Jenni
Jenni has had a uterine prolapse (when the uterus slips down into or out of the vagina), urinary incontinence (weeing unintentionally), and recurrent cystitis (inflammation of the bladder, usually caused by a bladder infection). She had a hysterectomy eight years ago. After recently recognising the impact of urinary incontinence on her life, Jenni made an appointment with her GP.
Jenni is a livery yard owner. She is widowed and has two adult children. Her ethnicity is White British.
Conditions: pelvic organ prolapse, urinary incontinence, recurrent cystitis
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Jenni has had uterine prolapse (when the uterus slips down into or out of the vagina), urinary incontinence (weeing unintentionally), and urinary tract infections. She’s been getting recurrent cystitis (inflammation of the bladder, usually caused by a bladder infection) for about 30 years; she’s had three bouts this month, treated with antibiotics. Following uterine prolapse, Jenni had a hysterectomy eight years ago. She had urinary incontinence after the surgery but got “on top of that” with physiotherapy. More recently, Jenni developed a bad cough which was diagnosed as nasal drip, and the constantly coughing brought back her urinary incontinence. She was referred to a female health physiotherapist but “it wasn’t helping at all because the harder I tried to build up the muscles, the more they were breaking down [with coughing]”. The physiotherapy appointments stopped because of the Covid-19 pandemic, so Jenni was “grinning and bearing it”.
At a recent health MOT appointment, it struck Jenni just how much her urinary incontinence upsets her and affects her life. She runs a livery yard and enjoys horse riding as “one of my escapisms” but stopped because there’s a lot of leaking when she rides. She thinks it’s a vicious circle: “I’m not doing the exercise I used to do, so therefore I’ve put on weight. So therefore, it’s probably making the incontinence worse”. She buys her own pads and changes them several times a day. Jenni says she came to accept and “put up” with urinary incontinence, partly because she didn’t want to add any pressure to healthcare professionals in the pandemic. She thinks this is also reflective of her character; she tries to manage and “put on a brave face”. After realising the impact on her, Jenni made an appointment with her GP. She’s had a telephone consultation and is due to have an internal examination soon. She also looked up urinary incontinence online and found out about treatment options.
In addition to her own health, Jenni had a lot of experience with healthcare professionals and services for her late husband who had a stroke and knee problems. She says sometimes a healthcare professional and patient won’t ‘gel’, but patients shouldn’t be afraid to speak up about concerns. She adds though that “there is a way of complaining” which is tactful. Jenni encourages healthcare professionals to recognise that patients are all different and “think outside the box” in terms of what matters to them.
Jenni first developed incontinence issues after her womb was surgically removed. This resolved after a while, but got worse again after she developed a bad cough.
Jenni first developed incontinence issues after her womb was surgically removed. This resolved after a while, but got worse again after she developed a bad cough.
I don’t think I suffered any other sort of problems until I had a hysterectomy, which would have been, oh when was that? That was probably about eight, ten years ago, when I did suffer a little bit from incontinence following that. I did get on top of that and it wasn’t too bad at all, in fact I don’t think it, once I got there it was okay. But then when was it, back in two thousand and-, beginning of 2019, so it’s a good two years or so ago, I started with a cough. And it wasn’t just a cough, it was a really, really, really bad cough. Cough, cough, cough, kept me awake at night, all sorts of things. I went to the doctor and I was put on inhalers and various things like that, and at that point in time again, the incontinence came back again. And I sort of mentioned it, but there wasn’t sort of, nobody sort of did anything or said anything and I just grinned and was bearing it. And I felt that probably it had just, all this coughing had just weakened my bladder. And so, I, as I say I put up with it.
Jenni started using a Kegel machine at the recommendation of her physiotherapist. Her incontinence symptoms have improved, but she isn’t sure whether this is because of her long-term cough resolving or the device.
Jenni started using a Kegel machine at the recommendation of her physiotherapist. Her incontinence symptoms have improved, but she isn’t sure whether this is because of her long-term cough resolving or the device.
I know when I went to see the physiotherapist last, the lady physiotherapist, I did ask her about these Kegel machines cos I think, I think I probably was looking up for something about, “What’s the best way to treat incontinence?” or something like that, and they came up. And I did ask her what she thought, and she said, “Well really the best thing is, is exercise.” But as I say I’ve been doing those and I just thought I would, I would try something else.
It’s a probe, and it has a variety of settings for various things, for stress, urge incontinence, various things like that. And you just set it various speeds or, or, intensities. I have to say when I first started using it, I had, it was on, I had to have it on a very low intensity but it has been building up so I’m tending to think well maybe the muscles are starting to build up, so maybe it is helping. And as I say I definitely think it is. Although it’s a catch 22 – I’m now not coughing, so it could be that because of not coughing it’s improving, or it could be because of the machine I’m improving.
Speaking about an example of having a melanoma removed, Jenni thinks it’s important healthcare professionals give a bit of guidance about treatment outcomes.
Speaking about an example of having a melanoma removed, Jenni thinks it’s important healthcare professionals give a bit of guidance about treatment outcomes.
And I would turn ‘round to him and I would say, “Well what do you recommend,” and it really annoys me when they say it’s up to me to decide. Because this happened when I had my first melanoma, and they rang me back and said, “Oh,” that, that they wanted to see me again and I was speaking to the doctor and, and oh, I finally went to see, and I thought well what do they say? Because, “Well I don’t know, you could have another—you could have more removed or you could leave it to see what happens,” and I went to see my consultant who had come back from wherever he was, and I said to him, “Well what do you think?” And he said, “Well let’s put it like this, there’s 75% chance it won’t come back, 25% percent chance it will, you won’t know whether you’re in the 25% percent until it happens.” So, I said, “What would you do?” He said, “Well I’d go for the 25%.” So, I said, “Okay, you know, let’s do it.” So, you need-, we need-, you need to be guided and told a little bit, but it’s-, specialists shouldn’t leave it up to you to decide.