Incontinence Self Help Tips

Normal Bladder Values

• Urinate 6-8 times per day. This depends on how much you drink and also what you drink
• Go to the bathrom 0-2 times at night. Pregnant women or those over the age of 65 may urinate 2 or more times at night. Somtimes night time voiding is just a habit. Try to avoid urinating at night just because you happen to wake up.
• Fluid Intake: For good hydration 6-8 glasses of water per day are recommended. If you are not drinking this much water, you may need to gradually increase your fluid intake over time. Pain in the bladder, (as in Interstitial Cystitis) may be exacerbated with sudden increases in fluid intake. Discuss your individual intake recommendations with your therapist and physician.
• 2-5 hours between trips to the bathroom. Voiding "just i n case" or simply because a bathroom happens to be available tends to become a habit. It is best to wait until your your bladder sends you a signal that it needs to be emptied. Your bladder needs to stretch and be able to hold a certain amount of urine. Emptying it too often will tend to shrink its holding ability.
• "10-Mississippi" Bladder Volume Test. A quick way to test if your bladder is able to hold and empty a "normal volume" of urine: As you start to urinate, count 1-mississippi, 2-mississippi etc. You should be able to count to 10-mississippi and still be voiding. If you have finished urinating much before 10 seconds, your bladder may need to be trained to "stretch". BLADDER TRAINING IS A WAY TO ACCOMPLISH THIS!
• Color of Urine: Color of your urine shoule be pale lemon. If your urine is a darker color or has a strong smell, it is too concentrated. You will need to drink more water to dilute the urine. Highly concentrated urine tends to irritate the bladder lining.

Deferment Techniques

• Applying Pressure on the Perineum. This activates the "clitoral" reflex. When pressure is applied to the perineum - the bladder relaxes. Sit on a rolled up towel so that the towel is positioned front to back like a sanitary napkin. This will help the bladder relax.
• Using "Kegel's" To Lessen The Urge. Contracting the pelvic floor muscles activates the "perineodetrusor reflex". When the pelvic floor muslces are contracting, the bladder automatically relaxes. As you sit on the towel, lift your pelvic floor muscles as you have been taught to do by your therapist and breathe out in small puffs at the same time.
• Crossing Your Legs. If you have weak pelvic floor muscles, cross your legs and try to tighten the muscles till the sense of urgency passes.
• Avoiding Bladder Irritants. Alcohol, artificial sweeteners, smoking, caffeine, sodas. Highly spicy foods or citrus foods may also be irritating.
• Avoiding Bladder Triggers. Certain sounds or environmental factors trigger the urge to urinate. Identify your "triggers" and avoid them while you are training your bladder. Some of these include: running water, entering a cold environment, jingle of keys as you try to enter your house, the sight of a toilet.
• Distraction. The brain can handle one thought at a time. Distracting your thoughts from "I gotta go" to something else to keep the brain busy, will lessen the sense of urgency. Balance your checkbook, read a newspaper or magazine, start counting backwards from 100 in intervals of 7 or 9, make up your grocery list.

Pelvic Pain Self Help Tips

Lessen Irritation To Vulvar Tissue

The skin inside of the vagina is wet and slipper like the inside of your mouth. Both the mouth and the vagina have "good bacteria" in certain amounts. Scrubbing with harsh soaps and douching may change this delicate balance and may contribute to your discomfort.

Bathing
• Avoid bubble baths. Take showers.
• You may sit in a warm sitz bath with Aveeno in the water.
• Use mild natural glycerin soap such as Neutrogena.
• Avoid scented soaps.
• Wash your hair with your head tipped back or way forward so that shampoo and conditioners do not run off into the perineum.

Toileting
• Wash your hands before you touch your perineum to avoid irritants coming into contact with these delicate tissues.
• Sit on the toilet in good posture and relax your thighs completely. Tension in the muscles around the vagina and urethra may prevent you from emptying your bladder completely.
• Tip your pelvis slightly forward while you urinate. There will be less contact between the urine and the vulvar tissue.
• After you urinate, spray the perineal area with clear lukewarm water. Gently pat dry with a white cotton washcloth or use white unscented toilet tissue. You may also use a hairdryer on "cool" setting to dry off.
• Use white unscented toilet tissue.
• Always wipe front to back to avoid spreading germs from the rectum into the vagina.
• Sweat and Urine can be irritating, keep vulvar tissue clean and dry.
• Always wash your hands before and after you use the bathroom.

Making Your Menstrual Period More Comfortable
• Using tampons may be irritating. If you use tampons, use unscented tampons for short periods, use the smallest size that fits, and do not switch brands.
• Change pads often to lessen moisture in the area. Even the adhesive on pads is sometimes irritating.
• Try "all cotton/re-usable" pads from Glad Rags. Phone 1-503-282-0436 or at gladrags.com
• Make your own pad: Wrap a wad of cotton in a soft/washed cotton cheesecloth or cotton flannel. Dispose of the wad of cotton and wash the cloth wrapping in a gentle detergent.

Clothing
• Wear white, 100% cotton panties.
• Panty liners may be irritating. Use these only if neccessary or make up a liner with 100% white cotton flannel that can be re-used. Change them often.
• Wash panties in hot water with mild soap such as Woolite. Double rinse in cold water. Do not use blecah or fabric softeners.
• Avoid restrictive/tight clothes: No jeans, panty hose, control top panties, thongs, girdles or spandex "gym clothes".
• Some clothes are treated with chemicals, wash clothes before you wear them, especially underwear.

Sexual Contact
• You are your partner should wash your hands before you start any sexual contact.
• Contraceptives: Some irritants may include spermicides that contain Nonoxyl 9 and other contraceptive gels and foams. Latex condoms and diaphragms may also be irritating.
• Some women are also sensitive to semen.
• Lubricants that may also be irritating are those that contain propylene glycol and/or chlorhexidine. Use vegetable oil, mineral oil, Femglide or Slipper Stuff for sexual lubrication.
• Avoid douches and hygiene products that contain fragrances or alcohol.

PURE Aloe (Ask your physician if you can use Aloe)
• Use those medications that are prescribed by your physician. Inform him/her if these medications are helpful.
• PURE Aloe has been helpful for many patients. PURE Aloe is especially rich in vitamins B1, B2, B3, B6, and B12, folic acid, biotin, calcium, magnesium, iron, zinc and potassium.
• Aloe for external application is available in a spray or gel. Use it with your physicians' permission.
• After each urination, apply aloe spray to your vulvar tissue.
• You may also applye PURE aloe gel to the vulvar area 2-3 times per day.
• You may drink Pure Aloe Juice. Mix 1/4 cup of aloe juice in with apple juice or lemonade and drink before breakfast and before going to bed.
• Most patients notice an improvement with aloe in 2 weeks or sometimes longer.

Comfort Measures
• Use ice on your perineum. You can place a sac of loosely packed froxed corn or peas into a plastic wrap and wear it like a pad.
• Gentle warmth may also help. Pack a white cotton ankle sock with a cup of uncooked rice and sew the open end. Heat the rice-sock in the microwave for 30-45 seconds and wear it like a pad.
• Do not use talcum powder, towelettes, baby wipes, lanolin or perfumes on the vulvar tissue.
• Purchase a "tush-cush". This is a pillow that has a cut out for the tailbone and relieves pressure on the tailbone.

General Exercise
• Walk 2-3 times a day. General exercise can have a significant positive impact on your levels of pain. It releases your body's "opiates".
• Certain exercise equipment in gyms can put pressure on your perineum. Avoid those machines. Sit on folded towels.
• Avoid bike riding and horseback riding. If you must ride a bike, you will have to build up the seat to avoid direct pressure on your perineum.

Deep Breathing Exercises
• Several times a day, focus on your breathing. This will help you relax.
• Take a deep breath slowly in through your nose feeling your belly and your vaginal muscles bulging out a little.
• Now exhale through your mouth, feel the belly and pelvic floor relax to their normal position.

Relaxation Exercises
• Lay in a quiet room with low lights and soft music.
• Close your eyes and take a deep breath.
• Feel yourself sinking into the bed and letting your hands and legs get "heavy".
• Think about blood flowing into your arms like warm molasses and warming them.
• Or think about an image of you lying in the warm sun on a warm, sandy beach.
• Daydream about places that have been peaceful for you: church, a stained glass window, a meadow, lakes, mountains or rivers.

Pelvic Floor Exercises
• Think about your bottom getting heavy and warm and you feel like you are "spreading or melting" into the chair.
• Now practice your "Kegel" exercises or strengthening the muscles around the vagina. Lift or pucker up the muscles around the vagina as if pouting for a kiss or sucking on the straw. Do this 10 times, hold each contraction for 10 seconds. Relax for 10 seconds between contractions.
• Now practice "lengthening" the same muscles. Place your middle finger in between your buttocks in the cleft, over your anus. Gently push out as if you are passing gas, you should feel the tissues "bulging out" a little. This is "stretching".