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A few questions…
Now before we start, I’ll explain a bit about how I approach the appointment.
First, I’ll do a short Medical Screening questionnaire, to see if there are any issues that are more medical in nature and which would suggest a visit to the doctor before proceeding. Then I’ll want to talk to your son for a fw moments, to make sure that he wants to be dry. Then if all that is OK, then we’ll go through a Case History form which I use to determine the causes and courses of treatment. After all that, then I’ll show you what we can do for ________ and you can decide how you want to proceed. In any case, you will learn quite a bit about the problem of nightwetting and will have a better idea if and when it might end. OK?
MEDICAL SCREENING:
Child’s name: Age: M/F
- Has your child ever had a bladder or kidney infection? ________
- Does your child urinate more than 9 times a day? _______
- Does your child have daytime wetting accidents, even just damp underpants? ______
- Has your child begun wetting the bed after 6 months or more of being dry? ______Does your child wake up more than once a night to drink water? ______
- Does your child have a problem with abdominal pain or chronic diarrhea? ______
- Does your child hold in bowel movements? ______
- Does your child ever soil underpants with stool? ______
- Has your child experienced a recent history of mood swings or other emotional problems? _____
- Does your child snore heavily at night in and stops breathing or stuggles to breathe? _____
- Does your child have insomnia, sleepwalking, or night terrors? ______
- Has your GIRL had any trauma, either physical or emotional, at approximately the time when her daytime wetting issues began? ______
If you answered “YES” to any of these questions, you should see your doctor or nurse practitioner
____________________________________________________________________________________________________________________________
So how often does she wet? _________ How many times a night/
And how long has this gone on? _____ Did he ever stop?_____
Does he wet during the day? _____ And there’s no problem with constipation?_____
Is he allergic to anything?___
Ever had asthma? _______
Diabetes? _____ Epilepsy? _______ Hearing/Speech issues? _______
Temper tantrums? ______ Hysteria?_____
Huperactive?______ Any suggestion of ADHD?
Any fear of the dark, or loud noises?______
Is he slow to get going in the morning? _____
How is the school behaviour? _______ Grade marks? ______
Attention span? ______
Self esteem? ________
DIET:
Any food sensitivities that you know of?__________
Do he/she get much pop? ______ Sugar?______ Candy? _______ Chocolate?_______ Caffeine?_____
Drink a lot of water? ______ When?_______ Milk?_______ Juices? ______
Now, everyone does these things, so we are not being critical because it seems natural to do whatever you can, but it helps us to treat a child if we know what has already been tried to get them dry.
Have you ever talked to a doctor about this? _________ And what did he say? ____
Did the doctor do any tests, or did he just say he’ll outgrow it?_____
And did he tell you when he’d outgrow it?_______
Did he tell you what to do if he doesn’t outgrow it? See him again when the child is seven, or ten, or fourteen? _____________
Have you tried taking your child to the toilet at night?______ what time?_______
And with what result? _______ In fact, most authorities feel that taking a child to the toilet without making them do it on their own power, is actually teaching them to go in their sleep.
Have you ever withheld drinks after dinner? ________ Did it help?_______ Did he get headaches or seem even more fuzzy in the night or in the morning? _____
Have you heard of bedwetting alarms? _______ Have you tried rewards? _______
Now, we ask these questions because there is a genetic component here, and also so we’ll know if the child identifies with anyone else at all. So about sleep issues:
Night terrors: Child_________ siblings __________ parents _________ relatives _________
Nightmares: Child_________ siblings __________ parents _________ relatives _________
Sleepwalking: Child_________ siblings __________ parents _________ relatives _________
Snoring: Child_________ siblings __________ parents _________ relatives _________
Sleep apnea: Child_________ siblings __________ parents _________ relatives _________
Talking: Child_________ siblings __________ parents _________ relatives _________
Tooth Grinding Child_________ siblings __________ parents _________ relatives _________
Has your child ever gone on sleepovers?________
Has he/she ever avoided sleepovers?__________
Has he/she ever been teased about bedwetting?______
Does anyone else know about this? ______
Has the bedwetting been a problem for you?________________________________________________
Has the bedwetting been a problem for your child yet? ______________
Is there anything going on in the home that may make this a bad time to work on this problem, like maybe a vacation coming up, or a new baby, or heavy workload? _______________________________________
Does your child use pullups? ______________
If we asked you to get involved, who would be helping him/her before bed? ______
And during the night, if necessary at first? ____________
Do you both work outside the home? ________
Have there been any significant family traumas, like the death of a grandparent, or divorce, in the last year or so? ______________________
Is he the natural child of both of you?___________________
How long have you been together then? ________
OK, now, has the child ever said he/she wants to be dry? _______
Has the child ever indicated that he wants to find a way to be dry?_____
Has he/she ever expressed fear of it never stopping at all? _________
Now, tell me, why do you want to see him/her dry?
So ———-, I recently talked to your Mom and Dad about your sleep problem, you know what I’m talking about, right? You go to bed with a nice dry bed, and sometimes wake up wet, right?
How many kids in your class wet the bed at night? ___
Do you know?
How do you know they don’t all do it? You see, this is a big deal secret issue, but it happens to a lot of kids. And like all kids, you can get dry someday, but with a little help you can be dry a lot faster.
Has anyone ever taught you how to sleep? Probably not. But we spend a third of our lives in bed, and how you sleep is really important to how you fell all day, how you focus and perform all day. So my job is to teach kids how to sleep properly, and I can help. I’ve worked with lots of boys of your age, and it works every time to help them to sleep more restfully and wake up dry. OK?
In fact the youngest child I’ve helped is two years old, and the oldest was a 35-year old nurse at a hospital. They learned how to be dry, and you can too.
So my question now is, IF you could be dry every night, for good, would that be a good thing?___
And if I showed you how to become the boss of your bladder, how to get dry for good, would you be willing to spend five minutes each night before bed, doing exercises that fix it?____
OK. So the thing I want you to understand is, it isn’t your fault. There are many, many kids with this problem. How many kids are in your class? Do they all wet the bed? ____
Adults snore, kids wet the bed, same thing!
So if you’re born into a family that has big feet, you’ll probably have big feet too. And if you’re born into a family of snorers or tooth grinders, then you’ll probably wet the bed for a long time. But that doesn’t mean we can’t fix it, because we can. I works every time.
The problem isn’t you, it’s us. It’s the way people live today. Our bodies were originally designed for people who sleep in caves and tents, like we did for thousands of years. In those days we could sleep when we wanted to, and eat whenever we were hungry, and no one had to go to school. But now we have to learn new sleep patterns that aren’t exactly normal,
Grade?_________
Favourite subjects at school? _________
Favorite sports? _____________________________________________________________________
Do you like school?___________________________________________________________________
Have any hobbies? ___________________________________________________________________
What time do you go to bed at night? _______ And when do you get up?_______
When do your parents get up? ________ And when do they go off to work?________
Do you share your room with anyone else? ______
Is your be a single, or a double, or a bunk? ______
Do you have a night light? _____ In the hall too? ____ IN the bathroom? _____
Is your room close to your parents? _____
If you have a nightmare and call out, do your parents hear you? _____
Are you easy to wake up at night? ______ How about in the morning? _____
If a phone rang or a fire alarm beeped in your room, would you wake up every time? ___
So you’re a pretty deep sleeper, aren’t you? ________
Now, when there’s a beep in your head during the day that tells you you have to go to the bathroom, you hear it, right? _______ And you don’t at night, right? ______ OK, probably all we have to do is to teach you how to hear that beep while your are sleeping too, so you can decide whether you want to hold it, or go to the bathroom. Just like in the daytime, when sometimes you go, and sometimes you hold. OK? It’s not too hard, but it does take a few weeks because you’re going to have to teach your unconscious brain some new tricks. And your unconscious brain learns by practice, not by reading or talking.
Constipation is a problem for many kids..
THE FIRST STEP:
In order to ‘feel it’ at night, you have to have a good strong bladder signal, and lighter sleep in order to ‘hear it’ in your sleep. You have to be able to go to bed feeling relaxed and comfortable, with no irritating chemicals in your system. So first, I’m going to ask you to change some of the things that you eat and drink.
And I want you to especially avoid chemical colours:
1 Avoid yellow dye (tartrazine)
2 Drink water every 2 hours:
NEXT, I need you to drink lots of water.
In order to have a really strong bladder signal, strong enough to hear it at night, you need a healthy bladder. You get this, by going to the bathroom every two or three hours, then having a big glass of water.
So especially when you come home from school, drink as much water as you can hold. And again an hour before bed, drink as much as you can hold.
And the third thing.. before you go to bed, practice going to the bathroom.
So ..
1. Eat healthy food
2. Drink lots of water, after school and one hour before bed
3. Practice waking up and walking to the bathroom, 2x each night.
So that’s all for now, this week you will be working on making your body really healthy. Get lots of sleep, avoid the problem foods, and drink lots of water\
Next week I’ll show you how to teach your brain to pay attention while you’re sleeping. OK?
Now I’m going to mail you some things and when you get the package, call me. We’ll talk again.
