Freedom to Play



Karon Gubbrud designed her backyard around the four young grandchildren she dearly loves.

When they come to visit, she pushes them on the tire swing, putters around the yard or jumps into the sandbox with them, scooping and building with a bucket of shovels, pails and trucks.

“Boys have to have a sandbox and I wanted one big enough to play with them,” she says, beaming as she sifts through the sand with her one-year-old grandson, Kayen. “You need to have enough room to get your toes in the sand. And you need room for all four little boys.”

Until recently, the 68-year-old Sioux Falls woman was limited by a problem that her four grandchildren just couldn’t understand. Their lively, energetic grandma often had her plans changed by urinary incontinence. Karon had to think out every trip in advance and sometimes skip or cut short the activities she wanted to do.

“How do you explain to two toddlers that we have to go home just as we get to the park,” Karon said, tickling the little boy’s sandy toes. “They just want to get on the swings and play.”

For more than 10 years the retired teacher has had to work her schedule and lifestyle around bladder problems that left her suddenly having to run to the bathroom. But a therapy that uses an implantable device to help train the bladder has changed her life, she says.

“I feel like it has just opened up my world,” Karon said. “There will be no stopping me now.”

Limiting lifestyle

For a healthy, adventurous person, urinary incontinence was a maddening problem, Karon said. Every time she visited a new place she had to immediately figure out where the bathroom was located. Even something as simple as her morning cup of coffee had to be planned around the day’s events, timed to not put too much pressure on her overactive bladder.

Taking her two-year-old grandson to story hour at the library would be an exercise in trying to not lose bladder control. Sitting on the floor and then standing up could put pressure on her bladder, leading to an embarrassing accident.

At any time of the day, she could suddenly lose control of her bladder when she coughed, laughed or sneezed or just changed body positions. This winter, she was enjoying herself at a formal dress event on a cruise when her bladder just suddenly leaked.

“There you are at a cocktail party in your in your formal dress and it just happens,” said Karon, who refused to give up the travel and activity she loved. “I’m enough of a brat that I just would do the things that I wanted to do, in spite of the concern for possible bladder problems. However, when I had such problems, it was embarrassing, frustrating and humiliating.”

Karon sought medical help years ago, while working a demanding job as a teacher of students with severe emotional problems. She often had to wait hours before using the bathroom because she couldn’t leave her students unsupervised. At that time, she was told that her bladder issues were likely caused by a severely distended bladder.

The only answer for her at that time was to use small catheters to fully remove all the urine from her bladder. She didn’t like the uncomfortable therapy and eventually quit it. Over the years, she just had to learn how to live with her condition, she thought.

A new option

This spring, her primary care doctor suggested that she talk with Dr. Kevin Benson. The urogynecology specialist with Sanford Health told her that her bladder problems were likely caused by injuries to the nerves between her bladder and brain, plus damage to her pelvic floor from having large babies – two of her children weighed close to 11 pounds at birth.

Karon was a good candidate for a therapy called Interstim, an implantable device that stimulates the nerves that control the bladder with mild electrical pulses. Benson said the therapy is appropriate for patients like Karon who have incontinence problems that are interfering with the quality of their life and have tried other treatments unsuccessfully.

“It’s an extremely nice option because we can take the patients that have the worst of the worst conditions and it makes them some of our best patients,” Benson said. “It’s life changing for these people.”

Patients go in for a simple outpatient procedure to have a small wire placed in their back that is temporarily attached to the device, which uses a slight electrical impulse to help the brain control the bladder and muscles related to urinary function. The device is then tested for a few days to see if it can improve the patient’s condition.

About 70 percent will find it effective and go on to have the device implanted in a minimally invasive out-patient procedure. It takes only minutes to place the device and its battery, about the size of a 50-cent piece, under the skin. The device causes no damage and can be easily removed if it doesn’t work.

“It’s an ongoing therapy that tends to continue to work over time,” Benson said. “Five years later, about 80 percent of patients are still getting the benefit.”

Changing her life

Karon said that she had no difficulty making the decision to try the device. It was an option that sounded far more appealing than the complete bladder reconstruction surgery that she feared she was facing. She found that the results were almost immediate, allowing her to be able to have control over her bladder for the first time in years. She’ll continue to have follow-up appointments with Benson to help her calibrate the device and make sure it is working properly.

This summer, Karon’s plans for her four grandchildren involve long walks, swimming, picnics in the backyard, uninterrupted playing, trips to the lake, zoo, parks and fire stations and even bike rides. She’ll be able to more easily travel long distances, golf, garden and dance. She can enjoy a cup of coffee in the morning, no matter what her plans are later in the day.

“I wish I would have done this five or ten years ago,” Karon said, as she kissed her grandson’s smiling face. “I feel like I’m a totally new woman today.”

Posted Date: May 2011

Freedom to Play

An overactive bladder kept getting in the way when Karon Gubbrud tried to play with her grandchildren, travel or even just enjoy a conversation with friends. Find out how a minimally invasive procedure ended her incontinence and opened up her world.