Your bladder can be a lot of things - flaccid, neurogenic, neurotic, incompetent, incomplete, reflexive, spastic… the list just goes on and on. So which one of the list above doesn’t belong, which one isn’t like the rest?
I’ll give you a minute to think about that. No Googling the answer.
So did you guess incompetent? I did (and I was wrong). It’s a trick question. They’re actually all possible adjectives for your bladder’s behavior. So in the interests of a little public education, I’ve pulled together the definition of each of these common bladder adjectives for your reference.
- Flaccid - a bladder that is unable to contract sufficiently to empty. It may be secondary to neural deficiencies or chronic obstruction. The bladder can be emptied by pressure applied to the area or via catheterization. Also called atonic bladder, autonomous bladder, nonreflex bladder.
- Neurogenic - Neurogenic bladder is a dysfunction that results from interference with the normal nerve pathways associated with urination. There are two categories of neurogenic bladder dysfunction: overactive (spastic or hyper-reflexive) and underactive (flaccid or hypotonic). An overactive neurogenic bladder is characterized by uncontrolled, frequent expulsion of urine from the bladder. There is reduced bladder capacity and incomplete emptying of urine. An underactive neurogenic bladder has a capacity that is extremely large (up to 2000 ml). Due to a loss of the sensation of bladder filling, the bladder does not contract forcefully, and small amounts of urine dribble from the urethra as the bladder pressure reaches a breakthrough point.
- Reflexive - Reflex bladder is also known as spastic bladder. It occurs when the stretch receptors in the bladder wall are triggered from a full or filling bladder sending signals to the brain and spinal cord to relax the sphincter muscles. This is an automatic involuntary action, and the person has no control over when the bladder will empty. Sometimes the sphincter muscles will not relax properly when the bladder contracts, and this can lead to a condition called Dyssynergia. One danger of dyssynergia is that it can lead to an overfull bladder, which could damage the kidneys from a reflux of urine.
- Neurotic – an outdated term for patients with a history of neurosis that center on the bladder. It can also be called irritable bladder. Key symptoms include: worry and anxiety focused on bladder activity, pain while urinating, nervous spasms of the urethra and bladder neck, persistent feeling of weight over the pubic region.
- Incompetent – A disorder of the sphincter muscles that restricts the functionality of the muscles that contract and release to control urination. Predominantly found in women who have had multiple vaginal births and men with enlarged prostates.
- Incomplete – A function of Underactive Bladder Syndrome (UAB). UAB is a urological condition characterized by bladder underactivity causing difficulty in voiding, resulting in incomplete bladder emptying. The International Continence Society (ICS) refers to the condition of detrusor underactivity, defined as a contraction of reduced strength and/or duration, resulting in prolonged bladder emptying and/or failure to achieve complete bladder emptying within a usual time span. Bladder underactivity may cause overdistention of the bladder, resulting in overflow incontinence.
- Spastic - a form of neurogenic bladder caused by a lesion of the spinal cord above the voiding reflex center. It is marked by loss of bladder control and bladder sensation; incontinence; and automatic, interrupted, incomplete voiding. It is most often caused by trauma but may result from a tumor or multiple sclerosis. Also called automatic bladder, reflex bladder.
Any adjectives I’m missing? Put your entries (and their definitions) in the comments section!
We’ve talked quite a bit about how to talk about incontinence and the importance of addressing the stigma of incontinence in society. Incontinence is a symptom of a medical issue, not a standard part of life, no matter your age. So we’re thrilled to share the article below from the Mundelein Review!
They interviewed our pal, Cheryl Gartley, CEO of the Simon Foundation for Continence! See full article here: http://mundelein.suntimes.com/opinions/17855744-598/taking-stigma-off-incontinence.html
Watching daytime TV, and all of the commercials for incontinence products, one might think that incontinence is a normal part of life and aging.
While television commercials do help in decreasing the stigma attached to incontinence, it is still a very sensitive subject and experts say that is not something that individuals should just live with.
“Incontinence is a symptom of something else happening in the body,” says Cheryle Gartley, CEO of The Simon Foundation for Continence, based in Wilmette. “As we age there are changes in the body. That very fact can make [seniors] more susceptible to incontinence.”
Gartley says that talking about incontinence can be challenging for many people, but she believes that it is so important for seniors, and others, who experience symptoms of incontinence, to talk with their physicians so that the underlying reasons can be explored.
“Incontinence is a generic term for the way that the bladder is misbehaving,” Gartley said. “Specifically say what is going on to your doctor. Do you leak urine when you lift your grandchild or when you sneeze or laugh? That is one set of circumstances that indicates stress urinary incontinence.
“Do you have a sudden urge to urinate and it may or may not be associated with leakage? That’s overactive bladder and that’s caused by something different in the body.”
She also says that there is a lot of misunderstanding about issues relating to incontinence and the bladder. “Most people do not understand that the bladder is a muscle. They think of it as a vessel. That misperception leads to some things that aren’t good for the bladder.” Gartley said that when someone stops to use the bathroom when they do not have the urge, but are going “just in case,” it can actually create problems, rather than helping. “If the bladder never gets the chance to fill to its full capacity, like any other muscle that isn’t used, it doesn’t get the chance to do the job it was designed to do and you increase the chance of a misbehaving bladder.”
Gartley also understands that people may be embarrassed to talk about incontinence problems. She says although it may be difficult, it’s important to remember that physicians and nurses are used to these issues and they are trained to help.
“We’ve done work on stigma a lot in health care.” said Gartley, who started the Simon Foundation 30 years ago because of a personal experience with incontinence. She started to look for help herself, and couldn’t locate any support. Shortly after starting the organization they were featured in an Ann Landers column. A few days later they received a call from the post office: 30,000 pieces of mail from people impacted by incontinence had arrived. “The need was unbelievable,” she recalls.
The Simon Foundation just published a new book, “Managing Life with Incontinence,” to support families and individuals. Gartley says the book is unique because in addition to providing information about how to talk to doctors, family and friends and what resources are available, there are stories of individuals who actually are affected by incontinence. The Simon Foundation can be contacted online at www.simonfoundation.org or (800) 23-SIMON.
Quite a few of our customers are dealing with incontinence as a result of prostate cancer treatment, so we’re thrilled to be able to share the guest post below from Dr Charles Chabert of Laparoscopic Urology Australia. He specializes in laparoscopic surgery which may reduce post-surgical complications like incontinence. Not to cannibalize our own customer base or anything but, lifelong incontinence is something we wouldn’t wish on anyone. So here’s a little info to whet your appetite!
Robotic laparoscopic radical prostatectomy is performed on male patients with prostate cancer. Laparoscopic surgery is less invasive than open prostate surgery. The removal of the prostate gland is called a prostatectomy. Prostatectomy is the removal of all cancerous cells. Keyhole surgery is also known as laparoscopic surgery, which aims to be minimally invasive with the use of tiny surgical cameras. The cameras are placed in the body through small incisions. Laparoscopic instruments can be hand held by surgeons or a computer can control them. Advanced computer systems that are highly advanced will control robotic arms to perform the prostate surgery.
Prostate cancer or Adencarcinoma grows from the glands and is a group of cells. The cells produce and give off fluids and the cancer comes from these fluids. Cancer can also take on the form like a gland in structure. When cancer is detected in the early stages, most surgeons will perform the open prostate surgery. The problems patients face with the open prostate surgery are urinary incontinence and erectile problems. Almost 20 percent of men develop urinary problems and 70 percent of men have erectile problems that keep them from having an erection strong enough for intercourse five years after the surgery.
With the advancement of robotic laparoscopic surgery, patients will have fewer problems in these areas, because the surgery is less invasive and easier on the more susceptible areas of the body to heal.
Surgeons need to be highly skilled in order to do laparoscopic prostate surgery while holding the instruments. Some parts of the surgery are extremely difficult and delicate to perform. When performing robotic prostate surgery the robot does all the necessary cutting while the surgeon controls the robot through a computer. The robot does all the surgery but the surgeon does all the thinking and directs the robot for the operation. The surgeon directs the arm and wrist movements of the robot while seeing the images that are in three-dimensional form on the computer. This way the surgeon gets a very natural feel while directing the robot.
Robotic prostate surgery involves the insertion of six laparoscopic ports into the body. These small holes go through the body wall so the instruments can be placed safely. One of the ports is used for the insertion of a small camera for the surgeon to see what is going on with the surgery. Two more ports are used for the arms of the robot that will be doing the cutting and holding of body tissues. All three of these ports are then hooked up to the prostate surgery machine. The other three ports that were opened up are for any other laparoscopic pieces of equipment or for the surgeon to use if human hands are needed to work on the patient.
An extremely specialized computer is used that will control all the motions of the camera and the working arms of the robot, by the surgeon who sits at the console. The nurse and assistants that are right at the side of the patient on the operating table change the instruments that are used by the robot. The surgeon controls all the movements of the robot that is inside of the patient. The nurses and attendants will do all the other tasks that the robot cannot do on its own. The surgeon will control the robot using his thumb and forefinger on the controls and watching the images in three-dimension on the computer screen.
The robotic instruments allow for more movement, which gives the surgeon a better chance to do work that is more detailed during the surgery. The cameras take in depth images that are high quality three-dimensional so the surgeon can see everything clearly. The images can be enlarged up to ten times on the computer giving the surgeon precise control over all aspects of the surgery. With the magnified images, the surgeon will have precise movements with the robotic arms and nerve damage can be avoided.
Patients will have a reduced blood loss and transfusions are unusual for patients that have robotic prostate surgery. Patients will also have a shorter hospital stay and less discomfort after the surgery. Patients can return to their daily routines faster than with open radical prostatectomy surgery.
For more information on laparoscopic radical prostatectomies and other forms of prostate cancer treatments, visit http://www.prostates.com.au/.
An impromptu filibuster is an unusual event. And while we wish to remain entirely apolitical, I can’t help the spark that occurred when I read this morning that Senator Rand Paul’s impromptu filibuster was brought down in the wee hours of the morning by the persistent demands of his bladder. After 12 hours and 52 minutes, nature was calling and he simply had to answer!
When Strom Thurmond set the record for a one man filibuster (24 hours, 18 minutes) in 1957, he prepared well in advance. He intentionally dehydrated himself in the steam room to reduce the pressing need to visit the little boy’s room. He also had a little help from his colleague Barry Goldwater who took the floor briefly for a entry into the Congressional Record and allowed the Senator a brief respite.
Senator Paul did not plan quite so far in advance. Fortunately, there is no need for Senator Paul or any other gentleman to dehydrate himself in order to avoid the bathroom or to rely on the kindness of his colleagues. Instead he can use Men’s Liberty and attach it to a leg or bedside bag. With a wear time of 24+ hours, you too can have that competitive edge to beat the filibuster record.
In this spirit, today, we’ve sent a pre-filibuster care package to Senator Paul for the next time he takes the stage. We included 3 Men’s Liberty devices, a leg bag and FreeDerm remover wipes. Men's Liberty is a revolutionary new device for managing men's urinary incontinence that should easily allow him to beat Strom Thurmond’s record and set a new bar for Senators talking at length without actually saying anything. Senator Paul’s filibuster was the 9th longest in Senate history, but he’s a young man, with many more potential filibusters to come!
Senate Majority Leader Harry Reid, D-Nev., may not have agreed with the substance of Paul's remarks but, according to USA Today, he saluted the GOP senator for exercising his right to speak at length.
"One thing I learned from my own experience with talking filibusters: To succeed, you need strong convictions but also a strong bladder," Reid said. "Senator Paul has both." May neither of these gentlemen need to exercise their bladder to this extent in the future.
And for any other Senators out there, if you’re contemplating a filibuster, let us know!
You’d think we’d run out of questions after a while, especially since we do this every week. In actuality, not really. With a growing base of new customers and healthcare professionals joining the Men’s Liberty family, there’s always someone new with questions I’ve never heard before. So I have to tip my hat to our Customer Care Reps and our Customers who so consistently think outside the box in ways I’d never expect. I salute you!
1. Why doesn't the small pouch drain into the bed bag? I have to almost lay the bag on the floor to get it to drain.
The Men's Liberty utilizes gravity drainage, meaning the bag must be below your bladder in order to drain. From your question, it sounds as though urine is draining into the small bag but not into the bed bag, which can indicate that there is an issue with the bed bag or tubing. I suggest trying a different bed bag and seeing if the same issue occurs. I would also recommend checking all your tubing to ensure that it is not twisted or kinked. If none of these resolves the issue, please call our Customer Care team and we will work with you to troubleshoot the issue and make sure we get it resolved for you!
2. You say do not remove plug on bottom. How do I empty the urine from the bag if I don't pull the plug? The bag does not hold very much fluid. My first day I had to empty the bag every two hours.
If you are regularly producing more urine than the small pouch can handle, we recommend attaching the drain plug to any standard leg or bedside bag to ensure sufficient drainage. However, if you just dribble and leak, the small pouch may be enough.
So unless it is connected to another large drainage bag, it is important to keep the plug closed in order to prevent leakage.
3. You said that it is covered by Medicare and insurance. Are all supplies needed in the future also covered and how do you receive supplies?
Yes. Once we get a letter of medical necessity and progress note from your physician, our distributors can ensure reimbursement from Medicare and/or your insurance provider. Additional documentation for future orders is obtained annually in order to ensure continued reimbursement. Our Customer Care team will take care of all this paperwork for you so that you get your supplies when you need them.
4. You asked my doctor to sign a letter of medical necessity. What is that? Is it like a prescription?
It’s similar. A Letter of Medical Necessity (LMN) is slightly different from a prescription and it is not necessary to purchase the product. If you wish to pay cash, you can do that, unlike prescription items like Viagra. However, a LMN is required in order to secure coverage for the product under Medicare or your insurance plan.
5. I’m just getting out of the hospital and will have a home health nurse helping me for the next 6 weeks. I’d like to resume using Men’s Liberty but the home health agency doesn’t want to buy the product, what can I do?
First, glad to hear you are on the mend! Second, due to Medicare regulations, only one entity can bill Medicare at a time. During a home health episode that means that they are the only ones who can bill your Medicare so they have to purchase all products you will be using, including Men’s Liberty. Unfortunately, sometimes that means they want to use products they are more familiar with, such as diapers or condom catheters. If your home health agency is reluctant, feel free to connect them to our Customer Care Team. We are happy to inform them about the product, why people use it and the benefits they can see. Once they’re bought in, it’s a lot easier to get them to supply your choice of product.
And last, but certainly not least, you can always look for a different home health service. Although sometimes it’s hard to remember, you are the customer here and you have the power to hire and fire. If your current provider isn’t providing the level and quality of service that you need, look for someone else who will!
Well, we’re just back from Detroit and let me tell you, brrrrrr. For us Florida types, that was just NOT okay! But snow aside, it was a great trip and we’re thrilled to be able to announce that we are kicking off a new partnership with Eloquest Healthcare®, Inc.!
Eloquest will be promoting our new urinary management device in hospitals all over the US! So our CSO Wendy, and Head of Sales, Courtney, raced to Detroit for an in-depth training with Eloquest’s head honchos and sales gurus.
It was great to get to share some of the oodles of info we have about incontinence with a really compassionate, engaged audience. They really got it!
The gentleman below is Terp, the head of National Sales and as you can see, he looks very pleased with himself after he successfully applied the Men’s Liberty to an anatomical model. Terp was one of about a dozen trainers who learned how to apply the device and how Men’s Liberty can change lives.
So while we won’t be officially launching until July, we’re thrilled to be getting started! And, no kidding, there’s quite the mountain to climb. In 2009, there were an estimated 38 million hospital admissions, of which 25% received indwelling Foley catheters. An estimated 38% of those catheters were NOT medically necessary. So what does that mean in practice? It means that in 2009, roughly 3.6 million people were catheterized in hospitals for NO reason! Patients were put at risk for avoidable infections, endured extended hospital stays and thousands of dollars in added bills accumulated, without any medical justification. Add into that the number of patients utilizing adult diapers, bed pads and condom catheters and the costs just keep rising. Does that sound okay to you?
So that’s the challenge. And we’re looking forward to working with Eloquest to promote discreet, dignified, dependable urinary management in acute care! We’ll keep you all updated as we get closer to that July launch!
Eloquest Healthcare®, Inc. launched as a Ferndale Pharma Group company in February 2008. Eloquest Healthcare provides solutions that drive positive outcomes for patients, caregivers and hospitals while complementing existing treatment protocols. You can find more info here: http://www.eloquesthealthcare.com/
“Adaptive Sports! It felt like I was reborn. It was a new life.It is like day and night. When I saw wheelchair softball on the TV, I said 'I can do that!'. I felt the sun shine in my life again." Hector Bruno, Chicago, IL
Where were you born and raised?
I was born in Manati, Puerto Rico. My family moved to Chicago when I was 5 years old. I’ve lived in Chicago ever since.
Are you involved with adaptive sports?
Yes a lot! First, I started playing wheelchair softball. Then, I got involved with wheelchair basketball, hand cycling, and sled hockey.
How did you become involved with adaptive sports?
I have a spinal cord injury due to a gun shooting in 1980 in Chicago. For 7 years, I did not know about wheelchair sports and was having a really hard time with life. Then, one day I was watching tv and saw a commercial with Keith Wallace, the coach of a Chicago wheelchair softball team.
What has adaptive sports done for you?
Adaptive Sports! It felt like I was reborn. It was a new life. It is like day and night. When I didn’t know about adaptive sports, I did nothing for years and years. Then all of a sudden, I saw wheelchair softball on the TV and I said “I can do that”. When you try it, you get hooked. It‘s the best thing that’s happened to me.
What are your long term aspirations?
I want to spread the word about adaptive sports and ABC Medical. I want to get as many people involved in adaptive sports - the sooner the better. As soon as someone gets out of the hospital, they need to start getting involved. They should not have time to think about their situation and be devastated.
You recently started coaching children? How do you like it?
Yes, I coach the RIC Cubs team. It’s the junior team. I love to see the look on their faces when they catch the ball. The children are between seven to fifteen years old.
So they are either newly injured or just starting to play wheelchair sports?
Yes to both. The look on their faces is great. I regularly tell them “good, you’re doing a great job,” because it encourages them. They like playing a lot and are extremely happy. They are like little angels.
What is one thing that you wish people knew more about adaptive sports?
Adaptive sports provide great options for people. It helps you get to know people who are involved in sports. It gives you confidence and inspires you. It makes you the best person you can be and helps you move on.
How did you deal with the challenge of being in a wheelchair?
What would people be surprised to hear about you?
I love challenges. I moved forward. You see the challenge, move forward and get ready for a new challenge.
I am stubborn. I am very stubborn. I hate when people say “no” or “you can’t”. The more you say “no” to me, the more I’ll say “yes”; the more you say “you can’t” , the more I’ll say “I can”.
Do you have anything else you’d like to share with us?
My only message is to always think positively, never take bad advice. Listen to those who give good advice.
Can you explain what you mean by “bad advice”?
People say “you can’t do this,” “you can’t do that because you are in wheelchair.”
Are there people out there who give bad advice?
Yes, a lot of people give bad advice! People who are ignorant about people in wheelchairs always give bad advice. They make you feel more crippled than you really are. That’s unnecessary. Unless I ask your opinion, do not approach me and try to tell me what to do. I appreciate it, but no thanks.
For more information or the full interview, visit ABC Medical's blog!
A man walks into a doctor’s office for his monthly check up with his daughter. During the examination, the doctor asks how his nightly incontinence is.
"Its fine," says the old man. "I just get up and go to the bathroom, and God turns on the light for me."
The doctor finishes up the examination, and then calls in the daughter to tell her about the God-light thing.
"Oh, my God!" says the daughter. "He's been using the fridge again!"
I burst out laughing when I heard that joke. In our office you learn to be a connoisseur of incontinence and diaper jokes. It’s just how we cope. The truth is we talk about incontinence all day, so sometimes our sense of normal conversational boundaries gets a bit skewed.
I guess that’s why I sometimes still get surprised by healthcare professionals who don’t talk about incontinence with their patients. I always figured they spent their lives mired in blood work, strange abscesses and bladder problems, they had to be used to it by now!
Turns out, I was wrong. Most doctors don’t talk to their patients about incontinence. Whether it’s because of shame, embarrassment or obliviousness, it doesn’t happen nearly as often as it should. According to the National Association for Continence there are 25 million incontinent adults in America today – the notion that only a fraction of those people ever talk to their doctor about a treatable health issue is, frankly, kind of scary.
So, with those thoughts in mind, we’ve pulled together our top four tips for doctors when they need to ask their patients about the bladder.
#1: Incontinence doesn’t mean they have a problem with their bladder.
There are lots of medical and congenital conditions which can impair the physical function of a person’s urinary system. But most people’s incontinence isn’t caused by a physical impairment. Many older gentlemen simply can’t reach the bathroom in time or are losing the muscle strength to hold it. So change your expectations and understand that you aren’t limited to discussing incontinence only when its associated with another diagnosis.
#2: If there is a caregiver involved, ask them too!
As family members age, they may increasingly have a partner or caregiver go to the doctor’s office with them. They may also employ part-time care assistants to help with household chores. These caregivers are a resource for patients but also for their healthcare professionals. They can provide an objective response that may be more informed and may be able to recall events in greater detail. Additionally, if they are cleaning up after an incontinent person, they have a strong incentive to look for options without the embarrassment.
#3: If you see something, say something.
If you notice a patient is wearing a diaper or pad, say something! If you noticed dried urine stains on their pants, say something. If you smell ammonia or urine when you’re near him, say something.
Sensing a theme here? I know you may be uncomfortable, but I swear, it gets easier with time. And just know that your patient is probably even more embarrassed than you are. But that doesn’t make the conversation less necessary.
#4: Get informed on the options!
Great, you’ve started that conversation; your patient has a problem, now what?
It’s important to know what options are available for managing incontinence. It’s not just diapers and pads any more. There are healthier options that are covered by most private insurance plans and by Medicare. I won’t bore you with all the options here but I would recommend checking out the article below on incontinence management options.
And since you sat through all that, here is another incontinence joke:
Two elderly gentlemen from a retirement center were sitting on a bench under a tree when one turned to the other and said:
“Slim, I'm 83 years old now and I'm just full of aches and pains. I know you're about my age. How do you feel?”
Slim said, “I feel just like a newborn baby.”
“Really? Like a newborn baby?”
“Yep. No hair, no teeth, and I think I just wet my pants.”
Prostate cancer is the second most common cancer among men, with more than 250,000 new cases diagnosed each year.
Prostate cancer treatment can include radiation, chemotherapy and/or surgery - and all these options can result in temporary or permanent urinary incontinence. That is because the prostate gland surrounds the urethra. Removing the prostate through surgery or destroying it through radiation frequently disrupts how the bladder holds urine and can result in leakage.
So what can you do to minimize the severity and duration of your post-treatment incontinence? We’ve talked to a lot of guys and healthcare professionals and they’ve shared some of their best recommendations for taking back control of your bladder.
#1: Get off that Foley ASAP!
You will most likely be placed on a Foley catheter for up to two weeks following prostate surgery. But there are risks to keeping the Foley in place too long, namely – increased muscle weakness, urinary tract infections and catheter induced hypospadias.
So as soon as your doctor recommends, get off that Foley! There are lots of options for managing incontinence after surgery but only one without complications – Men’s Liberty.
#2: Keep an eye on your liquid intake? Avoid diuretics.
It’s important to stay hydrated, but that doesn’t mean you need to chug a liter of soda. Avoid caffeine or carbonated drinks that can irritate your bladder and make you urinate more frequently. Check your urine for color (lighter is better) and if your urine ever turns a dark yellow - watch out, you’re dehydrated!
#3: Do your Kegel exercises!
Although more commonly associated with women, there are Kegel exercises out there for men. MedicineNet.com suggests the following to alleviate some forms of urinary incontinence:
Kegels are easy to do, once you know which muscles to target. One of the easiest ways to locate your muscles is during urination. Here's how:
- Halfway through urination, try to stop or slow down the flow of urine.
- Don't tense the muscles in your buttocks, legs, or abdomen, and don't hold your breath.
- When you can slow or stop the flow of urine, you've successfully located these muscles.
Some men find these muscles by imagining that they are trying to stop the passage of gas. Squeezing these muscles gives a pulling sensation; these are the right muscles for pelvic exercises. It's important not to contract other muscles.
To do Kegel exercises for men:
- Contract these muscles for a slow count of five.
- Release the muscles to a slow count of five.
- Repeat 10 times.
- Do a set of 10 Kegels daily, three times a day.
When you're first starting, it may be easier to do Kegel exercises lying down, so your muscles aren't fighting against gravity. It may also be easier to contract the muscles for just two or three seconds at first.
After a few weeks, increase the time until eventually you're contracting the muscles for a slow five or 10 seconds, and do the exercises standing up. That puts more weight on the muscles, boosting your workout and improving your control. Remember not to tense your buttock, legs, or stomach muscles while you’re doing Kegels.
#4: Establish a goal and stick with it!
Once you’ve mastered the mechanics, set goals on how you can remain active. Make a schedule and establish routes with available restrooms. Try finding a support group because life is more pleasant when you can share your challenges with other people who understand. Exercise as much as you can. Create a daily routine involving moderate physical activity and make it permanent.
The typical response when dealing with urine control is to cut back on social activities. This is understandable until you learn to manage it. But that’s the key – manage it; then get out and live life to the fullest.
#5: Talk to your doctor!
As the patient, it’s your job to be proactive. Don’t shy away from doing your own research and asking your Doctor about what you find. Most people with incontinence never mention it to their doctor. And when a patient comes in wearing a diaper, the Doctor may not even bring it up!
If you want a better option or have questions about you incontinence, ASK!!
Have you got any techniques that have worked well for you? Let us know!
We're thrilled to be partnering with ABC Home Medical and wanted to share a blog from one of their RNs focusing on pressure ulcers - a common malady some individuals with spinal cord injuries. Check out the full blog below:
The latest advice and helpful tip from our resident Registered Nurse.
A pressure sore is any redness or break in the skin caused by too much pressure in one area for too long a period of time. The pressure prevents blood from getting to your skin, causing the skin to die. Normally, your nerves send messages of pain or feelings of discomfort to your brain to let you know that you need to change position, but damage to your spinal cord keeps these messages from reaching your brain.
In order to prevent pressure sores, do pressure reliefs (also called weight shifting, pressure redistribution and pressure reduction) on a regular basis.
- Pressure relief is moving or lifting yourself to take the pressure off areas that have been under pressure, usually from sitting or lying in one position, so blood can circulate.
- When sitting in your wheelchair you should do pressure reliefs every 15 to 30 minutes for a duration of at least 30 to 90 seconds. Continue to perform pressure reliefs when sitting in a car or on other surfaces.
- If you are unable to perform a pressure relief independently, instruct the person who helps you with your daily care (family, attendant) to consistently move you to reduce pressure over areas at risk for pressure sores.
Check your skin, or have your attendant or caregiver check your skin, a minimum of twice a day (morning and bedtime). Look for changes in skin color (redness or darkening), blisters, bruises, cracked, scraped or dry skin. Feel for hardness, swelling or warmth, as these may signal skin breakdown. In some areas of the body, the bones are closer to the surface of the skin, causing increased pressure and risk for sores.
Below are some areas that the skin that is directly over bone and is at highest risk; check these areas very carefully:
Heel of the foot
The base of the buttocks ("seat bones")
Hip (from lying on side, something rubbing, or tight clothes)
Elbow (from leaning on it)
Knee (from spasms or side-lying with one knee on top of other)
Ankle (from lying on side)
Toes and bony areas of foot (from tight-fitting shoes)
Back of the head
Inspect areas of skin that are in contact with casts or braces twice daily. Use a mirror to inspect skin in hard-to-see areas. Pay attention to fingernails and toenails: an ingrown toenail or cut along your nail bed may lead to a sore which can easily be infected. As soon as you notice a discolored area, stay off the area until it returns to normal skin color.
Make sure you clean any areas in which you notice any discoloration, and keep all pressure off this area! Wash with mild soap and water, rinse well, and gently pat dry. Do not rub vigorously directly over the wound, as this will further irritate the skin. If you do notice a pressure sore and if any of the following occur, you need to seek help:
- An increase in the size or drainage of the sore
- Increased redness around the sore or black areas starting to form
- The sore starts smelling and/or the drainage becomes a greenish color
- You develop a fever
If pressure sores continuously occur, you may need to make some adjustments in your day-to-day routine. Reevaluate your diet and increase your daily exercise. You may also need to see a doctor or physical therapist to get your seating adjusted, as sliding in a wheelchair that does not fit properly can lead to pressure sores.