Helpful tips for managing urinary incontinence
Urinary incontinence is a prevalent issue, with anywhere from 25 to 50 percent of women reporting an episode in the past year.
“Managing urinary conditions can be frustrating and time-consuming, but there are helpful tips and lifestyle changes that can reduce the burden this condition causes,” says Jenna Hoppenworth, a Mayo Clinic Health System nurse practitioner.
Hoppenworth shares these tips:
Establish a fluid schedule.
Attempt to keep your fluid intake on a schedule to help retrain your bladder when to fill and when to empty. Also, limit fluid intake after 6 p.m. to reduce nighttime voiding and incontinence.
Stick to a toileting schedule.
Plan toileting attempts at least every two to three hours during the day. This helps prevent your bladder from becoming too full and causing overflow incontinence.
Perform pelvic floor exercises.
Strengthening the muscles of the pelvic floor can reduce urinary incontinence by as much as 90 percent. Kegel exercises can help.
Manage constipation.
Obstruction of stool is a common cause of incontinence and retention. Maintaining a healthy elimination pattern prevents stool from obstructing the stream of urine. Keep a bladder diary.
Try to keep a bladder diary for a few days to a few weeks to identify triggers of incontinence and retention. Important components to the diary include time of day, amount of fluid intake, how many times you went to the bathroom, how many times you leaked urine throughout the day, if you felt an urge to urinate before leaking and what type of activity you were engaged in at the time. Remember to bring this with you to appointments with your health care provider.
Create a calming environment.
Managing urinary incontinence can be stressful and emotional at times. Creating a calm environment takes the stress off the situation so that you can focus on emptying your bladder.
“It’s important to have a conversation with your provider regarding prevention of urinary retention and incontinence,” says Hoppenworth. “There are medications that can cause urinary retention as well as many medications that can alleviate the symptoms and causes of urinary retention.”
Dear Dr. Roach:
I’m almost 84, and all my life I have had a problem with sinusitis. Never headaches, just post-nasal drip and use of multiple tissues. (I really should buy shares in tissue companies, as I’d rather leave home without my clothes on than without a couple of tissues.) I blow my nose an awful lot.
Anyway, I have always thought that yellow mucus was a sign of infection, but recently my doctor assured me that the color is no longer considered an issue, unless it is a very dark brown. Do you agree with that opinion?
Normal nasal secretions are nearly colorless, and they become colored due to the action of bacteria. So, in cases of bacterial sinus infection, the mucus is usually colored. However, bacteria that normally live in the nasal passages can turn the mucus to a yellow or light-brown color even in the absence of infection. The color intensity is due more to the amount of time the bacteria spend in contact with the mucus. Mucus color is not a reliable indicator of infection.
My 73-year-old husband was diagnosed with atrial fibrillation about 10 months ago. His cardiologist feels that, at this
Answer: — V.M. Dear Dr. Roach:
time, all he needs to do is take an 81-mg tablet of aspirin each day, and when he turns 75, possibly take a medication such as Xarelto. My husband’s only symptom is shortness of breath when he exerts himself, e.g. walking, mowing the lawn, shoveling snow, etc. Will this type of exercise or work cause him problems with the atrial fibrillation?
— J.P. Answer:
Atrial fibrillation is a common diagnosis. I receive many questions about it. It is a lack of rhythm of the heart, and the heart rate also can become very fast, especially with exercise. The other major issue with atrial fibrillation is that clots can form in the atria, and these can migrate to critical organs, especially the brain, causing a stroke.
The two issues are treated differently. Stroke risk is assessed by the clinician, often using a scale such as the CHA2DS2VASc score, a predictor of stroke risk. I suspect your husband’s cardiologist is using this score, since it is at age 75 when the score becomes high enough to recommend an oral anticoagulant, such as warfarin or rivaroxaban (Xarelto). Some people with atrial fibrillation can be managed with aspirin, but many cannot.
The second issue is control of the heart rate. A few people with atrial fibrillation don’t need medication (or any treatment) for heart rate, but many do. I am concerned that your husband’s heart rate may be getting elevated during exertion. Hopefully his cardiologist has already evaluated this; if not, he should. A stress test or a 24-hour heart monitor are two of the most common ways to evaluate heart rate response to exercise. Heart rate can be controlled with medication.
An alternative is to try to get the person out of atrial fibrillation and back into a normal heart rhythm. This treatment strategy, called rhythm control, is not likely to be effective for people who have been in atrial fibrillation for many years and who have structural heart disease.
So, my answer is that a little shortness of breath may not be a bad thing, but your husband is at risk for having a fast heart rate, which should be checked.
The booklet on abnormal heart rhythms explains atrial fibrillation and the more common heart rhythm disturbances in greater detail. Readers can obtain a copy by writing: Dr. Roach, Book No. 107, 628 Virginia Dr., Orlando, FL 32803
Enclose a check or money order (no cash) for $4.75 U.S./$6. Can. with the recipient’s printed name and address. Please allow four weeks for delivery.