For 17 years Nancy Lepard lived with the frustration and embarrassment of a problem many people decline to talk about, even with their doctor.
She had a hard time making it to the bathroom on time.
Ever since she had a section of intestine removed in 2000 to treat a serious case of diverticulitis, her bowel has been fickle. Taking Imodium and eating a high-fiber diet—treatments that help some people—made no difference for Lepard, 81, a spunky retired daycare provider.
Fecal incontinence controlled her life. It dictated her schedule. With an utterly unpredictable digestive tract, she resorted to staying put all day in her home near Hastings, Michigan, for fear of an accident.
“I’ve had to leave church, or I’ve had to leave a person’s house, because I’ve already ‘done the dirty work,’ you know? And that’s just the way it was,” she said. “I never knew when it was going to hit.”
These episodes would leave her in tears, especially when they caught her off guard, away from home.
Only in the evenings did her intestines settle down enough to allow her to venture out.
This meant no lunch dates with friends. No road trips with Hillis, her husband of 64 years. No morning church services.
“It was awful,” she said. “Here I am almost 82 years old and I thought, you know, am I going to have to live the rest of my life like this?”
A hard way to live
By 2017 she’d had enough. Now the problem wasn’t just fecal incontinence but urinary incontinence, too. Desperate, she asked her doctor for help.
Dr. Platte assured Lepard she could help. She told her about an implantable device called InterStim, a neurostimulator that’s like a pacemaker for incontinence.
The system uses thin wires to send gentle electrical signals to the sacral nerves, improving control by regulating the brain-bowel and brain-bladder connection. The device is implanted below the waistline, in the side of the buttock. A handheld programming device lets the patient adjust the electrical pulses as needed.
Lepard and her husband were skeptical. Surgery to place wires near her spinal nerves? Could it really help her incontinence? And would her insurance cover it?
Dr. Platte urged her to do a five-day trial wearing an external device. If the trial is effective, she said, an implanted device is likely to work well, and insurance is likely to cover the implantation.
Dr. Platte won them over.
“She said, ‘I’m telling you, Hillis, this is going to make an amazing difference in your wife’s life,’” Lepard recalled.
The doctor’s prediction turned out to be correct. Two days into the trial, Lepard became a believer. She loved it. The trial device helped so much she didn’t want to return it.
A week or two later, insurance approved her for the surgery, and the next month—May 2017—Lepard returned to Spectrum Health as an outpatient to have the InterStim system implanted.
The change in Lepard’s life was almost immediate, and she hasn’t looked back. Now she can go shopping and get together with friends. Once a month she meets a group for lunch.
“I am thrilled. It’s given me quality of life,” she said. “I can’t imagine not having it.”
For Dr. Platte, seeing this kind of change in a patient’s outlook is one of the most gratifying parts of her work.
“I honestly believe for older women to have a vital social life is very important,” she said, citing a high rate of depression in the older population. “When a woman cannot leave the house because of urinary incontinence or fecal incontinence, it actually makes depression even worse.”
In addition, the InterStim system can help prevent serious injury, Dr. Platte said, by limiting a patient’s need to get up in the night to use the bathroom.
“If you have that fecal urge to go all the time, specifically at night, many women can fall, because older people are not as stable.”
The implanted device also saves patients money by reducing their use of absorbent products—something Americans spend billions of dollars on every year.
Women are more predisposed to fecal incontinence than men, according to Dr. Platte, whose clinic treats women only. Men can also be InterStim candidates.
The InterStim system isn’t 100 percent effective, and it does have drawbacks, Dr. Platte said. For example, patients with the device cannot undergo an MRI below the head. And the implanted battery needs to be replaced every five to eight years.
As Nancy sees it, the potential downsides are nothing compared to her newfound freedom. She encourages others not to suffer in silence.
“It’s not an easy subject,” she conceded, “but if they could (talk to their doctor), they could get the help.”
That’s why she’s willing to share her story so publicly.
“If I can help other people, that’s what I want to do.”