OAB – A WOMAN’S GUIDE TO PELVIC HEALTH

Women’s Urinary Incontinence: How to Be a Better Patient 5 Ways

June 18, 2013

by Elizabeth E. Houser, MD and Stephanie Riley Hahn, PT Find the Right Doctor Overactive Bladder Urge Incontinence Urge Urinary Incontinence Urinary Incontinence

If you’ve got women’s urinary incontinence, then you probably know that the process of actually becoming a patient–that is, seeing a medical professional–isn’t all that easy. It takes a lot of courage to overcome embarrassment and make an appointment, not to mention show up at the appointment.

If you have already overcome the first hurdle of making an appointment, then make the most of your courageous act by following these 5 tips on how to be a better patient. What do we mean by “a better patient”? We mean an empowered patient. When you are an empowered patient, you are a powerful advocate for your health. You become a powerful force in relieving and even curing your symptoms of women’s urinary incontinence, such as urinary urgency, frequency, and leakage. You become the key to a new sense of freedom for your life.

Sound good? Then read the following tips on how to become a better patient!

How to Be a Better Patient: 5 Tips You Can Use Today
Knowledge is power, and you will discover that a lot of our tips on how to be a better patient are related to increasing your level of knowledge… or translating your doctor’s knowledge into terms that make sense to you.

Tip #1: Know Your Terminology
While most doctors will try to translate their technical medical knowledge into layman’s terms, you can help yourself by learning the terms related to your condition–women’s urinary incontinence. For instance, did you know that there are three different types of urinary incontinence? You may have stress, urge (or overactive bladder, also called OAB) or mixed urinary incontinence. Learning at least a little about each type of urinary incontinence will give you a head start when you discuss your condition with your doctor. Get an overview HERE or dig deep and learn the full details about each type of urinary incontinence HERE.

Tip #2: Insist on Having Your Questions Answered
If you take the time to research your condition, and your most probable type of urinary incontinence, then you will probably have a list of questions by the time you see your doctor. If for any reason your doctor does not seem to want to answer your questions, be politely but quietly persistent. If your doctor continues to ignore your questions, consider finding a new doctor. Getting the answers to your questions is crucial to relieving your symptoms of urinary incontinence, so a doctor who dodges your questions or will not give you a straight answer may not be the doctor for you. One way to ensure your questions are answered is to bring a buddy with you to the appointment. Your buddy’s job is to ensure that your questions are answered, and that you do not get distracted by a ton of medical jargon. Having a good gal pal at your appointment can make all the difference!

Tip #3: Ask for Clarification as Often as Necessary
Many doctors are used to using medical terminology on a regular basis. While many healthcare providers are good at explaining those terms in a way non-medical people can understand, other doctors are less skilled at this. If your doctor uses a term you don’t understand, gently stop him or her and ask for clarification. If your doctor’s explanation still leaves you confused, ask for even more clarification. Don’t worry about whether you appear “stupid.” You are paying for your doctor’s time and attention, so make the most of it without worrying about “saving face.”

Tip #4: Fire Doctors Who Don’t Respect Your Time
Healthcare providers are feeling the “crunch” of needing to see more patients in less time. The result is often that you, the patient, wait for a long time to see the doctor only to feel rushed during the appointment. One way to be a better patient is not to tolerate a doctor who disrespects your time in this way. While a certain amount of waiting is to be expected, regularly waiting 30 minutes or more to see your doctor AND routinely feeling like you are being speed-walked through your appointment is not acceptable. Like all professionals, your doctor can and should be held to a certain level of efficiency and skilled time management. If your doctor routinely makes you feel like his or her time is more valuable than yours, it’s time to fire that doctor and find a new one.

Tip #5: Don’t Tolerate an Inefficient Office Staff
Many times the receptionists, nurses, and assistants that make up the office staff act as the conduit between you and your doctor after and between appointments. If you find your doctor’s office staff inefficient or unprofessional, you might be putting your health at risk. Suppose your doctor prescribes a new medication, and you begin having side effects, you will probably call your doctor’s office. In all likelihood, your doctor’s staff will take a message to pass on. If that message does not get passed on in a timely manner–or not at all–the side effects could really affect your health. Do not tolerate members of your doctor’s office staff that fail to pass on messages or minimize your situation. One way to be a better patient is to insist on speaking with the doctor or find a new doctor.

How to Be a Better Patient–Why It Is Important
As you can see, being a better patient is really about being persistent in seeking solutions to your women’s urinary incontinence. If you are unable to easily communicate with your doctor or the office staff, even after your best efforts to clarify communications–chances are that you will need to find a new doctor. You are more likely to find the solutions you seek with a doctor who “clicks” with you. So go forth and seek your perfect doctor!
If you enjoyed this post, we invite you to check out our book, leave a comment, contact us, download our free ebook, or interact with us on Twitter and Facebook.

Women’s Urinary Incontinence: What IS Normal? 7 Questions for You…

May 16, 2013

by Elizabeth E. Houser, MD and Stephanie Riley Hahn, PT Overactive Bladder Urge Incontinence Urge Urinary Incontinence Urinary Incontinence

When it comes to women’s urinary incontinence, what IS normal? How do you know if you have urinary incontinence or just have to pee a lot? Is a little leakage OK?

These are common questions that women often wonder about. We have taken 7 of the most common questions regarding women’s urinary incontinence, and answered them! If you wonder… read on!

7 Questions to Ask Yourself About Women’s Urinary Incontinence
If you sometimes wonder what’s “normal” when it comes to your urinary habits, check out the answers to these 7 common questions.

How much urine can a healthy bladder hold?
If your bladder is healthy, it should be able to hold up to two cups of urine easily for two to five hours.

How often should you need to urinate?
If your urinary system is healthy, you should not experience the urge to urinate more than eight per day. In addition, you should not need to urinate shortly after you have emptied your bladder

Is urinating at night normal?
For women with a healthy urinary system, getting up at night to urinate should not be a normal occurrence. Exceptions can happen if you drink fluids too late in the day, drink excessive amounts of fluid, or have had any food or drink that irritate the bladder (including alcohol, caffeine, spicy food, or acidic food).

Is it normal for certain foods or drinks to cause you to urinate more?
Yes, certain foods and drinks are known as bladder irritants. While these classes of foods and beverages do not affect all women the same way, they can have an irritating effect on many a woman’s bladder. Which foods should you avoid? Check out the article HERE.

Is urinary leakage normal?
Urinary incontinence or leakage is not normal at any age. Acceptance of this health condition as a normal sign of aging is the second most common reason women don’t seek help from a physician. Embarrassment about talking to a doctor about urine leakage tops the list, followed by women thinking that urinary incontinence “wasn’t enough of a problem.” As a result, less than 50% of women with urinary incontinence seek medical help, and those who do get help wait almost seven years. Don’t become part of that statistic! If you leak urine, seek medical help right away!

Is defensive voiding (“urinating just in case”) normal?
If you go to the bathroom often, “just in case” you might need to later, then you are practicing what is called defensive voiding. Women practice defensive voiding so that they can sit through a movie or make it all way through dinner without jumping up to use the ladies room. Defensive voiding is a sign of overactive bladder (OAB) or urge urinary incontinence. It is not normal. If you practice defensive voiding, seek help from your doctor.

Is sudden urinary urgency normal?
If the sound of running water, sudden immersion in cold water, a change in body position, or smoking causes you to experience urinary urgency, you need to call your doctor. Chances are that you have overactive bladder or urge urinary incontinence. If your urinary system is healthy and normal–and you pay attention to your body’s needs–you should never have to run for the bathroom!

Get it? Got it? Good! If you still have questions, check out the rest of our blog or ask your question on Facebook … we will answer!

If you enjoyed this post, we invite you to check out our book, leave a comment, contact us, download our free ebook, or interact with us on Twitter and Facebook.

Ladies: Read This if You Wonder What’s Up Down There

May 9, 2013

by Elizabeth E. Houser, MD and Stephanie Riley Hahn, PT Mixed Urinary Incontinence Overactive Bladder Pelvic Floor Weakness Pelvic Organ Prolapse POP Stress Urinary Incontinence Urge Incontinence Urge Urinary Incontinence

Sometimes there is nothing like another person’s story to really motivate and empower us to take action for our own health. If you are concerned that you may have women’s urinary incontinence–meaning you have symptoms like urinary urgency, frequency, or leakage–the stories in this article may interest you. These stories may also interest you if you feel like something is falling out “down there”… or if your bedroom encounters have gone from “hot to not”!

If you wonder, “What IS up down there?” then read on… these stories may resonate with you plus motivate you to get the help you need!

Are You Like Jane?
Jane, in her mid-thirties, loves how kickboxing is helping restore her figure after she gave birth to her adorable son. What she doesn’t love is the amount of urine she leaks every time she kicks or boxes. In fact, the leakage happens so often that she is thinking of stopping her exercise program altogether. Here’s what Jane doesn’t know. She has stress urinary incontinence (also called stress incontinence), the most common form of urinary incontinence, which affects 26 percent of women over age 18 at some point in their lives. Childbirth is a major cause of stress incontinence. Most women with urine leakage wait more than six years to get help. Yet research shows that urinary incontinence in 8 out of 10 women with the condition can be improved. How long will Jane wait?

Jane solved her problem. Find out how by clicking HERE.

Are You Living Karen’s Story?
Sixty-two-year-old Karen has bathrooms on the brain. She has to urinate 10 to 12 times a day and a few times at night. Sometimes she feels a sudden urge and doesn’t make it to the bathroom in time–she then leaks a large volume of urine. Karen has to carry several changes of clothing with her and buys adult diapers in bulk. Her situation is bad, but her embarrassment about seeking help is worse, so she just keeps coping with the condition by herself.

This is what Karen should know. Karen is suffering from the most severe form of overactive bladder, called urge urinary incontinence. About 17 percent of women in the United States have urge incontinence, especially women 50 and older, but less than half seek help. Getting help is important, because about 60 percent of women with urge urinary incontinence also experience depression (though the two conditions are not always related). Help is also important because 70 percent of women with urge incontinence report symptom improvement with conservative treatments like medication or physical therapy.

Discover how Karen stopped leaking urine by reading her story HERE.

Does Jo’s Story Ring a Bell?
Jo, age 40 and very fit, faces a complex situation: she has the same symptoms as Jane and Karen, meaning she leaks urine when she exercises or laughs as well as because of sudden urges. She’s had symptoms for only 11 months but is definitely going to ask her doctor for help, even though she feels embarrassed. Her symptoms are frequent and serious. What Jo will learn when she talks to her doctor: Jo’s doctor will tell her that she has mixed urinary incontinence, which is a combination of stress incontinence and urge incontinence or overactive bladder. Women with this mixed form of incontinence are more likely to seek help earlier because their symptoms tend to be worse and more frequent than symptoms of women who experience only stress or urge incontinence / overactive bladder. Mixed incontinence has a much stronger negative effect on quality of life, and women with this condition spend much more on laundry bills and adult diapers.

Jo was able to solve both types of urinary incontinence by using the steps outlined HERE.

Do You Share Susan’s Pain?
At age 68, Susan is suddenly experiencing low-back pain, chronic constipation, and the feeling that she is sitting on a ball. Luckily, she already has an appointment with her ob-gyn in a few weeks. She hopes her doctor will tell her what’s happening in her pelvic region. What Susan’s ob-gyn will tell her at her appointment: Susan feels like she’s sitting on a ball because her pelvic organs have literally popped out of place. She has pelvic organ prolapse, in which one or more of her pelvic organs have moved out of place and now bulge into her vagina. Susan’s ob-gyn will tell her that she is among the 3 to 6 percent of women who have severe pelvic organ prolapse, and will most likely need surgery to correct the problem. Surprisingly, between 43 and 76 percent of women have some degree of prolapse without knowing it and should be taking preventive action.

Susan was able to solve her pelvic organ prolapse issues with help from her doctor. Find out what Susan did HERE.

Do You Have “Not So Hot” Bedroom Encounters Like Cherie?
At age 42 Cherie is supposed to be in her sexual prime, at least according to the latest women’s magazines, but she feels far from sexy. With two children and a busy career, she considers sex to be at the bottom of her list. Further, sex with her husband just isn’t very pleasurable anymore because Cherie doesn’t feel much sensation in her sexual organs. She avoids sex as much as possible, but her husband is becoming upset and worried. She knows she needs to do something to resolve the situation, but she doesn’t know what.

How Cherie can solve her sexual problem: More than 40 percent of women are dissatisfied with their sex lives, and many of these women have decreased sexual sensation, which is what Cherie is experiencing. This decrease in sensation is often due to weak pelvic floor muscles, and the good news is that these muscles can easily be strengthened with pelvic floor muscle exercises. Studies show that women who do pelvic floor exercises reach orgasm more easily and experience more sexual desire. Cherie can improve her symptoms by following a simple pelvic floor exercise program, such as one from her physical therapist or the at-home program in chapter 7 in our book.

Cherie changed her bedroom encounters from “not, back to hot”… find out how by reading her story HERE.

Read, Plan, Do
Once you have read through these women’s’ stories, you should have a pretty good idea of what is going on with your pelvic health. Then make a plan. Will you call your family doctor for a referral to a urologist or will you visit your ob/gyn? Will you stop in and visit with your family doctor first?

Whatever you plan that takes you closer to solving your pelvic health issues is good. Then you must DO. A plan without action is not a very useful plan. So once you have your plan, do it! Take action for your own pelvic health. You will be surprised how much your quality of life will be affected by improving your pelvic health!

If you enjoyed this post, we invite you to check out our book, leave a comment, contact us, download our free ebook, or interact with us on Twitter and Facebook.

Overactive Bladder: Risk Factors versus Triggers

April 18, 2013

by Elizabeth E. Houser, MD and Stephanie Riley Hahn, PT Overactive Bladder Urge Incontinence Urge Urinary Incontinence

If you are a woman suffering from urinary urgency, frequency, or leakage, then chances are that you have considered the fact that you may have overactive bladder, or OAB. You may have done some research to educate yourself about your condition, and learn about possible solutions. You may have even seen your doctor to get an accurate medical diagnosis.

And, if you are like many women, you may still be confused. Specifically, you may be confused about the difference between risk factors and triggers for OAB. If so, don’t worry. Many women with urinary incontinence are unclear about these two terms, so you are not alone. The good news is that this kind of confusion is simple to clear up!

Risk Factors for Overactive Bladder
In a previous article we discussed the risk factors for OAB. When we use the term “risk factors,” we are describing the constant or chronic factors in your life that may be causing your urinary urgency, frequency, or leakage.

Being overweight is an example of a lifestyle factor that puts you a risk for OAB. Another example of a risk factor is having a low level of estrogen, which is a chronic condition that can cause bladder irritability, leading to OAB symptoms.

In other words, risk factors are the constant conditions in your life that cause or put you at risk for OAB symptoms. When you adjust your lifestyle in a permanent way–by losing weight or stopping smoking, for instance–you reduce your risk of experiencing symptoms like urinary urgency and frequency. By removing the causes of OAB from your lifestyle, you reduce your chances of getting or having this condition.

Triggers for Overactive Bladder
Unlike risk factors, triggers do not refer to constant lifestyle conditions. Instead, triggers are momentary events that may immediately bring on symptoms such as urinary urgency or leakage.

For instance, some women with OAB may feel the urge to urinate when they hear the sound of running water. Other women have symptoms triggered by drinking caffeinated beverages or eating spicy foods. Additional triggers include immersion in cold water, sudden changes in position, or drinking small amounts of liquid.

One lifestyle risk factor that is also a trigger for OAB is smoking. As a lifestyle habit, smoking increases your risk of having OAB because nicotine causes your bladder to be constantly irritated. At the same time, whenever you smoke a cigarette, you can trigger your OAB symptoms in that moment. This makes smoking both a risk factor and a trigger for OAB. Hence, some women become confused about the difference between risk factors and triggers.

For the most part, however, triggers can bring on OAB symptoms in the moment, while risk factors are constants in your life that increase your chances of having OAB as a permanent condition (permanent, that is, until you change your lifestyle and reduce your risk).

Hopefully this short article helps clear up any confusion about the difference between risk factors and triggers for women’s urinary incontinence, of which OAB is just one of three types!

If you enjoyed this post, we invite you to check out our book, leave a comment, contact us, download our free ebook, or interact with us on Twitter and Facebook.

Overactive Bladder (OAB) Risk Factors You Should Know About

April 16, 2013

by Elizabeth E. Houser, MD and Stephanie Riley Hahn, PT Overactive Bladder Urge Incontinence Urge Urinary Incontinence Urinary Incontinence

Do you suffer from urinary urgency the moment you sit down in a movie theater? Or maybe you have the nervous habit of looking for bathrooms everywhere you go. Or how about that track you have worn into your carpet between your bed and the bathroom–the result of getting up to urinate many times a night?

If the above description sounds like you, you likely have a form of women’s urinary incontinence called overactive bladder (OAB) or urge urinary incontinence. If you only experience urinary urgency without leakage, then your condition is most likely OAB or OAB-dry. If you do leak urine, then you probably have the more severe form of OAB, called urge urinary incontinence or OAB-wet.

Now that you know a little more about what is going on with your bladder, wouldn’t it be nice to learn more about the risk factors that cause urinary urgency and leakage? Let’s talk about them…

Risk Factors for OAB and Urge Incontinence
Before we describe the specific risk factors for OAB or urge incontinence, we first want to stress that regardless of these factors, urinary urgency, frequency, and leakage are not normal at any age. Urinary incontinence does tend to occur more frequently as we age, but it is not a normal sign of aging that should simply be ignored. Urinary incontinence can have a severely negative impact on a woman’s quality of life, and thus should be addressed as soon as symptoms appear. Symptoms can be effectively treated, especially if handled early in the process.

Now that we’ve give you our “soapbox” speech, we can get on with describing the risk factors for OAB or urge incontinence. Knowing the risk factors can help you evaluate your lifestyle, current physical condition, and other health conditions to determine whether any of these are causing or worsening your symptoms.

Risk factors that you may already know about include:
– aging
– excessive weight
– smoking
– being a woman (not fair, right?)
– urinary tract infections (especially chronic ones)
– certain medications (such as ones that act as diuretics)

Then there are these risk factors, some of which may surprise you:
– anxiety and similar nervous states
– low levels of estrogen (can cause bladder irritability)
– damage to any nerves associated with the bladder or urinary system (due to stroke, accident, or conditions such as Parkinson’s)
– health conditions such as uncontrolled diabetes

Note that the above risk factors describe more permanent lifestyle conditions that can contribute to urinary urgency and leakage due to OAB or urge incontinence. There are also temporary conditions, called “triggers,” that can aggravate symptoms. We will discuss those in an upcoming article.

In the meantime, we urge you to review the above risk factors to determine whether any of them apply to you. If any do apply, are you willing to change your lifestyle in a significant way to alleviate your bladder symptoms? While there is no way to stop the passage of time (aging) or easily change your gender, you can take action steps to lose weight, quit smoking, talk to your doctor about your medications and health conditions, or reduce the level of stress in your life.

We invite you to browse through the resources on our website to learn more about conservative lifestyle changes that can definitely improve your symptoms. Or, for the full list of possible solutions for women’s urinary incontinence, consider reading a copy of A Woman’s Guide to Pelvic Health. This book offers full descriptions of all three types of women’s urinary incontinence, plus three entire chapters chock-full of resources and solutions designed especially for you!

If you enjoyed this post, we invite you to check out our book, leave a comment, contact us, download our free ebook, or interact with us on Twitter and Facebook.