DEAR DR. DONOHUE: Our grandson soon will be 15. He still wets the bed. His parents have done everything from pills to alarms, but nothing helps. Sometimes he gets depressed, and that scares us. He says he will never be able to have a relationship with a girl. Sometimes we worry that he will hurt himself. Is there anything that can help this situation? — W.M.
ANSWER: I feel deeply for your grandson. No one can understand the isolation and hopelessness he has to grapple with. He could stand professional counseling. Perhaps a few facts will help him. Between the ages of 5 and 6, 15 percent to 20 percent of children are still wetting the bed. Of that number, every following year, 15 percent will stay dry during the night. By age 18, only 1 percent to 2 percent of these youngsters are still battling the problem. Your grandson has three years in which his chances of gaining control are good.
The problem of bed-wetting appears to stem from a brain that doesn’t respond to a full nighttime bladder by rousing the sleeper. It might be a delay in developing that response. Or it might be a delay in the attainment of a large enough bladder capacity to hold nighttime urine production. Or it might be that these children produce too little of the hormone vasopressin, which suppresses nightly urine formation.
Your grandson can once more try things he probably has already tried. He should measure carefully how much fluid he drinks in one day. Once he learns that number, he should drink 40 percent of the total in the morning, another 40 percent in the afternoon and limit fluid to 20 percent of the daily total from 5 p.m. on. He can increase his bladder’s capacity by holding off on urinating during the day. If he delays each time by five or 10 minutes for one week and then gradually lengthens the delay in following weeks, the bladder will stretch. This takes time. He has to be patient.
Alarms can work. They sound or vibrate when the first few drops of moisture touch them. It can be as long as six months of use before the training takes hold.
For occasions when he is invited to stay at other people’s homes for the night, desmopressin, as a pill or nasal spray, slows nighttime urine production.
DEAR DR. DONOHUE: I am so concerned about our grandson. He is a senior in college. He felt he couldn’t focus well enough on some of his difficult classes. He went to a doctor and was put on Adderall.
I am so worried that he will become addicted. Should I be concerned? — R.G.
ANSWER: Adderall is a drug of the amphetamine family. It does have the potential of leading to dependence. However, it’s been used for so many years for the treatment of attention deficit hyperactivity disorder that it can be well managed and not present a danger.
The doctor who prescribed the drug is responsible for monitoring how it is used. He or she will continue writing for its use only if it’s safe to do so.
I sincerely believe you do not have to worry yourself about your grandson.
Readers may write Dr. Donohue or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. ©2011 North America Synd.