There’s a certain amount of comfort around traditions. They build expectations; they feel comfortable; and most importantly enable a culture to build and thrive. In Australia we have the Boxing Day Test, the Sydney Fireworks display broadcast on TV and our most favourite ones of watching Chevy Chase in the movie National Lampoon’s Christmas Vacation and another movie Love Actually on Christmas Eve. Our Aussie traditions around Christmas and New Year also inevitably involve the beach (as I have alluded to in previous blogs). And as we packed up the car this year it caused me to reflect on our Aussie tradition when going away to the beach of packing everything bar the kitchen sink.
This year was no different despite it only being us two in the unit. We squeeze everything around the grandies car seats in the car and the coffee machine goes as does the Xmas tree. Literally we were up to our eyeballs in things to make the unit a home away from home. And I love the build up, the repack when it doesn’t fit the first time and I love having the final groceries perched on my lap all the way up. (I didn’t always love it when the kids were small – it was somewhat of a drag. Because they couldn’t understand what was taking so long, there were endless questions and a bit of whingeing and of course there was often the need to either take 2 cars or a trailer). But now it’s exciting, it’s a relief to be on the way and wonderful when we arrive.
This tradition has been built over 40 years.
Another tradition that has developed for us is sharing New Year’s Eve with some dear friends of ours. We three couples have just spent our 27th New Year’s Eve together and we wouldn’t miss it (if at all possible) for quids. There is always good food, lots of laughs, board games (Charades) and this year we added in a giant walk to Alexandra Bay and the Sunshine Beach National Park.
We had a swim half way round and as we walked the circuit through the forested area we all relished the dappled light through the trees and marveled this year at the first ever sighting of a wallaby.
The highlight of NYE is always reading last year’s resolutions and seeing who achieved their goals and writing the next years resolutions. It has given us lots of laughs and a bit of competition to see who gets the best score with achieving their goals for the year and it has certainly kept us all accountable.
We have developed other traditions around setting up camp on the beach every day with the two beach umbrellas and beach chairs, scavenging for pippies to use as bait for fishing and having fish and chips and (if possible) a champagne on the beach one night.
Traditions are worth contemplating. They are like rituals. Like good habits.
And as this is my first blog for 2019 I thought I would go back to basics.
The biggest problem patients encounter with managing any urinary incontinence (UI) they have is long-term (life-time) adherence to their management strategies. The evidence tells us that women drop off with the regularity of these treatment strategies in quite a short time.
Such regular strategies include:
- the discipline of maintaining regular pelvic floor exercises to bulk and strengthen their muscles;
- using an E-stim machine to help you if you have particularly weak muscles or it also can be used to help an overactive bladder;
- performing the knack before they cough and sneeze (and other increases in intra-abdominal pressure) meaning tightening muscles of the vagina and anus;
- sticking to the good bladder habits (drinking an adequate amount of fluid mostly water, avoiding excessive caffeinated drinks if caffeine is a provoker for their bladder, keeping alcohol to a moderate amount); managing their bowels well (constipation makes urinary incontinence worse); using urge control strategies to go with an adequate volume in your bladder (350-500 mls for an adult under 70 years, it may be slightly less as you age); avoid going ‘just in case’
- and if they are leaking urine wearing a proper incontinence pads as they have material in them to ensure good absorption of the urine compared with less adequate menstruation pads. (The common brands are Tena or Poise brand pads).This allows you to keep exercising (such as walking daily, attending the gym for strength work etc). If women stop exercising on a regular basis they become generally de-conditioned (muscle strength including the pelvic floor, bone density, cardio vascular system) and research has shown that women see urinary incontinence as a barrier to exercise (38% with moderate leakage and 85% with severe incontinence stop exercising due to UI).(1) Therefore it is better to exercise with an appropriate pad (as long as you have had your exercise regime assessed by a pelvic health physiotherapist) than to stop exercising because you are leaking.
So if you have urinary incontinence start the New Year off with some discipline and a sense of resignation – that just like cleaning your teeth – your adherence to these strategies is forever. You wouldn’t say: “I’ll give it 6 months of cleaning my teeth twice a day and see how it goes with my dental hygiene. After that I’ll just do it sporadically.”
Horrifying thought!
Well why treat urinary incontinence the same way. Do everything you can with ritualising the treatment strategies so they become good habits and you will find your urinary incontinence improves.
Happy New Year and here’s to a happy and healthy 2019 from Bob and Sue.
- Nygaard I, Girts T, Fultz N, Kinchen K, Pohl G, Sternfeld B. (2005) Is urinary incontinence a barrier to exercise in women? Obstetrics & Gynaecology Vol 106 (Issue 2) .