Episode Transcript
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Speaker 1 (00:03):
Good evening and welcome to another episode of
Nurse Maureen's Health Showpodcast.
As you know, I'm a registerednurse and a nurse continence
advisor, which is why I'm veryexcited to have my next guest on
.
Lisa Kirk has been a registerednurse for over 30 years, with a
background in acute care fromemergency nursing,
interventional radiology and amedical clinical nurse educator.
She's on the faculty at DouglasCollege in Vancouver, british
(00:30):
Columbia, training new nurses towork in our ever-changing
healthcare system.
Her expertise is in simulationand she is currently in doctoral
studies in healthcare education.
She's also married with twosons and two four-legged pups.
Good evening, lisa.
How are you?
Speaker 2 (00:41):
I'm great, maureen.
Thank you, nice to be here.
Speaker 1 (00:44):
Yeah, thanks so much for coming on and talking to me
about urinary incontinence.
It's such a shameful subjectand stigmatized, yet so many
people experience it and I knowyou see it a lot in the acute
care setting where you work, andnot to mention you know, I'm
sure, out in the public healtharena as well, and certain
(01:06):
friends have also talked aboutit.
So let's start by I'll ask youto explain for the listeners
what exactly urinaryincontinence is and what causes
it.
Speaker 2 (01:16):
Okay, well, from basically from the nursing side,
urinary incontinence is anuncontrolled loss of urine that
is of sufficient magnitude thatit actually becomes a problem,
and there are many causes.
So we know that there are somecauses of urinary incontinence
that can be transient, you know,they can come and go by causing
(01:40):
it, and some of those can beconfusion, depression, infection
medications, sometimes withrestricted mobility, or even
with constipation.
So we know that those are someof the transient causes of
urinary incontinence.
And then, of course, we havemore types of incontinence that
have a medical basis, for whichcould be things like stress
(02:03):
incontinence, which probablymore in your field, maureen, is
probably one of the more commoncauses of incontinence,
especially with women and men,and, of course, everything from
urge incontinence, overflow,reflex incontinence.
A lot of people also sufferfrom incontinence after trauma
or surgery, and then some fromfunctional incontinence, just
(02:26):
with that loss of mobility andbeing able to function with
their activities of daily living.
So there's lots of differentcauses.
So we always think that it'svery narrowed and it's down to
one, but it actually hasmultiple causes out there for
people anywhere from age six tothe older adult?
Speaker 1 (02:44):
Absolutely, and I think the one thing is that
there are treatments which we'regoing to be talking about
tonight.
Also, you know we mentionedstress, urinary incontinence,
very common for women afterthey've had a vaginal birth.
But you don't necessarily haveto have had a vaginal birth or
any children to have experiencedurinary incontinence.
Especially, you know, when youget increased intra-abdominal
(03:06):
pressure then you leak urine andyou'd get that with cough or
sneeze or that type of thing orexercise.
Lisa, how common is urinaryincontinence and who does it
typically affect, although youmentioned anyone from age six to
96 or 106.
Speaker 2 (03:21):
Right, absolutely.
You know from my experience andI think also from looking at
some of the literature here, itpredominantly affects women and,
let's face it, middle age toolder, perimenopause, menopause,
postmenopause, and men usuallyover 60.
But that primary group is womenwho are basically suffer from
(03:44):
urinary incontinence.
So yeah, that is the group.
Speaker 1 (03:47):
Yeah, it is mainly, but we're also seeing men,
especially men who've hadprostate surgery.
They often will experienceurinary incontinence afterward.
We're also seeing men who havehad prostate surgery or prostate
cancer treatments.
They will experience urinaryincontinence afterward as well,
and it's typically a stressurinary incontinence afterward
as well, and it's typically astress urinary incontinence.
Yes, also, you know, many womenthink that urinary incontinence
(04:11):
is just a normal part of aging,or they just think it's normal
to leak when you cough or sneeze.
Is that true?
Speaker 2 (04:17):
No, it is absolutely not true and that is definitely
proven that there that is not anormal aspect of aging, even
though sometimes we think insociety it's it is.
It is not.
Speaker 1 (04:29):
Absolutely.
What are some of the biggestchallenges people with urinary
incontinence face and I want youto talk about in their daily
lives, but also in the hospitalsetting, in the acute care
setting, you know.
Speaker 2 (04:39):
I think one of the biggest challenges is that it's
one of those things that wedon't like to talk about and
it's not really in thediscussion.
And even when you think aboutpeople who get admitted to
hospital you know we dohistories, you know maybe you
know you're here for a surgerywe go through, you know a little
bit of a systems assessmentwith you or you're here for an
(04:59):
outpatient procedure, but I canhonestly say there is nothing on
that form or that states do yousuffer from urinary
incontinence and if you do, whatare some of the strategies or
interventions that you need fromus to help you while you're
with us or in the hospital?
Like to talk about it?
(05:26):
It's definitely not on theassessment and even looking now
at nursing education, I have tosit and I have to think and go.
Where is that actually taughtin our program?
And at this very moment I can'trecall.
Speaker 1 (05:35):
Yeah, I don't think it's taught?
Speaker 2 (05:37):
No, I don't either.
We talk about catheters,catheter care, you know, routine
toileting, those kinds ofthings, but we actually don't
talk about it.
Speaker 1 (05:47):
And it's such a common problem.
And you know when people areadmitted to the hospital, they
can be admitted continent andthen be discharged with
incontinence and that can reallychange their lives, whether
they can live independently anylonger.
You know whether they need tobe admitted to long term care.
It increases the you knowwhether they need to be admitted
to long-term care.
It increases the you know has afinancial impact on them
because they might need pads anddiapers, cause they think that
(06:10):
those are the only treatmentsfor urinary incontinence.
They have extra laundry, theyneed caregivers, and so it
really changes the game for alot of people.
How about people in theireveryday lives that are walking
around?
You know?
Middle-aged, young, activeleaking urine.
Speaker 2 (06:27):
Leaking urine, and that's just it.
And you know, and actually it'sfunny it's I was walking in the
mall and I walked past an olderadult and I could smell urine
and I kind of went okay.
So of course in my nursing mindI'm going okay.
So maybe some you know stress,incontinence, you know
(06:48):
incontinence, maybe not wantingto wear a pad right, like what
kind of you know resources doesthat individual have?
So just that whole piece.
So I can't help but think aboutit, what that means.
And we know that a lot of womenwill.
We're used to buying sanitarypads, sanitary napkins.
So for a woman to go and buysome pads to use if they're
(07:12):
dribbling a little bit,absolutely.
But what about for a man?
What is that stigma?
For them to actually walk inand, you know, buy pads right
that they can use to for urinaryincontinence, and I would think
that that would be a really bigstigma that that might be faced
right.
Speaker 1 (07:29):
Oh, absolutely.
People feel a lot older.
They gain weight, they stopexercising.
They actually age a bit fasteras well.
When they feel like they'reaging a bit faster, they feel
like they're older.
I've heard 40-year-old womentell me they feel like they're
grandmothers because they'releaking urine and, as you
mentioned, there's oftenembarrassment or stigma.
People worry that their homesare going to smell.
Long-term care facilities mayhave a scent as well.
(07:52):
How do you help patientsovercome that to seek treatment?
Speaker 2 (07:59):
how do you help patients overcome that to seek
treatment?
That and you know, I thinkthat's the biggest question
right now is that how do we,when we bring them into hospital
, the incontinence, I think you,as you stated, they change and
evolve when they're in there,because maybe now they're in bed
, we're not getting them up asoften, right, and maybe they're
incontinent once because maybethey can't get up to the
bathroom.
Now, all of a sudden, we put apad on them and then we put a
(08:23):
liner in that pad, so they'relike in a tens and we put them
on these individuals.
So what are we telling, youknow, these patients that, oh,
here, just pee in the pad and?
And as a nurse, I have to behonest and as a nurse educator,
I find that to be one of themost disturbing things that we
do for people that are inhospital, when we just tell them
to just pee in their pads.
(08:44):
Right, we need those resources,we need to get them up.
Do we always have the resourcesto do that?
Sometimes we don't, right, thewards are busy and other things
are going on and we know thatwith urinary incontinence, it's
good when people can get up andbasically use the washroom to
pee every two to three hours,right, like, get on that routine
(09:05):
, follow that pattern, right.
But how do we do that inhospital when there's so many
other things going on?
So I think that's a really bigquestion.
But that seems to be the trendof care.
Is that, especially for ourolder folks, that we just put
pads on them right?
That everybody normallyincontinent?
Just because you're older,you're incontinent.
So I think that is a little bitof ageism.
Speaker 1 (09:31):
there right People can be admitted with urinary
tract infections and I knowthat's a very costly situation
for hospitals because somebodycan present to emerge with
confusion and they end up havinga urinary tract infection.
They may be incontinent as well, the you know more chronic
(09:53):
wards and then need to beadmitted to long-term care when
you know we could have addressedthat in the emergency
department with some of thelifestyle changes and strategies
like localized estrogen, forexample, for perimenopausal,
menopausal, especiallypostmenopausal women.
But what are some of thoselifestyle changes that women can
use and men can also use totreat urinary incontinence?
Speaker 2 (10:17):
Well, I have to be honest, one of the biggest
things that I always hear andI've heard this from the
urologists as well is alwaysnumber one if you smoke, stop,
because we know that the smokingdefinitely leads to that.
And I've heard more than moretimes says stop the caffeine.
You know the heavy coffee, theheavy tea drinkers, and you know
I think that's maybe why nursesare so bad with some of the
times we drink a lot of coffeeand a lot of tea, right,
(10:41):
caffeine, and and I have.
I have a good friend and shesays to me she says, honestly, I
haven't had kids, but you know,if I cough, I leak urine, if I
I can't jump on a trampoline, Igot to be careful how long I'm
(11:02):
out for a walk for.
And she says I never, I haven'teven had kids.
And then I'm dealing with thisand and you know she's, she's
skinny, she's thin.
So, once again, weightreduction and, you know, losing
that extra weight or another wayas well.
But, yeah, like it, it happensto all of us, right, and the
chances are.
Speaker 1 (11:13):
And and those are a bit of a fallacy that only women
who've had babies leak urine.
Also, you know, women and mencut back on their water-based
fluids as well, because theythink if I don't drink water
then I won't leak or I won'thave to go to the bathroom.
But it causes concentratedurine which can be more
irritating to the bladder.
And you mentioned caffeine andalcohol and citrus and they can
(11:36):
all irritate the bladder.
All the things we love can bebad, you know the traditional or
the conventional wisdom?
the traditional advice has beenpelvic floor exercises like
Kegels.
Are they enough to manageincontinence or do most patients
need additional support?
Speaker 2 (11:52):
Well, for me, I think , for somebody who is maybe you
know at home that perimenopausal, menopausal or active lifestyle
, who can do those exercises.
I think that's, you know, stillsomething we should still be
doing.
Time could be a factor, butwhen you get into older adults
or people with limited mobility,I mean that is probably not
(12:14):
going to be an option forsomebody, right depending.
But yeah, I think that.
And then taking the time to dothem you know what I mean.
That's like you do themproperly.
Speaker 1 (12:25):
You know a lot of people haven't been taught how
to do them.
I'll tell.
I'll explain it like squeezethe rectal muscle, the muscle
that prevents you from passinggas, that's the one.
Or you know you can also use itfor bladder retraining or urge
suppression.
So do them quickly if you getan overwhelming urge to go to
the bathroom.
But, but mostly women will cometo me after a year, year and a
half, of trying Kegels.
They'll say they Kegel to death, they Kegel until the cows come
(12:47):
home and it didn't work.
And it's not going to work forstress, urinary incontinence, or
.
You know there's a lot ofpeople turn to social media
influencers who are trying tosell programs or supplements or
whatever you know to supportbladder health.
Not going to work.
But you know there's a veryinteresting device that's on the
market which is called theEmcella or the Kegelthrone and
(13:07):
that's gaining wide attention asa non-invasive treatment for
urinary incontinence.
Can you explain how it worksand who would be a good
candidate?
Speaker 2 (13:15):
Well, you know I'll do my best to explain how it
works, but I have used it.
So, basically, when I know itfirst came out and I was
suffering from urinaryincontinence I will be honest,
just more stress, incontinencewith coughing, had to be careful
with activities.
I'd had two vaginal bursts, butalso with episiotomy and other
(13:36):
things that went with that.
So I had some challenges.
So, even though doing the Kegelexercises tried to keep my
weight down and I love my coffee, it's really bad.
I really love my coffee.
So that was something I wasn'tgoing to give up as a nurse.
So when I was introduced to thelovely machine I said, okay,
let's give it a try.
(13:57):
So I did the initial like sixsessions and even after two
sessions I don't know how toexplain it.
You're sort of sitting on thisthrone, and that's a good word
for it.
You're sitting on this throneand they adjust the power which
is providing like a Kegel typeresponse, or or what do you want
(14:19):
to call it, maureen, you knowlike it's stimulation like it's
zapping it's zapping me downthere, so it's like it's doing
these lovely little zaps.
it's zapping me down there soit's like it's doing these
lovely little zaps that are likeequivalent to these kegel
exercises, but of coursemultifold.
And after two sessions and two30-minute sessions I actually
noticed a difference, so itactually helped like I could.
(14:40):
I could sneeze, I could coughand go.
Hmm, I'm okay, right.
I didn't have to worry aboutthat.
And then after six sessions itwas like, okay, I'm good, I
actually got on my little minitrampoline.
Perfectly fine, it was amazing.
Yeah, it was a really goodresponse.
Speaker 1 (15:00):
That is awesome.
Yeah, I hear that from a lot ofpatients, that it you know that
it starts working before thesix, but the six treatments are
recommended for sure.
So that's awesome.
So you have your own personalexperience with it and it's
dignified.
You're sitting on the chairwith your clothes on.
Speaker 2 (15:17):
There's no legs up in the stirrup on the M-Cellar or
the Kegel throne, which is whatwomen really don't love.
Speaker 1 (15:23):
You know, it's like oh, I got to go to the
gynecologist Like it can be oneof the worst days of a woman's
life, especially if she workswith the gynecologist anyway.
Speaker 2 (15:33):
Exactly, it can be so bad, that's right.
And then it's just that whole.
You know, I always what did onewoman say to me?
She goes how come every time Ineed something for female health
, my feet are in stirrups?
I said that's a good question.
Right, that is a good question.
Speaker 1 (15:48):
So not with the M cell or the Kegel throne, and so
that's what's just so niceabout it, and also you can go
back to work, you can do it onyour lunch hour.
It takes like 28 minutes persession, absolutely Six sessions
over two or three weeks, aslong as there's 48 hours in
(16:08):
between.
And so what kind of results canpatients expect from the
Emcella or the Kegel Throne, andhow would you say it compares
to other treatments?
Speaker 2 (16:12):
Well, I think you know, when you think about the
need to do all those repeatexercises, if you're doing them
on your own and all the dietmodifications that I think are
still important.
But this machine, like, reallygives you the opportunity that
you can make that appointment.
You can go in, you can sit onthe machine for like, your 28
minutes, read your magazineabsolutely no phones or
(16:33):
electronics, right.
So you're right, you have toactually sit and relax for a
little bit and think aboutthings and then you just stand
up and you walk away, right,right, and that's a huge piece,
it's, it's, it's easy.
Yes, we need the appointmentsand there's probably a limited
access to them out there, but Ican't help but wonder how, if
(16:53):
this is part of, you know,rehabilitation for somebody's,
you know incontinence, why don'twe have them in some of the
hospitals?
Why?
is that not part of thetreatment for some of these
older adults?
We have physio, we have OT.
Why can't we have this type ofmachine available that somebody
(17:14):
who's suffering from?
The urinary incontinence, canactually get a session in
healthcare, like in an acutecare setting for it.
Speaker 1 (17:22):
I couldn't agree with you more, and you know what
Urinary incontinence really it's, so undignified, it really
impacts a person's quality oflife.
It can lead to isolation,depression, feelings of
exclusion, increased laundry.
It's a financial impact,especially for people as they
age and maybe on a fixed income.
(17:42):
They're having to buy theseexpensive pads and diapers which
can cost $1,000 a year onaverage.
So it's a great option and I dofeel it should be part of the
treatment options that areoffered, and you know, at the
moment, oftentimes nothing isoffered to patients.
It's more like can you put upwith it?
Or you know there's a procedurefor that, but that procedure,
(18:03):
you know, involves, you know,taking time off from work,
recovery over a two to six weekperiod, and you know whereas
this, can you know, benefit somany people.
The Kegel Throne is just anawesome device and I'm so glad
that you tried it and that youhad a good experience with it.
And do you go back every yearfor like one or two?
Speaker 2 (18:23):
Yeah, I do one or two little repeat sessions and I've
referred a couple, a couple ofmy friends you know, along the
way and say go give it a try,I've had some good success with
it as well.
It's just making sure that youdo those follow up right, those
follow up sessions really dohelp.
That's a big piece, so yeah, Ithink it's definitely,
(18:43):
definitely something that Ithink and maybe I mean, maybe
this is bad to say, but you knowwomen's health, I think
sometimes women get labeled ascomplainers.
Right, you know you'recomplaining and you know, just
accept it.
This is just part of this isjust part of your aging, this is
just part of menopause.
But it's not right.
Speaker 1 (19:02):
This is not normal no absolutely, and the M-Cella
increases blood flow andactually strengthens the pelvic
floor muscles, and so it helpswith lubrication.
Many women report betterorgasms, and it just can overall
change a person's life, andit's for men and women, and for
women who might have a pessaryin situ for a pelvic organ
prolapse, you can still use theKegel Throne or the Emcella.
(19:28):
Yeah, yeah, it's just if you'repregnant or have a pacemaker,
you know there are somecontraindications to it, but
it's very important that youshare your medical history with
your healthcare provider who'sproviding the Emcella service to
you, and you know.
So metal hips or any metalimplants, that kind of thing are
contraindicated as well.
(19:49):
Yeah, but otherwise, you knowit's a great option for most
people, as you mentioned, andI'm so glad that you know you're
not leaking urine, you're justcarrying on and you don't have
any other surgery to lookforward to or admissions to
hospital.
Speaker 2 (20:05):
Admissions to hospital and just, you know,
think about like even just thewait list for some of these
procedures.
And you know, the more we talkabout this, it's like okay, so
why can't some of theseurologists have these in their
office?
Speaker 1 (20:16):
Yeah, exactly.
Speaker 2 (20:17):
Like why can't I have a seat on?
The Kegel throne while you waitfor me.
Speaker 1 (20:25):
Exactly, I'm going to be about an hour, so you know
30 minutes on there, exactly,grab some lunch, read a book.
Speaker 2 (20:29):
We'll put something up on the screen for you to
watch and while you're in here,and maybe that needs to be
normalized right.
Speaker 1 (20:38):
Of course, of course.
And Lisa, what advice would yougive to somebody?
Because there's still a shameand a stigma associated with it?
But what advice would you giveto somebody Because there's
still a shame and a stigmaassociated with it?
But what advice would you giveto someone struggling with
urinary incontinence buthesitant to seek help?
Speaker 2 (20:50):
You know, I think I would say to someone you know
what this isn't?
it's not normal, and it's normalto feel stigmatized and that it
isn't normal, but it actuallyis a normal process that can
happen and we need to get out ofthat shame and seek out some
help, and maybe that's where weneed to have more.
(21:12):
You know you have your podcast.
Maybe we need more, some onlinesite where patients can go and
ask questions right, when can apatient go and you know, type in
that question or talk tosomebody to get some answers.
I don't know what the nurseline has, or is it passed down
by word of mouth, Because I tendto pass my information about
(21:32):
the mCELLA down to people I'vemet or women I've talked to, or
in the hospital.
I might pass that on, pass thaton right, so by word of mouth.
But you're right, I think weneed more continence advisors.
I think it needs to be anotherarea of nursing that maybe we
look at as having more of right,Absolutely.
Speaker 1 (21:53):
Instead of less of Exactly, they cut those
positions.
Yeah, it's great that youmentioned you know where can
people get more information,because for more information
about the Amcella or theKeglethron you can go to
btlestheticscom, that'sb-t-l-a-e-s-t-h-e-t-i-c-scom.
Lisa, thanks so much forjoining the podcast.
Speaker 2 (22:14):
Thank you very much, maureen, for having me.
This has been great.
And just to you know, when Ifirst was introduced to the
Amcella, it was like, oh, thisis very interesting.
I had no idea any this evenexisted.
And then, after doing it, itwas like, okay, this is good.
Like more, more people whosuffer need to use this device.
(22:35):
I think it's amazing.
So Absolutely.
Speaker 1 (22:38):
Thank you so much, lisa.
That's awesome advice.
Lisa Kirk is a registered nurse.
She's been one for over 30years and she works in acute
(23:05):
care and emergency nursing,interventional radiology, and
she is also a medical clinicalnurse educator.
She's on the faculty at DouglasCollege training new nurses to
work in our ever in healthcareeducation.
She is a busy person.
If you think that somebody youknow might benefit from tuning
into this episode, feel free toshare.
You can always text or emailthe show.
My email isnursetalkathotmailcom and you
can text at 604-765-9287.
I'm Maureen McGrath and youhave been listening to Nurse
Maureen's Health Show Podcast.
(23:26):
Thanks so much for tuning in.
I'm Maureen McGrath and youhave been listening to the
Sunday Night Health Show Podcast.
If you want to hear thispodcast or any other segment
again, feel free to go to iTunes, spotify or Google Play or
wherever you listen to yourfavorite podcasts.
You can always email me,nursetalk at hotmailcom or text
the show 604-765-9287.
(23:48):
That's 604-765-9287.
Or head on over to my websitefor more information.
Maureenmcgrathcom, it's been mypleasure to spend this time with
you.
Did you know that a weak pelvicfloor can lead to urinary leaks
, discomfort and even impactyour confidence in the bedroom,
(24:10):
whether you're a woman dealingwith bladder control issues or a
man looking to improveperformance and blood flow,
btl-m-cella is the solution.
This non-invasive treatmentdelivers thousands of pelvic
floor contractions in just onesession, like doing 11,800
Kegels, without the effort,stronger muscles, better control
(24:31):
and enhanced wellness withoutsurgery or downtime.
Take the first step toward astronger you.
For more information or to finda provider, go to
btlastheticscom.
That's btlastheticscom.
Good evening and welcome to another episode of
Nurse Maureen's Health Showpodcast.
As you know, I'm a registerednurse and a nurse continence
advisor, which is why I'm veryexcited to have my next guest on
.
Lisa Kirk has been a registerednurse for over 30 years, with a
background in acute care fromemergency nursing,
interventional radiology and amedical clinical nurse educator.
She's on the faculty at DouglasCollege in Vancouver, british
(00:30):
Columbia, training new nurses towork in our ever-changing
healthcare system.
Her expertise is in simulationand she is currently in doctoral
studies in healthcare education.
She's also married with twosons and two four-legged pups.
Good evening, lisa.
How are you?
Speaker 2 (00:41):
I'm great, maureen.
Thank you, nice to be here.
Speaker 1 (00:44):
Yeah, thanks so much for coming on and talking to me
about urinary incontinence.
It's such a shameful subjectand stigmatized, yet so many
people experience it and I knowyou see it a lot in the acute
care setting where you work, andnot to mention you know, I'm
sure, out in the public healtharena as well, and certain
(01:06):
friends have also talked aboutit.
So let's start by I'll ask youto explain for the listeners
what exactly urinaryincontinence is and what causes
it.
Speaker 2 (01:16):
Okay, well, from basically from the nursing side,
urinary incontinence is anuncontrolled loss of urine that
is of sufficient magnitude thatit actually becomes a problem,
and there are many causes.
So we know that there are somecauses of urinary incontinence
that can be transient, you know,they can come and go by causing
(01:40):
it, and some of those can beconfusion, depression, infection
medications, sometimes withrestricted mobility, or even
with constipation.
So we know that those are someof the transient causes of
urinary incontinence.
And then, of course, we havemore types of incontinence that
have a medical basis, for whichcould be things like stress
(02:03):
incontinence, which probablymore in your field, maureen, is
probably one of the more commoncauses of incontinence,
especially with women and men,and, of course, everything from
urge incontinence, overflow,reflex incontinence.
A lot of people also sufferfrom incontinence after trauma
or surgery, and then some fromfunctional incontinence, just
(02:26):
with that loss of mobility andbeing able to function with
their activities of daily living.
So there's lots of differentcauses.
So we always think that it'svery narrowed and it's down to
one, but it actually hasmultiple causes out there for
people anywhere from age six tothe older adult?
Speaker 1 (02:44):
Absolutely, and I think the one thing is that
there are treatments which we'regoing to be talking about
tonight.
Also, you know we mentionedstress, urinary incontinence,
very common for women afterthey've had a vaginal birth.
But you don't necessarily haveto have had a vaginal birth or
any children to have experiencedurinary incontinence.
Especially, you know, when youget increased intra-abdominal
(03:06):
pressure then you leak urine andyou'd get that with cough or
sneeze or that type of thing orexercise.
Lisa, how common is urinaryincontinence and who does it
typically affect, although youmentioned anyone from age six to
96 or 106.
Speaker 2 (03:21):
Right, absolutely.
You know from my experience andI think also from looking at
some of the literature here, itpredominantly affects women and,
let's face it, middle age toolder, perimenopause, menopause,
postmenopause, and men usuallyover 60.
But that primary group is womenwho are basically suffer from
(03:44):
urinary incontinence.
So yeah, that is the group.
Speaker 1 (03:47):
Yeah, it is mainly, but we're also seeing men,
especially men who've hadprostate surgery.
They often will experienceurinary incontinence afterward.
We're also seeing men who havehad prostate surgery or prostate
cancer treatments.
They will experience urinaryincontinence afterward as well,
and it's typically a stressurinary incontinence afterward
as well, and it's typically astress urinary incontinence.
Yes, also, you know, many womenthink that urinary incontinence
(04:11):
is just a normal part of aging,or they just think it's normal
to leak when you cough or sneeze.
Is that true?
Speaker 2 (04:17):
No, it is absolutely not true and that is definitely
proven that there that is not anormal aspect of aging, even
though sometimes we think insociety it's it is.
It is not.
Speaker 1 (04:29):
Absolutely.
What are some of the biggestchallenges people with urinary
incontinence face and I want youto talk about in their daily
lives, but also in the hospitalsetting, in the acute care
setting, you know.
Speaker 2 (04:39):
I think one of the biggest challenges is that it's
one of those things that wedon't like to talk about and
it's not really in thediscussion.
And even when you think aboutpeople who get admitted to
hospital you know we dohistories, you know maybe you
know you're here for a surgerywe go through, you know a little
bit of a systems assessmentwith you or you're here for an
(04:59):
outpatient procedure, but I canhonestly say there is nothing on
that form or that states do yousuffer from urinary
incontinence and if you do, whatare some of the strategies or
interventions that you need fromus to help you while you're
with us or in the hospital?
Like to talk about it?
(05:26):
It's definitely not on theassessment and even looking now
at nursing education, I have tosit and I have to think and go.
Where is that actually taughtin our program?
And at this very moment I can'trecall.
Speaker 1 (05:35):
Yeah, I don't think it's taught?
Speaker 2 (05:37):
No, I don't either.
We talk about catheters,catheter care, you know, routine
toileting, those kinds ofthings, but we actually don't
talk about it.
Speaker 1 (05:47):
And it's such a common problem.
And you know when people areadmitted to the hospital, they
can be admitted continent andthen be discharged with
incontinence and that can reallychange their lives, whether
they can live independently anylonger.
You know whether they need tobe admitted to long term care.
It increases the you knowwhether they need to be admitted
to long-term care.
It increases the you know has afinancial impact on them
because they might need pads anddiapers, cause they think that
(06:10):
those are the only treatmentsfor urinary incontinence.
They have extra laundry, theyneed caregivers, and so it
really changes the game for alot of people.
How about people in theireveryday lives that are walking
around?
You know?
Middle-aged, young, activeleaking urine.
Speaker 2 (06:27):
Leaking urine, and that's just it.
And you know, and actually it'sfunny it's I was walking in the
mall and I walked past an olderadult and I could smell urine
and I kind of went okay.
So of course in my nursing mindI'm going okay.
So maybe some you know stress,incontinence, you know
(06:48):
incontinence, maybe not wantingto wear a pad right, like what
kind of you know resources doesthat individual have?
So just that whole piece.
So I can't help but think aboutit, what that means.
And we know that a lot of womenwill.
We're used to buying sanitarypads, sanitary napkins.
So for a woman to go and buysome pads to use if they're
(07:12):
dribbling a little bit,absolutely.
But what about for a man?
What is that stigma?
For them to actually walk inand, you know, buy pads right
that they can use to for urinaryincontinence, and I would think
that that would be a really bigstigma that that might be faced
right.
Speaker 1 (07:29):
Oh, absolutely.
People feel a lot older.
They gain weight, they stopexercising.
They actually age a bit fasteras well.
When they feel like they'reaging a bit faster, they feel
like they're older.
I've heard 40-year-old womentell me they feel like they're
grandmothers because they'releaking urine and, as you
mentioned, there's oftenembarrassment or stigma.
People worry that their homesare going to smell.
Long-term care facilities mayhave a scent as well.
(07:52):
How do you help patientsovercome that to seek treatment?
Speaker 2 (07:59):
how do you help patients overcome that to seek
treatment?
That and you know, I thinkthat's the biggest question
right now is that how do we,when we bring them into hospital
, the incontinence, I think you,as you stated, they change and
evolve when they're in there,because maybe now they're in bed
, we're not getting them up asoften, right, and maybe they're
incontinent once because maybethey can't get up to the
bathroom.
Now, all of a sudden, we put apad on them and then we put a
(08:23):
liner in that pad, so they'relike in a tens and we put them
on these individuals.
So what are we telling, youknow, these patients that, oh,
here, just pee in the pad and?
And as a nurse, I have to behonest and as a nurse educator,
I find that to be one of themost disturbing things that we
do for people that are inhospital, when we just tell them
to just pee in their pads.
(08:44):
Right, we need those resources,we need to get them up.
Do we always have the resourcesto do that?
Sometimes we don't, right, thewards are busy and other things
are going on and we know thatwith urinary incontinence, it's
good when people can get up andbasically use the washroom to
pee every two to three hours,right, like, get on that routine
(09:05):
, follow that pattern, right.
But how do we do that inhospital when there's so many
other things going on?
So I think that's a really bigquestion.
But that seems to be the trendof care.
Is that, especially for ourolder folks, that we just put
pads on them right?
That everybody normallyincontinent?
Just because you're older,you're incontinent.
So I think that is a little bitof ageism.
Speaker 1 (09:31):
there right People can be admitted with urinary
tract infections and I knowthat's a very costly situation
for hospitals because somebodycan present to emerge with
confusion and they end up havinga urinary tract infection.
They may be incontinent as well, the you know more chronic
(09:53):
wards and then need to beadmitted to long-term care when
you know we could have addressedthat in the emergency
department with some of thelifestyle changes and strategies
like localized estrogen, forexample, for perimenopausal,
menopausal, especiallypostmenopausal women.
But what are some of thoselifestyle changes that women can
use and men can also use totreat urinary incontinence?
Speaker 2 (10:17):
Well, I have to be honest, one of the biggest
things that I always hear andI've heard this from the
urologists as well is alwaysnumber one if you smoke, stop,
because we know that the smokingdefinitely leads to that.
And I've heard more than moretimes says stop the caffeine.
You know the heavy coffee, theheavy tea drinkers, and you know
I think that's maybe why nursesare so bad with some of the
times we drink a lot of coffeeand a lot of tea, right,
(10:41):
caffeine, and and I have.
I have a good friend and shesays to me she says, honestly, I
haven't had kids, but you know,if I cough, I leak urine, if I
I can't jump on a trampoline, Igot to be careful how long I'm
(11:02):
out for a walk for.
And she says I never, I haven'teven had kids.
And then I'm dealing with thisand and you know she's, she's
skinny, she's thin.
So, once again, weightreduction and, you know, losing
that extra weight or another wayas well.
But, yeah, like it, it happensto all of us, right, and the
chances are.
Speaker 1 (11:13):
And and those are a bit of a fallacy that only women
who've had babies leak urine.
Also, you know, women and mencut back on their water-based
fluids as well, because theythink if I don't drink water
then I won't leak or I won'thave to go to the bathroom.
But it causes concentratedurine which can be more
irritating to the bladder.
And you mentioned caffeine andalcohol and citrus and they can
(11:36):
all irritate the bladder.
All the things we love can bebad, you know the traditional or
the conventional wisdom?
the traditional advice has beenpelvic floor exercises like
Kegels.
Are they enough to manageincontinence or do most patients
need additional support?
Speaker 2 (11:52):
Well, for me, I think , for somebody who is maybe you
know at home that perimenopausal, menopausal or active lifestyle
, who can do those exercises.
I think that's, you know, stillsomething we should still be
doing.
Time could be a factor, butwhen you get into older adults
or people with limited mobility,I mean that is probably not
(12:14):
going to be an option forsomebody, right depending.
But yeah, I think that.
And then taking the time to dothem you know what I mean.
That's like you do themproperly.
Speaker 1 (12:25):
You know a lot of people haven't been taught how
to do them.
I'll tell.
I'll explain it like squeezethe rectal muscle, the muscle
that prevents you from passinggas, that's the one.
Or you know you can also use itfor bladder retraining or urge
suppression.
So do them quickly if you getan overwhelming urge to go to
the bathroom.
But, but mostly women will cometo me after a year, year and a
half, of trying Kegels.
They'll say they Kegel to death, they Kegel until the cows come
(12:47):
home and it didn't work.
And it's not going to work forstress, urinary incontinence, or
.
You know there's a lot ofpeople turn to social media
influencers who are trying tosell programs or supplements or
whatever you know to supportbladder health.
Not going to work.
But you know there's a veryinteresting device that's on the
market which is called theEmcella or the Kegelthrone and
(13:07):
that's gaining wide attention asa non-invasive treatment for
urinary incontinence.
Can you explain how it worksand who would be a good
candidate?
Speaker 2 (13:15):
Well, you know I'll do my best to explain how it
works, but I have used it.
So, basically, when I know itfirst came out and I was
suffering from urinaryincontinence I will be honest,
just more stress, incontinencewith coughing, had to be careful
with activities.
I'd had two vaginal bursts, butalso with episiotomy and other
(13:36):
things that went with that.
So I had some challenges.
So, even though doing the Kegelexercises tried to keep my
weight down and I love my coffee, it's really bad.
I really love my coffee.
So that was something I wasn'tgoing to give up as a nurse.
So when I was introduced to thelovely machine I said, okay,
let's give it a try.
(13:57):
So I did the initial like sixsessions and even after two
sessions I don't know how toexplain it.
You're sort of sitting on thisthrone, and that's a good word
for it.
You're sitting on this throneand they adjust the power which
is providing like a Kegel typeresponse, or or what do you want
(14:19):
to call it, maureen, you knowlike it's stimulation like it's
zapping it's zapping me downthere, so it's like it's doing
these lovely little zaps.
it's zapping me down there soit's like it's doing these
lovely little zaps that are likeequivalent to these kegel
exercises, but of coursemultifold.
And after two sessions and two30-minute sessions I actually
noticed a difference, so itactually helped like I could.
(14:40):
I could sneeze, I could coughand go.
Hmm, I'm okay, right.
I didn't have to worry aboutthat.
And then after six sessions itwas like, okay, I'm good, I
actually got on my little minitrampoline.
Perfectly fine, it was amazing.
Yeah, it was a really goodresponse.
Speaker 1 (15:00):
That is awesome.
Yeah, I hear that from a lot ofpatients, that it you know that
it starts working before thesix, but the six treatments are
recommended for sure.
So that's awesome.
So you have your own personalexperience with it and it's
dignified.
You're sitting on the chairwith your clothes on.
Speaker 2 (15:17):
There's no legs up in the stirrup on the M-Cellar or
the Kegel throne, which is whatwomen really don't love.
Speaker 1 (15:23):
You know, it's like oh, I got to go to the
gynecologist Like it can be oneof the worst days of a woman's
life, especially if she workswith the gynecologist anyway.
Speaker 2 (15:33):
Exactly, it can be so bad, that's right.
And then it's just that whole.
You know, I always what did onewoman say to me?
She goes how come every time Ineed something for female health
, my feet are in stirrups?
I said that's a good question.
Right, that is a good question.
Speaker 1 (15:48):
So not with the M cell or the Kegel throne, and so
that's what's just so niceabout it, and also you can go
back to work, you can do it onyour lunch hour.
It takes like 28 minutes persession, absolutely Six sessions
over two or three weeks, aslong as there's 48 hours in
(16:08):
between.
And so what kind of results canpatients expect from the
Emcella or the Kegel Throne, andhow would you say it compares
to other treatments?
Speaker 2 (16:12):
Well, I think you know, when you think about the
need to do all those repeatexercises, if you're doing them
on your own and all the dietmodifications that I think are
still important.
But this machine, like, reallygives you the opportunity that
you can make that appointment.
You can go in, you can sit onthe machine for like, your 28
minutes, read your magazineabsolutely no phones or
(16:33):
electronics, right.
So you're right, you have toactually sit and relax for a
little bit and think aboutthings and then you just stand
up and you walk away, right,right, and that's a huge piece,
it's, it's, it's easy.
Yes, we need the appointmentsand there's probably a limited
access to them out there, but Ican't help but wonder how, if
(16:53):
this is part of, you know,rehabilitation for somebody's,
you know incontinence, why don'twe have them in some of the
hospitals?
Why?
is that not part of thetreatment for some of these
older adults?
We have physio, we have OT.
Why can't we have this type ofmachine available that somebody
(17:14):
who's suffering from?
The urinary incontinence, canactually get a session in
healthcare, like in an acutecare setting for it.
Speaker 1 (17:22):
I couldn't agree with you more, and you know what
Urinary incontinence really it's, so undignified, it really
impacts a person's quality oflife.
It can lead to isolation,depression, feelings of
exclusion, increased laundry.
It's a financial impact,especially for people as they
age and maybe on a fixed income.
(17:42):
They're having to buy theseexpensive pads and diapers which
can cost $1,000 a year onaverage.
So it's a great option and I dofeel it should be part of the
treatment options that areoffered, and you know, at the
moment, oftentimes nothing isoffered to patients.
It's more like can you put upwith it?
Or you know there's a procedurefor that, but that procedure,
(18:03):
you know, involves, you know,taking time off from work,
recovery over a two to six weekperiod, and you know whereas
this, can you know, benefit somany people.
The Kegel Throne is just anawesome device and I'm so glad
that you tried it and that youhad a good experience with it.
And do you go back every yearfor like one or two?
Speaker 2 (18:23):
Yeah, I do one or two little repeat sessions and I've
referred a couple, a couple ofmy friends you know, along the
way and say go give it a try,I've had some good success with
it as well.
It's just making sure that youdo those follow up right, those
follow up sessions really dohelp.
That's a big piece, so yeah, Ithink it's definitely,
(18:43):
definitely something that Ithink and maybe I mean, maybe
this is bad to say, but you knowwomen's health, I think
sometimes women get labeled ascomplainers.
Right, you know you'recomplaining and you know, just
accept it.
This is just part of this isjust part of your aging, this is
just part of menopause.
But it's not right.
Speaker 1 (19:02):
This is not normal no absolutely, and the M-Cella
increases blood flow andactually strengthens the pelvic
floor muscles, and so it helpswith lubrication.
Many women report betterorgasms, and it just can overall
change a person's life, andit's for men and women, and for
women who might have a pessaryin situ for a pelvic organ
prolapse, you can still use theKegel Throne or the Emcella.
(19:28):
Yeah, yeah, it's just if you'repregnant or have a pacemaker,
you know there are somecontraindications to it, but
it's very important that youshare your medical history with
your healthcare provider who'sproviding the Emcella service to
you, and you know.
So metal hips or any metalimplants, that kind of thing are
contraindicated as well.
(19:49):
Yeah, but otherwise, you knowit's a great option for most
people, as you mentioned, andI'm so glad that you know you're
not leaking urine, you're justcarrying on and you don't have
any other surgery to lookforward to or admissions to
hospital.
Speaker 2 (20:05):
Admissions to hospital and just, you know,
think about like even just thewait list for some of these
procedures.
And you know, the more we talkabout this, it's like okay, so
why can't some of theseurologists have these in their
office?
Speaker 1 (20:16):
Yeah, exactly.
Speaker 2 (20:17):
Like why can't I have a seat on?
The Kegel throne while you waitfor me.
Speaker 1 (20:25):
Exactly, I'm going to be about an hour, so you know
30 minutes on there, exactly,grab some lunch, read a book.
Speaker 2 (20:29):
We'll put something up on the screen for you to
watch and while you're in here,and maybe that needs to be
normalized right.
Speaker 1 (20:38):
Of course, of course.
And Lisa, what advice would yougive to somebody?
Because there's still a shameand a stigma associated with it?
But what advice would you giveto somebody Because there's
still a shame and a stigmaassociated with it?
But what advice would you giveto someone struggling with
urinary incontinence buthesitant to seek help?
Speaker 2 (20:50):
You know, I think I would say to someone you know
what this isn't?
it's not normal, and it's normalto feel stigmatized and that it
isn't normal, but it actuallyis a normal process that can
happen and we need to get out ofthat shame and seek out some
help, and maybe that's where weneed to have more.
(21:12):
You know you have your podcast.
Maybe we need more, some onlinesite where patients can go and
ask questions right, when can apatient go and you know, type in
that question or talk tosomebody to get some answers.
I don't know what the nurseline has, or is it passed down
by word of mouth, Because I tendto pass my information about
(21:32):
the mCELLA down to people I'vemet or women I've talked to, or
in the hospital.
I might pass that on, pass thaton right, so by word of mouth.
But you're right, I think weneed more continence advisors.
I think it needs to be anotherarea of nursing that maybe we
look at as having more of right,Absolutely.
Speaker 1 (21:53):
Instead of less of Exactly, they cut those
positions.
Yeah, it's great that youmentioned you know where can
people get more information,because for more information
about the Amcella or theKeglethron you can go to
btlestheticscom, that'sb-t-l-a-e-s-t-h-e-t-i-c-scom.
Lisa, thanks so much forjoining the podcast.
Speaker 2 (22:14):
Thank you very much, maureen, for having me.
This has been great.
And just to you know, when Ifirst was introduced to the
Amcella, it was like, oh, thisis very interesting.
I had no idea any this evenexisted.
And then, after doing it, itwas like, okay, this is good.
Like more, more people whosuffer need to use this device.
(22:35):
I think it's amazing.
So Absolutely.
Speaker 1 (22:38):
Thank you so much, lisa.
That's awesome advice.
Lisa Kirk is a registered nurse.
She's been one for over 30years and she works in acute
(23:05):
care and emergency nursing,interventional radiology, and
she is also a medical clinicalnurse educator.
She's on the faculty at DouglasCollege training new nurses to
work in our ever in healthcareeducation.
She is a busy person.
If you think that somebody youknow might benefit from tuning
into this episode, feel free toshare.
You can always text or emailthe show.
My email isnursetalkathotmailcom and you
can text at 604-765-9287.
I'm Maureen McGrath and youhave been listening to Nurse
Maureen's Health Show Podcast.
(23:26):
Thanks so much for tuning in.
I'm Maureen McGrath and youhave been listening to the
Sunday Night Health Show Podcast.
If you want to hear thispodcast or any other segment
again, feel free to go to iTunes, spotify or Google Play or
wherever you listen to yourfavorite podcasts.
You can always email me,nursetalk at hotmailcom or text
the show 604-765-9287.
(23:48):
That's 604-765-9287.
Or head on over to my websitefor more information.
Maureenmcgrathcom, it's been mypleasure to spend this time with
you.
Did you know that a weak pelvicfloor can lead to urinary leaks
, discomfort and even impactyour confidence in the bedroom,
(24:10):
whether you're a woman dealingwith bladder control issues or a
man looking to improveperformance and blood flow,
btl-m-cella is the solution.
This non-invasive treatmentdelivers thousands of pelvic
floor contractions in just onesession, like doing 11,800
Kegels, without the effort,stronger muscles, better control
(24:31):
and enhanced wellness withoutsurgery or downtime.
Take the first step toward astronger you.
For more information or to finda provider, go to
btlastheticscom.
That's btlastheticscom.
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