Saturday, September 8, 2007 

Incontinence: A Taboo Subject

Urinary incontinence or loss of bladder control. Its not at all uncommon and no one really wants to talk about it. Seeing the television commercials are a big step, yet talking about it remains something that might be whispered about behind closed doors. Chances are, your medical provider may not even talk about it. Its been my experience that when women are asked, they are often so surprised that an answer does not appear until a few visits later.

One brave woman opened up an asked this question in a womens forum:

Let's talk about kegels. Or rather, incontinence. I know, it's a very delicate subject, and I have frequently been embarrassed, ashamed, etc. about this little problem. For one thing, I didn't think I'd even face this until into my 80s or so. I'm too young to have to wear pads every day. I do kegels, when I think about it. I'm probably 10 pounds overweight, most of it in my belly and thighs. I don't have health insurance, so getting that little 'tie-up surgery is out. And besides, my little sister had that done and 6 years later, it's no longer effective. Anyone else struggle with this?

So, lets talk about urinary incontinence (UI) in women. To begin with, there are several types, but well focus on the two main ones here.

Stress urinary incontinence (SUI) (thats the kind that occurs when you sneeze, cough, lift something, etc) is the most common form, affecting about 50% of those who experience incontinence. It seems to be more common in younger women, though occurs in older women as well.

Urge urinary incontinence (UUI) is more common with advancing age (this is the kind that when you gotta go, you GOTTA go NOW!). Many women will have a mixture of both.

There are various causes, but interestingly enough; studies have been inconsistent in identifying factors that regularly contribute to UI. Some contributing factors may include:

  • childbirth the more vaginal deliveries, the greater the overall risk
  • current smoking status as been associated with UI (though the results are inconsistent in former smokers)
  • obesity (it does improve with weight loss)
  • constipation
  • hysterectomy Some studies show a 60% greater risk of UI following a hysterectomy.
  • hormone therapy (A recent study showed that hormone therapy actually has been shown to increase the incidence of UI. JAMA. 2005;293:935-948.)
Kegels become and important part of treatment with SUI since frequently the pelvic floor muscles are weakened. Just like we need to do strength training for our overall health, we need to do pelvic muscle strength training to support our bodies.

When doing Kegels, it's important to make sure you are doing them correctly. To identify the correct muscles, sit on the toilet and try and stop your urination. You may notice that your attempts at stopping urinary are ineffective...well those are the very muscles you need to work on. Use this as a bench mark for yourself and re-test yourself weekly.

Kegels must be done several times each day. Fortunately, they can be done anywhere and no one need know what you are doing. When they are done frequently enough, most women will be able to tell a difference. In addition to the contractions, try holding the muscle tight for a count of 8-10.

Other possible treatments include: behavioral modification therapy using biofeedback, physical therapy using weighted cones to help strengthen pelvic floor muscles, bladder training, acupuncture, medications and surgery.

Treatment often takes a multi-pronged approach beginning with an evaluation to discover the exact type of UI that is present (they have different treatment approaches). Often times, treatment will consists of a few different modalities.

For women who wish to try self treatment first, do consider doing kegels, and increase your fluid intake. While that sound counter-intuitive, concentrated urine, along with caffeine are actually bladder irritant and will make the problem worse. Keep a diary to assess how often this is a problem, what may be some contributing factors, and what you are doing to address the problem. When you do see your health care provider, take this diary with you.

If you are faced with this issue, please do see your health care provider for an exam. Left untreated, it generally does not get better on its own, but can improve with the proper treatment.

2005, Barbara C. Phillips, Nurse Practitioner and founder of OlderWiserWomen inspires women to embrace the freedom, magic and wisdom of Successful Aging. Visit http://www.OlderWiserWomen.com for your copy of "Celebrating You: 50 Tips for Vibrant Living".

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Where Do Great Ideas Come From?

At a Photo Club meeting I attended recently, the President made a comment on another meeting he had attended, where someone in the audience asked the presenter where to find good subjects to photograph. The presenter in question started giving specifics instead of identifying the core issues in question, Attitude and Perspective.

Clients often ask me the same question about ideas, Where or how does one come up with a good idea for a business or service, for a new product to develop or a theme for an ad? Oddly enough, the answer is the same; it depends on your attitude and perspective because inspiration is everywhere. Everywhere around you, there are clues to great ideas but you have to be receptive to see or hear them. Once you are open to really listening and observing, you tend to notice things you werent aware of in the past. Its sometimes uncomfortable to look at the world around you and respond to it differently than others do, but it can be very rewarding.

Is the world around you a place of abundance and opportunity or a difficult barren place? Do you think of life as a constant struggle or an adventure?

Take a look at www.MixZup.com. This retail concept is an idea that originated in a three-year-olds mind. The important point is that Julias mother Lynne was someone who did not patronize her daughter by saying, Isnt that cute. and then telling her to put on socks that match. She really listened to her daughter, considered the factors that prompted Julia to express her individualism by wearing socks that do not match and recognized it as an opportunity. Children, with their ability to think outside of the limitations most of us have developed and placed on ourselves as adults, are great at coming up with innovative, unconventional ideas.

To get back to the example of the photographer; often businesses tell me they need photos and their son, daughter, or spouse has an expensive camerathat's great, but its not about the equipment. Its about the eye behind the camera and the ability to be open to recognising a great shot.

It doesnt matter how much business training or ability you have if you use it as an excuse to stop listening and observing. If you close your eyes and ears to the opportunities around you, you are limiting your life, not just your business opportunites.

How many successful businesses would never have gotten off the ground if the owner considered the fact that they had no business experience or no money?

Today, make a decision to think of business as a series of adventures and ideas waiting to be implemented.

First Ponder, Then Dare

Nancy Fraser is the President of Nota Bene Consulting. Her business experience encompasses over 20 years in media sales and management, ownership of a retail store and involvement in the real estate industry. Free marketing information and tools are available in Notable News http://www.notable-marketing.com

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