More Health Issues... JOY!!!

This last week I received two telephone calls from two different offices...

The first was from the Dermatologist to tell me they got all the Cancer on my neck. WOOHOO! I can breathe a sigh of relief. Although, I will be going back several times over the next few weeks for various follow-ups and will have to continue seeing Dermo for the rest of my life. It sucks having pale skin, but I will do what is necessary to keep myself healthy.

The second was from my PCM's office. I have what is known as Stress Incontinence, which requires a referral to a specialist in the Urogynecologist field. According to the Mayo Clinic, Stress Incontinence a condition where you may feel embarrassed, isolate yourself, or limit your work and social life, especially exercise and leisure activities. With treatment, you'll likely be able to manage stress incontinence and improve your overall well-being. I will be calling Walter Reed Army Medical Center this next week to schedule an appointment.

Stress Incontinence is VERY common in women.

Here is some information, all taken from the Mayo Clinic website to help you determine if you too have a problem. I went a long period of time before discussing the issue with my doctor, but after some strong encouragement from a friend, I sucked it up and made the call.

My final straw was participating in an evolution with a large number of personnel and wetting myself and not having anywhere to go to fix the problem.

If you experience urine leakage during the following activities, it is time to call your doctor:

- cough
- sneeze
- laugh
- stand-up
- lift something heavy
- exercise

Do not let the loss of urine during these activities interfere with the above daily activities.

The primary leading cause of the loss of tone in my pelvic floor and urinary sphincter muscles was probably childbirth, remember, I have had four children. A few other contributing factors may be:

- Urinary Tract Infection
- Illness that may cause chronic coughing and sneezing
- Obesity
- Smoking, which causes chronic coughing
- Diabetes, which can cause excess urine production and nerve damage
- Excess consumption of caffeine and alcohol
- Medications that cause a rapid increase in urine production
- sports, suck as tennis or running

Some Risk Factors:

- Age
- Childbirth
- Body Weight
- Previous Pelvic Surgery

Some complications of Stress Incontinence:

- Personal distress
- Mixed Urinary Incontinence
- Skin Rash or Irritation

Preparing for your appointment

What you can do to get the most from your visit to the doctor, prepare in advance:

- Write down any symptoms you're experiencing. Include all of your symptoms, even if you don't think they're related.
- Make a list of any medications or vitamin supplements you take, regardless of how common you think they are. Many over-the-counter supplements can irritate the urinary tract. Also write down doses and how often you take the medication.
- Have a family member or close friend accompany you. You may be given a lot of information at your visit, and it can be difficult to remember everything.
- Take a notebook or notepad with you. Use it to write down important information during your visit.
- Prepare a list of questions to ask your doctor. List your most important questions first, in case time runs out.

For urinary incontinence, some basic questions to ask your doctor include:

- Will my urinary incontinence go away eventually?
- What tests might I need to determine the cause of my incontinence?
- Will changing my diet help with my incontinence?
- How does my weight affect my condition?
- Could pelvic floor exercises help me? How do I do them?
- Could the medicines I take be aggravating my condition?
- Are there any medications that would help with my bladder control?
- What additional testing will I need to undergo?
- Will I need surgery?

Make sure that you understand everything your doctor tells you. Don't hesitate to ask your doctor to repeat information or to ask follow-up questions for clarification.

What to expect from your doctor
Be prepared to answer questions from your doctor. Potential questions your doctor might ask include:

- How often do you leak urine?
- When you leak urine, is it a few drops or are your clothes soaked?
- Do you leak urine when you laugh, cough, sneeze or lift heavy objects?
- Do you leak urine when you exercise?
- How often do you urinate in the toilet during the day?
- Do you wake up at least twice during the night to urinate?
- What's your typical daily fluid intake?
- Do you drink beverages with caffeine or alcohol? How many each day?
- Does anything seem to make your incontinence better? How about worse?
- What's the most bothersome aspect of your problem with urinary incontinence?

During work-up, your doctor will look for:

- A medical history
- A complete physical examination with particular focus on your abdomen and genitals
- A urine sample to test for infection, traces of blood or other abnormalities
- A neurological exam to identify sensory problems
- A urinary stress test, in which the doctor observes urine loss when you cough or bear down

Some specialized tests that may be needed:

- Measurements of postvoid residual urine
- Measuring bladder pressure
- Creating images of the bladder as it functions

Treatments and Drugs:

Behavioral therapies

- Fluid consumption
- Healthy lifestyle changes
- Scheduled toilet trips
- Pelvic floor muscle exercises

Devices

- Vaginal pessary
- Urethral inserts

Surgery

- Injectable bulking agents
- Open retropubic colposuspension
- Sling procedure
- Inflatable artificial sphincter

Some lifestyle and home remedies, may include:
- Shed extra weight
- Add fiber to your diet
- Avoiding eating or drinking substances that may irritate your bladder
- Maintain proper fluid intake
- Don't smoke

Why am I putting myself out there (embarrass myself)? I do not want to see anyone go through what I went through. It is important for all of us to be educated and get treatment immediately.