FARGO, N.D. — Barbara Johnson's life as she'd known it ceased to exist for a reason that she once tried desperately to hide.
As happens to some older women, especially those who have given birth to children, she was plagued by incontinence. Her condition became so severe that she avoided venturing outside her home once she retired.
"I was pretty much housebound," she said. "It was just a devastating and degrading situation in my life."
In Johnson's case, her incontinence was fecal. Because of muscle deterioration, she lost control. The inevitable result was embarrassing accidents and frantic rushes to public restrooms.
"I couldn't go shopping," she said. "To get outside of the house was a challenge."
Johnson, 67, who lives in Detroit Lakes, Minn., used to work in office support in Moorhead, Minn. Sometimes she would have to leave work early in the event of an accident.
Once retired, she almost became a hermit, relying on her husband and friends to run her errands. The limitations on her life made her desperate. She lost hope and fell into depression.
"I was ready to drive my car into a tree," she said. "I didn't want to live."
Johnson was tested for intestinal infections and other ailments, but doctors couldn't find a solution to her problem — until an implant procedure became available a few years ago.
In an outpatient procedure, Dr. Bhargav Mistry, a surgeon at Sanford Health, implanted a device called Interstim, made by Minnesota firm Medtronic. The implant, which was approved earlier for urinary incontinence, stimulates a sacral nerve that controls the muscles on the pelvic floor.
Using a remote control, Johnson is able to adjust the electrical current that stimulates her muscles to work as they should — and restore normalcy to her life.
"It started working right away," Johnson said. "I have complete control over it now."
Mistry has implanted 61 of the devices in patients ranging in age from 35 to 91, most of them older women. He said he carefully screens patients to make sure they are good candidates for the procedure, and as a result has a success rate of about 90 percent. Sometimes an infection will require him to remove the device and replace it, after the infection clears.
"No damage done," he said, since the infection is local.
"I really like this procedure," Mistry added, noting that it makes such a big difference in patients' lives and comes without the need of general anesthesia.
Besides restoring bowel control, the implant reduces urgency, giving the patient more time to get to a bathroom.
Johnson, who once did her best to hide her problem because of embarrassment, decided she wanted to tell her story in the hope she can help break down the stigma and make those suffering from incontinence know there could be a solution for them.
"Naturally, I didn't want to tell too many people because it was embarrassing," she said.
Because of embarrassment, the problem of incontinence is underreported, underdiagnosed and undertreated, Mistry said. It's a conversation many patients are afraid to have with their doctors.
A study last year published in the journal Obstetrics & Gynecology found 7.2 percent of women between the ages of 30 and 90 had fecal incontinence, defined as occurring monthly, and often cases were associated with old age, urinary incontinence, major depression and other illnesses.
Because of its hidden nature, the prevalence of the problem is hard to quantify, Mistry said. But, he added, the tall stacks of adult disposable diapers in big-box stores hint at the scope of the problem.
Johnson, meanwhile, is grateful to be able to come and go as she pleases. She's even able to travel to Latin America for mission work through her church, something she couldn't imagine doing before her procedure.