April 23, 2011

I graduated from Georgetown University . . . . Hospital's incontinence program

AND I GRADUATED WITH HONORS! (grin)

Thursday I had my final meeting with Lisa, my exercise therapist at Georgetown University Hospital, to complete their program of exercises to alleviate problems with incontinence. As I mentioned before, I probably never would have signed on for a training program like this had it not been for my taking their BIG exercise program designed for people with Parkinson's.  Since this proved so beneficial, I decided to give the incontinence program a try but without much expectation that it would really work.

I was wrong (once again). Within a week after the first session, which just focused on mastering the Kegel exercise,  I was only making  one bathroom visit a night instead of my former 3 or 4 trips.  Kegel exercises involve tightening the pelvic floor muscles by contracting them as you would if you wanted to stop the flow of urine. It helped having Lisa as a coach to be sure I was getting this right.  But if you go to YouTube and search for "kegel exercises," you'll find a number of instruction videos.  It's basically a simple exercise that can be done while waiting for a pot to boil, a TV commercial to end, or a red light to change. But it's probably better to just do a set of them while not distracted by other things.  It only takes a few minutes.

Subsequent training sessions with Lisa added to the basic Kegel  the pelvic brace exercise which strengthens the surrounding muscles and adds further strengthening to the bladder floor. The brace exercise calls for on the exhale pulling in your stomach as though you were puncturing a balloon (a big one in my case) and then tightening the lower abdominal muscles while continuing to breath (i.e., not holding your breath).  It took me awhile to zero in on this, but it paid off.  Now, in addition to only making one bathroom visit during the night, I can go 3 hours or more during the day without desperately looking for the nearest men's room.  

I can remember going to the theater last summer to see the Scottish Black Watch play and becoming very nervous when I was told that my seat was going to be in the stands they had set up on the stage. My immediate thought was "Jeez! what if I have to go in the middle of the performance."

For an example of how different things are now, I went to the annual meeting of my company  last Saturday, drank several cups of coffee, sat through the meeting and the lunch that followed without even thinking about locating the men's room.

My final instruction sheet from the training program calls for me to combine the basic Kegel exercise with the pelvic floor brace exercise and to do a set of "quick" exercises and "endurance" exercises a couple of times a day. The quick exercise calls for rapidly contracting the muscles -- holding for 2 seconds and relaxing for 5 seconds 10 times.  The endurance exercise calls for contracting the muscles and holding for 10 seconds and then relaxing for 10 seconds. Both should be done in coordination with the breath - contracting on exhalation. It's also recommended that I count out load while doing the endurance exercise to make sure that I'm breathing regularly and  not straining.    I have to be careful to not use the buttock or leg muscles while doing the exercises.The relaxation pauses are as important as the exercises.

I found it was a great help for me to work with a trainer on this.(And, with a prescription from my neurologist, it was covered by Medicare.)  But if one isn't available, written instructions can be helpful.  Here's one that's pretty good:

http://idsportsmed.com/patient_education/article/what-is-core-stability

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