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A woman having a panic attack because she can

Survival Mode and Incontinence Effects

It was about 7 am, lightly snowing, and still very dark outside. I needed to be sure that I got to work early because I didn’t want my co-workers and students to see me struggle. Hiding what it takes for me to get to work every day is my normal because I don’t need their sympathy nor do I want them to use it as an excuse to fire me.

As I parked the car, I jumped out a little too fast and while getting my walker out of the car, I lost my breath.

I had my walker open to support me

At least I had a place to sit. Unable to hold my body up, I felt like a balloon that had lost all of its air. I am deflated with no bounce and I am unable to move. The wind is blowing in my face and the snow is lightly falling. It is so dark out. I can only see the outline of people through the streetlight. None of them offer to help me.

This is a different feeling than needing to use the bathroom

This is not the feeling of pressure on my bladder from coughing too hard or from waiting too long to get to the toilet, but this has happened to me before. It’s a familiar feeling. My body has gone into survival mode. It means that all my resources have gone to my lungs, heart, and brain to save my most needed resources in this moment. This is the likely outcome of not having enough oxygen in my lungs.

It is a sudden feeling

I need to use the washroom, probably more than I realize. At this very moment, I cannot move so it will have to wait. Getting out of the car and pulling my walker out has cost me to use up all of my resources of energy. The thought goes through my mind that I may urinate right here and now while sitting on my walker. It begins suddenly and I will just have to wait it out and hope for the best.

Pursed lip breathing

I try to use pursed-lip breathing, but I am panting so hard that taking a breath in through my nose is harder than you can imagine. As I get more agitated and concentrate on how much I need a washroom, I get short of breath. Now, I feel the need to defecate too. I know I need to control the panic because I am all alone and I have to manage this situation.

This is a situation that is a part of COPD that no one ever talks about. Even doctors don’t fully understand the impact this has on their patients because no one ever talks about it.

Scanning the area, I am contemplating making it to the bathroom in time. I know I have clean clothes in the trunk but right now I can’t move, so getting them will be impossible.

Grounding yourself to let this feeling pass

To begin, I am using a mindfulness exercise in grounding to try to bring myself back to a normal breathing pattern.

  • Seeing 5 things and say their names out loud
  • Feeling 4 things and say the names out loud
  • Hearing 3 things and I say the names out loud
  • Smelling 2 things and I say the names out loud

Finally, as I begin to regain a normal breathing pattern, I reach into my pocket and get the candy. As I put it in my mouth, the sensation of having to urinate and defecate becomes manageable.

Finally, I can move again. Episodes like this often leave me feeling drained and in need of a rest to recover.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The COPD.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

  • TracyCarnahan
    2 months ago

    I too am glad this is being discussed, it’s only one of the many unappealing side effects of COPD. I had been wondering if men experienced this as well. I didn’t have the mindfulness exercise knowledge, I usually just sit gasping, trying to get a grip and breath through my nose. So thank you for giving us that. I’m not sure I will be able to say these things outlaw while gasping but I will give anything a shot that might help.
    I am increasingly convinced that our loved one’s should be reading copd.net . I’m going to figure out how to send a link to them.

  • Barbara Moore moderator author
    2 months ago

    Thank you for responding TracyCarnahan, Yes men do suffer with this too. I am glad this article resonated with you. Please do ask your family to join in the conversation any time. We appreciate your comments. Barbara Moore (site moderator)

  • Leon Lebowitz, BA, RRT moderator
    2 months ago

    Hi TracyCarnahan and thanks for your comment here. You may want to suggest to your family to register here on our website. They will then have access to all the content, if that is what you have in mind. Registration is free: COPD.net/register.
    All the best, Leon (site moderator)

  • Judy
    2 months ago

    I am so glad I read this article. This feeling of having to urinate when I am breathless has happened to me several times before. I had asked my pulmonologist if this had anything with my COPD, emphysema and he said he had never heard of it being a connected problem. I have been on O2 24/7 for several years. I am end stage COPD and it is becoming more of a problem lately. I am just so relieved to know why this happens, thanks for this information.
    Judy

  • Barbara Moore moderator author
    2 months ago

    Thank you for commenting Judy, I know many doctors haven’t given much thought to this connection but when it happens to you… it just makes sense. Barbara Moore (site moderator)

  • Laurene
    3 months ago

    Thank you for this very interesting article.
    I noticed the connection some time ago and asked my pulmonary doctor about it. He didn’t know anything about it.
    We learn so much from each other! And I will certainly pass on this very valuable information to others.
    And I should include my doctor.

  • Barbara Moore moderator author
    2 months ago

    Thank you Laurene, Your doctor will appreciate knowing that he can learn something from you too. I am glad you enjoyed the article. Barbara Moore (site Moderator)

  • Leon Lebowitz, BA, RRT moderator
    2 months ago

    Hi Laurene and thanks for your comment in response to Barbara’s article. I’m sure she will be gratified to read what you have said. In a community like ours, learning from one another is a tremendous advantage for each of us. All the best, Leon (site moderator)

  • slp1945 shady
    3 months ago

    I can so relate to all of these comments. I don’t feel so alone now, and will try these suggestions. I tend to have anxiety in bed at night, very scary and my breathing gets worse. I look forward to the information shared here, COPD is a battle for me everyday.

  • whales94
    2 months ago

    I can so relate to this. Bedtime is NOT my favorite part of the day. Even on good days when I know its bedtime my anxiety level starts to rise and I can just feel those bronchial tubes narrowing. One thing that has helped tremendously is I bought a very comfortable recliner called the “catnapper” and it certainly lives up to its name. I’ve been sleeping on that most of the time.

  • Leon Lebowitz, BA, RRT moderator
    2 months ago

    Hi whales94 and thanks for your post. As you’ve said, anxiety can be a factor as one is trying to relax and getting ready for sleep at night. Glad to hear your found a good recliner to help you manage this. I also thought you might find it helpful to look over this article on COPD and sleep: https://copd.net/living/getting-best-sleep-even-copd/. All the best, Leon (site moderator)

  • John Bottrell, RRT moderator
    2 months ago

    Hi. Whales94. Those are comfortable chairs. Glad you were able to find one to help you sleep better. Thanks for sharing your experience with the community. All the best. John. Site Moderator.

  • Barbara Moore moderator author
    3 months ago

    slp1945 shady , I hear you. I tries your patience when you are consistently short of breath. I am happy that this article resonated with you. Thank you for commenting. Barbara Moore (site moderator and author)

  • Linnie
    3 months ago

    I loved this story because it is the way I am. I have my walker with the seat which has been a great help. I also carry a Depends with me and I wear a Depends also so at least I will not make a big mess. This was so embarrassing before I found adult diapers!

  • Barbara Moore moderator author
    3 months ago

    I hear you Linnie and so do many others here on COPD.net. Many didn’t realize it had to do with shortness of breath. Thank you for commenting today. We appreciate all comments. Barbara Moore (Site moderator)

  • sandrahenton
    3 months ago

    I am so glad to see this article! This has happened to me several times. Every time I have a flare up, I feel the need to urinate! I never mentioned it to my doctor. I never thought too much about but did wonder why it happened when I was short of breath!!! Thank you for sharing!!

  • Barbara Moore moderator author
    3 months ago

    Thank you for commenting today. We appreciate your feed back. Barbara Moore (site moderator and author)

  • Leon Lebowitz, BA, RRT moderator
    3 months ago

    Hi sandrahenton and thanks for your post. Glad to hear this article resonated so clearly with you. We appreciate your input. Leon (site moderator)

  • pat02
    3 months ago

    Barbara, thank you so much for the post. This is something we don’t hear about but should as it is a common thing with COPD..This was one of the hardest things to accept with this disease.
    Thank you again!!
    pat

  • Barbara Moore moderator author
    3 months ago

    I am surpised thst doctors do not know about it. It shows that we dont always tell them everything. Barbara Moore ( site moderator and author)

  • Linda
    3 months ago

    Hi Barbara, I know this feeling all too well. I haven’t driven my car recently and I don’t work, I’m retired but one time I stopped to get gas and it was very windy. I went inside the station and paid ahead and then came out to pump it. My gas tank is on the passenger side of the car. By the time I walked around the car the wind had taken my breath and as I struggled to breath and pump this gas at the same time, I knew I couldn’t do it. So I thought I’ll just open the car door and sit there a few minutes to recover only to realize the passenger doors were locked. Another customer was just leaving the station and I asked him if he could please pump my gas for me cause I had to sit down. So he said he would (it was already paid for) I slowly made it to the other side of the car and started to get in when the gas station owner came out and wanted to know if he should call an ambulance. I said no I just needed to sit down. I knew once I got to sit that the feeling of needing to urinate would become controllable. The purse lip breathing and talking myself into relaxing helped me recover. I must remember your ‘mindful exercise’. and try that. It’s very hard to NOT panic when I get breathless. Right now I’m retaining water and am on a water pill so needless to say……….I’m staying home right now. Thank you and God bless. ~Linda~

  • Barbara Moore moderator author
    3 months ago

    That is a volatile situation, with COPD and water pills. You will be floating without the bathroom close at hand. Thanknyou forbyou kind words. Barbara Moore ( site moderator and author)

  • nmjs
    3 months ago

    I am so grateful that this issue is being discussed! I also have found that most doctors haven’t heard of this—perhaps because it is very embarrassing and people don’t want to mention it. I’ve had urinary issues a couple of times, as well as the need to soil myself. It’s been a couple of years, but I remember feeling very clearly that I had to make the choice between breathing or losing control. Such a helpless, Humiliating feeling.

  • Barbara Moore moderator author
    3 months ago

    It is not your fault and I hoped to remove the stigma around this issue. Its just your body doing what it does. Thank you for commenting. Barbara Moore ( site moderator)

  • Janna
    3 months ago

    I am on 3 ltr continuous oxygen and any time I am up walking around for any length of time this happens to me, I get short of breath, I immediately have to urinate and eventually have to defecate too if I move long enough. My pulmonary doctor explained that with COPD any excertion makes it difficult for your lungs to distribute oxygen to the critical areas of the body it needs to function, brain, heart and lungs, so it is unable to extend energy to the bladder and the bowels, so it just lets them go, truly a survival mechanism. I never leave the house without deficating first if I can and I always wear a pad when I leave, just in case because sometimes I simply can’t make it in time. I always use a walker you can SIT on and in large stores I used their electric carts. I also have my own electric cart I carry with me so that I keep walking at a minimum. My biggest problem is that people who do not have COPD do not believe you when you describe different issues we have. My family believes most of the things I suffer with are “all in my head” that everything is a panic attack. When you can’t breathe, yes you do panic, but the issues that happen to me and other COPD people are real they are not in your imagination. Especially when you can’t catch your breath. Thank you for this article, so nice to read articles that definitely relate to me, it helps not being the only one…

  • Barbara Moore moderator author
    3 months ago

    Those are some great tips on management. Thank you for sharing. Barbara Moore ( site moderator and author )

  • DaveF
    3 months ago

    OMG. Well described. I have been through the EXACT scenario a few times. But now over a year since it has happened. I didn’t have the “ mindfulness” exercise. (Useful – I need to save). I now keep a bag in the car to breath in and out of for hyperventilating relief; haven’t had to use it. I think I’ve learned to pause and relax long before reaching that scary state. If I never go though it again, it will still be too soon. Again thanks for sharing. I expect others have had same experience.

  • Barbara Moore moderator author
    3 months ago

    Thank you for commenting and sharing your experience with the community.
    Barbara Moore ( site moderator and author)

  • Sesame
    3 months ago

    I am on oxygen 24/7 and have been there more times than I care to remember. Now, whenever I go out to run any errands, I make sure that my last stop is a place with a restroom and stop there before I leave whether I think I need to or not. I also carry a hospital urinal in the car and have used it in interesting places! (My “pipes” only work when I am standing, so it’s not as easy as you might think!)

  • Barbara Moore moderator author
    3 months ago

    Thank you for commenting. Nothing about COPD is as easy as it should be but glad you git it under control. Barbara Moore (site moderator and authur)

  • hdkrazee
    3 months ago

    Thank you for this article! I have a problem with, whenever I get home from somewhere, I immediately have to use the bathroom. I have to use a stair climber, which isn’t very fast. I usually end up urinating before I get to the toilet, and it bothers me. However, now I know how to try to handle it!

  • Barbara Moore moderator author
    3 months ago

    You may think of some personal protection as well. Thank you fir your comments. Barbara Moore (site moderator and author)

  • lynn2u
    3 months ago

    Thank you for this article. You are so right! Even Pulmonologists do not know about this! I learned about it through feeling it and researching it and understannding the physiology of it. And, I too, then learned that pursed lip breathing along with mindfulness meditatiion helped. In breath to a count of 2 and out through pursed lips for twice the length of time with ever increasing counts up to 4 in and 8 out until the urges subside. Thank God you had a walker. Stopping and sitting down is a must! I have had the unhappy experience of losing both so this article is very important. People need to learn the coping skills before they have the lose of continance experience!!

  • Barbara Moore moderator author
    3 months ago

    Thank you for your kind words and for responding. It is something we can all master if we can stay mindful and not get scared of it. Barbara Moore( sote moderator and author)

  • BobU
    3 months ago

    When I first told my Dr about this, he acted like he had never heard of it happening.
    Since there doesn’t seem to be a whole lot of awareness about this issue, I decided to call it “anoxic incontinence.”

    Being on supplemental oxygen doesn’t always prevent it from happening. I’m on 4L continuous and it still happens to me.

    Had to swallow my pride and use depends when I go out.

  • Barbara Moore moderator author
    3 months ago

    Hi BobU, thank you for commenting today. It is something that we have a hard time talking to doctor about and many never do. I am pleased that you are using the tools in your toolbox to keep you comfortable when you need it the most. Barbara Moore (site moderator)

  • nedra
    3 months ago

    Thank you for sharing this because I so share these feelings. I will say to get shortness of breath and the immediate feeling to urinate happens often, but does pass if I sit still and concentrate on breathing.

  • Barbara Moore moderator author
    3 months ago

    Hi Nedra it sounds like you have put some thought into this and have it under control now. Thank you for letting us know what works for you. Barbara Moore (Site moderator and author)

  • liz710
    3 months ago

    Thank you for writing this. I thought my problem was a new medical issue having nothing to do with COPD. Good to understand that I am not alone with this, but dont wish it on anyone. Thank you for the mindfulness exercises. I will write them down to use as needed.

  • Barbara Moore moderator author
    3 months ago

    Hi Liz710, I appreciate your kind words. Most people don’t mention it because it is too personal and like you they believe it has nothing to do with COPD. If you read the comments. many people think it is a issue of something else. Thank you for taking the time to comment. We appreciate every comment. Please feel free to reach out anytime. Barbara Moore (site moderator and author)

  • DK86
    3 months ago

    I’m sorry to say I’m not unfamiliar with this situation.
    Just a few weeks ago while on a walk I could feel the incontinence and bowels losing control. Instead of stopping I tried to slow my pace. That didn’t work. Ended up calling my wife and asking her to bring the car around and a bunch of towels. My advice is if you feel this coming on stop what your doing and focus on breathing. Don’t start again until feeling has completely passed.

  • Barbara Moore moderator author
    3 months ago

    Hi DK86, Your advice is right one. Thank you for commenting. I know too well how personal it is but it is not something to be ashamed of. It is just survival mode of our bodies. Barbara Moore (site moderator and author)

  • Mendo Bruce
    3 months ago

    I notice you didn’t mention using oxygen. The symptoms you are experiencing there are most likely due to desaturation. Are you one of those who is too vain to wear oxygen in public ? If so, you are doing yourself a great disservice.

  • nedra
    3 months ago

    I experience this often and wear oxygen.

  • Barbara Moore moderator author
    3 months ago

    Yes Nedra, this can happen even when we are using 02. I will often get short of breath even with 02 going. Learning to manage it is the key. Thank you for commenting today. Barbara Moore (Site moderator and author)

  • Barbara Moore moderator author
    3 months ago

    In fact I do wear 02 now on a regular basis. My doctor didn’t want me to wear it then and I always did as I was told.
    Funny thing was that as soon as I did start wearing 02, my employer no longer required my services.

  • Girs
    3 months ago

    Ah! This is me. When I mentioned the scenario, my normally highly informed GP confessed she had never come across it before, and therefore couldn’t explain it. This post has helped me understand why, when having breathing difficulties, usually accompanied by a panic attack, I have an all but overwhelming need to pee. Thank you.

  • Barbara Moore moderator author
    3 months ago

    Thank you for taking the time to comment. Doctors don’t hear about because their patients find it too personal to talk about it. Once you have the sensation of having to go….slow down and pace yourself concentrating only on your breathing. Barbara Moore (site moderator, author)

  • Leon Lebowitz, BA, RRT moderator
    3 months ago

    Hi Girs and thanks for your post. So glad to hear this article was of such benefit for you to read. We appreciate your input. All the best, Leon (site moderator)

  • Janet Plank moderator
    3 months ago

    Barbara, thank you for sharing, this does help others to realize they aren’t alone. I can relate to the UI. Your mindfulness exercise is something that could be useful in different situations and good to know. It’s sad, that no one stopped in your time of need. Maybe we need to carry whistles.
    Janet (site moderator)

  • Barbara Moore moderator author
    3 months ago

    Thank you Janet. I appreciate you saying that you resonated with the article. Barbara Moore (site moderator Author)

  • bksw48
    3 months ago

    I had this happen but could not get to the point of controlling the urges. By the time I was able to make it to the bathroom, I had loss all control of both bodily functions. Thank goodness no one was in the office yet. Still, I had to leave work and go home. Made up an excuse. It was awful. Never lost bowels before. Knew my COPD was getting much worse. Soon after I had to retire from my job, that I loved. Been on oxygen ever since. That was 2 years ago. This problem really needs to be discussed more! And, thankfully, it has not happened again with the bowel!

  • Barbara Moore moderator author
    3 months ago

    I hear you load and clear. It is extremely upsetting situation to be in especially when you are alone
    I too had to give uo my job shortly after this episode. Thank you for commenting
    We appreciate your feed back. Barbara Moore (site moderator & Author)

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