In the July/August edition of the Family Caregivers’ Grapevine, we published an article featuring tips and resources for incontinence care. A reader pointed out that VCH’s Continence Promotion and Management Program is no longer in operation.
Not sure of where to redirect readers, we connected with North Shore’s own Maureen McGrath, a nurse continence advisor with Doctors Stephen Kaye and Carolyn Donnelly, for some more information on this important topic. It became apparent quite quickly that McGrath is passionate about getting help for those suffering and that she has a wealth of knowledge to offer. Read on for Maureen’s tips and resources.
McGrath shared that there are only three bladder and bowel clinics care programs in BC covered by MSP, and they are located at St. Paul’s Hospital, Abbotsford General and Richmond General Hospital. The wait is anywhere from 4-9 months for clinics covered by MSP. A patient can receive care in McGrath’s clinic within a week or two. ”It has been my experience that although speaking to a family doctor may be a good first step if he/she is trained in diagnosis and treatment of urinary incontinence but referral to a specialist such as a gynecologist or uro-gynecologist may be necessary. Patients may also self-refer to a Nurse Continence Advisor (NCA),” says McGrath. “Urinary incontinence is complex and diagnosis is key to treatment. There are 5 different types of urinary incontinence: 1. Stress 2. Urge 3. Overflow 4. Functional 5. Mixed
Bladder Health education is integral to success. That said, diagnosis through proper assessment is key and which is within the scope of the NCA. “We do a history, medication review, ascertain contributing factors, provide diagnosis and treatment recommendations.”
Here are a few recommendations for caregivers:
- Dilute urine is less irritating to the bladder than concentrated urine. Drink enough water based fluids so your urine is clear 90% of the time.
- Treat constipation by increasing fibre, ensuring adequate fluids and taking advantage of the gastrocolic reflex. Constipation is a contributing factor to urinary incontinence.
- Moisturizing your vagina is just as important as moisturizing your face. Upwards of 75% of women lose estrogen, the hormone regulator of the urogenital tract and vagina. Personal moisturizers like Gynatrof or low dose localized estrogen treatment is important for vaginal health and may help to reduce the risk of a urinary tract infection (UTI)I (which may lead to leakage of urine). It is very dangerous for women over the age of 65 to get a UTI as it places them at risk for sepsis.
- Kegels are important but must be done appropriately by squeezing the rectal muscle (the muscle that prevents you from passing gas) to the count of 3, holding it for 3 and releasing it to the count of 3.
- Bladder irritants in moderation. (bubbly drink, spicy foods, tomato, chocolate, citrus, vitamin C, caffeine (limit coffee to1 cup/day) to name a few.
- For stress urinary incontinence (leaking with cough, sneeze and/or exercise) or a pelvic organ prolapse that results in urinary retention, leakage or discomfort, a pessary which is a small medical grade silicone device to support your urethra, bladder or uterusis a great conservative option that resolves the issue immediately and gets a woman back to her regular activities!
McGrath thinks the most important piece of information is that THERE IS TREATMENT! “Leaking urine is never normal. One doesn’t have to suffer needlessly.”
Maureen is in private practice in North Vancouver at #103-1221 Lonsdale. To book an appointment email her directly at: firstname.lastname@example.org
For more information on Maureen McGrath and her work, visit: http://www.backtothebedroom.ca
or listen to The Sunday Night Sex Show on News Talk 980 CKNWhttp://globalnews.ca/bc/program/sunday-night-sex-show
Thank you so much for your insight, Maureen!