The STIGMA OF FECAL INCONTINENCE

We come into this life incontinent, we go out the same. We acknowledge it, we accept it, this is the circle of life. We don’t talk about poop, except when using the word in a moment of anger or frustration in its more popular slang terminology.   I can’t remember ever hearing a mom say she was totally creeped out by poop in her baby’s diaper (we don’t “love” it, we simply recognize it’s a normal part of child development). I can’t remember anyone talking about the graphic end of life process in a way that was disrespectful. But what about when something happens in between those two stages? Heaven forbid we talk about fecal incontinence, much less admit it has happened to us.

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Fecal incontinence absolutely occurs, more frequently than you would imagine-it simply doesn’t get talked about. Way too much stigma. As a pelvic organ prolapse (POP) advocate, incontinence is one of those layers that come with the turf. I’ve written about FI (fecal incontinence) a couple of times, discussed it during radio interviews, had multiple communications over the years with practitioners as well as women in various stages of POP navigating awkward symptoms. I’ve always wondered “what’s the big deal”? Poop is a normal bodily function. Fecal incontinence is the body signaling that something is a bit off kilter. No different than snot when you have a cold. No different than throwing up when you have the flu. No different than bad breath when you have periodontal disease. While we don’t like any of these other bodily functions, we don’t avoid talking about them like they are the plague. So what’s so different about poop?

Why can’t we talk about incontinence out loud? Why do we worry so much what others will think of us if it happens to us? Why can’t we discuss poop in open conversation?  STIGMA has kept this topic off-limits. That has to change. Someone has to talk about poop out loud and what happens when everything “lets loose” in public. The unmentionable stuff. So let me start the conversation….

My life as a POP advocate means I talk about the unmentionable stuff all the time; it’s necessary in order to generate change. I freely initiate conversations when opportunities present themselves about the aspects of POP that make others squirm, not because I enjoy making others feel uncomfortable, I’m simply trying the lift the veil that has covered POP for thousands of years in order to enable the world to recognize and address it. I look at my body as a “lab rat”, available for experimentation to better understand not only my own dynamic, but also to increase my ability to better recognize the needs of women navigating POP. When I experience something I feel is relevant to my ladies, I can’t wait to share. This is one you’re going to be a bit surprised to read. But not nearly as surprised as I was to experience.

For the past year or so I’ve been noticing a subtle loss of contraction both vaginally and rectally. I do all the right stuff, exercise (both internal and external muscles), I have a pretty healthy diet, I check my posture regularly, use bio-identical hormones to optimize both estrogen and testosterone. I monitor MS flags to keep the condition in check.  I’ve mentioned my contraction concerns to research connections, I’ve mentioned it to practitioners, I’ve spent a considerable amount of time digging through neurologic pelvic floor research. No one seems to have an answer (I confess I haven’ttried biofeedback yet; I need to fit an appointment into my sideways schedule). My “gut” says my weakened vaginal/rectal  contraction has something to do with internal adhesions; I was shocked the last time I had internal MFR (vaginal myofascial release therapy), the improvement in pc contraction was significant and I'm hopeful a treatment or two will do the trick for me again.

So…..now onto the part of my story that will get your attention. I went to the airport, excited to leave for  Nepal, a vision I’ve had since 2009, but exhausted from the trip and meeting prep I’d worked on in the prior  weeks. A few blocks from the airport my stomach started to warn me I’d need to find a bathroom as soon as I got go there; I wasn’t concerned. We parked the car at the curb and my driver helped carry my suitcases inside and then it hit me-I was not going to make it to the bathroom on time. I could feel a tiny bit of poop leaking out; and then while I scanned the room looking for the bathroom, I felt everything bust loose. And I do mean everything. It just kept coming and coming, poop sludge. I quickly mentioned I was pooping my pants and ran for the bathroom. The shoes I’d been breaking in the past week apparently stretched out a bit too much, they kept slipping off my feet threatening to make me fall like a ton of bricks with a load in my pants. Yikesville to say the last.

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I made it to the bathroom, hit a stall, pulled my dress up and pantyhose and undies down (thank God for pantyhose, my new favorite travel companion) and realized this was not going to be an easy fix. Everything had to come off except my bra. I put my pantyhose into the stall paper garbage bag used for tampons (throwing out runless pantyhose about killed me) then put my undies in the toilet to wash then out (they were brand new), and the automatic flusher kicked in and snatched them right out of my hand and down the toilet. I wish I had a picture of the look on my face (I’m cracking up now just thinking of it, I must have had such a funny shocked/ticked off expression, they were BRAND NEW). At that point all I could think of was get cleaned up, you’ve got a plane to catch to fulfill a dream you’ve been waiting five years to explore. So I stood by the sink in the bathroom, naked from my bra down, cleaning poop from every crevice imaginable. A woman walked in to use the bathroom; I apologized to her for the smell and told her I had an accident in my pants and she said don’t worry about it, that’ll happen sometimes. After she left another woman came in; I again apologized for the mess and she also said don’t worry about it. When she came out of her stall and washed her hands, she asked me there was anything she could do to help. I thanked her profusely and described the person with my suitcase and his location and asked her to have him bring my suitcase with fresh clothes. (Turned out he had followed me to the bathroom and was waiting right outside the door.) He handed me the suitcase; I finished cleaning up, got dressed, and popped an Imodium prior to registering for my flight, asked an attendant to please empty the garbage in the bathroom where I’d used up every paper sanitary garbage bag to contain paper towel washcloths, and was on my way for a two day flight to Nepal.

Here’s the important part of the story. Not once during this event was I embarrassed. I was rattled when my bowels first let loose, I was frustrated when my shoes threatened to trip me on the way to the bathroom, I was ticked off when the toilet sucked my brand new underwear down the toilet, I was grateful the women who came into the bathroom were so understanding. But I was never embarrassed. I’m going to assume it’s because I talk out loud about all aspects of POP every day and feel we all should in order to bring the condition into the 21st century.

It confirmed what I’ve been feeling for the past six months-the stigma that drapes the symptoms of POP women find embarrassing is shifting. Yes incontinence may be a bit easier for me to navigate than others because my life is embedded deeply in the POP arena, but the fact that I responded the way I did tells me that the energy which surrounds me is evolving as well. Change is not coming; it’s already here-we move forward together.