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Is It TMI to Talk About LBL?
When I’m not blogging about LBL, I speak at women’s conferences. Last week, I found myself in front of a banquet hall filled with ladies mostly 40 to 65 in age. Some were retired, though most were career and business women. I wasn't there to talk about light bladder leakage. I was showing them how to make small subtle shifts to produce bigger, more positive results in their lives.A woman in the audience raised her hand. She was struggling. Overworked, she just couldn't let go and let her staff take on some of her tasks. “I’m stressed when I’m not in control. And I’m stressed trying to do it all myself,” she said. When the topic of stress
I said, “When you’re stressed, cortisol and other stress hormones are released that trick your body into believing you’re in danger. It changes your body chemistry, and can even aggravate your bladder, and make things like light bladder leakage worse.” Every pair of eyebrows in the room rose in unison. Oops. Did I go too far? “Sorry,” I said, “maybe that was too much information.”
The woman who had shared said, “No! That’s NOT too much information.” Another lady on the opposite side of the room echoed, “That is not too much information at all.”
The room filled with anticipatory silence. What I thought was TMI actually created an “I’m-not-the-only-one” feeling of relief, and a desire to know more. Though I didn't go on to talk about LBL, I did offer some ideas for managing stress, and curbing the need for control that drives us women to do everything all by ourselves. Here are a few of those tips applied specifically to managing LBL.
1. Don’t make radical changes. You will get nowhere when you tell yourself to just stop being stressed about LBL. Consider how far outside your comfort zone it would be to say, “From now on, I’m going to jump on our trampoline, take those long road-trips I've been avoiding, and tell ladies in the restroom that I’ll leak if they don’t let me cut to the front of the line.” Resistance rears its ugly head when you try forcing big changes on yourself. Instead, focus on making small incremental shifts that ride under your resistance-radar. Maybe start by asking one friend you trust to take a trip to the mall across town, and let her know you have an app on your phone that locates bathrooms along the way. You just may find she needs to “go” as often as you do. Small changes done consistently build courage and a steady stream of victories. As the saying goes, “Yard by yard, it’s hard, but inch by inch, it’s a cinch.”
2. Go deep. When you’re in a situation that has you feeling vulnerable or out of control, notice if your breathing has become shallow. Then take a few deep, slow breaths in and out to shift your body from a stressed state to a calmer, more resourceful state. It helps to make a daily five-minute practice of deep breathing while doing Kegel or other pelvic floor strengthening exercises every morning and evening.
3. Learn from those who have been there. I spent over a year interviewing successful people when I wrote my bestselling book. What they all had in common was a commitment to continuous learning, especially from those who had already done things they wanted to master. To succeed, they were willing to try, fail, learn, and try again. Failure is a necessary part of the process. We as women are conditioned to avoid failure, and not ask for help when we’re struggling. It isn’t always easy to ask for help. Here’s the good news - women are natural helpers. When you seek out communities of women (like the one here) you benefit from the knowledge of women who already know how to manage LBL. One easy way to start learning from those who understand and experience light bladder leakage is to listen to my LBL podcast series on iTunes. Or ask an LBL-related question through the “Ask Marilyn” box. One in three women experience LBL. When you talk with women, your partner, and your doctor about bladder leakage, it really isn’t too much information. It’s simply taking the steps you need to take to learn to manage it.
How about you? Who have you talked to about LBL? And are you glad you did? Share your thoughts on Marilyn’s blog page at Poise.com
Is It Time to Give Up Coffee?
Not all bladders are created equal. Some are robust while others spasm from the sound of coffee brewing. Why do some women have overactive bladders and leak while others don’t? And what sets off a sensitive bladder?
To answer these questions, I sought out the advice of Urogynecogist Robert A. Starr, MD,Professor and Chairman of Urology at Oakland University William Beaumont School of Medicine in Rochester, Michigan.
Why do certain types of food and drink cause some women to experience bladder leakage but not others?
Dr. Starr explained that no one knows for certain. "In general urine is a toxic substance, and the bladder has to protect itself," he said. "If the bladder has any breakdown of that protection—for example, if you have a bladder infection and have horrible urgency, frequency, and burning—it’s really the urine that’s stimulating the nerves that's creating all that."
Some women seem to have a more protected or robust bladder than those who are more sensitive to certain foods and drink. Exposing the bladder to caffeine, alcohol, chocolate, citrus, spicy or tomato-based foods can cause a sensitive bladder to spasm, causing a strong urge to go and leaking.
How much coffee is too much?
There seems to be no rule of thumb as to how much is too much. Some women are ultra-sensitive to one cup of coffee and some might drink a whole pot and not be bothered at all.
When Dr. Starr asks his patients to stop drinking coffee or to cut back, they sometimes become defensive. Some even ask him, "Well, do YOU drink coffee?” He puts it in the perspective of “if you play, you pay."
"When it comes to LBL, caffeine is one of the worst culprits because of the sensitivity to the nerve endings in the bladder," Dr. Starr said, "It also acts as a diuretic, which causes you to make more urine and have a more irritable bladder."
When women complain of severe bladder irritability and leakage, Dr. Starr has them start a daily voiding diary to keep track of how often and how much they’re leaking and using the bathroom. By using a voiding diary, you may discover that in the morning you're going to the bathroom frequently and maybe experiencing some leaking, but as the day goes on it gets further apart. And by the time you go to bed at night, you sleep through the night. If that’s the case, Dr. Starr takes an objective look and asks, "What do you do in the morning?" More often than not, women say that they drink coffee.
Can giving up coffee completely stop LBL?
Dr. Starr says, "Absolutely, I see it all the time. Though, it usually takes quite a while to convince someone to do that. For many, when they stop drinking caffeine they get headaches and just don’t feel good." He suggests weaning off slowly by drinking half decaffeinated and half regular coffee at first. Then drink just decaf, and eventually no coffee at all because even decaf can aggravate the bladder.
How can you know for certain that caffeine is contributing to LBL?
Dr. Start suggests going cold turkey for three or four days, as you should see a difference in that time period. If you see no difference, go ahead and drink coffee.
Coffee isn't the only caffeinated beverage that causes problems. There are a lot of energy drinks on the market right now that are loaded with caffeine. Dr. Starr says those drinks are as bad or worse than drinking coffee.
"If LBL is caffeine driven, I cannot fix it when patients aren't participating in their care," said Dr. Starr. If caffeine contributes to your LBL it comes down to your willingness to help yourself and make the necessary behavioral changes.
What’s the best replacement for caffeinated drinks?
Of all the drink options women have, water is the best choice. Even so, a common mistake women make is drinking too much water. "The amount of water you need depends on what you expend," Dr. Starr said, "If you’re working-out and sweating, you’ll need more water. Thirst is designed to be here for you so you don’t get too dehydrated. If you drink beyond your thirst and you have an overactive bladder, it’s going to make it worse."
For those of you who want more variety than plain water, I asked Dr. Starr for other options. Out of the juices, he says apple juice is a good choice as its less reactive to a sensitive bladder than more acidic choices like orange and pineapple juice. If you MUST drink soda, Dr. Starr considers clear soda that is caffeine-free a better option than drinking a soda with caffeine.
What about you? How do you keep a sensitive bladder in check? Share your thoughts on Marilyn’s blog page at Poise.com
Next Blog Post: 3 Ways to Start the LBL Conversation with Girlfriends »
On a Girls Night Out—3 Ways to Start the LBL Conversation
On a girls' night out, what do you and your gal pals talk about? Men, family and work? Yes. Shoes? Of course. Who else but your girlfriends gushes about your fabulous footwear? My friends and I used to lust over trendy stilettos. Now, we’re thrilled (ok, jealous) when one of us finds a comfortable pair that passes for modern or attractive.
Does LBL make the list of things women talk about on a girls night out? Probably not. But I believe it should. And I’ve discovered some easy ways to bring up the conversation so that women keep talking.
Why talk about LBL? For the same reason you talked with your girlfriends about periods and boys in your teens, pregnancy and childrearing as a new mom, and hormones and hot flashes at the onset of menopause. Life gets easier when we support and encourage each other.
Maybe your best friend hasn’t had an LBL moment. Even so, she cares about you, and wants you to feel safe confiding in her. You never know what kind of helpful encouragement, advice or experiences your friends have to share. And you have a lot to share with them. Those friends who’ve kept quiet about it are just waiting to get YOUR support, too.
Here are three conversation starters to try the next time you’re out with friends:
Be informative. Women love discovering new things. Educate them. Tell your friends what you’ve learned about https://www.poise.com/experts-and-education/articles-and-qa/article?id=1455 Kegel exercise, and https://poise.com/personal-stories-and-blogs/lbl-blog/detail?threadID=800000682 other pelvic floor strengthening exercises . They’ve probably heard of Kegels, and it’s good for woman to do, whether they leak or not. Start the conversation with, “I was reading an article about Kegel exercise and I’m giving it a try. Do any of you do Kegels?” Once this conversation starts, LBL comes up naturally.
Talk about celebrities. Turn on the television or search the internet, and you’ll find celebrities sharing their experiences with LBL (click here for an example) Tell your girlfriends, “I was watching TV, and ...” Be sure to add, “I was so impressed that she was comfortable enough with herself to talk about it. I wish more women would.” Or if you have a different view, share it, “I was surprised that she’d share that on TV. That’s something we share among friends, not the entire world.” This offers an invitation to share.
Break the ice. When you mention LBL straight out, it gives your girlfriends permission to exhale. Tell them, “I’ve got that strong urge to go. Watch out ladies, I need to be first to the restroom.” Or “I sneezed so hard I peed a little.” When you’re comfortable being vulnerable, it’s easier for your friends to relax, drop the pretenses and share openly too.
Sometimes it’s a friend who starts the conversation. When that happens, be ready to say, “Me too!” We do that with just about everything else.
Friend: “I started dying the grey out of my hair.” You: “I do that too.”
Friend: “I blew up at my kids and now I feel terrible.” You: “Been there, done that.”
Friend: “I laughed so hard, I leaked.” You: “That happens to me when I jog. Every time I sprint, I leak.”
Go for it!
The next time you’re out for the evening sharing a glass of wine with your girlfriends, look for opportunities to bring up the LBL conversation. You just might set yourself (and some of your friends) free. There are so many ways to manage LBL and sharing is a the most rewarding way to find solutions, camaraderie and closer connections.
What about you? Have you found good ways to start an LBL conversation? Share your thoughts on Marilyn’s blog page at Poise.com
Acupuncture for LBL
A couple years back, I toured the William Beaumont Hospital Women’s Urology Center in Royal Oak, Michigan. I was impressed with their state of the art approach to managing LBL. And surprised to see they offer alternative treatments like acupuncture to help women with LBL, PMS, and symptoms of menopause.
I didn't know acupuncture had made it into mainstream health care. I mentioned it to a few friends and family members, and found out that my niece uses acupuncture to help manage allergies. My girlfriend got pregnant after adding acupuncture to her infertility treatment plan, and her husband sees an acupuncturist regularly to manage chronic pain. How does acupuncture help?
To find out, I contacted Carey Ryan, R.Ac , a registered acupuncturist at the Integrative Medicine Acupuncture Department at William Beaumont Hospital. “They keep doing studies and it’s proven to be very effective,” Carey said, “Physicians consider acupuncture a complimentary treatment that doesn't interfere with traditional treatments.”
Much like meditation, and yoga, acupuncture has a way of calming the body, and shifting it from a stressed state to a relaxed, healing state.
“Acupuncture is a method used in Chinese medicine to promote health and well-being,” Carey explained. It works through the nervous system. Our bodies have nerves or energy channels that correlate to specific organs, like the bladder. When an acupuncture needle stimulates specific nerves, it affects specific organs, triggering the body's self-healing mechanisms.
I was fascinated to hear that the acupuncture needles are hair thin, and electrodes are sometimes attached to provide a little bit of electricity. “The body is electrical, especially the nervous system,” Carey said, “When a muscle isn't firing, and you put a little electricity there it will fire the muscle and reestablish it.” Think of it as turning the muscle back on. An acupuncturist can improve the functioning of pelvic floor muscles by stimulating the nerves associated with those muscles. When there are functional problems in organs such as the bladder or kidneys, acupuncture can help restore function.
“Do women ever get nervous about the needles?” I asked this because needles make me nervous. Carey laughed, “It only takes a couple needles to make you feel calm and peaceful.”
Though acupuncture can be helpful to women experiencing bladder leakage, Carey cautions that it is not a quick fix. Treatments need to be spread out over time to retrain the nervous system, and support the nerves related to urinary functioning.
I asked Carey what she most wanted women to know about acupuncture. Her answer was simple, “It helps on many levels, and leaves you feeling deeply relaxed and at peace” The hospital she works for obviously agrees, because acupuncture is a service covered under their employees’ health plan.
What about you? Have you tried alternative treatments like acupuncture to help manage LBL? Share your thoughts on Marilyn’s blog page at Poise.com
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