What’s going on downstairs?
When I was in primary school, I used to wet my pants. That’s shameful, right? Actually, around 5% of early school-aged children have trouble holding in their urine, for a whole host of reasons — and experts all agree that the best way to manage this, if it isn’t caused by underlying medical issues, is with patience and understanding.
Not in the 1980s, I’m afraid. I was an anxious, shy child, and anxiety would make me want to pee. A lot. Asking to go to the toilet would be drawing attention to myself, and that was a terrifying prospect, so I’d “hold on” for as long as I could — I know now that holding in urine is one of the worst things to do, causing a concentration in the bladder which increases irritation and makes it nearly impossible not to urinate to relieve the pressure, but I was just a kid. All I knew was that maybe I could hide the fact that my pants were wet, but I couldn’t hide the fact that I’d needed to go to the toilet in the middle of class time, would probably have the request denied by the teacher anyway (“why didn’t you go at recess?”) and be subject to ridicule by the other kids.
Eventually, I learned to control my bladder better, but I never really outgrew the shameful feelings associated with urination. Public toilets are a nightmare — I usually try to wait until someone’s using the hand dryer, or the person in the next stall starts to pee first. And that’s in the place you’re supposed to be peeing! At university I’d sit toward the back of the room so I could slip out unobtrusively (mortified if ever anyone asked where I was going). Wherever I go I map out the toilets first, just in case of emergency. In Australia, we’re actually pretty lucky and have accessible toilets in most public spaces — I found out this is not the case when I wandered all over the Scottish town of Anstruther with a full bladder, trying to find a place to pee in, desperation increasing at every loo-less park.
In the last few months, though, the need to urinate has dominated my life. At first I thought I had a UTI — pretty much every woman is familiar with those, and they don’t usually cause too much trouble. I went to the doctor, who told me I had an overactive bladder and gave me some medication, which actually made things quite a bit worse. I was getting up five or six times through the night, and it was extremely painful. The increased frequency through the day was interfering with my job (you try keeping your mind on the classroom when the only place you want to be is the toilet!). Eventually, after a couple of months of various testing and trials of different medication, the doctor sent me for a CT scan, thinking I probably had kidney stones.
I did not. The CT showed up a “26mm mass consistent with primary transitional cell carcinoma” on the anterior wall of my bladder. Apparently these are typically slow-growing and it could have been present for years. All I could think of, when I was told, was that if I hadn’t been embarrassed for so long, I might have found out about this sooner. Then again, maybe it had to be so symptomatic to hint at its presence, because there was no real reason for the doctor to suspect. The risk factors for this kind of cancer are age (I won’t be over 60 for a good while yet), smoking (I’ve never smoked in my life) or exposure to heavy industrial chemicals (I don’t think the occasional hair dye counts). In my case, it seems it’s just the luck of the draw.
I’ll be having surgery in the next few weeks. I don’t know what the outcome will be but fingers crossed, there’s no signs of involvement of other organs or muscle on the scan so I’m hopeful that it will just be in, out, a few good drugs and sitting back to be waited on for Christmas.
The one thing that’s been stuck in my head, since all of this has happened, is this: women needing to go to the toilet is a bit of a joke to society. We laugh about it, especially when we’ve had a baby or two — yep, my downstairs area is a mess, damned kids! There are ads for incontinence pads showing women playing tennis with a carefree, confident air as if it’s no big deal at all. So we write off these symptoms as just part of a woman’s lot.
Please don’t. Don’t make bodily functions shameful to your children, and don’t be afraid to talk about them as an adult. Not being embarrassed could save your life.
