Five Stories That Should Make Every Pediatric PT & OT Uncomfortable (in a good way)
Why Pediatric Bowel and Bladder Health Belongs in Every Therapist's Toolbox
Are we still acting as if bowel and bladder health is someone else’s problem?
If we only focus on muscles and milestones, we’re missing the real, messy, life-changing work our kids desperately need.
AND WE’RE NEVER GOING TO SEE THE RESULTS WE’RE HOPING FOR.
It’s taken me a few (many) years to get here, but I truly believe that ignoring the gut is harming our kids, and it’s time to shout to the world about it.
Why Now?
Because first and foremost, the kids and families struggling continence and constipation are seriously impacted (excuse the pun) and although it’s true that we should have helped them get it sorted years ago - NOW is the next best time.
And the best person to help us do that is Dawn Sandalcidi, PT, RCMT, BCB-PMD
Dawn is a pioneer in this work and I have been so privileged to be able to work with her as one of our Clinical Excellence Online (CEO) experts.
I could make a long list of the things she has helped me see - that were honestly hiding in plain site, but the first thing I had to learn from her (and she’s so great at teaching it) is to not feel weird talking about pee and poop to families and colleagues.
So now, totally reformed and comfortable in this space, here’s 5 stories that should make you uncomfortable. Not because we’re talking about pee and poop, but because we’ve all had kids like this and it’s uncomfortable to think that we may have missed some huge opportunities to help them, simply by reaching out to Dawn and other therapists experienced in this area of work.
Uncomfortable is good!
Most times we need to get pushed out of our comfort zone to make changes for the better, and these stories will make you feel uncomfortable about not taking action. They are inspiring, motivating, mind blowing and life changing (and I’m not exaggerating).
Tell me if it doesn’t give you that loving nudge to reach out to Dawn to pick her brain and absorb some of her wisdom!
You can do just that! Just Click HERE to join us
1. The Persistent Wetting Mystery: “They Poop Every Day-So What?”
This 7-year-old was seen by every specialist under the sun and still struggling with wetting accidents. Mom (a nurse!) and the therapist were convinced constipation wasn’t the issue. After this child was pooping daily, no pain, no smearing.
But value of years and years of clinical experience meant that Dawn saw something nuanced in the case history and suspected otherwise.
Sure enough, scans confirmed her suspicions.
Dawn goes on and on about this and this story really brings it home » daily poops don’t mean a child isn’t constipated, especially when other symptoms persist.
Have a listen to see how they addressed this and the fabulous outcomes they saw
2. The Spinning Top Urethra: When “Try Harder” Isn’t the Answer
A 9-year-old with seven outfit changes a day.
Think about how this impacts quality of life.
Even though the family and medical team doubled down on constipation treatment, the wetting was getting worse and the team was stumped.
Dawn cut through the noise and called a rare diagnosis-spinning top urethra - none of the specialists had picked this up but when mom had the info she needed to take to the team from Dawn - the diagnosis was confirmed.
It’s such a win for the family and reminder of the value of clinical wisdom. We are the one that spend the time understanding the whole picture for the family, and when we team up with an expert who spends ALL her clinical time on this topic - it’s not really surprising that it’s the therapists who figure it out!
3. The Night Wetting Breakthrough: “Almost” Fixed Isn’t Fixed
A 13-year-old with endless night wetting, even after textbook-perfect therapy and GI protocols. The specialists had discharged and recommended behavioral interventions - but the therapist was not ready to give up?
One CEO session with Dawn and the missing puzzle piece surfaced. One tweak to the program and for the first time this child was having success with being dry.
Sometimes being satisfied with “almost there,” is not good enough. Real change by real expert collaboration changes lives.
4. Avoiding Surgery: The 4-Year-Old Who Didn’t Need a Colostomy
This story is so important to pay attention to.
A 4-year-old lined up for a colostomy!!
Such invasive surgery because the team had not been able to manage significant chronic constipation and where reaching for last resorts. Working with the therapist, guided by Dawn, this child is out of nappies, off laxative and did not need surgery!
Life changing is an understatement…
5. A Wake-Up Call: “I Didn’t Know What I Didn’t Know”
When an uber experienced therapist says she didn’t know, it gives us all permission to be a little kinder to ourselves - but also to step up and take note.
You can’t know that you’re missing a big piece of the puzzle when you don’t even have the right puzzle in front of you.
Working with Dawn was a transformative experience for this six-year-old with severe dyskinetic cerebral palsy experiencing unexplained pain and distressing episodes.
Addressing chronic, severe constipation that had been present for decades produced unexpected wins.
Huge wins!
Decreased tone, better sleep, better regulation!
Better motor function!!
Dawn’s expert guidance on fluid intake, bowel clean-out, and collaborative care led to dramatic improvements. Bowel health was a crucial gap in treatment for this child but like so many of us do - we just assume that difficulties managing bowel and bladder are just part of the CP picture.
Ie we’re not asking the questions that need to be asked - and its so within our wheelhouse to support families with these simple bowel and bladder strategies- or look for more expert answers when we need to.
Kids can’t thrive if their basic body functions aren’t working-and neither can their families.
You don’t have to be an expert to make a difference. Start by asking the right questions. Get curious. Partner with specialists when you need to. And never underestimate the power of looking beyond what you’ve always done.
We owe it to our kids to see the whole picture-not just the muscles, not just the milestones, but the messy, real-life stuff that makes or breaks their quality of life.
If you’re a therapists who isn’t afraid to ask, “Could this be a bowel or bladder issue?”
Then come join our live Zoom workshop » An Ask-Me-Anything with the amazing Dawn Sandalcidi
You’re not alone in this. I’ll be there asking questions too.
And honestly? The changes you might make from the things that you learn are bigger than you think.
Ready to talk about the stuff nobody else wants to? Good. That’s where the real change starts.
Listen to Dawn’s WiredOn Development Interview HERE