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Incontinence Support Blog

Jumping Hurdles

Posted by Nurse Nicole

Apr 11, 2017 1:35:34 PM

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There is no discrimination when it comes to who “should” live a healthy lifestyle- it includes all of us, don’t you think? Declining health does not focus on one ethnicity, sex, race, religion, or age.  Sometimes declining health is a wakeup call to start making changes; however, prevention is the best solution to a potential problem. Realistically, you can spend your entire life leading the healthiest lifestyle and will still face the possibility of health problems. Like anything else in life- “just do the best you can” while taking time to enjoy each moment we have!

 Let’s talk about information based on the most common hurdles that seniors face.

1. Arthritis (inflammation of the bones)

There are more than 100 different types of arthritis, and it is more common in women than men. According to the CDC, 22.7% (52.5 million) of adults reported doctor-diagnosed arthritis, with significantly higher age-adjusted prevalence in women (23.9%) than in men (18.6%). By 2040, an estimated 78 million (26%) US adults ages 18 years or older are projected to have doctor-diagnosed arthritis.

  • Living with arthritis: Aches and pains are only the beginning of this problematic diagnosis. Use heat such as warm baths or heating blankets (which are my FAVORITE! Anyone else love the warmth of heating blankets?!) Heat helps loosen the muscles surrounding the joints, making mobility easier. You must be careful when using heating blankets persistently with Men’s Liberty because the blankets can get up to 160 degrees Fahrenheit and this could interfere with the adhesive. Low- impact activities such as swimming or cycling will also be beneficial for someone with arthritis and will increase your range of motion- it is important to stay in motion as much as possible to prevent stiffness of your joints.
  • Prevention: Although there’s no true way to fully prevent arthritis, there are some things you can keep in mind to help reduce the symptoms. Always prevent unhealthy weight gain, which causes extra pressure on your joints), take fish oil (or eat lean fish) to help reduce inflammation and pain, and of course – don’t smoke.  According to Mayo Clinic, “toxins in smoke cause stress on connective tissue, leading to more joint problems”.

2. Heart disease

Coronary Artery Disease, Congestive Heart Failure, Peripheral Artery Disease, Congenital Heart Disease are all some examples of heart disease. The CDC states that heart disease is the leading cause of death for both men and women, with ~ 610,000 people dying in the US from it every year.

  • Living With: One common symptom of heart disease is shortness of breath. With heart disease, blood is not being pumped or circulated properly. When blood is not circulating well, it is not bringing oxygen to your tissues and oxygen is not flowing properly through the lungs. This causes shortness of breath and/or light headedness. “Heart disease” is a very broad term and involves multiple subcategories that involve different symptoms such as swelling of the limbs and/or numbness.  
  • Prevention: A few ways to prevent heart disease include: Not smoking (Isn’t this a solution for everything?), decrease salt intake, and exercise. These will all help to keep the blood flowing throughout your body and prevent you from retaining excess fluids!

3. Cancer

Such a broad, but ugly term. According to the most recent study done in the United States by United Stated Cancer Statistics: more than 1,600 people a day died of cancer in 2013. The most common cancers include skin cancer, lung cancer, breast cancer, prostate cancer, colorectal cancer, and bladder cancer.

  • Living With: Common signs and symptoms of cancer include night sweats, fatigue, significant weight loss or weight gain. Of course there are additional signs and symptoms depending on the specific type of cancer. With colon cancer, you may experience a change in your bowel movements; Breast cancer you may usually find a lump under the skin; Laryngeal/pharyngeal (throat) cancer, you may experience a significant persistent cough, hoarseness, or difficulty swallowing. 
  • Prevention: There are things you can do to help prevent cancer, but there is no TRUE prevention.  Smoking is associated with many different types of cancer. Many people believe smoking only increases your chances of lung or throat cancer, but this is not true.  According to the CDC, “People who smoke cigarettes are 15 to 30 times more likely to get lung cancer or die from lung cancer than people who do not smoke”. However, smoking is not inclusive to lung cancer and is proven to increase your chance of developing any type of cancer.

Avoiding excessive sun exposure or persistently using sunscreen/ cover-ups can help prevent your chances of getting skin cancer.  These are solely suggestions, because cancer can affect anyone, anywhere, at anytime.

We don’t have a glass ball that shows us the future and what we will be faced with. Although it is beneficial to be knowledgeable, don’t fret on the possibility of something developing.

Taking care of your health and noticing symptoms are the two most important things you can do.

Like most things in life, we jump them as they come!

~Nurse Nicole

 

Resources:

  1. "Arthritis Pain: Do's and Don'ts." Mayo Clinic, 26 Oct. 2016. Web. 04 Feb. 2017.
  2. "Heart Disease." Mayo Clinic. N.p., 29 July 2014. Web. 28 Feb. 2017.
  3. "Cancer Symptoms." Mayo Clinic. Mayo Clinic, 23 May 2015. Web. 23 Mar. 2017.

Topics: medical research, proactive patients, incontinence, Nurse Nicole, cancer, Arthritis, Heart Disease

Understanding Incontinence is Your Best Defense

Posted by Andy Orrell

Jul 14, 2016 12:00:37 PM

There are some unbelievable stories that float around concerning urinary incontinence. I like to term these stories, “Incontinence myths." I’ll do my best to explain the difference between incontinence myths and true facts, as believing the myths can harm your ability to deal effectively with you urinary incontinence.

The first story I hear all the time is that people who have incontinence have small bladders. Not true…that’s one of those incontinence myths. We’re all born with a normal sized bladder, which is the correct size for our body. Because you may urinate often, you may think your bladder is too small and therefore fills up quickly, resulting in the urge to urinate. Forget that logic…your bladder is not too small. The only exception to a normal sized bladder, which we are all born with, is if someone has had bladder surgery to purposely reduce the size of the bladder. But this is an anomaly. So forget about the small bladder syndrome…it’s a myth.

The second story I hear often is that to stop incontinence you need to cut back on drinking liquids. This theory also falls in the category of incontinence myths. If you suffer from incontinence you may be tempted to drink less, but this can make the urine more concentrated, aggravating the bladder and making it more active. The very best advice is to drink moderately in small amounts throughout the day rather than gulping large cups of liquid at one time. A good rule of thumb is if you’re thirsty or if your lips are dry, drink. If you’re not thirsty, don’t drink. Pretty simple. Get in the habit of sipping water between meals to get your liquid requirement for the day. Remember, drinking less liquid than your body requires can lead to dehydration. Truly a myth!

This story I just heard the other day. A good friend of mine honestly believed that incontinence affects only old people. Again, this is another incontinence myth. Incontinence is actually very common. One in eight men experience incontinence at some point in their lives. Incontinence affects more people under the age of 53 than over. Incontinence is not a normal part of aging…and aging alone does not cause incontinence. Dispel this myth!

Another one of the many incontinence myths I hear all the time is that Kegal exercises only work for women. Kegel exercises certainly work for men and are just as effective for men as they are for women. Regular Kegel exercises can prevent and, in some cases, even reverse incontinence. It is important that one learns how to do Kegel exercises correctly. Once learned, it is recommended that they be done on average three times each day. If you follow that exercise regimen, you should see improvement because you will be strengthening the pelvic floor muscles, which keep the bladder from dropping.

The final and most upsetting myth I hear from people is that the only way to treat incontinence is to wear unsanitary diapers or dangerous condom catheters. This is a major falsehood. I believe, as do the thousands of our satisfied customers, that the better solution is the Men’s Liberty.

Men’s Liberty is made from BioDerm’s proprietary medical adhesive, hydrocolloid, that creates a secure, skin friendly seal around the urinary opening to ensure that all urine caused by leakage is collected in a small pouch that hides discreetly in your pants. Simpler, better, and definitely safer than the alternatives.

BioDerm provides an excellent training program for application and use of the product. Another benefit is that Medicare helps pay for the Men’s Liberty external catheters; Medicare does not pay for diapers or absorbents that you purchase from your local drugstore.

Call our care team today at 1-800-814-3174. They are here to help you.

Topics: customer care, medical research, diaper alternatives, Health Literacy, incontinence

Your Genes Are Not Your Fate

Posted by Mens Liberty

Mar 29, 2016 11:20:00 AM

In March of 2008, Dr. Dean Ornish, a renowned physician gave a TED Talk in Monterey, California entitled “Your Genes Are Not Your Fate.”  The talk was powerful and impactful, and during his talk, Dr. Ornish shared some incredible research!

We thought you’d enjoy a summary of his talk, beginning with a couple of fascinating facts about changing our genes.  Yes – we can change our genes – first by creating new ones, and second, by changing our lifestyles!

 

The best news is that when you make lifestyle changes, you don’t have to wait a long time to see the results!  Dr. Ornish says that “when you eat healthier, manage stress, exercise, and love more, your brain actually gets more blood flow and more oxygen.”

He goes on to say that after making these changes, our brains become measurably bigger.  “Walking for 3 hours per week for only 3 months caused so many new neurons to grow that it actually increased the size of people’s brains.”

Dr. Ornish says there’s some things that we can eat, drink and manage to increase our brain cells – things like:

  • Chocolate
  • Tea
  • Blueberries
  • Alcohol (in moderation)
  • Stress management

And of course, he lists some foods and substances that decrease our brain cells, such as:

  • Saturated fat
  • Sugar
  • Nicotine
  • Opiates
  • Cocaine
  • Alcohol (excessive)
  • Chronic stress

Here’s a really interesting fact.  Dr. Ornish says that “your skin gets more blood flow when you change your lifestyle, so you age less quickly and your skin doesn’t wrinkle as much, and your heart gets more blood flow.”

He says that we can actually reverse heart disease, and that after only a year, “clogged arteries become measurably less clogged!” 

He continues “We’ve shown that you may be able to stop or reverse the progression of early prostate cancer and by extension, breast cancer - simply by making these lifestyle changes.  Tumor growth was inhibited 70% in the study group who had made these lifestyle changes.”

Now isn’t just this news alone enough for all of us to immediately consider making some immediate lifestyle changes?!  This change in lifestyle has the power to substantially increases our quality of life, and who doesn’t want a better quality of life?!

Now here’s some news that may interest all of our followers…  “Even your sexual organs get more blood flow, so you increase sexual potency.”

And here’s some news that isn’t so great, and definitely a reason to quit smoking if you are a smoker…  “Nicotine, which constricts your arteries can cause a heart attack or a stroke, but it also causes impotency.  HALF of guys who smoke are impotent!”

Dr. Ornish then addresses a subject that is close to our awareness – prostate cancer.  During his talk, he shows a “heat map” and then talks about a study they’re getting ready to publish that says “we found that over 500 genes were favorably changed, and in effect turning on the good genes – the disease-preventing genes, and turning off the disease promoting genes.

So much of what Dr. Ornish is reporting is really terrific news!  And as Dr. Ornish pronounces, “these findings are very powerful, and they’re giving many people new hope and choices!”

This is a very strong argument for all of us to make lifestyle changes that are now PROVEN to substantially improve our lives.  Don’t we owe this to our loved ones?  Of course we do!

So here’s our question:  After hearing Dr. Ornish’s report, what are you going to do IMMEDIATELY to implement a healthier lifestyle?

We want to hear your answers!  Please participate and let us know!

Topics: medical research, Health Literacy, compassion

Coming Together - A Community for the Cure

Posted by Caleb Bartlett

Nov 26, 2013 9:17:00 AM

In 19 years it has never ceased to amaze me how much behavioral psychology is at play around Spinal Cord Injury. There are always the personal, day-to-day battles with victories and losses a person in a chair faces just living life, but one of the greatest obstacles toward complete recovery from a spinal cord injury is often the sluggish and competitive community surrounding it.

This community of patients, doctors, therapists, trainers, caregivers and family make up a fraction of the global health care landscape, but the trickle-down effect of the recent trend in medicine to be the first across the finish line has had enormous implications. Everyone is vying for being the best treatment, most effective technology, the accurate results and the one to hold the trademark that the motivation for saving lives and truly finding a cure has taken a backseat to this materialistic ideal of "Look at me and what I did."

The ones needing the cure aren't helping either. Quads are jealous of Paras cause they're more independent... the Paras are pissed caused Quads get more attention... the men resent the women cause they can get a date easier and the women are sad because men can catheterize themselves safer. You think I'm kidding, I wish I was. I've received messages from spinal cord injured people telling me I was wrong to get stem cell treatment because I might be disappointed!

My all-time favorite line is when anyone, be they an industry professional or fellow spinal cord injury, says to me "I just don't think it's a good idea cause I don't want you to get hurt." Would someone please tell me how as a society did we become so passive-aggressive then have the unmitigated gall to pat ourselves on the back and call it compassion? At the risk of this post turning into a rant let me explain why I bring this up.

In order for healing of any kind to take place whether it is mental, emotional or physical it requires an environment. Think about disease, it festers in a climate suitable for its gestation. Health is no different. Why do we wash our clothes, vacuum our floors, bathe daily and brush our teeth? We want to create a healthy place for life to flourish.

The ultimate environment for anyone to make any headway in the face of spinal cord injury whether they have received stem cells, any other radically progressive treatment or not any at all there must be an equilibrium. Yes, a healthy skepticism can be a valuable thing as long as it fosters research and an honest exchange of information, but once we lose sight of the ultimate goal and the needs of those who have been injured to make a full recovery we negate any chances of true progress. I bring this to light today because we need to get on with the business of healing. I need to get on with it and so do you. We have to create a climate for a cure.

To those of us in chairs I am putting out a call... to cut the crap. Yes, being paralyzed really, REALLY sucks. It hurts and affects every single area of our lives, but we're not alone. There's not one spinal cord injury on this planet, there are thousands. All suffering the same fears and dreaming the same dreams. Someone may have more or less than you, but we all want to walk again. We may not all achieve it the same way, but who are we to dare criticize a fellow survivor for how they choose to reach that goal?

To the doctors, trainers, and therapists... I sure love you guys, and G-d knows we're grateful, but do us and everybody else a favor... get over yourselves. Just because you are doing research, helped someone in a chair learn to transfer themselves or got them to a certain level of independence does not mean you've solved the problem. Just because a task is easier doesn't make it better. Catheterizing is still catheterizing whether you do it on your own or someone does it for you. Learn to listen, really listen. You are an outsider and respect it. You will never be able to fully understand, so don't lull yourself into thinking you do.

Finally, to all of us... whatever role you play in this quest... get on the same team. Support each other. If you want stem cells, get'em! If you just want to do therapy, do it! If you want to go holistic, vegan, Chinese herbal, shamanic, yoga, and get naked around a bonfire I say go for it and more power to you! We have to build the environment for a cure.

The cure. The cure is our mantra. The cure is the goal.

Topics: Caregiving, medical research, spinal cord injury, Spinal Cord Injury with Caleb

New Study Refutes Link Between Fish Oil Supplements & Prostate Cancer

Posted by Sarah Woodward

Jul 31, 2013 10:41:00 AM

Exciting news for those of you out there who are regular consumers of fish oil supplements!

A recently released analysis on a small subgroup of study subjects that assessed omega-3 fatty acid levels in plasma is misleading and irresponsible according to Life Extension scientists at in Fort Lauderdale, Fla.

Conducted by researchers from The Ohio State University Comprehensive Cancer Center at the Fred Hutchinson Cancer Center in Seattle, Wash., and published in the Journal of the National Cancer Institute, the analysis of a small subgroup (about 6% of the overall study population) was widely identified as suggesting that too much fish oil might boost prostate cancer risk. Researchers from Life Extension, an organization dedicated to finding new scientific methods to enhance and expand the healthy human life span, say the study's misleading findings and irresponsible reporting by most national media outlets may scare people away from continuing to take omega-3 supplementation that is very beneficial, if not life-saving, to their health. They go on to note the numerous studies that show potentially positive results.

The Ohio State study used data from a clinical trial on vitamin E and selenium supplementation for cancer prevention, and added on a single blood test for omega-3 at baseline to determine whether there was an association between plasma levels of omega-3 fatty acids and incidence of prostate cancer. Not mentioned or discussed by the media was that only one blood test for omega-3 fatty acids was conducted at baseline while study subjects were followed for six years' time (and in another very small group up to nine years' time). Given that the study authors did not capture whether or not the study subjects actually ingested any fish oil supplements, and despite the fact that plasma omega-3 fatty acid testing reflects short-term dietary response, not long-term intake in cells and tissues, the mainstream news media circulated the message that  a very small difference in the average total long-chain omega-3 blood level between men who did develop prostate cancer and those who did not. Unfortunately, the media did not report that the difference was so small that consuming a fish dinner the night before the only test for either six or nine years' time would impact the results. The study itself is a correlation-based study that did not test for causality but merely for associations between variables, and therefore is hypothesis-generating, not in any way meant to be interpreted as identifying cause and effect.

"From these findings it is clear that unlikely fish oil supplements were not consumed to any degree remotely applicable to health-conscious individuals ingesting fish oil supplements," said Steven V. Joyal, M.D. and chief medical officer for Life Extension.

"The danger of this deeply flawed, compromised analysis is that aging men obtaining health information through the mainstream media will cease omega-3 fatty acid ingestion," says Dr. Joyal.

"We hope this study will stimulate more research into the role of omega-3 fatty acids in prostate health," notes Michael A. Smith, M.D. and senior health scientist for Life Extension. "Conversely, the consequences may be profound if aging men shun omega-3 fatty acid supplementation as a result of this flawed study and follows its implied recommendations to consume more omega-6 fats, which are already ingested in elevated amounts in the typical Western diet, resulting in an imbalance in omega-3 to omega-6 fatty acids and a pro-inflammatory internal environment," adds Dr. Smith.

According to Life Extension, over the past two decades, hundreds of research trials have demonstrated strong, consistent, positive evidence that the omega-3 fatty acids EPA+DHA from fish oil may contribute to a healthy heart, brain, and mood and even help support healthy joint function in arthritis. Additional research suggests fish oil may be beneficial for health in patients suffering from certain types of cancer. For example, a recent analysis of omega-3 consumption and prostate cancer by Szymanski in 2010 reported a large reduction in late stage or fatal prostate cancer among cohort studies. Furthermore, a new meta-analysis by Zheng this year of 16 independent cohort studies involving over 16,000 breast cancer events and more than 527,000 participants, showed a significant inverse relationship between EPA+DHA levels and risk of breast cancer.

Other studies have shown that DHA and EPA decrease proliferation and increase cell death in prostate cancer cells, and that omega-3-enriched diets slow prostate tumor growth in animals.A clinical trial published in 2011 gave patients about to undergo prostatectomy either a low-fat diet plus fish oil supplementation or a Western diet with no supplements for four-to-five weeks prior to surgery. The fish oil supplemented group showed a 32.2% decrease in malignant cell proliferation when prostate tissue was analyzed after surgery.

Orange Line

It seems clear to me that this debate will continue - will you join in? Do you take any supplements for your health? Do you see any impact? Let us know!

 

Topics: medical research, prostate cancer

Understanding Spinal Cord Injury with Caleb: Part 2

Posted by Sarah Woodward

Jul 29, 2013 3:28:00 PM

CalebAs I promised last month I will be sharing a bit about life with a spinal cord injury. Most of the symptoms or side-effects of a damaged spinal cord are similar across the board. Degree and intensity of these effects are determined by the factors I outlined in my last post, level and severity of trauma being key. Much of what I will share today is subjective based on my personal experience, but in my communication with friends in the spinal cord community and study of the condition many experiences are the same, if not variations on a particular set of issues.

THE PHYSICAL EXPERIENCE

Before I go any further please understand that many of you know me personally. Much of what I am about to discuss has remained intensely personal and only a few people know the extent of my physical situation. I will be explicit so be forewarned. This is not an attempt in any way to gain sympathy, it is simply a presentation of a very real life as I have lived it, be it right or wrong over the last 19 years.

In April of 1994 during my junior year of high school I was swimming with 2 friends in an above-ground pool in Crescent Beach, Florida. I have lived around water and water sports my entire life. My father is a surfer, an excellent swimmer, avid fisherman and sailor. He saw to it both of his sons were comfortable around water. By 16 I was a surfer as well with several large hurricane swells under my belt, more than a few Northeasters, river rafting Florida's springs and diving for conch in the Bahamas. I've had reef scrapes, fin cuts, banged my head, bounced off of packed sand bars, gotten pounded in the shore break, even dove into the shallow end, but for some strange reason on that day I caught it wrong.

I foolishly was attempting an upside-down cannonball, which is called a "watermelon". The point is to of course make a big splash. Which I did, but not quite in the way I intended. I did not clear a full rotation before connecting quite solidly with the bottom of the pool. I landed across the back of my shoulders where my neck meets my back. The sudden impact forced my neck forward so violently it crushed the C5-C6 Vertebrae. X-rays later revealed what is called a "burst fracture". This means that the spinal column became so compressed it caused the vertebra caught in the pressure point to "explode". Imagine you are holding 3 checker chips between your thumb and forefinger. If you apply enough pressure the one in the middle will pop out. This is essentially what happened in my neck.

I immediately knew what I had done. The first sensation was that my body vaporized into thin air, accompanied by what seemed like thousands of air-raid sirens between my ears. Next was the pain. I didn't know pain like that was possible. Like a hot dagger at the base of my neck shooting lightning bolts of electricity into my skull. In my field of vision I could tell I was face down, floating just below the surface of the pool, my arms floating like limp seaweed unresponsive to the survival impulses of my brain telling them to get me to the surface for air. I knew I was drowning and in seconds it could be over.

The next thing I felt was rising up out of the water. I realized my friend Jennifer was holding me in her arms. All I wanted was air. I could barely get enough because the muscles that expand the rib cage had been paralyzed along with my diaphragm which would not return without intense respiratory therapy three weeks later. I could barely speak the words "I've broken my neck..." To this day I owe so much to two very special women, April Johnston and Jennifer Tooley who acted quickly and maturely to save my life. Within the hour I was life-flighted by helicopter to what is now Shands Medical Center in Jacksonville, FL. The flight was loud and cold and only added to the intense ringing and pain growing in my head and neck. As my body went into shock I vomited up and into the oxygen mask, the contents of my stomach pouring into my ears and hair and down my neck. This happened twice. Upon landing I was rushed into the ER. At this point things became a blur of wires, tubes, scissors, clipboards and questions. Finally with the pain, now worse than ever, like fire burning my brain, I fumbled with the words, but got them out, "Please... put me out." That was it, everything went black.

I awoke 8-10 hours later in a morphine-induced stupor, wires and tubes everywhere. In my nose. In my mouth. An oxygen mask over my face. I still could not feel my body. What followed over the next three to five days all runs together. I remember many details, bits and pieces, but don't ask me to put them in order. The diagnosis was acute spinal trauma, incomplete, caused by a crushed C5 vertebra. To repair the damage bone was grafted from my left hip into my spine and my C4, C5 and C6 vertebrae were fused together using a titanium plate. My neck was stabilized by what is known as a Halo. A rather ghastly-looking device that uses a ring around the crown of the head fastened to the thickest part of the skull by four screws. That ring is in turn secured to four steel rods which bolt to a rigid vest lined with lambs' wool and worn tightly around my chest.

Because of inhaling massive amounts of pool water within 48 hours I developed a massive infection and critical pneumonia. Unable to clear my lungs they collapsed and after 18 hours on a C-PAP machine it blew a hole in my right lung. Regular suctioning left me choking and vomiting. I had to be put on a ventilator via a tracheotomy and given massive doses of antibiotics. A G-tube and J-tube for feeding rounded out the ensemble and I spent the next three and a half weeks in the trauma ward of University Medical Center. Slowly sensation began to return is various ways. It often felt like sparks, bursts of electricity. I thought for sometime,  until they told me otherwise, that I was lying in some sort of traction contraption because my spine waking up felt like I was balanced on a metal beam. Tingling and burning, shooting pains, buzzing and popping in my brain. My lungs getting vacuumed out frequently. The prognosis was that I would spend my life attached to a breathing machine, but in my unit there was a very special person who truly was one of those along the way to whom I owe my life. They called him "Trauma Bob". He was my respiratory therapist, a tough old Navy veteran who was covered in tattoos and smoked like a chimney. Bob understood that the lungs and diaphragm are muscles and in the same manner by which physical therapists could strengthen and develop arms and legs a respiratory therapist could help regain use of the respiratory system. Little by little each day he worked with me. I blew up balloons, inhaled and held my breath, yawned, coughed and all sorts of other breathing exercises. Then Bob would step outside for a cigarette. Go figure.

Years later however, I would thank God for every breath, whenever I'd get a cold or infection that would land many a spinal cord injury survivor in the hospital with pneumonia, I would think about Trauma Bob, wonder where he is, say a prayer and hope he quit smoking. I spent exactly four months in the rehab hospital of Memorial Medical Center in Jacksonville. As I slowly regained strength and rest the emotional impact of what had happened to me began to set in. I will get to that in-depth in next month’s posting, but it bears great importance here because as I began to understand the limitations of the injury the reality of what was potentially ahead of me was not something any 16 year-old should ever have to face.

One of the first sensations to return was hunger. Then I slowly acquired what is known as deep sensation. I could tell where my legs were, but if you squeezed my left foot I would confuse it with the right. Pain and burning around the injury site left rather quickly to be replaced by shooting electric impulses up and down the spine. My hips and legs felt as if they had fallen asleep and the tingly returning of blood was waking them up, only they weren't waking up and the tingling remains to this day. The moment they sat me up on the therapy mat I went white as a ghost, dizzy and vomited. You would too if you'd been flat on your back for a month.

The indwelling catheter draining my bladder was removed and replaced by a scheduled catheterization four times a day. This was done to encourage the bladder to drain on its own, something I could not regulate and control on my own and so it remains to this day. To prevent accident an external catheter is worn which is essentially a condom lined with an adhesive and open at one end that is attached to a tube, the tube allows the urine to drain into a bag concealed under my clothes. Yes, it comes off, yes you get wet, yes you must be washed, dried, changed and so must the wheelchair and its cushions. The entire process can take up to an hour and half and is still something that occasionally happens. During my time in rehab it happened as often as three times a day. Over the last nineteen years it has occurred in restaurants, the car, on a friend's rug, in church and with house full of guests over for a holiday. The next step was to regulate my bowels. One of the primary causes of disease and detrimental conditions in spinal cord injury is the body's inability to remove toxins on its own. For instance, I don't sweat. Most of my body cant tell hot or cold therefore it doesn't know when to perspire. I've suffered burns, cuts and insect bites and not known of them for hours afterward. So in the case with regulating my digestive tract an enema was administered every other night followed by a sponge bath, and later a shower when the halo was removed. That schedule continues to this day and for those of you who are thinking this through, yes accidents do happen, the various causes can be detected and prevented in the future, but yes, they happen. In the car, on an airplane, in Madison Square Garden, even during dress rehearsal for a play you're directing in college. This personally is perhaps the most difficult aspect of spinal cord injury from a mental and emotional standpoint and I'm sure the reader can understand why.

As my strength returned my ability to balance my torso became key. I have no nerve control over my core and therefore those muscles have greatly atrophied. This is why I currently have a condition called "quad belly". As the muscles that hold the inner organs in place atrophy gravity pulls the organs forward giving a somewhat beer-belly appearance. It becomes more accentuated with weight gain obviously. Back to balancing the torso... the best description I've heard for living with paralysis from the chest down goes like this... Go to your local gym, find the biggest pilates ball in the place, sit on it, place your hands in your lap, lift your feet up off of the floor and try not to fall over. Now do this everyday, all day for years on end. You must learn to eat, shower, get dressed, maneuver a wheelchair, open doors, even make love all while feeling like the lower half of you is about to roll right out from underneath you, which sometimes, it does.

In the early 90s the strides forward in physical therapy were yet to come. The general attitude was get them healthy, get them the skills to cope and send them home. Anything else they achieve is up to them. So in late September of 1994 they sent me home after five months in the care of the hospital. Since that day very little about my day to day schedule has changed. While there have been moves across the country, college, career changes, an ever-changing spiritual journey, new friends, old friends and even dating and relationships it's still pretty much the same. In the morning the external catheter is removed, I'm washed and dried and a new one is applied. The bed-side bag that has caught the urine from the night before is emptied, washed and put away and replaced with a small one strapped to my leg. My skin is checked for red spots, sores, any blemishes or injuries of any kind. Then I get dressed with the assistance of a family member and lifted into the chair. Either an aide or a family member assists me with my hair and brushing my teeth. I can burn myself on the stove so my meals are prepared. If I need to use the restroom I can feel my bladder and lower abdomen constrict, my blood pressure goes up slightly and the bag on my leg fills up. It is then drained in the bathroom. This too requires assistance. In the cold weather my bones in my legs and hips develop a deep soreness related to the arthritis and bone loss from sitting for nineteen years. This usually causes me to become tired around 2pm so I sleep for an hour by propping up a pillow next to my desk and leaning on the wall. Because my digestive system moves much slower than normal I've developed a gluten allergy. In recent years I've become very conscious of diet. Spirulina, alkaline shakes, herbal tea, fruit juice, smoothies, organic eggs, chicken, fresh fish, green veggies and salad are staples. I've lost weight in the last year and I have a bit more to go. In the late evening I transfer back onto my bed, remove my clothes and transfer to a special chair that allows me to use the restroom and shower. My bathroom is modified so that I can roll in, turn around and roll into and out of the shower with little effort. The shower is large with two heads, one is removable to ensure I am thoroughly rinsed. Any soap residue can quickly turn into a nasty, raw rash. Once the whole process is complete which takes over an hour, I am transferred back to my bed where another new external catheter is applied along with the bed-side bag. I wear white anti-embolism stockings to ensure good circulation. This is when I get a fresh pair. Finally my aide positions me on my side, propped up by pillows, where I will sleep several hours until I wake up and need repositioning. In the morning the process is repeated all over again.

Caleb 2This has been my primary mode of life since my injury. Spinal cord injury affects every single area of your life. Through all of this the people I owe everything to, and that includes my very life, are my family. My father, my brother Chris, my brother Ethan and my mother. Ethan and my mother above all. I owe them everything. It is because of them I am as healthy as I am. Doctors and other medical professionals are often amazed at my level of health and resistance to disease. It is because of their daily commitment and self-sacrifice, 24 hours a day for nineteen years that I have never had another over-night stay in the hospital. They have taught me what true love and friendship is and what it means to be loyal. I love them with every fiber of my being.

Topics: urinary management, wheelchair, Caregiving, medical research, spinal cord injury, physical therapy

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

I want to tell my doctor: "I want a second opinion."

Posted by Mens Liberty

May 11, 2013 11:00:00 AM

Medical diagnosis can be tricky – particularly when it’s your very own health we’re talking about.  So who cares if you want a second opinion?

Well the doctor’s ego might… 

And no one wants to hurt a caregiver, even your doctor.  In our polite society, we often put other people’s feelings ahead of our own.  Some people believe it may be considered “insulting” to your doctor, or at the very least “awkward”.  And it shouldn’t be – really!

So here are some “nice” ways to do it and what to incorporate:

  • Be Upfront – Don’t go behind your doctor’s back.  Your doctor will appreciate your honesty.  Those health records are your records, and the law requires doctors to give you access.

  • Say It Straight – Medicine is complicated, so try saying “I understand there are tons of studies, some contradictory, and doctors have different ways of interpreting them.  I wonder if you think I should get another doctor’s position on my situation?”

  • Be Nice – It goes a long way.  Add the nice statement, “I appreciate the time you’ve spent examining me.  I know this was a difficult diagnosis for you to call.  Seeing an additional doctor is just so I don’t sit up all night forever wondering.

What might be some of the clues or situations in which you might ask for a second opinion?
  • Being bounced around between doctors is one scenario.  Determining your exact diagnosis will ultimately assist in developing the most effective treatment.  It is SO VERY IMPORTANT!

  • Any type of diagnosis that is severe warrants asking for a second opinion - particularly diseases such as cancer.  Especially, if you have a nagging feeling that the diagnosis isn’t sitting well with you.  Trust your intuition.

  • Another reason to ask for a second opinion is trying to determine a course of action when there is more than one treatment option.  This is close to the saying “two heads are better than one.”  A reassuring opinion is worth its’ weight in gold!

Okay - so what if no diagnosis is being made?  You don’t want to lose faith in your caregiver, particularly if they are a specialist.  So a graceful request for a second opinion can potentially move you closer to further answers, and subsequent solutions.

We highly recommend that you get a copy of your records.  That way, you know what is currently recorded about you.  Write your questions and concerns down prior to visiting with the new doctor.  Having the critical information and your misgivings or concerns recorded will help the second opinion doctor focus on you.

Who to go to?  Ask your doctor - they know who’s reputable in their field, and more than likely, they want the best for you.  Or, do some research yourself.

A little known research tool is Google Scholar (http://scholar.google.com/).  With Google Scholar, you can search published books, abstracts and articles across many disciplines and sources.  This is very helpful when trying to identify a person that is active in the field that is specific to your case.

You are actively putting your health first.  Congratulations!  In addition, you are standing on the shoulders of giants when you’re able to view relevant works from academic publishers and professional societies.

One final special note:  Don’t give up any appointments with your first doctor, just in case the second opinion doctor doesn’t work out for whatever reason.  Makes sense, right?!

We wish you the best!  Know that we’re here for you, and we’re interested in you having the best health possible!

And don’t forget…  We want to hear from you!  Tell us your “Second Opinion” stories, and let’s all share your ideas!

To your best health!

Topics: doctors visit, hospital errors, medical research