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Why Jayme Didn't Go To Camp

My kids just left for summer camp. Chatting with my mother-in-law the other day, I asked if her kids had ever gone to overnight camp when they were younger.

"Sure," she said, "Margaret and Debbie went. Bruce went." And she stopped there. She didn't mention her other son, Jayme, my successful, charming forty year old brother-in-law.

"How come Jayme didn't go?" I asked. Was he adopted, I wondered? Did he have some crippling disease as a young boy?

"He was a bed-wetter," she told me, loosing this family secret on someone she should have known would put it in every newspaper in which he could get printed.

"Back then," my mother-in-law told me, "the doctors just told us he was a heavy sleeper and he'd grow out of it. But he didn't grow out of it until he was in his teens. We rented this thing they put under the sheet. As soon as it got wet, a bell would ring. Well, it'd ring and everybody would wake up. Everybody but Jay. It was terrible for him. He didn't go to overnight camp. And he didn't sleep over friend's houses. It was embarrassing. Kids can be cruel."

The emotional trauma that Jayme grew up with is not uncommon. Night-time bed-wetting, also known as nocturnal enuresis, is a problem for one out of every seven children between the ages of 5 and 6 years old. A surprisingly large number of children, nearly 10% over 8 years old, wet the bed at night. Three and a half million kids in the U.S. are bed-wetters. And boys are affected nearly twice as often as girls.

Bed-wetting that occurs after toilet training is not a disease in very young children. Accidents are expected. Even early school age children have occasional accidents. But everyone - parents and peers - expects a child to be dry by the age of eight or nine. After that age, nocturnal enuresis can wreak havoc on a child's life, as well as his family's.

There are a lot explanations for bed-wetting. Blame has been placed on emotional problems, developmental delays, urinary tract abnormalities, allergies, a hormone deficiency, and "deep sleep." In individual cases, one or more of these factors may be the cause. But I like my mother-in-law's explanation of her son's problem the best.

"The little nerve in the head that says, 'Ding-ding! Wake up! You're bladder is full,' doesn't work."

After any clear anatomical or pathological problems are ruled out, there are several treatment options. Most doctors don't recommend treatment for 6 year olds. But for 7 year olds, pajama moisture sensors that awaken the child when he wets may be recommended. This is a behavioral modification approach that can take months to produce results. Quicker and more effective are drug treatments. Tricyclic antidepressants like imipramine have been reported to have success rates up to 50%. How it works isn't clear. Another drug, desmopressin, has an even greater success rate. This drug works on the theory that bed-wetters have a deficiency of the hormone that the body secretes to save water. This hormone is supposed to increase at night to help the kidneys conserve urine and reduce the filling of the bladder during sleep. Recent medical studies have shown that levels of this hormone fail to rise at night for many bed-wetters. Adding this hormone, which can be prescribed as a nasal spray, can alleviate the problem by correcting the deficiency.

Despite today's medical options, many parents never seek help for their child's nocturnal enuresis. Many attempt to correct the unacceptable behavior of bed-wetting by a variety of methods that border on psychological child abuse. Some use physical punishment. Some shame and embarrass their children by publicly displaying wet sheets or making the child wash the dirty linens. More often than not, a child's psychological problems are due to, and not a cause of, bed-wetting.

Jayme turned out to be a great guy, though sadly he never got to go to camp. But today, a child with the same problem can pump a desmopressin spray in his nose, stay dry all night, and just be one of the guys in the bunk.