Archive for the ‘relapse’ Category

Wireless Alarm for 10 Year Old

Wednesday, August 4th, 2010

My 10 year old son used a wearable bedwetting alarm when he was 8, with great success. He has started wetting again over the past few months. His doctor says his urine is fine. I walk him to the bathroom when I go to bed, which usually keeps his bed dry. I mentioned restarting the alarm to him but he is resistant, saying that he doesn’t like the feeling of having something on his shoulder. He’s become more anxious about things like that as he’s gotten older. Do you have any suggestions?

I think your idea of restarting an alarm is a good one. For some reason, he is now sleeping through the signal that he needs to wake up and walk to the bathroom. Finding an alarm that is acceptable to him is important. Both the wireless models are popular with kids in his age group. The Malem wireless and the Rodger wireless have multiple sounds to choose from. He can pick a tone that he likes (kind of like picking your ring tone for your phone) and that he most easily alerts to. The Malem wireless attaches to his briefs and the Rodger wireless comes with two pair of special briefs with the sensor built in. You might ask him which style he would prefer. Remind him that the sound will be coming from a unit across the room and not from a unit on the shoulder. This will require him to get out of bed to turn it off and he can walk to the bathroom at the same time. This should enable him to re-develop the ability to wake up and walk to the bathroom when he needs to.

Bed Wetting Medication

Wednesday, March 10th, 2010

My son is 8 and wets every night. My doctor mentioned that he can prescribe a medication to help. I’m a little nervous about giving my son medicine for this. Can you tell me more?
The most frequently prescribed medication for bedwetting is DDAVP (desmopressin). This synthetic form of the natural hormone vasopressin decreases the quantity of urine produced for the next eight to 12 hours. It begins to work quickly, usually within one hour of taking it. This medication is designed to curb bedwetting by making the urine more concentrated and decreasing the total amount of urine produced that night.

Medication often has immediate results, but when you stop it, the relapse rate is high-about 80 percent. DDAVP allows about half the children who use it to sleep dry that night, which makes it particularly useful for sleepovers and camps. DDAVP is available in two forms: a nasal spray and tablet. The tablet is now preferred because it delivers a more consistent and convenient dose. The nasal spray has a Black Box Warning because of some reported cases of seizures and death because of water intoxication. Also, children with allergic congestion can get erratic results with the nasal spray.

Dosage of DDAVP must be individualized, with one to three tablets (0.2 mg.) each night before bed as the recommended dose. The greatest number of dry nights is achieved by 0.4 to 0.6 mg. nightly. If your child is taking the medication for a situation outside of his home, such as sleepover camp, start it ahead of time to establish the appropriate dose. Your child’s doctor or nurse practitioner is responsible for determining your child’s dosage, but the general recommendation is as follows:
• If your child wets when taking one tablet, increase it to two.
• If wetting occurs with two tablets, his dosage should be three tablets.
• Three tablets is the maximum amount recommended for any age group.

DDAVP is generally safe with few side effects. Reported side effects include headache, stomach ache or water intoxication if a large amount of water is ingested after taking it. The manufacturer provides fluid guidelines, recommending no more than four ounces of water before bedtime. This medication can be safely used for three- to six-month intervals with a one week break. If wetting persists, it can be used for another interval. DDAVP is expensive, as much as $3-4 per tablet. The cost should be taken into account when considering long-term use.

DDAVP does not stop wetting in every child. Increasing the length of time taken will not make it work. The expected results should be seen in a week or two. Parents should realize that this medication does not provide long-lasting effects, but it does provide short-term dryness for many children. For long lasting results, getting to dryness by using a bedwetting alarm has a more permanent response.

How to Stop Bed Wetting Relapse

Thursday, February 18th, 2010

SH writes, My son age 11 has used the wetting alarm and seemed to be cured. He stopped wetting the bed and didn’t get up to pee. He just held it till morning. Once in a while he would have a wet night. We just assumed it was from drinking too much late at night. Recently he has started having basketball practice at night which makes him drink fluids more. He has had several wet nights this month. When he has a wet night he does not realize that he has wet himself until he is cold and wet. It is quite alot of pee. Does this mean he is actually not trained and needs to start all over again after a couple years of sucess?

I do occasionally see relapses just like you’ve described. It sometimes does occur in kids who mostly just sleep through until morning dry. Because he has more fluid in his system before he goes to bed, his bladder isn’t able to hold it all night and he must get up to urinate. For some reason, the ability to wake to a full bladder isn’t there and he wets. I recommend restarting the alarm as soon as possible so that he can be alerted when the wetting is occurring. Over time, his body should be able to put together the sound with getting up. If he doesn’t respond to the loud sound, you go to his room and remind him what he should be doing. Most of the kids can get back on track by doing this. It’s better to restart the alarm for a few weeks and conquer the problem again than wait longer, hoping it will just go away.

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