- Welcome my friends to the "Bob and Brad" podcast.
My name is Mike Kenitz
and today I'm interviewing physical therapist, Sarah Haag.
She is an expert
in urinary incontinence and bladder control.
She is also the part owner
in Entropy Physiotherapy and Wellness and the author
of the book "Understanding and Treating Incontinence."
So without further ado, here is Sarah.
So how can someone manage their urinary incontinence
on a daily basis?
- Great question.
So again, part of it's gonna depend
on the type of incontinence that they have
and one of the things that you'll see on the television
is that to just manage it with continent pads, right?
So you could buy a pad, put it in there,
it'll just catch the urine.
And I will say, thank goodness those exist.
There are people who like if that helps you stay active,
if that helps you get outta the house,
these are great things.
But unfortunately, I think too often
as I would say women in particular shrug their shoulders,
go to the store and buy some and really don't look
at the other things that they might be able to change
to improve or eliminate their incontinence.
So some of the things that you can do is one, exercise.
So we already talked a little bit
about pelvic floor exercises in general,
but also just being fit reduces your risk
and can reduce your incontinence.
So being a healthy weight,
having good cardiovascular fitness,
all of these are things that can help lower your risk
or lower the incidence of urinary incontinence.
And then some other things, and I actually
already mentioned it a little bit, is managing constipation.
So having good bladder and bowel habits, making sure
that that bowel is emptying well,
can actually improve bladder function
'cause we don't think about our bowel
and our bladder being that close to each other.
But if we look inside, they're actually
they are very close to each other.
And if we do have constipation say in our rectum
it can kind of crowd the bladder
and make it more likely to leak
and a little bit more irritable.
Smoking is not good for much
and it is really not good for our bladders.
Two reasons.
One, it does increase your risk of bladder cancer
but also the coughing.
So our pelvic floor again is just like any other muscle
and when we cough we tend to stress the pelvic floor.
And so if you cough once
or twice we should absolutely be able to stay continent.
But if we're coughing all the time,
those muscles definitely fatigue
and we're gonna increase the likelihood
that we're gonna have incontinence.
Looking at diet.
So like I said
there are some things that irritate some people's bladders
but before you give up all the things you love in life
and drink only water, I always recommend do a voiding log
even if it's on your own to go,
"Whoa I didn't drink any plain water today,
and every time I had that carbonated water,
I had to go to the bathroom really bad."
So sometimes people can figure this out on their own.
It's not a secret for healthcare providers.
You know your bodies as well
as any, well, better than anyone else.
And then behavior.
So sometimes when I bring up,
well we might have to look at changing some behaviors,
people can get a little bit like, "Oh what are we gonna do?"
But when people have experienced incontinence
or are concerned that they are going to be in incontinent,
they sometimes change their behaviors.
Like, well at one extreme, not leaving the house ever
but other times going to the bathroom just in case.
So they'll go out for a day
but they will know where all the bathrooms are
and they will hit everyone
along the way just in case.
That can start, so I do explain it this way
it can make our bladder a little lazy.
So our bladder's supposed to be able to fill up
and hold like four to 600 milliliters of fluid, right?
So that's a couple of cups.
But if every time it gets this full, I go and empty it,
my perception and my understanding
of what's happening in my bladder can shift a little bit
and go like, oh, I can empty now.
And it'll actually prefer to empty sooner
and more often rather than let it fill all the way up.
So we're actually training ourself
to go to the bathroom more often.
And so then we need to look at that and say, okay
can we start lengthening the trips between the bathroom?
'Cause really when we're looking at norms
so I don't want anyone to get super nervous
if they ever go more than this.
Really we're looking at just getting up zero
to one time a night if you're 65 or under
and one to two times a night if you're 65 or over.
And during the day, we're looking at
well actually over a 24 hour period we're looking
at just six to seven times to the bathroom a day to urinate.
And you know, I've had patients
where they go 30 times a day, okay
we need to take a look at that
and figure out what do we need to do?
Is it changing your fluid intake?
Is it using some sort of distraction?
Is it a breathing exercise?
What do we need to do so
that you can stay out of the bathroom longer and stay dry?
I think probably if I could like just
the one thing is you asked about managing it,
but one of the questions was,
can urinary incontinence be cured or only managed?
And ultimately urinary incontinence can be resolved
meaning go away completely for some people.
And I think that it's fair to have that expectation
but kind of like a lot of areas of our health,
we have to do things to take care of ourselves
to stay healthy.
And I think if we do that there are many people
who can be, I wanna call it cured of urinary incontinence.
- Sure, I'm sure it's a long process, but if you stick to it
these things can correct themselves over time.
All right.
- And sometimes it's, I was gonna say just real quick
sometimes it's not as long as people think it'll take,
sometimes small changes can make a huge difference.
So it's not always a huge mountain to climb.
Sometimes it's just a tiny little change.
And there you go.
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