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Too Embarrassed to Ask?

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Dear COPD Coach,
I have a rather embarrassing question to ask you. I was diagnosed with moderate COPD just a few years ago. While I am still able to get around fairly well and am just on oxygen at night, I have noticed that lately when I get out of breath during activity I get this huge urge to either urinate or have a bowel movement. Sometimes this urge is over-powering and I am embarrassed to say that it has on a couple occasions resulted in having an “accident.”

My first question is why this happens, and secondly, what can I do about it?

-Need To Go

Dear Need To Go,
This problem is fairly common with those with respiratory problems and often one we do not discuss outside our COPD circle of friends. What is actually occurring is that when you get out of breath, your brain goes into (for lack of a better term) survival mode. In this mode, the brain triggers blood to the most essential organs that must keep working for us to remain alive. Unfortunately, this does not include the bladder or sphincter muscles. The result is the sudden need to either urinate or have a bowel movement. Often times after experiencing this urge, when you are finally able to eliminate, you might be somewhat surprised how little is actually eliminated.

Panic with COPD With that said, there are some things you can do. Personally, my COPD philosophy is that I have never met a restroom I didn’t like, and rarely pass up an opportunity to visit when I am out and about. In fact I have gotten in the habit and become somewhat an expert in scouting out locations of convenient restroom facilities. While use of the facilities whenever possible does not reduce the urge to eliminate, it does significantly reduce the chances of a major accident!

Since I travel in excess of 100,000 miles a year this has become a major concern - especially in airports. Just before boarding, and often times before deplaning, I make it a point to use the restroom whether I feel the urge or not. Since regaining my usual oxygen saturations after a flight takes a little time (even though I use oxygen), I find that making my way up the jet way incline often causes me to get out of breath, so it just makes sense to anticipate what is most probably inevitable. I have spoken with others in similar circumstances who tell me when they anticipate excursions that might cause them to get short of breath they actually use adult incontinence products. There are new products becoming available all the time, most with very little bulk, so you can be reasonably assured that nobody will know but you.

The other thing I have found is that the quicker I rush to find a bathroom, the more I get out of breath and consequently, the greater the urge “to go.” In many cases I find that if I stop, relax and concentrate on regaining my breath, the urge often subsides. This only really works when you first sense that you are getting out of breath, and the urge to eliminate is not really strong.

Avoiding beverages, especially those with caffeine or alcohol prior to and during situations where you might get out of breath can really help. I find that if I avoid beverages prior to and during a flight, the urge is not nearly as bad.

The important thing to remember is that while this problem might be embarrassing, it is something that often you do not have a lot of control over. The important thing is not to go into a panic mode as that will often cause the problem to get worse. Plan ahead, use facilities when they are available, avoids liquids when out and about and you should not experience any unpleasant situations.

Best regards,
-The COPD Coach

Ask the Expert is aimed at providing information for individuals with COPD to take to your doctor, and is not in any way intended to be medical advice. If you would like to submit a question to the Coaches Corner email us at We would love to hear your questions and comments. You can address your emails to any of the following: COPD Coach, Caregiver Coach, COPD Doctor or COPD RT.


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  • And check your pulse oximeter!! When mine hits '90' and my pulse is over 105, I know the urge is about to happen.....I stop and do PLB slowly to raise my sat and the urge resolves. Each person is different. It is not always when you are short of breath, but you can have a low sat for other reasons and the urge will be there. I always carry a pair of underpants in my purse. It happens to men too.
    • Thank you! I never thought of that but will give it a try starting today!

  • Thank You soooo much for addressing this little issue need to go, as I asked my pulmo dr about this... he kinda snickered and said he never heard that one before. I am starting to think I need a new pulmo dr. as he has also told me i will not, period...progress with this disease of COPD since I stopped smoking, but it is ok to try to work in construction as I have for 30 yrs.
  • Thank you for discussing this problem. I have become quite familiar with the incontinence products in the last few months. Thanks for these other suggestions. This has been very helpful with the most embarrassing part of COPD.
    • Thank you for asking the question Donna. I never associated incontinence with Copd

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