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Greetings to each of you!   With the falling leaves, cooler weather, jackets & fall sports, you may have found a new "bounce " in your step these days.   Have you  been for a walk in the woods?   a bike ride?   been to a football or soccer game?   If not, think of something you can do to get outside & enjoy the brisk fall air, then go do it !!
 
This month I want to address an issue that is of importance to men:   "What Men Should Know About Overactive Bladder".   Approximately 33 million Americans are affected by overactive bladder and the risk increases with age   Contrary to popular belief, men are just as likely as women to develop the problem, although men are less likely to experience wetting accidents.
 
In men, symptoms of overactive bladder (a problem in which a frequent and intense urge to urinate may be accompanied by leakage) can be mistakenly attributed to benign prostatic hyperplasia (BPH), an enlarged prostate.   In fact, some men do have overactive bladder and BPH.   Bladder control problems may also be caused by stress incontinence, a leakage of urine brought on by activities such as coughing, sneezing, laughing or exercising.   These conditions can all overlap, so a proper evaluation by a physician is key for an accurate diagnosis.   If overactive bladder is the problem, a variety of effective treatments are available.  
 
Root Causes:    When nerves carrying messages to and from the bladder don't work properly, the detrusor muscle, a large, smooth muscle in the bladder wall that squeezes urine out of the bladder at the time of urination, can become overactive and squeeze the bladder before it has filled adequately.   In many cases, the reason for this over activity is unclear.   Experts speculate that overactive bladder may be related to aging.   Damage to the nerves in the pelvic area during surgery may be another contributing factor.
 
Medications, such as some sedatives, diuretics and sleeping pills, can contribute to overactive bladder, as can certain food products.   Concentrated citrus products and caffeine can reduce the body's ability to retain urine.  
Alcohol, carbonated beverages, milk or milk products, tomatoes or tomato-based products, spicy food, sugar, honey, corn syrup and artificial sweeteners also tend to aggravate overactive bladder.   Eliminating any of these from your diet might help.
 
Best Treatment Practices:    Managing overactive bladder involves eliminating bladder irritants, drinking 4 to 8 glasses of water a day (more diluted urine results in less bladder irritation), strengthening the pelvic floor muscles, re retraining  retraining the bladder and taking medication.    You can learn these techniques using a bladder-training program; it takes about 60  days to see results.   The goals are to hold about one pint of urine in the bladder and to urinate every 2 to 4 hours throughout the day.
 
Begin by keeping a detailed bladder control diary for at least 72 hours.   This helps you keep track of what you drink, how much you drink, how may times you urinate and how much each time (a minimal, moderate or large amount).   Document whether you felt a strong, sudden urge to urinate, and what activity was interrupted by the need to urinate..   Note any leakage.  
 
Kegel exercises can be performed daily to strengthen you pelvic floor muscles and help reconnect the transmission of nerve impulses between your bladder and brain.   When you feel the urge to urinate, try to hold the urine for five minutes before going to the bathroom.   As your muscles get stronger, each week try for five more minutes.
 
Prescription drugs for overactive bladder relax the bladder muscle and decrease its sensitivity to irritants.   By reducing the sensation of urgency, the drugs also provide more time to get to the bathroom.
 
Options of Last Resort:  When medication and behavioral therapies do not provide sufficient relief, doctors sometimes turn to neuronmodulation.   This minimally invasive procedure involves the implantation of a device that emits electrical impulses to stimulate the sacral nerves located in your lower back just above your tailbone   These nerves control the bladder and other muscles that are involved in urination.
 
When To Seek Medical Care:  If you answer yes to one or more of the following questions, speak to your doctor about overactive bladder.   Your doctor may refer you to a urologist for more detailed testing and treatment.

• Do you urinate more than eight times in a 24 hour period?
• Do you go to the bathroom so frequently that it interferes with the things you want to do?
• Do you have to get up two or more times at night to go the bathroom?
• Do you frequently have strong, sudden urges to urinate?
• Do you have uncontrollable urges to urinate that sometimes result in wetting yourself?
• Do you use pads to protect your clothing from wetting?
• When you go out, do you make sure you know the location of available bathrooms?
• Do you avoid certain places if you think there won't be an available bathroom?

(source: Johns Hopkins Medical Letter - Health After 50, June 2011)
 
If you wish further information on the above, please contact me,    -   Reva Luce, RN, BSN - Parish Nurse  (856) 829-0218

Community Flu Clinic at Epworth UMC 

Saturday, October 29 - 9 AM to 12 Noon in Main Level Sunday School rooms.   Sponsored by Moorestown Visiting Nurse Assn. &  Epworth UMC.   $30 for Flu immunizations & $45 for Pneumonia immunization.

Please note the following information:
**If you have Medicare and part B as your primary insurance  you will not have to pay for the immunization.   Please be prepared to show your Medicare card at the HMO or Managed Care Plans as your primary insurance .     Moorestown VNA will provide a receipt for you to send to your insurance company for reimbursement.
**If MVNA is denied payment from Medicare, you will be billed for the cost of the immunization.
 
This is another event provided for the benefit of the community and our own members as well.   It is important that we have at least 20 persons arrive for immunizations, or we are billed $50  for having the event.   Last year we gave only 14 immunizations and had to pay the $50 we were billed.   PLEASE sign up in the Narthex for this event; and, encourage your friends and neighbors to come also.