How I (32F) Cured My Oab!
Update 9/2/22: I've had a few people DM me wondering if I'm still "cured". I'm happy to report that I'm still peeing a lot less often 6 months later! Also thank you all for making this the top post of all time in r/OveractiveBladder, it's truly an honor lol.
Copied from a response I sent someone in a DM:
"I haven't been tracking like I was when I wrote that post, but from what I can tell, I'm still peeing a lot less often! I went on a short road trip with a friend this past weekend and I didn't have to stop to pee once during the 3 hour drive there. On the way back, I made it 2.5 hours before I needed to make a stop. During that trip we were out and about a lot doing touristy things, and I never once stressed or even thought about bathroom access. In fact, sometimes my friend had to go really bad, and I didn't need to go at all."
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Hi! I've made huge progress with improving my oab symptoms in the past week and wanted to share my story and steps I took in case it can help someone else out there. Apologies in advance, this got kind of long but I didn't want to leave anything out.
tldr; I went from peeing 15-20 times a day to 7-8 times a day in less than one week thanks to adjusting my caffeine and water intake, increasing physical activity, adjusting my mindset, and bladder retraining.
About Me
I'm 32F, never been pregnant, no health issues/medications (never had a UTI), work a desk job as a programmer, live a pretty sedentary lifestyle, and am currently overweight by 30 lb. I have had to pee "a lot" for my entire adult life. I don't have incontinence, just high frequency (15 to 20 times a day) and frequent/intense urgency. The earliest that I remember being aware of it was at the age of 19 while on a first date because I kept having to pee and I was so embarrassed. I don't know how it all started, but if I had to guess I'd say it probably started in high school/college with peeing in between classes "just in case".
When I was 20 or 21 I brought it up to my obgyn. Nothing came out of that appointment except "don't eat citrus fruits". I never brought it up with a doctor ever again. Recently my oab got so bad that I was going to schedule a doctor's appointment, but thought I'd do some research and see if there was anything I could try at home first. Turns out there was! I saw significant improvement on my very first day of making changes which was Tuesday, March 15th. Here is everything that I'm doing:
Reduce Caffeine/Coffee
Adjusting my caffeine intake was probably the most important change I've made. I knew caffeine was a diuretic but I’m pretty addicted so I just kind of ignored that fact. What I didn't realize is that coffee is also a bladder irritant and was probably contributing to my frequent urgency, especially because it’s so much worse in the first half of the day when I am consuming coffee.
Not only was I drinking 24-30 oz of coffee every single morning, I'd often have a cup or two of green tea in the afternoon. If I was extra tired I'd have up to 48 oz coffee in a single day. I decided to reduce my intake rather than quit cold turkey. I now have 14-16 oz of coffee in the morning, and I've cut green tea out altogether for the time being. I also "sandwich" my coffee with water. So before I have any coffee I'll drink 4-8 oz of water, and after I finish any coffee I'll do the same.
Surprisingly, I have not felt any caffeine withdrawals, and as a bonus I am sleeping better.
Proper hydration
The next change was learning how to properly hydrate. I now drink 64-72 oz of water (about 2 L) per day. It seems counterintuitive but being under-hydrated makes oab worse. No more intentionally dehydrating myself!
I also started adding electrolytes (nuun) to my water. Electrolytes help your body absorb water better, and I've noticed a big difference since doing this. Fluids don't "run right through me" like they used to.
Another important change is I now sip slowly throughout the day and no longer chug. Your cells needs time to absorb water and if you flood yourself too fast your body will just flush out what it can't absorb.
I also stop eating and drinking at least 3 hours before bedtime.
Increase physical activity
I work a desk job, and apparently this can make oab worse.
I’ve also worked from home for the past two years, so my daily step count is low compared to when I was working in a huge office where I had to walk 5 minutes to use the bathroom or go to the cafeteria. I now make sure to stretch and move around at least a couple of times throughout the workday. I've also started going on daily walks.
It's hard to tell for sure if this has directly helped my oab, but being more active definitely can't hurt so I'll continue to do this. Plus, I recently learned that being overweight puts extra pressure on your bladder, so I now have yet another reason to shed the extra weight!
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Edit: Here's an article about the link between prolonged sitting and urinary issues - https://www.everydayhealth.com/urinary-tract-infection/symptoms/excessive-sitting-can-harm-urinary-tract/.
This motivated me to actually start using my standing desk! My goal is to stand for 2 hours first thing in the morning, and for 2 hours after lunch.
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Adjusting my mindset
The next change I made was a mental change. Starting to break the habit of "peeing just in case" before leaving the house, or simply because a bathroom is nearby and I "might as well" use it. The first time I left the house without using the bathroom, I played it safe and just went on a 15 minute walk around my neighborhood. It was pretty anxiety-inducing and I had some urgency on the way back, but I survived! This win gave me the confidence I needed to do it again the next day when I went to run a couple of errands. I'm also changing my internal dialogue. "I don't need to pee right now. I've only had half a cup of water and I just peed an hour ago. I can wait. I'm in control." It sounds silly but it kind of works. Deep breathing exercises to help get me through urgency or anxiety. Learning the difference between feeling like I have to go, and actually having to go. And of course good old distraction. I've been watching standup comedy to distract myself from my bladder when needed.
Bladder retraining/keeping a bladder diary
Making the above-mentioned lifestyle changes put me in a good position to try bladder retraining. I now try to wait at least 2 hours in between trips to the bathroom. And when I do go, I take my time. I sit there for a couple of minutes, relax my PF, and try to "double void". I realize now I wasn't always emptying my bladder completely because I was always in a rush (probably because I was pissed off at peeing for the 3rd time that hour). My oab got much worse during the pandemic because of working from home and having easy access to the bathroom 24/7. I would use the bathroom pretty much the minute my brain received any signal whatsoever from my bladder, which was often. I thought it wasn't safe to hold it and that you should go as soon as you have any urgency. I now understand that not all feelings of urgency are equal, and that this behavior will quickly get you into a viscous cycle of having to pee all the time because your bladder “forgets" how to stretch to its full capacity.
Some days are easier than others. Since starting this I’ve had times where it’s agony to wait 30 minutes, and there have been times where I’ve waited 4 hours no problem. Don’t get discouraged if you have a bad day, progress is not linear!
Keeping a bladder diary was essential in helping me visualize my progress with retraining, because this would give me the confidence and motivation to keep going. I could also visualize patterns and adjust my behavior if needed. Example - I slacked on drinking water one day, so I didn’t start until 4pm and didn’t finish until around 9pm. I had to get up from bed to pee a few times as a result. I now make sure to start drinking water much earlier in the day.
Day 1 of keeping a diary, my average interval (time in between trips to the bathroom) was 60 minutes. Day 6 my average interval was 139 minutes! Increasing the interval has of course decreased the # of times I go per day. On day 1 I went 16 times, a perfectly normal number for "the old me". Yesterday I went 8 times, and the day before that I went only 7 times! Right now on day 7 it's almost midnight and I've gone 7 times today. So I've more than doubled my average interval from 60 to 139 minutes, and I've cut my daily # of trips by more than half, from 16 to 7. My nighttime frequency has also dramatically improved. I used to get up several times in the night (like 3 to 6 times), and now I'm getting up once or sometimes not at all! I still can't really believe those are my numbers. For the first time in over a decade I'm starting to feel like a normal person.
Edit:
Pelvic Floor
Since a couple of people asked, I wanted to quickly talk about PF. When I first started researching, everything I read talked about kegels to strengthen your PF, so I spent about a day doing kegels. Luckily I quickly realized I don't have a weak PF (no stress incontinence/leaking), and if anything I have a tight PF (frequent urgency and occasional trouble emptying completely). But if I had to guess I'd say I don't have any serious PF issues.
My advice to anyone reading this is, you should figure out if you have a weak PF, tight PF, or if your problems are not PF related at all. There are exercises you can do at home for both weak and tight PF, or you can look into physical therapy.
Thanks for reading this far if you're still with me! I'm so happy and hopeful about my oab for the first time ever. I feel like I'm getting my life back. I truly hope my tips can help even one person out there. I also want to mention I have no idea if my results are typical or not. I've read that it can take weeks or months to see improvement so I'm honestly pretty shocked at how quickly I'm seeing results. My guess is I am seeing faster progress because I made so many changes at once overnight, and also maybe because I don't have any physiological "cause" for my oab that I know of, such as IC or PF issues. Happy to answer any questions in the comments!