If you take away anything from this post, the message is this: Please take care of yourself. Like, actually. Mental health and physical health are more important than research. Stress can irreversibly affect your health.

You wouldn’t think it’d happen to you, right?

Reading that, some of you might be thinking, “okay, well this lady was probably unhealthy beforehand in some way“, or “the way she stressed is probably way too extreme and not something I’d put myself through“.

I was totally healthy. I didn’t experience stress levels that exceeded stress I’d faced before. I just didn’t handle it well and it took a toll on me.

You don’t want to be like me and develop a lifelong condition that dictates your day-to-day. I have to think about restroom availability whenever I go anywhere. I hate spontaneity because I need to look up bathrooms and plan my water intake. I take medication for it to suppress the symptoms. And I’ll be doing so for the rest of my life.

But enough about the details. Let’s start from the beginning.

Warning Signs

I didn’t always have a weak bladder! I was a perfectly normal and pretty athletic kid growing up. I went on trips with my family, played a bunch of sports, and enjoyed all sorts of activities. During college and early in grad school, I traveled spontaneously, partied, and went on lots of hikes.

The symptoms came on gradually over a month or so in the spring of my 1st year of grad school. I started having to use the restroom all the time during lectures (you know, those dreaded first- and second-year required courses). It was really hard to focus in class knowing I’d have to get up and pee again, and again, and again. Like, every 15 minutes. It was really embarrassing.

I was really stressed that spring because of a few things that happened in my research rotation. The thing was, I had already secured a spot in the lab that I did my prior rotation in, but my program required us to complete rotations throughout the first year for experience. So, I wasn’t even stressed about making sure that final rotation would turn into a permanent position. The thing was, the faculty member who ran that lab I was doing my rotation in was genuinely not fit to be a mentor. He was one of those types. I won’t get into it here, but it was just a really unhealthy environment to be in.

2nd year of my Ph.D. rolled around, and the symptoms weren’t getting much better. They were getting worse, actually. I gave up on a final exam for a class I took in the fall of my 2nd year of because I couldn’t handle my bladder. I peed once during the exam, but immediately after coming back into the exam room I felt my bladder acting up again. I just scribbled the rest of the answers and turned it in super early. I was so embarrassed for turning it in early I didn’t even look at the proctor and rushed out. Looking back, I wish I had asked for some sort of accommodation.

A Spooky Series of Events

During that fall, I was out at a Halloween party and I had to pee multiple times during the night. Not like 2 or 3 times because of too much beer, but like ever 10-15 minutes. It was so bizarre. We were at an outdoor Halloween event in our city, and they set up a ton of porta-potties everywhere. I never had an issue finding a porta-potty, but I had to use them so much throughout the night.

My friend and I were headed to another party, and I had to literally run into a restaurant and pay them to let me pee too. My friend that I was with was pretty concerned about it and asked me if I had considered going to a “urologist”. I had never even heard of urologists at that point, so I said no, but that I’ll look into it.

The next morning, scrolling through the websites of a few urology clinics in my area, I felt so dejected and apprehensive. They were filled with pictures of catheters, bladder bags, and old men! My friend definitely had a point, and I needed help, like, medical attention. So that week, I saw my PCP at the campus health center and got a referral to see a urologist in the university hospital system.

Keep in mind, this was all during the beginning of the 2nd year of my Ph.D., so I was still balancing coursework, dissertation research, and extracurriculars.

The Good Doctor

(Shout-out to one of my favorite shows.)

That winter, my urologist appointment rolled around. As I expected, I was the only woman in the urology office, but I wanted to make the most of my first appointment so I tried to keep my spirits high. When it was finally my turn, I was instructed to pee before I saw the doctor, so he could do an ultrasound to see how effectively I had emptied my bladder. I peed, then waited in the examination room.

My urologist walked in a few minutes later, and gave me a fist bump (this was in 2017 by the way, way before COVID made fist bumps mainstream). He was really nice and approachable. I told him about my symptoms and the fact I was in grad school and had been really stressed. He did an ultrasound of my bladder and showed me that I emptied my bladder effectively. Some patients who have bladder issues aren’t able to do that, so they have a lot of residual urine in their bladders, but thankfully that wasn’t an issue for me.

He diagnosed me with Overactive Bladder (OAB) and prescribed me oxybutynin, also called Ditropan.

He explained that OAB can be caused by all sorts of factors, but from his perspective, it was definitely my grad school stress that caused it. He told me about all sorts of dietary changes to make to try to minimize the symptoms, like cutting out coffee, cheese, sugary foods, acidic fruits and veggies like tomatoes, alcohol, etc. That was usually his first recommendation for patients who were newly diagnosed.

Give up coffee? Give up the star ingredients of pizza? That sounded absolutely impossible to me. I subsisted on coffee and pizza. That’s pretty much the classic grad student’s diet. I had stopped drinking alcohol on 1/1/2017, so alcohol wasn’t an issue, but quitting alcohol hadn’t been helping alleviate my symptoms anyway.

Surely, I could just take some prescription meds, practice some de-stressing self-care, and get rid of this OAB?

He then told me that it was lifelong, and that managing the symptoms was pretty much all I could do. For the rest of my life. It would be in the form of medication, bladder training, avoiding trigger foods, bladder botox, or if it gets too bad, getting a catheter. Like, there literally isn’s a cure for OAB.

I was floored. I’d have to feel this way forever? Or, even if I did get on meds and manage my symptoms a bit, I’d still have a weak bladder for the rest of my life? That appointment shook me.

The doctor probably sensed my bewilderment. He reassured me that I could still live a normal life, and that plenty of people have OAB – a lot of them don’t even realize or get a diagnosis like I did. He was honestly a really great doctor and made the whole experience at least partially bearable. He was probably one of the only doctors I’ve ever seen in my life that didn’t make me feel rushed, not one bit.

At the end of the appointment, he asked me if I was looking forward to anything. My face sometimes says way too much, so maybe he was trying to help me get perspective on the situation and take my mind off of it. I told him I was seeing Panic! at the Disco (Death of a Bachelor Tour) in concert soon, but I was worried about having to pee multiple times during the show. He said he liked P!ATD too, and he said he’d make sure to get my prescription registered the moment the appointment was over, so that I could start taking the oxybutynin before the concert and let it build up in my system.

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The appointment ended and I took the bus home. I was pretty overwhelmed and the only thoughts on my mind were to get home before I had to pee next, and to get that prescription filled right away.

Getting on Medication

I started taking the oxybutynin right away, so it was winter of my 2nd year of grad school. It did help ease my symptoms. My frequency went from having to pee every 15 minutes or so, to every 30 minutes to 1 hour or so, depending on how much water I had been drinking.

It took a while to kick in fully, but eventually, I felt like I had my life back.

Sure, I was still envious of my friends who could go entire museum outings and concerts without running to the restrooms, and I always went to the restroom before and after meals at restaurants, but I started feeling better about the whole thing. As long as I did my best to empty my bladder before leaving home, and made sure there were restrooms wherever I planned to go, I was fine.

I eventually learned the urological importance of two stores that I already highly valued in my life: Starbucks and Target. Other solid spots to find bathrooms ended up being malls, CVS and other pharmacies, big box stores like Home Depot and Best Buy, and grocery stores.

I had gotten a handle on my symptoms, sure, but I was still internally grappling with the reality of the situation. I was still processing the fact that it won’t ever go away.

The Path to Self-Acceptance

It was sort of like I was on autopilot when it came to the physical aspect and getting on meds. I had an issue, was presented the path to handle it, so I followed that path and obtained the solution. I was still in grad school, anyway. I had to commute every day by bus, work in the lab all day, participate in extracurriculars, and find my way home without peeing my pants. I solved the issue in a practical sense with basic logistics and scheduling water intakes. I had to.

Mentally, though, I was struggling. I was so embarrassed about having developed OAB. I mean, come on, bladder issues at 23?

Knowing and accepting it’ll be lifelong: that was the biggest hurdle for me. I had to come to terms with the fact that I’d have to think about my bladder every day for the rest of my life and to essentially plan things around my bladder condition.

The next 6 months were the months that I struggled pretty severely with bladder-related anxiety. Thinking about something makes it seem worse than it really is, you know? Rumination might be a good word to describe it.

Thinking about my bladder made me more aware of the constant urge I felt, and that made me want to pee more, and that made me want to find a bathroom, which made me anxious about leakage, which made me think about my bladder and holding the pee, which made me want to find a bathroom, which made me feel I should be more calm, but that made me more stressed about everything. That sort of thing.

I had some pretty embarrassing times where I’d run into random restaurants and grocery stores begging to use the restroom because I just wasn’t thinking straight and was so overwhelmed and obsessed with solving the urge to pee. One time, I ran through a neighborhood asking multiple shops if I could use the restroom because I was afraid to just hop in an Uber and quickly get home while holding my bladder. I eventually had a grocery store that had a bathroom “under maintenance” let me use it.

But, those first 6 months of disbelief and processing my diagnosis led to pretty quick acceptance. I started being very open with people about my OAB. I just called it “my bladder condition” , “my bladder issue”, or even “my bladder thing” depending on who I was talking to. No one’s ever given me a hard time about it and now I leave in the middle of lab meetings and board games without any embarrassment.

People mention “bad backs” and headaches all the time. That’s the energy I started having with my “bladder thing”.

You know what the crazy part is? I’ve never peed my pants or leaked. Leakage is thankfully not a part of my OAB experience.

The Pumpkin Seed Oil Hype?

There are definitely some hyped up supplements and products that claim to help with bladder-related issues, like daytime urination frequency and nocturia. I haven’t turned to those and haven’t purchased any, with the main one being pumpkin seed oil. They’re all unregulated by the FDA, by the way, as are a lot of hyped up beauty supplements & ingredients (I have blog posts about this kind of stuff because I truly find it fascinating how companies do that).

I hate jumping on fads like those especially when the products aren’t regulated and all the effects in the literature are extremely biased. I know this because I actually wrote a blog post about the studies that have been done on pumpkin seed oil and its effects on urination frequency, just to inform myself. I think that was either the 1st or 2nd blog post on this blog that I ever wrote. I totally get the urge (no pun intended) to grab the next solution, the next supplement, the next cure-all, but I’m a bit too frugal (and nerdy) for that sort of behavior.

I’m definitely keen to trying new medications and supplements if the evidence is strong, but for now, I’m just going to stick with what my urologist has been recommending me over the years I’ve been going to him.

The Stress Management Lesson

So yes, the point of all this is that you need to manage your stress and to remember it can mess you up. Yes, you! If I could go back in time, I’d shake myself by the shoulders and really remind myself:

• Take it day by day
• Whatever you’re stressing about isn’t worth messing up your mental and physical health for
• Whatever you’re stressing about can be handled in due time
• My value isn’t tied to my research progress
• Actively and repeatedly strive to incorporate things you loved before grad school began back into your life
• “Meh, I’ll make it through. I always have.”

I don’t know what it is about the grad school environment, or the academic environment in general. I feel like I had so much going on in my life in undergrad: 3 classes a day, labwork, my campus tour guide job, snack-filled study sessions with friends at night, parties, concerts, and road trips. As grad school started, I became so hyper-focused on one or two things every week that stressed me out way too much. That dilution factor wasn’t there anymore.

In grad school, stress is so real. Trust me, I know. Anxiety is real, too. I’ve had a handful of panic attacks in my apartment during the first year of grad school. They weren’t even because of anything grad school related, but grad school pressures certainly didn’t help me manage other things going on in my life. All that built up and I guess my bladder was what “went”.

I already talk about all sorts of self-care and wellness tips and all sorts of lessons and tips about grad school in my other posts so I won’t reiterate them here. I have already written plenty about how to handle stress, at least in ways that worked well for me during grad school. Yep, it included never working weekends, rolling into lab when I felt like it (usually around 10AM), and going to therapy.

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I’ve always wanted to write about my experience with OAB and share it, mostly for myself, like for a therapeutic purpose. But I hope that my post helps people realize they’re not alone if they have an invisible condition like me. I totally understand the need to plan every move in public and always having a sliver of your mind occupied by responsibilities related to the condition, every single day. I also hope that people who read this are inspired to really tackle stress management in ways that work well for them.