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Incontinence Support Blog

Holistic Kidney Health

Posted by Caleb Bartlett

Feb 22, 2017 3:43:45 PM

 As a survivor of spinal cord injury for almost twenty-three years I have been blessed with very good kidney health. Sadly, many of those in a similar situation have not been as fortunate. I recognize that not all conditions have the same cause and not everyone reading this may have a spinal cord injury, but considering that most of the readers of this blog are using or are affiliated with the Men’s Liberty product in some way kidney health was a good topic to tackle. Kidney health starts with hydration. With the constant availability of soft drinks, energy drinks, teas, and other beverages filled with sugar and sugar substitutes that tease our brain’s pleasure centers it’s easy to think we are hydrating when we aren’t. This month I am going to give a few simple (and cost-effective) methods to hydrate properly and prolong the life and cleanliness of your kidneys. 

If you have ever cleaned the filter on a fish tank or air conditioner you know how the smallest particles can build to a nasty mess over time. As you go about your daily life the blood pumped through your body not only carries nutrients, but removes the impurities that are rejected by cells to maintain health. Bacteria, uric acid, heavy metals, salts, and other toxins make their way to the kidneys where they are filtered, drained into the bladder, and washed away when you urinate. When the body lacks the proper balance of fresh water the blood and kidneys must work harder to push those toxins out. Think about it… what moves faster through a straw, a milkshake or, well… water? So how do you get a proper hydration cycle?
  1. Give your kidneys a much-needed break. Oftentimes we are conscious about what we eat, but not what we drink. Read the label. Sugar, aspartame, artificial flavors, sweeteners, and chemicals you can’t pronounce should be removed from your diet. Coffee and tea are acidic and the caffeine they contain will dehydrate you regularly.
  2. Drink natural things. Water, herbal teas, freshly juiced fruits and veggies. If you have been diagnosed with sand in your kidneys water with lemon and cranberry juice low in sugar regularly will help greatly.
  3. Observe your body. When do you urinate most during the day? If you have paralysis, does your sitting position or laying down effect how you urinate? Do you have difficulty when it’s very hot or very cold? Share this with your doctor.
  4. Watch what you eat. Eat simple foods. Find healthy proteins and vegetables and stop fast food and snack foods like chips and cookies.
  5. Move around. Avoid a sedentary existence as much you possibly can. Get your blood pumping and moving those impurities from your body.
Kidney infections are nothing to play around with. An ounce of prevention is worth a pound of cure. If you need to make a lifestyle change, do it. Sure, that sugar-sweet soft drink tastes good and gives a happy feeling, but isn’t a long life and good health better that a few moments of satisfied taste buds? Best of luck, and take care of your body.

Thanks for reading.

Topics: doctors visit, urinary tract infections, Guest Blogs, incontinence, Kidney Health

How to Pack for a Trip to the Hospital (if you're incontinent)...

Posted by Mens Liberty

Nov 10, 2015 2:00:00 PM


Welcome back – this week we’re going to be tackling some really practical advice. If you’re like me, when you are planning a stay in the hospital, whether it is for inpatient surgery, or another reason, it is important to be prepared. A well-packed bag is essential for having a comfortable stay in the hospital. But the big question is – what does “well packed” mean exactly?


Never fear – here is my MUST-HAVE list. Feel free to change this around to suit your needs but this is what gets me through a hospital stay.

  1. Pajamas or night clothes for each day. You spend all day and night in your PJ’s and tend to sweat more in the hospital,(especially with those plastic coated mattresses,) so you can usually only wear PJ’s for one day. Also don’t go for skimpy items. I have seen patients in hospital PJ’s or other clothing made of nylon and they tend to make you perspire and become uncomfortable, when in bed for any length of time.
  2. Socks and slippers – hospitals are filled with recycled air and they only have one temperature – cold! So even if you’re not a “hot” person by nature – don’t forget the fuzzy socks. A new pair for every day.
  3. Baby wipes or wet wipes for cleaning up hands, face and bottoms and for overall “freshening up,” especially if you can’t shower as often as you like. These are an absolute lifesaver!
  4. 2 in 1 shampoo and conditioner – this saves time washing your hair when you feel awful. Even better try using Dry (i.e. waterless) Shampoo – for freshening your hair when you are unable to wash it yourself. While it’s not as good as a real hair wash, if you are unable to get out of bed or wash your hair as much as you would like, then this can be a good alternative.
  5. Moisturizer – Some hospital atmospheres can be very drying on the skin, especially if it has air conditioning or you are having bed baths. So don’t skimp on lotion or moisturizer. I particularly like the spray on moisturizer from St Ives for those hard to reach spots!
  6. Incontinence Supplies – hospitals will have pads or diapers but they buy them in bulk from the cheapest supplier possible so they feel just slightly better than sand paper – not okay. And let’s be honest here – no one wants a Foley catheter if they can avoid it. So whether or not you use Men’s Liberty, bring your supplies with you – one for each day plus two just in case. You’ll be glad you did.
  7. And last but not least – bring a comfortable outfit to wear home. Something slightly nicer than your PJs but comfy. Your going back out into the world and for some reason they don’t seem to like you to wear your PJs 24/7.

Well that’s my list – did I forget anything? What can’t you live without? Let us know in the comments!


 

Topics: urinary management, doctors visit, proactive patients, tips from Men's Liberty users

Using all the right words, with all the wrong people.

Posted by Mens Liberty

Oct 16, 2013 3:45:00 AM

Welcome back everyone. As you should already know its health literacy month and today something dawned on me as I read an article in the recent edition of the WOCN Journal*; when it comes to health literacy maybe it’s more of a difference in communication rather than a literacy issue. For example, when a patient calls us we ask him if his doctor is aware of his incontinence. Many times that patient will respond in confusion with “incontinence, what do you mean? I’m calling because I keep having accidents in my bed at night”.

The patient isn’t wrong in his terminology and neither are we. But, as healthcare providers and caregivers it is our responsibility to meet the patient in their environment and make them feel confident and comfortable talking about these issues with us. If we are constantly correcting them or using terminology they don’t understand, then they may be less likely to talk to us about their health problems. This will only lead to greater health illiteracy.

So lesson learned. We’re going to start right here making a push towards the “straight talk” that caregivers and patients say they want. Admittedly, urinary incontinence is a sensitive and
embarrassing topic. And clinical sounding words are a nice way of distancing yourself, of depersonalizing the problem. Not anymore – the WOCN study gave us a lot of ideas about how you talk about bladder issues – and we’re going to use these moving forward!

Here are a couple of the highlights: instead of incontinence, how about: “having accidents, leaking, losing control, wetting or messing their pants, having a urine problem, urgency, being unable to hold it and not getting there in time”

And instead of complications, let’s talk about skin that is “rashy, pimply, pink or red, blotchy, inflamed, irritated, chapped or chaffed, dry and cracking, thinning, broken skin, bleeding, sore, raw and excoriated.”

The next step is encouraging health care providers to be more proactive in inquiring about the existence of incontinence and the skin damage that can occur as a result. And of course, we’re going to continue to encourage caregivers to be more proactive in bringing incontinence issues to the attention of their loved one’s healthcare provider immediately and independently looking for solutions.

Many caregivers would give their right arm for a reliable way to reduce their laundry pile and forget about stains on furniture. However, most are unaware of all the options that are available to them and even fewer use the internet to look for this information. This has to change.

So join us, and take a step in the right direction this month. No more finger pointing over incorrect terminology. Let’s work together to give the patients what they want and need. Let’s ask more questions, listen more, and have engaging conversations. Health literacy isn’t a one way road filled with uninformed patients; it’s a roundabout with no lights where healthcare providers, patients, and caregivers meet and need to adapt to differences in communication in order to make it to their destinations.

As always thanks for reading. Do you have other terms we should use? Do you have a story as patient, caregiver, or healthcare provider that you would like to share? Feel free to leave your comments.

*REFERENCE: http://journals.lww.com/jwocnonline/pages/default.aspx

Topics: doctors visit, Health Literacy

How to Improve Your Health Literacy

Posted by Mens Liberty

Oct 10, 2013 3:30:00 PM

October is upon us and that means it is officially Health Literacy Month. What is health literacy you ask? Well health literacy is the degree to which individuals have the ability to obtain, process, and understand basic health information and services needed to make appropriate health decisions.

The concept of health literacy may sound easy to grasp, however, according to the National Network of Libraries of Medicine only 12% of the population has a proficient health literacy level. Sounds like we have some room for improvement, aye?

Well today I have an article brought to you by Dr. Carolyn M. Clancy, M.D., who provides some basic, yet useful tips on how to improve your health literacy.

Orange Line

There is a truism in health care: When you don't fully understand or can't act on information about your health care, you are more likely to be in poorer health.

Nearly all of us, about 9 of every 10 American adults, have some problems with health literacy.

Health literacy is not only about reading. It's about understanding difficult health terms and issues. Even highly educated people can have trouble understanding health care information.

For example, health literacy plays a role in how well:

  • Someone is able to take the right medicine at the right time.
  • A person with diabetes properly manages the condition.
  • A parent follows instructions for helping a child recover from surgery.

Health care is complicated and the health care system can be confusing. That's why so many people have trouble understanding information about their health and health care options. Older adults, minorities, immigrants whose first language isn't English, poor adults, and people with ongoing mental and physical conditions are more likely to have a hard time. But everyone can have trouble sometimes, especially when you're sick or have just been told you have a disease.

Limited health literacy can literally harm your health. If you have trouble understanding instructions, you may have a hard time managing a health condition or taking your medicines correctly. You may end up in the hospital more, spend more on health care, and have poorer health. Limited health literacy can also decrease your chances of getting important tests, like mammograms, or helping a loved one with his or her care.

Doctors, nurses, pharmacists, and hospitals can all play a role in helping patients better understand and use health information.

My agency, the Agency for Healthcare Research and Quality, has developed tools to help doctors and their office staffs improve communication with all patients so they can better understand a doctor's instructions and other important medical information. Another tool helps pharmacists talk to patients about how to use drugs safely.

While these efforts can help, you can take steps, too. To improve your health literacy:

  • Ask questions. Then, make sure you get and understand the answers. If you don't understand, ask the doctor or nurse for more information. Asking questions may not always be easy, but it can get you the information you need to take better care of yourself.
  • Repeat information back to your doctor or nurse. After your doctor or nurse gives you directions, repeat those instructions in your own words. Simply say, "Let me see if I understand this." This gives you a chance to clarify information. Studies show that doctors and patients often have very different ideas of what the patient is going to do after leaving the doctor's office. For example, if a clinician advises you to 'take two' Coumadin, it is really important to know if they mean 2 milligrams—or two pills. Repeating back can help avoid potentially serious mistakes.
  • Bring all your medicines to your next doctor's visit. Ask your doctor to go over all of your drugs and supplements, including vitamins and herbal medicines. More than one third of adults struggle to understand how to take their medicines. Reviewing your medicines can help you and your doctor. You may even discover some mistakes, such as two drugs that shouldn't be taken together.
  • Have another adult with you. This might be especially true when you expect to receive important information.
  • Let the doctor's office know you need an interpreter if you don't speak or understand English very well. You have a right to an interpreter, at no cost to you. Even if you speak some English, tell the doctor's office what language you prefer when you make an appointment.
  • Make a Pill Card. My agency has published step-by-step instructions to create an easy-to-use Pill Card to help patients, parents, and others keep track of medicines.

With Health Literacy Month coming up in October, this is a good time to try these suggestions. You might even improve your health—or the health of someone you care about.

Thanks for reading and as always feel free to comment!

Topics: doctors visit, Health Literacy

Fear & Medicine, a Lesson for Healthcare Professionals & Caregivers

Posted by Sarah Woodward

Sep 30, 2013 9:55:00 AM

Today I wanted to share a blog from Danielle Ofri of Slate.com, a MD and PhD, who wrote a moving story about fear and medicine. And it spoke to me, although she wrote as a mother, I know a very similar fear as a caregiver. Trusting our loved ones to a complicated system, filled with jargon we may never truly understand requires a leap of faith that anyone who hasn't walked a mile in our shoes will probably never understand.

So take a look, does any of this sound familiar to you? Do you have a story to share? Let us know!

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When my son was 18 months old, his doctor recommended that he get tympanostomy tubes in his ears because of recurrent ear infections. He might not be hearing clearly during this critical stage of language development. Being a physician myself, I researched this thoroughly. It turns out the evidence supporting the procedure is slight—it may help with hearing and language, but all kids seem to catch up whether or not they had the tubes.

In the end, though, I made my decision more as a parent than as a doctor—I wanted my child to have the best opportunity for language development, and besides, it was a low-risk  procedure.

Two weeks later I scooped my sleeping boy out of bed before dawn, buckled him into his car seat, and hailed a taxi on the darkened city streets. At the hospital, my son snuggled in my lap as I sat on a recliner that was wheeled into the OR. Everyone was cheerful and friendly. The nurses sang songs, and the surgeon pointed out the elephants on his hat. I was given a hose with anesthetic to wiggle in front of my squirming son, to sedate him enough for the staff to get him onto the table.

We played with the hose for 10 minutes. Just when I thought that this technique would never succeed, my son slackened slightly, lolling his head against my chest. At that moment, the OR staff clicked into action. The cheery demeanor dissolved and everyone was all-business. The patient was whisked from my arms and in less than three seconds he was strapped on the table with a mask over his face, preternaturally still, unhumanly still.

At that moment, my faith in science plummeted from beneath me. My decades of medical training, my Ph.D. in biochemistry, my grounding in the scientific method, all evaporated in the blink of an eye. The sight of my son—stone-still on the OR table, deathly rigid—completely unhinged my confidence that “everything would be OK.” Suddenly, I was not sure that anything would be OK. My little baby—23 pounds including race-car pajamas and diaper—was minuscule and fragile under the ministrations of five lumbering adults and gargantuan, stainless steel equipment. And there was nothing I could do to help him.

An orderly began to lead me out of the OR, and suddenly I stopped and clenched onto his arm. “Please,” I beseeched him. “Please make sure my son is OK.” He nodded and reassured me, even though he had no role at all in the surgery. But he was wearing blue scrubs, so to me he was somehow part of the frightening medical complex that had swallowed up my son.

I paced the waiting room, the knot in my gut twisting painfully. What if something bad  happened? Adverse outcomes were rare for this procedure—I knew that—but when a procedure is performed frequently enough, rare occurrences will eventually happen. I circled the waiting room stiffly, nursing my guilt.

When the surgeon appeared without my son in tow, my heart stuttered to a standstill. I steeled myself for the bad news. “It’s done,” he said with a shrug. “He might be a little cranky when he wakes up, but everything went fine.”

It took some time for the reality of his words to sink in. Even when a sleepy, tousled boy was placed in my arms, the panicky choke of fear still gripped me. I have always been a rational person, confident in the power of facts. Knowledge armed me against the existential fears of the universe. Yet here I was facing a minor surgical procedure, and all of my armor crumbled in a heartbeat. My heart ached for parents whose children are truly ill, for the frightening bargain of uncertainty they must make as they entrust their children to the medical system.

It is as though there is a precipitous drop in front of you, but a Plexiglas bridge extends across the void as in the classic behavioral psychology experiments. The medical system beckons, “It’s safe. We’ll guide your child across the glass bridge.” But your emotions, your life experience,
your gut, and your eyes can only see the sheer drop. 

Cradling a restless boy in my arms, it suddenly dawned on me that we ask patients every day to step over this void, to trust in the system. In matters both small and large, we ask them to step onto a glass bridge, reinforced only by our assurances. Even if they are able to  intellectually evaluate the risks and benefits, at some point they have to make an all-or-nothing decision whether to cross that bridge.

My son recovered rapidly—he was into trouble before lunchtime—but my emotional vulnerability lasted far longer. I’m still an empiricist, and still hold strong faith in the power of the scientific method, but now I appreciate now quickly and resolutely this armor of rational protection can dissolve.

When I sit with a patient now, deciding on a treatment, I still lay out the risks and benefits as systematically as I can. But then I take a moment to acknowledge the raw fear that cannot be assuaged by even the most convincing clinical data. This conversation can’t eliminate the necessary leap of faith. But at least there is some recognition of the stomach-plummeting sensation that occurs when the patient edges their toes out onto that clear glass bridge.

Danielle Ofri is an associate professor of medicine at NYU School of Medicine and editor-in-chief of the Bellevue Literary Review. Her newest book is What Doctors Feel: How Emotions Affect the Practice of Medicine.


 

Topics: family, urinary management, doctors visit, Caregiving, healthcare professionals

Losing my temporarily able-bodied status, one physicians story

Posted by Sarah Woodward

Aug 17, 2013 9:57:00 AM

Today I wanted to share this amazing post from physician Sandra Shea. Originally posted over at the awesome KevinMD.com, she has a powerful reminder to share about how we think about our bodies and about people with physical disabilities like spinal cord injury.

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I thought of Peter when I lost my TAB status.

I lost it on vacation. These things happen. Suddenly, one Friday night in Florida, I was no longer a TAB. Shouldn’t have been too surprised, I guess.

But I didn’t expect it would involve a chicken.

I should explain.

I’m a medical educator: I have a PhD in experimental psychology/neuroscience, and I teach first-year medical students. In our curriculum, the students work through patient cases that are grouped by organ system. At the end of each case, we have a wrap-up in which we highlight the case’s diagnostic features and answer any student questions. Most of these discussions are faculty-led, but occasionally they’re run by a patient whose history mirrors the case we’re studying. Peter was one of these.

Like the patient in one of the neurological cases, he had fractured his spine in a diving accident. In a matter of seconds, he’d been transformed from a typical teenager to a tetraplegic (someone paralyzed from the shoulders down), although he retained some motion in one arm.

Peter opened his sessions by telling the students that he would answer any questions they had about any aspect of his condition.

“The doors are closed, but your curiosity should be open,” he’d say.

Each year they’d start hesitantly, but eventually move into delicate questions that ranged from how bowel movements were completed to how he participated in sexual activities, and with each question he and they developed a stronger tie. Peter would answer their questions quickly and candidly (even when they asked his opinion of physicians).

Then, one day, a question stopped him cold.

“I was wondering about the terms we see applied to patients with spinal-cord damage,” a student said. “Do you prefer ‘handicapped,’ ‘crippled’ or ‘disabled’? Does it really matter?”

Peter paused, flushed, bit his lip and took a deep breath.

“Yes,” he said. “It does matter. Some of my colleagues prefer the term ‘disabled’ to ‘handicapped,’ but I have no strong preference between those two. I would, however”–he nudged his electric wheelchair forward–”strongly emphasize that I and most of the people I know would like the word ‘crippled’ removed from the language.”

He paused and looked around.

“The word carries demeaning and perhaps hateful connotations. To many, calling someone ‘crippled’ is the same as putting the person in a box, sealing it and tossing it away. The other terms imply a process, not an ending. And you TABs just don’t quite get the difference.”

The students looked at one another; whispers ran through the room.

Peter smiled.

“Yes, TABs. You’re all TABs,” he said, “except you.” He nodded at a young woman in the front row, her foot encased in a walking cast.

“What do you think a TAB might be?” Peter asked.

We all just looked at him.

“Temporarily able-bodied,” he said.

“If you think about it,” he continued, “being able-bodied might be all that you know. You’ve always gone where you wanted when you wanted and not been slowed by injury or disease. But that doesn’t mean you’ll stay that way. Someday you’ll probably need crutches or a cane, or be in a wheelchair for a little while or maybe for the rest of your life.”

There was a thoughtful silence.

Then one student spoke. “So it’s sort of like the Sphinx’s riddle in Oedipus Rex: ‘What is the creature that walks on four legs in the morning, two legs at noon, and three in the evening?’ The answer is a human being. A human being crawls as a baby, walks at midlife and uses a cane when elderly.”

“I’ve never thought about it that way,” Peter said. “But yes, in a way, that fits.”

A few years later, Peter died after a series of strokes. He was not yet fifty.

I thought of him as I sat in the Key West emergency room, waiting for a pair of crutches and a thigh-to-calf knee brace.

My injury had come about earlier that day, as I was stepping down from some uneven stairs onto the sidewalk. Nearby, a hen and her chicks were foraging. Descendants of the fowl bred here long ago for cockfighting, they were part of the population of chickens that runs loose on the island. The local lore has it that, since Key West is a bird sanctuary, the chickens can’t be harmed.

A skateboarder heading along the sidewalk must have taken that to heart; he ducked around the hen and rolled directly into my path.

Stepping back up the stairs to avoid a collision, I slipped, landed with all my weight on my turned leg and felt something slide and something tear. The slide was the kneecap dislocating, and the tear was later revealed to be the posterior medial meniscus, the knee’s cartilage “shock absorber.”

Some months from now, after surgery and rehab, I hope to regain my TAB status.

But even as I put away my crutches, I hope I’ll never put away my memories of Peter, his generous spirit, and all of the lessons he taught.

Sandra L. Shea is an associate professor, department of family and community medicine, Southern Illinois University School of Medicine.  This piece was originally published in Pulse — voices from the heart of medicine

Topics: doctors visit, healthcare professionals, spinal cord injury

Coping with your MS Diagnosis, tips from Men's Liberty

Posted by Sarah Woodward

Aug 13, 2013 10:10:00 AM

We know that there are lots of diagnosis which are associated with urinary incontinence, including multiple sclerosis. And when you first get diagnosed its easy to feel totally overwhelmed. So whether you've been diagnosed with MS or something else, we are thrilled to share some basic coping tips from David Novak.

 Orange Line

Certainlypeople react in a variety of ways when they find out they’ve been diagnosed with Multiple Sclerosis (MS).  It might help to know that while the news of the diagnosis is not the most pleasant, many people with MS have been able to successfully manage their symptoms and live fruitful and productive lives in spite of it. With the right education, information, treatment and support system, you can do the same.

Immediately Plan Your Treatment

Upon receiving news that you’ve been afflicted with MS, it might take some time to deal with your feelings and thoughts.  However, addressing strategies for treatment is not only extremely
important for the condition itself, but also for your good mental health.

With Multiple Sclerosis, it's vital to begin treatment as soon as you are diagnosed. In most cases, addressing it early gives you a significantly better chances of reducing the number of symptomal relapses you may have, which can slow down the progression of future issues. The ultimate goal is to interrupt and slow down the advancement of the disease, and at the
same time, avoid further interruption of your life and the things you want to accomplish.

Be True to What You Feel

As with mny life-altering situations, coming to terms and being true to your feelings wth your MS diagnosis is paramount.  Whether you feel mad, sad, scared, anxious or ashamed, just know that all of those feelings are experienced by many who are in the same situation.  It also might be comforting to know that these feelings will change and dissipate over time. So, sit with your feelings.  Get them out.  Give yourself time to get used to these emotions, because this is the best way to move forward after you have lived with these feelings for a while.

It's also important to remember not to blame yourself. Multiple Sclerosis is not your fault, and having the condition is not your fault either.  There’s nothing that you did in your life that could have prevented it, but there are many, many things you can do to make your life significantly easier.  

March Forward, and Get Out There!

This is a new chapter in your life.  Sure a diagnosis of MS is challenging to cope with and will have an impact on your life, but it also means that there will be good challenges in your life that, if overcome, will allow you to live a very fruitful, satisfying and accomplished life. Continue to do the things you like, especially staying active.  This will help you stay focused
and positive. You’ll find out that when you stay busy and do the things you love, that you will live in much the same way you always have. This can include your career, your personal relationships, your family and your daily routine.  

Don’t Be Shy about Your Diagnoisis

It’s normal to feel alone and want to be alone after you receive a diagnosis.  But this may not be the best course of action. Having a support system with nearly everything you do in life is
extremely helpful.  It’s no different with MS.  Don’t cut yourself off from the people closest to you. The support of your friends and family can make all the difference in the world as to how you handle the disease. There’s no doubt that living with MS can be stressful and challenging.  And those whom you share your life with probably know you best.  Having them around to share experiences with and talk with can make everyone feel better about the situation, especially you. 

Outside support groups with those afflicted with MS like you are especially helpful.  You’ll have those around you that really understand what you’re going through, mentally, spiritually, physically and emotionally.

David NovakDavid Novak is a international syndicated newspaper columnist, appearing in newspapers, magazines, radio and TV around the world. His byline has appeared in GQ, National Geographic, Newsweek, The Wall Street Journal, Reader's Digest, USA Today, among others, and he has appeared on The Today Show, the CBS Morning Show and Paul Harvey Radio. David is a specialist at consumer technology, health and fitness, and he also owns a PR firm and a consulting company where he and his staff focus on these industries. He is a regular contributing editor for Healthline. For more information, visit http://www.healthline.com/.

Topics: doctors visit, tips from Men's Liberty users, multiple sclerosis

67% of Survey Respondents say Fear of Accidents is their #1 Worry

Posted by Sarah Woodward

Jul 27, 2013 10:20:00 AM

Recently, Parentgiving.com conducted a great opinion survey on the troubling condition reaching out to nearly 5,000 people who use self-care products for incontinence. The goal was to learn how you cope with incontinence and if a greater awareness about it as a medical issue has erased its stigma and prompted more people to talk to their doctors about treatment. They also asked respondents to share both their frustrations and their strategies for maintaining quality of life.

Results show that while progress is being made, there is still distress and frustration. Slightly over 70% have talked to their healthcare provider about incontinence—many of them are taking or have tried medications, and a few have had surgical procedures. For nearly 25%, incontinence is a known part of an ongoing medical problem, from MS, Alzheimer's and Parkinson's disease to prostate surgery for men and uterine prolapse for women.

Twenty five percent are taking or have taken medications, but less than half report that the meds help. Some can't take incontinence drugs because they'd interfere with medications prescribed for other conditions or because they just can't afford them.

Other medical conditions and costs were among the reasons some people declined to have surgery to correct incontinence. Others chose not to have it because the results were too iffy or because they felt they were too old. One respondent already had two surgeries, neither of which helped, yet three others found their surgery successful—procedures involved a sling or implanted stimulator. At the other extreme, a few respondents reported that their doctors didn't bother to suggest any treatment or minimized the condition.

A few did find help with a non-invasive approach: "My doctor sent me to a 6-week continence program with a local therapist. It's very hard to do the exercises consistently, but if I don't then the problem gets worse."

The discouraging finding is that nearly 30% of respondents have still not sought medical attention. Reasons are varied. A few people still feel embarrassed about bringing it up, even to an experienced medical doctor. One respondent wrote, "Too embarrassing to discuss, especially since I don't think there's anything she can do about it. Also, if there's a pill for it, I already take so many pills I rattle when I walk."

Others just assume it's just a normal part of old age (it's not!) or don't know that there are treatments that might help. Some feel that their more life-threatening medical issues, from diabetes to stroke recovery, take precedence when they're at the doctor's office. For a few, the possibility of yet another medication to add to their existing regimen is financially out of the question, so they just don't bother to bring up incontinence. But one person offered this advice to anyone still hesitating about asking for medical care: "If you don't feel comfortable talking to your doctor, please find another doctor."

How Incontinence Products Factor In:

Survey results offered insights into what concerns you most and how you manage incontinence:

* Fear of accidents is the top concern.
Two-thirds of respondents ranked this as their number one worry. The lack of product selection came in second at 21%. People want more product choices, which will, in turn, help them feel more secure about avoiding accidents.

* Online is the way people want to buy products.
Nearly 46% buy products online where you can get the widest selection and have anonymity.

* Absorbency is the key feature in choosing products.
An overwhelming 81% ranked this first. Information on a product's absorbency should be front and center on product descriptions, say the respondents. Comfort ranked second and the ability to buy a product online ranked a strong third at 36%, above both cost and anatomical design of items.

* Many people are satisfied with their incontinence products. In fact, 40% are very satisfied. However 44% are only somewhat satisfied—there's room for better education about products to help people find those that are more effective and the respondents had numerous suggestions for incontinence product manufacturers to improve styles.

Orange Line

The only issue I have to take with the study, is that it ignores any available alternative to diapers/pads. It focuses just on cash sales, ignoring options covered by insurance. For seniors and their caregivers, frequently on fixed incomes, this is no small thing to overlook.

So for the 60% of you who aren't totally satisfied with your current incontinence product, consider Men's Liberty. The external, non-invasive design provides security for 24+ hours, discreet shipping to your door and you can reduce or eliminate your out-of-pocket costs through insurance or Medicare coverage.

Click me

 

For full survey results: click here.

Topics: family, doctors visit, Caregiving, proactive patients, diaper alternatives

Is Your Prescription Causing Your Incontinence?

Posted by Sarah Woodward

Jul 23, 2013 10:07:00 AM

As most of us know, medication often has some surprising side effects. But did you know that some common medications can affect your bladder control?

So if you're dealing with incontinence and are taking any of these medications, talk to your doctor. It's possible that different medications may alleviate your symptoms!

Medications that can cause urinary incontinence

Medication Effect Symptoms
Diuretics, such as hydrochlorothiazide (Esidrix, Hydrodiuril, Oretic), furosemide (Lasix), bumetanide (Bumex), triamterene with hydrochlorothiazide (Maxzide) Increase urine production by the kidney. Frequent urination, overactive bladder, stress incontinence.
Muscle relaxants and sedatives, such as diazepam (Valium), chlordiazepoxide (Librium), lorazepam (Ativan) Cause sedation or drowsiness, relax urethra. Frequent urination, stress incontinence, lack of concern or desire to use the toilet.
Narcotics, such as oxycodone (Percocet), meperidine (Demerol), morphine Cause sedation or drowsiness; relax bladder, causing retention of urine. Lack of concern or desire to use the toilet, difficulty in starting urinary stream, straining to void, voiding with a weak stream, leaking between urinations, frequency incontinence.
Antihistamines, such as diphenhydramine (Benadryl)Anticholinergics and calcium-channel blockers, such as verapamil (Calan), nifedipine (Procardia), diltiazem (Cardizem) Relax bladder, causing retention of urine; in some cases, increase urine production. Difficulty in starting the urinary stream, straining to void, voiding with a weak stream, leaking between urinations.
Alpha-adrenergic antagonists, such as terazosin (Hytrin), doxazosin (Cardura) Relax the bladder outlet muscle. Leaking when coughing, sneezing, laughing, exercising, etc.

Credit for the above chart goes to: Anthony Komaroff, M.D., Editor in Chief, Harvard Health Publications and the Harvard Health Blog!

 

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Topics: urinary management, doctors visit, medical research

7 Medical Procedures You May Not Need...

Posted by Sarah Woodward

Jul 19, 2013 10:20:00 AM

You're facing minor surgery, and your doctor orders routine preoperation tests. Do you get them?

You're a senior with insomnia. Prescription sleeping pills are OK, right? You see an ad for a screening to detect a potential stroke. Good idea?

Probably not, the experts say. All three are among the unnecessary or potentially harmful tests and treatments identified by 17 key medical specialty societies, which recently, in Washington, released their lists of questionable procedures as part of the Choosing Wisely campaign.

That campaign, set up by the nonprofit American Board of Internal Medicine (ABIM) Foundation, began in 2012 when nine medical societies first offered their lists of unnecessary treatments.

Consumer Reports is a partner in the Choosing Wisely campaign, and John Santa, M.D., who directs that group's health ratings, says, "We know Americans believe more health care is better, and all prevention is good." But, he stresses, "waste and overuse is a major issue — and it's frequent across all medical disciplines."

Christine K. Cassel, president and chief executive of the ABIM, says the Choosing Wisely campaign is "about the right care at the right time for the right patient."

Here are seven overused tests or treatments commonly prescribed for people age 50-plus that experts now say you probably don't need if you're healthy.

1. Recommendation: Avoid routine presurgery tests for eye and other low-risk surgeries (American Society for Clinical Pathology and American Academy of Ophthalmology).

Men and women facing elective surgery — eye, foot and cosmetic operations, as well as biopsies — routinely undergo unnecessary blood and other tests. "You need to ask: Why do I need these tests?" says Lee Hilborne, M.D., an official with the clinical pathology society. Cataract patients, for example, often get an EKG, blood work and a chest X-ray, says William Rich, M.D., of the ophthalmologists group. "They're paying for tests we don't think are necessary," he says. Average costs run $300 to $400.

Danger: Aside from the cost, a few test results come back abnormal even though the patient is fine — causing anxiety and further tests that could delay the surgery.

Exception: A patient with a severe heart condition or symptoms that could be heart-related should have a presurgery EKG.

Diabetic patients need a blood glucose test and those on diuretics should have a potassium test.

2. Recommendation: Don't take prescription sleeping pills as the first choice for insomnia (American Geriatrics Society).

Insomnia is very common in older people, but experts say seniors should avoid some widely prescribed sleeping pills, such as Restril and Ambien. Instead, talk to your doctor about other therapies, such as counseling to improve sleep patterns through lifestyle changes.

Danger: Meds called sedative-hypnotics, including benzodiazepines, double the risk of falls and hip fractures, leading to hospitalization and death in older adults, according to several large studies.

"It's not entirely clear why; it may be there's some carryover the next day," says Cathy Alessi, M.D., president-elect of the American Geriatrics Society.

Exceptions: For seniors, prescription sleeping pills (sedative-hypnotics) should be reserved for anxiety disorders or severe alcohol withdrawal after other therapies have failed.

3. Recommendation: Don't get a screening test for carotid artery disease unless you have symptoms (American Academy of Family Physicians).

Companies provide screenings for carotid artery stenosis — the narrowing of arteries that can lead to strokes — but unless you have symptoms, don't get scanned. "The scientific evidence is very clear that more people are harmed than helped by having this test, and we advise against it," says Glen Stream, M.D., board chair of the family physicians group.

Danger: Screening someone with no symptoms of carotid artery disease could lead to further tests and even surgery, which carries increased risk of stroke.

Exception: If you've had a transient ischemic attack (TIA) or ministroke, you may need a diagnostic test.

4. Recommendation: Talk to your doctor about not having a urinary catheter. If a catheter must be used, have it removed as soon as possible (Society of Hospital Medicine).

One in five hospital patients has a catheter, but about half don't need one. Sometimes they're used for incontinence or the convenience of the patient or health care staff.

"Don't get a catheter put in. But if you have to have one, get it out as quickly as you can," says John Bulger, an official with the society that represents hospital physicians. While patients hate it, wetting the bed or intermittent catheterization is far preferable to the continuous use of a catheter, he adds.

Danger: Urinary tract infections from catheters are more prevalent the longer a catheter is in place. Urinary tract infections are the most common hospital-acquired infection, and can be fatal. About 13,000 people a year die as a result of infections from catheters, a study found.

Exceptions: If you have surgery, you may need a catheter. Guidelines call for its removal the next day.

5. Recommendation: Skip the annual Pap test (American College of Obstetricians and Gynecologists and American Academy of Family Physicians).

If you're under 65, get a screening every three years. After 65, if you've had several normal Pap tests, you can stop having them.

"Pap smears annually are a waste of money," says Gerald F. Joseph, M.D., of the OB/GYN group. "In average-risk women, studies show no advantage to annual screenings over those performed at three-year intervals."

Danger: False positive results cause anxiety for patients.

Exception: If you've had cervical cancer or cervical disease, continue annual Pap smears. Cervical cancer is caused by the Human Papillomavirus (HPV), which is transmitted through sexual relations.

6. Recommendation: Don't use testosterone for erectile dysfunction (American Urological Association).

A number of TV ads and men's clinics are pushing this remedy, but most men should skip testosterone supplements if their testosterone levels are normal.

"Anecdotally, we know a lot of prescriptions are being written for testosterone for men with normal testosterone," says Daniel A. Barocas, M.D., assistant professor of urologic surgery at Vanderbilt University Medical Center. But he says the prescription doesn't work for erectile dysfunction.

Danger: Testosterone does not affect the ability to get an erection. It enhances libido or sex drive but not performance. It also reduces fertility and may make prostate cancer blossom. Prostate cancer thrives on testosterone. Gels can irritate the skin; injections can increase red blood cells.

Exception: If you have other symptoms of low testosterone, including loss of muscle mass and body hair, talk to your doctor to see if hormone testing is right for you.

7. Recommendation: Don’t order a blood test for creatinine or upper-tract imaging for patients with an enlarged prostate (American Urological Association).

Most men after age 50 have enlarged prostates, which result in urination that disturbs sleep and a weaker urine stream.

Danger: Even routine tests are not risk-free. Patients spend time and money and may get false positive readings, leading to other tests. CT scans mean radiation exposure.

Exception: Tell your doctor about blood in the urine, pain with urination or urinary retention.

The full list is available at ChoosingWisely.org.

Topics: doctors visit, medical research, healthcare professionals, urinary tract infections, Medicare