April 9, 2014

Urinary Incontinence: A Reminder, a New Option, and a Tip

I'm handling my incontinence the same way I've always dealt with issues in my life: erratically. I've always been like this. I identify a problem, study it, craft a solution, dedicate myself to following through, lose interest, and move on to something else.

Incontinence came into my life after my cancerous prostate was removed in 1995. The problem subsided after a few months, and I became much more focused on the other major consequence of the operation -- impotence.

Now, with age and Parkinson's, incontinence is back and steadily becoming a bigger problem. Four years ago, I had some success doing the BIG exercises for Parkinson's, with the help of my physical therapist. I had several sessions designed specifically to help with incontinence. They helped a lot. But, as is my pattern, I slacked off on the exercises and -- surprise! -- the problem returned, more troublesome than ever. For about half a year now, I've been using protective absorbent pads.

A Reminder: Kegel Exercises Work. I Just Need to Do Them!
If you research incontinence, one of the first recommendations will be the Kegels -- exercises to strengthen the urinary sphincter and pelvic floor muscles that control urination. When these exercises are done correctly and regularly, they can really improve bladder control.

How to do the exercises:
First, locate your pelvic floor muscles. Imagine that you are trying to prevent passing gas. Squeeze and lift the rectal area without tightening your belly or buttocks. You should sense a pulling or closing feeling in your genital area when you squeeze. Men may feel their penis pull in slightly.

There are three ways to do the exercises:
  • Holding. Slowly tighten, lift, and draw in the pelvic floor muscles and hold them for a count of three. Relax, then repeat.
  • Quick flicks. Rapidly contract and release your pelvic floor muscles. Quickly tighten them, lift them up, and let them go.
  • Urge control. Do this exercise when you feel the urge to go to the bathroom. First, stop and stand very still. Sit down if you can. Contract your pelvic muscles three to four times to keep from leaking. Relax. Take a deep breath and let it out. Try to think of something other than going to the bathroom. Contract your muscles again if you need to. When you  feel the urge abate somewhat, walk normally to the bathroom. Repeat the exercise if necessary.
You can do these exercises almost anywhere -- while you're driving, watching television, standing in a line, sitting at your desk.

The Kegels and Me 
I failed to make the Kegels part of my established routine; that's what went wrong before. I'd do them only when I thought about it, and in time I thought about it less and less. Now, this problem is yet one more I can solve during my 3-4am "quiet hour." I already have a set of exercises and stretches I do during this time. I can easily incorporate the Kegels into several of those routines, and add a few independent Kegels, too. I see results after only a few weeks.

A New Option: Botox
Botox recently received FDA approval to treat an overactive bladder. The drug is made from a toxin produced by the bacterium Clostridium botulinum, which helps stop muscle spasms. When Botox is injected into the bladder muscle, the bladder relaxes, increasing its storage capacity and reducing episodes of urinary incontinence.

It was interesting that the FDA approved Botox as a treatment for incontinence due to neurological impairments from spinal cord injury, multiple sclerosis, and Parkinson's.

The injection, often done in an office setting, remains effective for about six to nine months. Treatments can be repeated, but there should be at least 12 weeks between treatments. In clinical trials, 30 percent of patients treated with Botox due to neurological diseases later required catheterization for urinary retention.

I'm due for one of my regular checkups with my urologist about the prostate cancer, and I'll ask him about Botox. But for now, I'd rather just continue with the Kegel  exercises.

A Tip: Tommy John Underwear
Until I recently resumed my Kegel exercises, I was dealing with increasing incontinence by resorting to absorbent pads. I hadn't even known until recently that special pads for men are available and can be bought online, avoiding the embarrassment of buying feminine pads at the local CVS.

Surfing the net one evening, I made another great discovery: a new line of Tommy John men's underwear featuring a radical new design. The ads show hunky young men, which may explain how I stumbled across the product in the first place.

Their promotion department will be appalled by the reason I'm touting their product, and by my photo layout. The new design moves the access opening from the side (where it's been forever) to the top. This change provides quicker, easier access when I'm racing for the toilet.

There's more. As you can see in this photo of the underwear inside out, the new design permits wearing an absorbent pad while still providing access from the top opening.

I'm sure the Tommy John marketing department will want to tout this feature in a full-page ad in The New Yorker. I'm available as a model.

1 comment:

Anonymous said...

You are a good sport with a quirky sense of humor. I appreciate that. As a hospice nurse I like finding suggestions such as yours. This underwear is new to me. I am going to make note of it and suggest it to patients with like problems. As for your own issues, alas, I have no solution. You seem to handle it well.