Day in the Life: Oh, THAT

[One of the occasional series of posts about my typical day.]

THAT is something I sort of want to skip over.  In fact, it is one of the reasons I’m not using my name on this blog…I somehow doubt this would be the ideal post for a potential employer to read ;)

So far, in the “typical day” we’re going through, I’ve woken up, turned off the CPAP, done some stretcheshad some “sweaty snugglebunnies” with the man of the house, used my inhaler, taken my vitamins, worked out with an aerobics tape, and showered & dried off.  7 posts, and I don’t have my underwear on yet.

Consider this a TMI warning.  No, seriously.   I’m warning you, because getting on my underwear also deals with…

Stress Incontinence.

Yes, that.  Two little words. A heap of embarrassment. Years of avoiding comedy clubs. It’s something most people don’t talk about.  But, hey, I’ve learned a few things about managing it, and yes, I’ve been told (and told and told and told) it’s weight-related.

So here it is: I’m fat and I wear a pad every day.  Not just any pad; an incontinence pad.  I use the Poise pads with wings, not because I have delusions of sudden, spontaneous flight but because wrapping the “wings” around the crotch of my briefs helps keep the pad properly situated.

But I’m getting ahead of myself.

What it is.

Stress incontinence is an involuntary loss of urine that occurs during physical activity, such as coughing, sneezing, laughing, or exercise. […]

Stress incontinence is a bladder storage problem in which the strength of the muscles (urethral sphincter) that help control urination is reduced. The sphincter is not able to prevent urine flow when there is increased pressure from the abdomen. NIH

When does this tend to occur?

Risk factors for stress incontinence include:

  • Being female
  • Childbirth
  • Chronic coughing (such as chronic bronchitis and asthma)
  • Getting older
  • Obesity
  • Smoking


Are there other kinds of incontinence?

Urge incontinence, aka “overactive bladder”, is the other common problem.  The two can also coexist.

What can be done about it?
What I was initially told, of course, was to lose weight and do Kegels.  I have since learned of other options, including medications and surgery, but at the moment I am comfortable using Kegels to improve my control and pads to deal with leakage.

I’ve also learned that bearing down a bit as I finish in the bathroom helps get that last “little bit”, which helps.

What do you mean, improve control?

I’ve improved my sphincter muscles; I rarely leak while laughing anymore.  I’m also better able to tense them extra-tight before lifting a heavy object or sneezing.  Basically this means I only leak if I’m taken by surprise or if coughing etc is very strong.

What sort of pads?

Currently I use Poise pads, which are built specifically to deal with leaks of this sort.  Previously I used menstrual pads, but really – urine is a lot “runnier” than menstrual fluid, and the pads are built differently (video).  Mostly I use the “light ultra thins with wings”, but if I have a cold, I switch to the “moderate with wings” or “maximum” sizes.

Do you carry pads with you?

I usually have a pad or two in my purse.  But I often don’t need to change it, unless it’s during my period, or during the 3-4 days of  “clear discharge” between my periods.  Generally I wear 1 or 2 pads a day.

Doesn’t that get expensive?

Generally it’s $10/month or less.  If I have a cold or otherwise am sneezing/coughing a lot, it can be double or triple that.  (Also, if I have a cold/flu, I will run the shower on extra-hot while I’m in the bathroom to break up mucus.  This tends to get the productive coughing “over with” while I happen to be sitting on the toilet anyway – it makes me less congested and reduces how many pads I use.)

What about your period?

If it’s a heavy day, I wear a tampon and my Poise pad.  If it’s a light day, I use a Poise pad.  I go through more Poise pads than usual when I have my period, but not as much as I would with menstrual pads.

Do you sleep with a pad?

I prefer to sleep in the nude, which precludes pads :)   Really, it depends on how I’m feeling.   If I’m sneezing or have my period, I have a bunch of soft, well-laundered washcloths by my bed that I will often fold and use at night.   (The stack of clean washcloths is also useful for cleanup after more intimate moments with the man of the house. ;)

If I have a cold or flu or otherwise am coughing a lot, then I put on undies and a pad.

Anything else?

I don’t put off going to the bathroom.  I also empty my bladder before exercising or sex.







24 responses to “Day in the Life: Oh, THAT”

  1. vesta44 Avatar

    Good post. I deal with this also, and even if I wasn’t fat, I would probably still deal with it as I have every one of the risk factors except smoking. So eliminate TEHFAT, and I’m still female, I’ve had kids, I’m older (54), and I have exertion-induced asthma/chronic bronchitis. Kegels do help, as does the “bearing down” to make sure the bladder is as empty as it can be.

  2. living400lbs Avatar

    Thanks Vesta. I think part of my embarrassment was running into this in my still-virginal twenties and being told that, “It tends to happen when you’ve had kids or are obese.” I was easier to embarrass then…harder now.

    And yes, I’m thinking my asthma may be related too. :)

  3. ellie Avatar

    This is a really awesome post. Before reading this, I did think of incontinence as somewhat shameful, but your matter-of-fact treatment of it makes it sound like no big deal – it doesn’t sound messy or difficult, or like it interferes with your life or functioning at ALL. major props to you for being able to discuss it so matter of factly – I realize that it is somewhat shameful for you (and you don’t want to associate your name with it), but the language of the posts speaks to a different tune. Were I incontinent, reading this would be incredibly reassuring.

  4. Patsy Nevins Avatar
    Patsy Nevins

    I am older, fat, a mother, & I have cerebral palsy & arthritis. I deal daily with stress incontinence & have done so to some extent ever since I was very young & not really fat; I can remember sneezing hard or especially laughing hard as a child of 11 or 12 & peeing my pants. I does indeed get worse with childbearing, aging, & menopause. I know many other woman of all ages & all sizes, including very thin, who experience this, & yes, it is often seen as a guilty secret. I have done lots of kegels & find that, for me, it is of limited benefit, but I believe that is because of the generalized lack of strength & tone in my muscles caused by the CP. As I have mentioned in other comments, I am & always have been very active, including doing such things as 1500 crunches daily while in one of my compulsive phases, & lifting weights, etc., but there always seems to be a limit to how strong & toned my muscles will become & I always have some quirky problems which seem CP-related. For instance, I frequently have difficulty coordinating the swallowing & breathing reflexes, so I choke more easily & often than most people. Oh, & is nearly choking to death a great stress incontinence moment!

    Thank you for the courage you have shown in discussing this openly. It is seen as something shameful, but it is not, it is just something which happens to many people, something with which we must cope as best we can, & it is not a sign of a lack of character or self-respect or good hygiene, etc. Like so many other things which are held up these days as an example of personal defects or ‘unhealthy lifestyle’, it is neither of those things. We need to stop accepting the shame our culture heaps on us for being imperfect human beings.

  5. living400lbs Avatar


    it doesn’t sound messy or difficult, or like it interferes with your life or functioning at ALL.

    Not really, no – I’ve gotten used to dealing with it :)

    major props to you for being able to discuss it so matter of factly – I realize that it is somewhat shameful for you (and you don’t want to associate your name with it), but the language of the posts speaks to a different tune.

    Thanks. I don’t want a potential employer to find this on a pre-employment Google, but otherwise, I’m pretty okay talking about it … now. It does freak some people out, hence the warnings.

  6. Dolcina Avatar

    I realise it’s way, way late to comment on this post, but I’ve only just found your blog.

    I just wanted to say thanks so much for this post. I had stress incontinence from when I was about 5 years old until my mid twenties. I don’t know if incontinence pads were around then, but my mother thought I was doing it on purpose and certainly wouldn’t have bought any for me. It added up to a daily ritual of shame and misery that makes me cringe to this day. I mostly try not to think about it, but reading your post I realise that accepting my fat body really has to mean accepting my fat, used-to-be-very-leaky body as well :) So, thanks.

    Incidentally, I was told recently that my grandmother had exactly the same experience between pretty much the same ages, so it there may be a genetic predisposition thing going on.

    1. living400lbs Avatar

      Not too late, Docina, and welcome. I’m glad you have been able to put some of the pain behind you.

  7. Ashley Avatar

    Another belated thanks for this post. I’m currently pregnant, and have been dealing with stress incontinence related to my pregnancy. Basically, if I barf I pee. I laugh too hard I pee, I sneeze too much I pee. It’s random, and thankfully only a few drops each time, and I’m not too perturbed by it, though the husbandman is a bit squicked out. Oh vell.

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  9. Sassyinkpen Avatar

    I just discovered your blog today, and I’m really enjoying reading all the posts – you have a very calm approach to all this stuff that is wonderful.

    I especially wanted to applaud this post because if more of us could talk about these things, then we’d all find out just how DAMN MANY of us actually DEAL with them – I do! – and they just wouldn’t be such a shameful issue anymore.

    So thank you – and I wanted to simply add myself to the list so the next person who reads this sees more and more of us who are in the same boat.

  10. FrumiousMe Avatar

    Hey there, i just found your blog and i wanted to say – thanks. your honesty and practicality are much more helpful than my doctor/mum/everyone just telling me to lose weight and it will all go away. i’ve dealt with this particular problem since i was “normal” sized.

  11. […] Living 400lbs| Leave a comment Two years ago, I wrote 2 of the most-read posts of this blog: on stress incontinence and jock itch.   I worked hard on both of those posts. I was a bit embarrassed to admit they were […]

  12. Dee Avatar

    I had a bit of this when I was suffering from whooping cough last year, and it’s good to know how to deal with it if it ever happens again (as I expect it will when I’m older). Thanks.

  13. Kirsten Avatar

    Stress incontenence can strike any woman, regardless of her size/weight, in particular if she’s had children. In fact, I dont know a single woman, fat or thing, who’s had children that doesn’t have some degree of SI. I know women who’ve had 4 or more children, and have very minor issues, and have some friends with only one child who go through whole boxes of pads in the span of 24 hours.

    I have one friend, who has no children, and is not nor has ever had a weight problem who has SI–and the doctors do not know why other than she just does. she’s had a surgery where they “sling” her bladder and it has only eased it, not cured it.

    so there ya go!

  14. The WellRounded Mama Avatar

    Good for you for opening this topic to shame-free discussion. I have been fortunate that this has not been an issue for me, despite being older, fat, and having had four children. However, because of my work with childbearing women, I know it is a very common problem indeed for women of all sizes, and a source of much shame for many of them. I’m glad to see someone discussing it more openly.

    Readers should know that there are physical therapists who specialize in physical therapy for the pelvic floor, and who are often able to improve incontinence issues significantly if given the chance. Some women also find help with Maya Abdominal Massage (you can google it).

  15. […] first wrote about stress incontinence a few years ago in quite a bit of detail.   I haven’t been finding the “wings”, so I’ve […]

  16. In Progress Avatar
    In Progress

    I got a dreadful yeast-type infection from Poise brand pads. It took nearly a year to get rid of it. Other pads don’t cause the problem.

    One of the mysteries of the universe is why they make the pads so skinny. Why not manufacture them so they cover at least the “full crotchal region?”

    In other disappointment news, I took Vesicare for a month and found freedom for the first time in a decade. I have a very overactive bladder which throws me a surprise spasm party several times a day, plus stress incontinence. (I’m fat, old, had kids.) Vesicare solved about 70% of my incontinence–handy when traveling! But I had been taking the samples my doctor gave me; when I got a prescription, my *half* of the cost would have been $64 a month. I didn’t even buy it. It was nice while it lasted.

  17. Shannon Marie Canning Avatar

    I just discovered your blog today, and I’m really enjoying reading all the posts –I wonder if you have advice if if anyone else might have ideas for helping me.

    I know I suffering from the Stress Incontinence. I have not broke down about wear anything like depend or poise yet for the urine accidents. Plus, I do go without underwear since reach 300lbs. My main issue is dealing with my heavy bleed during the menstrual cycle. I also think I going through the beginning of menopause. (Bleeding has been weird this year…I think I skip months but I have bleeding accident similar to the urine accidents in between normal period times.)

    I am also 400lbs due to my thyroid problem. I am also suffer from chronic bronchitis and asthma too.

    I use to have to interlock about 6 Overnight Maxipads to attempt to make on pad that I thought fit me. This work when I was 218lbs but it stop working at 300lbs. I cannot do like you by wearing the tampon and pad. First of, my arms are too short and I cannot place one inside of me. If I could I cannot wear tampons anyways they make me sick. My mother tried to get me to wear them back when I first start at age 11. Every attempt I got sick.

    When I was around 290 and 300lbs, I started to make a contraption with two pair of my underwear and not sure on total amount of belted depends that I use. It too hard to explain and too embarrass to try to show a picture of it. Let just say I cannot wear the depends underwear…they are not big enough to pull up over my hips and stomach, I do not think I can get them over the thighs. I cannot use the belted depend as describe on the package.

    I gain another 100lbs since I start to wear my contraption. Well, it hurt and I hate to wear it. Plus, with how heavy I am it still does not cover enough area for accident are happening all the time. It goes out and down leg. If I get it in a good spot it only help most of the middle and might protect the left side but accident on the right side or vice verse. Hard to explain but maybe you can picture the image.

    I needing better ideas. Without a job and medical insurance I cannot up and go talk to someone to just remove what needs to be remove to stop bleeding 100%. As a return College student, I am fixing to graduate and hope I will be back in the workforce again after unemployment since 2005. If I get a job, I cannot explain that I need to be home for a week or more because I start my period today and I had no methods of protecting myself. I do not know how long I will be on it. Normally I bleed one full week.

    There no way to shit 24/7 on a toilet and who would want too. I had a Radiology apt on Dec 27th 2012 and waiting for the results. I guess I hoping they can help me.

  18. Sandra Fowler Avatar
    Sandra Fowler

    I’m really chuffed that you posted about the little problem no one talks about. I’m a 30 year old woman weighing it at just under 300 pounds and living with urge incontinence. Mine is so bad,I fully wet myself perhaps once a week.

    My doctor was shocked when he heard that I do kegals all day, every day and it’s still like this. Losing weight is the plan in place.

    What really chuffs me about this is the tendency by people to NOT say things. We don’t talk about embarrassing things. We don’t talk about uncomfortable things which unfortunately leaves a great lot of us feeling like we’re suffering something….rare or unheard of when, like stress’s actually VERY common. Good on you!!

  19. Anon Avatar

    HAHAHAHAAHAHAHAAHAHA “risk factors include being female” omg hahahaha

  20. Lily Avatar

    Just a PSA for other late readers to this blog- dearkate is a brand of underwear meant for period and/or stress and urge incontinence. They have linings which are super absorbent, but fit like normal panties. You need a pad too, when you have your period (or tampon) but for overflow or incontinence, it’s a lifesaver.

    Unfortunately, the 3X (largest size) only fits up to a 58″ hip according to their size chart. They’re also very expensive, but re-usable which helps. From personal experience, a major overspill overnight from menstrual blood was soaked up just fine and the panties were bone dry, as were my pants and sheets.

  21. Tamara Eckstadt Avatar

    I, too, have stress incontinence, and have been contemplating keeping wash cloths by the bed as I like to sleep nude as well. I’m afraid hubby will think I’m nuts. He knows I wear a Tena pad every day and at night, but sometimes it’s just not comfortable. Thank God I don’t have periods anymore (I’m 55 y/o, 325 lbs and 5’6″). But you’ve given me courage to purchase more wash cloths!

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