December 27, 2010

An exercise program for incontinence that works! (for me - so far)

charter maldriverna

I am midway through a four-visit exercise therapy program that's given at Georgetown University Hospital for those struggling with incontinence.  It already has worked for me in reducing my prior 3 or 4 pee breaks during the night to one and is beginning to help with the daytime leakage. As I've noted before, I've had incontinence since my 1995 radical prostatectomy and aging and PD have accentuated the problem.

I benefited greatly from GU Hospital's  BIG exercise program specifically designed for those with PD and my exercise therapist suggested i might want to also try the incontinence program. My urologist agreed and  sent a prescription so that it is covered by Medicare.

Much of the program so far focuses on using the Kegel exercise that is often recommended for incontinece. See these links (which are directed at women because they have incontinence issues more frequently than men)

I tried using Kegel exercises in the past without success.  This time, with professional guidance; it's starting to work.

Here's my current exercise program (which no doubt will change as I complete the final two therapy visits)

Kegel Exercise

  • Quickies: Hold for 2 seconds, relax for 5 seconds -- Repeat 10 times
  • Extended:  Hold for 5 seconds, relax for 10 seconds -- Repeat 10 times
Do both (1) lying on side, (2) sitting, (3) standing.  Do both exercises in each of these 3 positions 2 times a day.

Note: Lisa, my therapist, says the relax times are as important, if not more important, than the hold times.

Pelvic Brace Exercise

Once a day, lie on back and "deflate the balloon" (mine's more like a beach ball) by pushing the belly button down toward your spine  without inflating the stomach. Perform this exercise at 50% or less of full effort. Put your fingers on the lower abdomen and feel the stomach going in. Hold for 5 seconds. Do  10-20 times a day

Note: The objective here is to strengthen the lower abdominal muscles to create an internal girdle  to support your bladder and pelvic organs. They are important to use with activities that cause leakage.

I'm not having too much success here, but I suspect that my next two therapy visits will involve other techniques to bolster this exercise.  Stay posted.

Two hours before bedtime exercise

Lay down with your legs above the level of your heart and supported by pillows. While in this position
  • Make circles with your ankles 20 times in each direction 
  • Pump your ankles up and down 20 times.
Note: This exercise is aimed at giving you a better shot at reducing the number of times you get up during the night.  As we age, our veins may become less efficient at pumping fluid from our arms and legs toward our heart while we are upright during the day. Then at night when we lie down, the veins  are better able to pump fluid into our system where it is converted to urine.

Urge Deference Techniques 

During the day when the urge to urinate come on, avoid rushing to the toilet.  For me for starters, Lisa recommended that I try  to wait one to 1 1/2  hours between voidings. When the urge comes on, stop, pause and do a few Kegels rather than race to the toilet. Try to distract yourself.

The idea here is to retrain your mind set away from thinking that you have to find the nearest toilet every time an  urge to urinate surfaces.

Since the morning is when I have the  greatest problem with leakage and urinary urges, Lisa asked about my morning fluid consumption, which clearly is a big part of the problem.  Since my past problems with  insomnia seemed to be linked (at least in my mind) with constipation, I had developed the practice of having two large cups of coffee after breakfast accompanied by a large glass of water to facilitate a morning bowel movement..  When traveling and having more trouble then usual with constipation and insomnia, I would add a diet Pepsi to get things going.  (My hosts in Pokhara, Nepal would always stock a large supple of diet Pepsi when they knew I was coming.)
Lisa pointed out the obvious connection between this morning flood of caffeine and fluids and my urinary problems later in the morning.  Since insomnia and constipation, no longer are a problem, thanks to 5-HTP, I've switched to one large cup of coffee and one small glass of water in the morning. This seems to help.

As I said, I'm just mid-way in this program.  I'll keep you posted as we progress.

If you want to see if a program like this is available in your area, check this link:


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