area can slightly compress the urethra as well as activating the pelvic floor muscles to help hold back pee.

🧻 Performing a kegal: Activating the pelvic floor muscles can help hold back pee. To kegal, think about "closing your holes" as you exhale. Then keep breathing. Holding your breath only increases interabdominal pressure (IAP) which presses down on the that full bladder. So think about breathing across your collerbones and let your nose and mouth be pressure escape valves so the pressure goes up and out versus pushing down onto your bladder.

Let me present you with a few ideas for road trip tools.

🧻 A woman's urinal. These are far from a nasty (empty) Mountain Dew bottle and this version is even disposable. Great option for not only roadtrips but also camping, a gross public bathroom situation, on a boat and many more! Check these out!

🧻 Carry your own extra-large toilet covers. You will touch nothing gross with these babies. Portapotties, public toilets, the works. Never fear again! Check these out!

🧻 Carry your favorite hand-sani and wet wipes to keep you feeling clean and fresh.

🧻 Consider leak-proof underwear (either disposable ot washable) or leak pads to increase your confidence. I personally use the brand Knix, but there are a gazillion out there these days.

As a pelvic health physical therapist, I am always going to recommend that you seak a pelvic floor PT evaluation. Completing a bladder journal and interpreting it with a professional, learning your personal irratants, learning how to bladder train and best practices for your own situation will all only amply your successes. Remember: although incontinence is common, it is not normal. It should not by minimized or normalized.

Example of a Bladder Journal

The end of the road....my personal arch nemesis is when I finally reach my toileting destination and have been TOTALLY FINE but then end by nearly sprinting in order to not pee my pants. I would swear that my bladder knows that I toilet is nearby. But its not my bladder that knows (dun, dun, dun) its my brain. This is called the pavolian response. Not familiar? Check this out. My brain has been conditioned is this way making my last few seconds of a trip totally nuts. Dropping all bags, Doc staying in the car, heart pounding nuts. Don't be like me. Get bladder training. Cut off those darn palvlonean dogs. End your road with a nice big stretch and a pat on the back that you can do this! And roadt trips can be fun again! Congratulations you bad-ass!