June 22, 2025 • 40 mins
Bladder issues can impact people at any age, with a third of women over 35 affected by bladder leaks.
Wrapping up World Continence Week, how can we help remove the stigma around incontinence?
Tim Beveridge is joined with Pelvic Health Expert Caitlin Fris...
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Speaker 1 (00:05):
You're listening to the Weekend Collective podcast from News Talk ZB.
Speaker 2 (00:24):
Yes, welcome back to the Weekend Collective. By the way,
if you missed our politics, a couple of great interviews.
They're not just on the situation in the in the States,
but we also had a chat with chat with the
president of the Cork Islands Tourism Council around what's going
on with their funding and the reaction to Mark Brown's
handling of things to do with China and things. Quite
a fascinating, quite a fascinating hour actually, and Jeffrey Miller,
(00:45):
Juri political analyst as well on you know the madness
of what Trump's done. You can go and check that
out look for the Weekend Collective on iHeartRadio News Talk
z B. But right now we're shifting the topic completely
because this is the Health Hub and it is World
Continents Week, and so we're gonna have a chat about
(01:05):
one of those. Maybe let's just say it's probably a
stigmatized topic because it's not the sort of thing that
you just bring up in the middle of lunches. It's like,
I've got some problems within continents and bladder health. But
bladder issues can affect people at any age, with a
third of women over thirty five affected by a bladder leaks,
and so we can have a chat about that. And
we've got a pelvic health expert and physio. I think
(01:28):
that physio as well. Caitlin Friss?
Speaker 3 (01:30):
Is it?
Speaker 2 (01:31):
Do I get the pronunciation right there?
Speaker 4 (01:32):
At Caitlin My name Caitlin Fress.
Speaker 2 (01:35):
Yeah, I'm wondering if I mispronounced something else. Now I'm
going anyway, just a little bit about you. First, a
pelvic health expert, So you come from your physiotherapist, tell
us about the journey to ending up in this area
of medicine, and you know what's such a big deal.
Speaker 4 (01:53):
I graduated as what I call a normal physio, you know,
like backs and hips and knees. And then I went
and got a junior rotating job on an Auckland City
hospital on the woods. And I was working in Autho
at the time. And so lots of fractured hips, lots
of little old ladies coming in fracturing their hip, and
most of the time it's because they were trying to
(02:14):
get to the toilet too quickly, or they were getting
up at night and falling over and fracturing their hip.
The average life span after a hip fracture is about
six to twelve months because there's such a cascade of
medical issues that can happen, like the operations, really big
postop infections, lack of mobility, and then it's a pretty
(02:35):
high rate of mortality after something like that.
Speaker 2 (02:38):
So with that being so dark, it sort of ties
into the because we had a conversation with actually it
was just the other day on Martoiki we had Alex
Flint and we're talking about the danger of falls and
what a serious impact falls can be, and it was
about balance and testing your stability and things. And here
we are talking about that having in continence, a problem
(02:58):
with leaky bladder, sprint to the toilet, slip, whoop sea,
And then.
Speaker 4 (03:02):
Yeah, it's one of the biggest reasons why people need
higher level of care rest home or hospital level care.
And so if you're thinking about at like a public
health or a like public spin level, it's quite a
big issue when you think about it that way. But
what I found was that we were kind of like
slapping a pad on these women and kind of sitting
them off to their rest home without actually addressing their continents.
And that's when I started to think, oh, there's probably
(03:22):
more preventative measures that we can take on this, and
so I at the time there wasn't any post grade
training that you could do in New Zealand specific to that.
So I went over to Melbourne and did the postgrade
certificates through Melbourne UNI and then I've just worked a
women's health and public floor physio since then.
Speaker 2 (03:39):
The people it's look, is there a stigma with it?
Or are we better at talking about these issues? Do
you think? I mean, I guess if somebody walks in
the door to see you, they're ready to talk about
it because it's a problem. But I mean it's a
sort of broader observation around the stigma on these things.
Speaker 4 (03:56):
Yeah, I mean it's easy. You say, it's hard to
tell because everybody I talk about bladders all day every
day in bowels and sex and all those sort of
stigmatized issues. But even still to this day, I might
be the first person that someone mentions it too when
they walk into the door, or they often say like,
I wish I wouldn't have known earlier that there's something
(04:16):
I could do about this. We do know that yes,
one and three women over the edge of thirty five
have some sort of bladder leakage and that could be
like a small leak with a cough up to like
winning their pants all day every day into pads, So
a big range of bladder leakage. But we know that
about about two out of three of those women won't
seek help for it.
Speaker 2 (04:36):
So what actually can mean and what comes to mind
is Pelbert floor exercises and things like that. But I
don't know if I'm thinking of the wrong thing. Yeah, Kegels,
I guess yes, I don't think I've forgotten that. Well,
I wouldn't know too much about Keegel's being a bloke,
I guess would I. But you do have a pelvic
floor yeah, So how much is is it preventable? Because
(05:00):
you're a physio and I guess that you're a pelvic
health expert. Is that all to do with muscular tre
and structure rather than other sorts of diseases and things.
Speaker 4 (05:09):
The pelvic floor When we talk about treatmental management of incontinents,
the pelvic floor exercises are very small part of it.
Continence is actually really complex, like there's a lot of
stars that need to align in order for our palvispiel
to hold urine it and so there's it's there needs
(05:32):
to be lots of structural components in exactly the right angle.
There needs to be hormonal stuff going on. There needs
to be like what you're drinking, how you like, how
you mobilize, all that kind of stuff affixed your continent status.
So palpit floor exercise, yes, it's part of it, but
there's a huge other, mostly education and how you're drinking.
(05:52):
If we if we cure someone's constipation, their blooder liquor
draw often get better, So we might not even like
address their palpic floor, might just get their bowels a
bit better. How they're exercising. If they're doing lots of
like jumping on the trampoline, that can sort of make
leakage worse heavyweights.
Speaker 2 (06:08):
Okay, so actually there be exercises which intuitively I might
think I better get go practice jumping on the trampoline
because then I can start thinking about how to control
it and then I get better. But you might say, well,
actually that's not a helpful exercise.
Speaker 4 (06:21):
It will likely get worse over time if you do that.
Speaker 2 (06:23):
Yep, So no, okay, no bouncing on trampolines.
Speaker 4 (06:27):
So yes, powerful excise are a part of it, but there
is a lot more, lot more to it. Back pain
can affect it, and.
Speaker 2 (06:33):
Blokes as well. I mean, I know that the stats
are the stats are I mean a third of women
over thirty five, which I mean intuitively what you say
about so many stars having to align to be continent,
that stat would just tell you that it must be
easy for just one little thing to go wrong and
or hey, presto, then you've got something you need to address.
Speaker 4 (06:53):
Yeah, absolutely, and you actually, when you look at incontinents,
there's lots of different types, and it's really important to
tease out which type of incontinent somebody has, so somebody
might have stress. You're in your incontinence, which is the
leakage of urine on effort laughing, coughing, sneezing, jumping on
the trampoline. That's usually a structural issue where the bladder
and the urethra isn't being held correctly against the pubic bone.
(07:14):
Or they might be urge your own incontinence, which is
the sudden overwhelming urge to need to go to the toilet.
Rushing to get there, you might leak on the way,
and that there'll be people listening right now, like going yep,
nodding their head.
Speaker 2 (07:26):
Actually, I almost wonder I don't please don't text me
on this because sometimes you get how many people are
sitting there just gradually doing a few clenches, thinking how
is my I mean, it was one of those I'm
sitting here clenching, going okay, that's such and such. But
is that for men? For instance? What are the causes different?
In how different are the causes of incontinence with men?
Speaker 4 (07:47):
Yes, I mean the pelvis, the male palvis is not
actually that different to the female one. It's just one
less passage when you look thinking about the pelvic floor.
But there's often different issues that contribute to it. So prostatectomy,
when the prostate is removed from prostate cancer, there's a
really high rate of incontinents because they're one of the
continence mechanisms inside the urethra.
Speaker 2 (08:07):
That sort of, I mean, I guess, just on a
side issue, that's probably gives an example or a demonstration
of why people don't aren't recommended to necessarily have you
prostate removed if you've got some cancer, if they can
treat it otherwise that you die with prostate cancer because
the side effects of having a prostatectomy. Said it for
me prost detective, not as a prostetectom me. There we go.
(08:29):
It can be quite.
Speaker 4 (08:31):
Significant that yeah, Blader lukage erectarla's function. Yeah, absolutely, we'd.
Speaker 2 (08:36):
Love to take your calls on this. And look, I
know it's it's it's not like just talking about what
do you do when you're with some sort of basic
issue that we might talk about on talk back all
the time. But in contidence, if you've got any questions,
you might be asking for a friend. I know that
there are people who are nervous when they are when
they've conceived a child because of what pregnancy the effects
of pregnancy on continence, and what are the effects of
(08:59):
pregnancy on continence.
Speaker 4 (09:00):
So a lot of people think, I mean, a vaginal
birth is going to stretch all the structures and the palace,
so that's going to result in quite a lot of
incontinence in a lot of people. But pregnancy itself can
make a difference because you've got i mean, babies are
pretty heavy for your poor old palvic floor, and that's
sitting on there for nine months plus You've got the
hormonal changes of pregnancy, so the high estrogen state of
(09:22):
pregnancy makes everything a bit little bit lax and loose.
Speaker 2 (09:25):
Is it something that generally returns to normal or is
that the reason? I mean, if you look at the
stat of women over thirty five, most people are going
to have babies, I mean are probably done so by
their mid late thirties. So is that part of the
stat that women post childbirth are significantly represented in those stats? God,
that was a long way women have had babies. Are
(09:46):
they more much more at risk?
Speaker 5 (09:47):
Yes?
Speaker 4 (09:47):
Yeah, so more at risk after a vadinal birth, but
still at risk after a c section because you've had
a pregnancy on the palvic floor and on the structures
inside the palviace.
Speaker 2 (09:56):
Can you do anything during I mean, is it preventable
or mitigatable?
Speaker 4 (10:03):
You can reduce your risk of birth injuries which can
cause leakage. We've got some really good research on doing
your public floor exercises led by a physio, So not
just doing your squeezes every so often has to be
a sort of a prescribed set of exercises for your
public floor because everybody's palpt floor is different. But if
you do that every day right through your pregnancy, there's
a lower rate of and continence after birth, and it
(10:25):
also helps to reduce the leakage during pregnancy that might
happen too. There is also other things like exercising regularly
during pregnancy basically to keep the babies weight in the
average range. Obviously, bigger baby, more stretch or damage. And
also peranial message, which is a sort of pulvit floor
stretch that you can do or have somebody else do
(10:47):
to you in that last trimester of pregnancy. Yeah, your
face is priceless.
Speaker 2 (10:52):
I'm sorry, Well, I'm just yeah, that sounds fuller more
hands on? Should I say? Look, we want your cause
on this if you've got any questions around it, because
you know, this is an issue that affects so many people. Actually,
just one quick question. Why is it? Just it seems
(11:13):
intuitive that as you get older that certain functions you
can't take for granted. But is there I mean, can
you also as you get older? Is there why do
we suddenly have to get up in the middle of
the night.
Speaker 4 (11:26):
Yeah, so our kidney's actually change how it processes urine
as we get older. So over the age of sixty five,
it's normal to under the age of sixty five, it's
abnormal to get up to go to the toilet over
one time a night, and over the age of sixty
five it's abnormal to get up over two times a night.
So it does increase over time just with the kidney function,
(11:49):
but also that can be affected by things like, you know,
lots of cups of tea during the day or drinking
at night, or your quality of sleep or sleep ap near.
All these things can affect getting up a night as well.
Speaker 2 (12:02):
What's the difference between young people not noting thing? Is
it just your physicality that you you might have a
fair bit of liquid before you go to bed, but
somehow because a lot of people will wake up in
middle of the night because they have that sensation, why
are they getting that sensation They're needing to go even
though they're successfully holding it. In versus a young person
who doesn't even get the sensation of needing to go,
(12:23):
is because the muscles are starting to work, they.
Speaker 4 (12:25):
Probably have more bladder capacity, but also the kidneys aren't
producing as much your own overnight in a younger person.
Speaker 2 (12:31):
Okay, well there you go. So if you are getting
up in the middle of the night, I might have
missed that, but you might have said that earlier. Actually,
but yeah, there you go. Don't worry. It's not your
muscles giving way. It's just that your kidneys function, they
are producing more fluids. So there's an excuse for it.
And who cares what the excuse is. You want to
get it fixed? Eight hundred and eighty ten eighty. We're
going to take your cause and we'll do it right
now then.
Speaker 6 (12:51):
Now Hello, Hi, Hi timber Ridge. How are you good?
Speaker 2 (12:55):
Thanks?
Speaker 6 (12:57):
Yeah, I'm here. I'm just fascinated with the conversation that
is going on with regards to the public out and
expertise on yeh. Basically, I actually run a small ENO's
brand called Margocoro that offers a caffeine free coffee alternative
made from chicory root called Chai coffee. It has many
(13:22):
health benefits, but I have seen that some physiotherapy clients
says that reducing caffeine actually helps with bladder control. Can
can Kathleen explain us basically with regards to the caffeine
effects the bladders and.
Speaker 2 (13:39):
Our Yeah right, okay, you're caffeine bladders.
Speaker 4 (13:44):
Yeah, there's For some people, the caffeine can be a
bloody irritant, so it gets in when you drink it,
it gets into your bloodstream and then into your bladder
and irritates the lining of the bladder and then the
bladder muscle, So the bladder has a muscular wall, and
it starts to spasm and as a reaction to the
ritin that's inside it, So it sends you to the
toilet more often and with urgency. But everybody's sort of
(14:05):
has different sensitivities to caffeine, So some people are fine
and other people will be quite sensitive to it.
Speaker 2 (14:10):
Because you get people who I mean, they drink caffee
at the caffeine up to about nine o'clock at night,
then go sleep like a baby. I'm like, what's with that?
Either that it's very weak coffee?
Speaker 4 (14:19):
Yeah, exactly.
Speaker 2 (14:20):
OK, let's take some more calls A Sally Hello.
Speaker 5 (14:25):
Hello, I've just forgotten the name of It's I'm gonna.
Speaker 2 (14:30):
It's Caitlin, and you're Sally, and I'm Tim. Where you go?
Speaker 5 (14:37):
Apparently people were getting treatment for the bladder the same
that they put on the wrinkles on their face.
Speaker 2 (14:47):
What's that called botox?
Speaker 5 (14:50):
Botox? But I was told that it only lasts for
nine months and it's got to be done again and
also that you get a lot of infection if you've
been treated with botox something new that surely there's something
new that they can put a plug in the head
(15:13):
stop the drips.
Speaker 2 (15:15):
Well, I mean intuitively, Mike, think if it's if there's
a leak that you plug it. But I'm not sure that.
I'm not sure that's going to be what Caitlin's going
to tell us. What do you reckon, Kaitlyn.
Speaker 4 (15:23):
There are quite a few procedures out there for bladder
in continents it is for most people. Most urologists and
eurogyonocologists will say get the natural continent mechanisms going again,
so that would be address your palvic floor and also
something like vaginal estrogen cream, which you'd speak to your
GP about. Vaginal estrogen cream can be just as effective
(15:46):
as a lot of bladder medications out there. So if
you've tried that, then it's time to speak to a
urologist or eurogynecologist. Is plenty of different it's changing all
the time. Actually, yes, botox into the bladder muscle, but yes,
it does wear off after about nine months, and it's
something that needs to be redone again and it's not
effective for everyone. But it is effective for some people.
(16:08):
There's also like a filler, you know, like a filler
that you put in your face. Not botox, but a filler.
I think it might be collagen, but I'm not sure
what the substrate is. But it can go into the
urethra and that's quite new as well. Not enough research
to say how helpful that is, but there's a lot
of there's a lot of people doing some pretty interesting
stuff out there. It'd be a conversation with your GP
(16:28):
and a specialist about that.
Speaker 2 (16:30):
Thanks for your call, Sally. I've got a question. Somebody's
asking what are kegel exercises and what's the difference between
kegels for men and women.
Speaker 4 (16:41):
Keegle exercise is just another term for public floor muscle exercises.
Should I go through a set?
Speaker 3 (16:47):
Now?
Speaker 2 (16:48):
Okay? Well, go through a set, yep? I mean describe them? Okay, yeah,
So you're.
Speaker 4 (16:53):
Going to join me, Tim sitting upright in your chair, right, yep.
I want you to make sure that your weight is
down through the sipbones and like those bony bets on
each but chet yet so you're not tip forward or
back or side to side. You're a nice neutral in
the palvist. I want you to imagine your palvic floor
being a diamond shape, so from the front, your pubic
bone at the front to your tailbone at the back,
and then you're so like a hammock or a bowl
(17:16):
at the base of your palvist a. Right on top
of that bowl of muscle sits your two palvic organs.
Women have three, so bladder at the front, uterus for
women in the middle, and then the rectum at the back.
And there's three passages that run through the center, so
the urethra or the urine tube at the front, the
vagina's in the middle, and then the anus through the back. There,
So your pelvic floor when you squeeze them, you want
(17:38):
to think of the two sides of the palvic floor
and your three passages in the middle. They squeeze together,
they block off those two or three passages, they lift
up inside of you and they pull forward towards your
pubic So.
Speaker 2 (17:49):
You've got to do that sort of like close everything
off and then think about lifting them up.
Speaker 4 (17:53):
Yes, but I just saw you squeeze your glutes because
you bobbed up in the chair. That's not your palvic floor.
I should be able to not be able to tell
that you're doing it from the outside, so it's quite internal.
I'm going to use. It's a que that might work
for males and females. I want you to imagine that
you've got a big fart brewing, and you're in an
elevator full of people.
Speaker 2 (18:14):
And I do not want them to know.
Speaker 4 (18:16):
And you do not want them to know, so they're
all looking at you. Oh, you squeeze around the back
passage that ring a muscle around the anus, lift it
up inside of you and towards your pubic bone. It
might also feel like you're lifting everything up away from
the curic asset of your underwear.
Speaker 2 (18:29):
It's actually quite hard work, it is. Yeah, I get
to release it as well.
Speaker 4 (18:32):
You're allowed to relax it now, let it or go.
You're also meant to keep breathing. Okay, I think I'm
sweating and I'm doing it too, So you actually be able
to talk as well.
Speaker 2 (18:41):
Well. I couldn't notice except you did change your posture there,
well done, You did it very well. So and do
you just so it's basically and do you pretend you're
also trying to stop wieing? Yes, so you do both
of them.
Speaker 4 (18:53):
And both passages lifting up inside of you, and a.
Speaker 2 (18:56):
Woman would have a different sensation of doing that, would
they because of vagina?
Speaker 4 (18:59):
Yeah, kind of like I might just use a different que,
but I'd use that back passage queue for women as well.
But the thing is that everybody's palvot floor is different.
So some people might need to work on strength of
their palvot floor, so lifting up that actual max strength
capacity of your public floor. Some people need to work
on relaxing it. And having an overactive or a two
tight palvic floor can contribute to a week sorry, mimic
(19:20):
a week public floor and cause leakage. So actually strengthening
an overactive or a tight palblot floor can make things
weaker over time or make things worse over time. Sorry.
Some people need to work on endurance. Some people need
to work on coordinations, so palvot floor exercises.
Speaker 2 (19:32):
So if they're not, just so, you've just given me
some kegle exercises and everyone else is listening. Wonder how
many people are clinching right now? But hopefully milliar but
how many? How many? So do you just hold it
for a few seconds and they relax and do that?
What a dozen times? Or something or what.
Speaker 4 (19:46):
Well, it's different for everyone. So again, when I do
an assessment of a palvot floor, I'll see what they
can manage and I'll be working them to fatigue. Well,
write that down and make them do that like three
times a day.
Speaker 2 (19:55):
If somebody's got a problem with incontinence, is are those helpful? Exercise?
How helpful are those particular sides? Because it's something that's
to do with sexual function as well, a whole bunch
of things, isn't it.
Speaker 4 (20:03):
Yeah, So again public flow weeks is there only a
part of like the management of incontinents, but as about
seventy percent of people with leakage will be able to
cure or significantly improve their symptoms with conservative management.
Speaker 2 (20:15):
Okay, look, we'd love your calls as well. If you've
got any questions. You might just be asking for a
friend as well, who's expressed you know somebody's I don't know,
people share these problems with them with each other. Give
us a call. Eight hundred eighty ten eighty. My guest
is Caitlin Frist. She is a pelvic health physio. Actually,
by the way, where do people track you down? I
(20:35):
mean I didn't put that the right way I work.
Speaker 4 (20:39):
I co own a physio and pilarate studio called Unity Studios.
We have three in Auckland, so you can visit www
dot Unity Studios dot co doz.
Speaker 2 (20:49):
Actually I've got lots of questions, but I do need
to take a break, so you can. You can call
with yours break on eight hundred eighty ten eighty hopepilly
not twenty seven past four. Yes, welcome back. This is
(21:18):
the week in Collective the Health Harbor that we're doing
a I don't want to say we're doing a special,
but it is a World Continents week and we're shining
a light on in continence and bladder health and taking
your calls on anything you've got. My guests Caitlin Friss,
she is a pelvic health physio and Peter Hello.
Speaker 3 (21:35):
Hi.
Speaker 7 (21:36):
There was a gynecologist, I think it was in the
seventies or eighties in christ Church Hospital who believed I
should pee and then stop their p and start again
to keep exercising going. I don't know if that applied
to women as well. Then the issue is food like
turmeric and garlic and other things. And then I've heard
(21:57):
other stories about trampoline's doing other things for lots of
other issues. So is there any anthing cranberry of urine infection?
Speaker 2 (22:07):
Okay, we've got three questions there, Peter, I think that
we've we've touched on the trampolining, which is not necessarily helpful,
although intuitively it might be, Caitlin, hang on a second week,
just turn your microphone on there, We thank you.
Speaker 4 (22:20):
Yeah, trampolining often will make things worse rather than better.
The what was the first stopping?
Speaker 2 (22:29):
Stopping which is actually I don't have that's an old
it's a sexist ter my wive's tale, but an old myth.
Is it true or not that it helps stopping starting
while you're going?
Speaker 6 (22:39):
Well?
Speaker 4 (22:40):
Interesting, there's been a bit of a trend up until
recently it was said not to do that because it
might contribute to urinary tract infections, but we don't actually
know that for sure. And interestingly, there was a really
good study in China recently that got men after a prostatectomy,
so taken their prostrate out, they were incontinent, and they
made them stop the flow of urine in halfway through
(23:02):
the w every week that they did, and they had
a really significant improvement in continence scores. Compared to the
group that didn't do that. So that's all very new research,
so it might be helpful. I usually say to my women,
probably don't do it every week because we don't want
to risk a U tony, but once or twice a
day might be quite helpful to train that internal urethrial
(23:24):
sphincter muscle.
Speaker 2 (23:25):
Is your retention? Is that something that you just don't
manage to evacuate everything when you go wheeze.
Speaker 4 (23:31):
Yeah, it's usually a sort of almost like a paralysis
of the bladder where it doesn't we out and it
can be really dangerous.
Speaker 2 (23:38):
Is why Is that why you talk about the kegels
for some things? But there are other ways of also
trying to learn to relax the muscles because it's almost
like you've got to let it. There's some sort of
I don't know, mental sort of zen approach to just
letting yourself go to the loop.
Speaker 4 (23:53):
Yeah, yeah, absolutely. And post operations or catheter removal, there's
a really big issue they called a failed truck or
a failed trial of removal of catheter where they take
the catheter out and then you go to the toilet
and you just cannot we even though you want to
even though you have the urge you sit on, the
toilets just not coming. And one of the theories behind
that is that the muscles just aren't relaxing, aren't letting go,
(24:16):
and so having really good control and awareness around your
public floor contraction and relaxation can help help with that problem.
Speaker 2 (24:24):
Right, Let's take some more calls Sally, Hello, helloly Hi, Yeah.
Speaker 8 (24:30):
Hi, Yes, that's what you were talking about there, that retention.
I've got a thirty two year old besh on their daughter.
She had major surgery in January for an ovary that Luckily,
she was able to tell me there was something wrong
just because she wouldn't lean forward on the toilet after
going toilet. So we went and had surgery and had
(24:52):
the ovary removed with the big blown uptists in it,
and so then she had a catheter. They took the
catheter out, and I wouldn't leave the hospital until she
did go toilet naturally.
Speaker 7 (25:06):
But that was in.
Speaker 8 (25:06):
January and we're now nearly July. She can hold on
for hours, she can sit on the toilet and nothing happens.
She doesn't go, so because she's special needs, she can't
tell me if she wants to. But it won't come out,
or if it just won't come so she sits on
the toilet eve in the morning and nothing. She won't
(25:29):
up petill one o'clock in the afternoon, and then she
has enough just before bed and that's it.
Speaker 4 (25:36):
Yeah, that's tricky. Even one significant stretch of the bladder wall,
so one episode of urinary retention can contribute to almost
like a like a floppy bladder muscle, which means that
it will you will really struggle to empty. So that's
why it's really important to do timed toileting with something
like someone like that. So setting a timer for three
hours where you can, if possible, to empty the bladder
(26:00):
even if she feels like she doesn't want to.
Speaker 8 (26:02):
Okay, I know, but I take it here and she
sits there. So when we left the hospital, the gynecologist said,
this is a eurology problem, another gynecology problem, so we
don't come home. But then the Eurology department wrote and said,
we've reviewed your cases. It's not urgent enough. So I
only how that can justify that when we don't know what.
Speaker 4 (26:23):
The cause is.
Speaker 2 (26:24):
That's a difficult one, isn't it an Any further comment
on that Caitlin.
Speaker 3 (26:28):
Really.
Speaker 2 (26:28):
I mean, I guess she's in the system being seen
by gynecologists neurologists.
Speaker 4 (26:31):
But yeah, I just keept pushing with the specialists for sure.
Speaker 2 (26:34):
Advocacy is probably the thing you've got to keep up with.
They're selling. I'm sure you're doing great job with that. Hey.
One person just says your confidence discussion concerns me. I'm
eighty and I sleep through without any toilet break. Should
I be concerned given that I should probably have at
least one?
Speaker 4 (26:49):
No, celebrate it.
Speaker 2 (26:52):
There you go, John Victory. For John, that is that abnormal?
Speaker 4 (26:57):
No, I mean it's normal to go once or twice,
like there's a range over. But I'd be started if
I was eighty. I'm not getting up at night.
Speaker 2 (27:04):
I mean, I guess what it raised questions about whether
someone's maybe not hydrating enough during the day, which is
why they're not going, And that's I don't know.
Speaker 4 (27:11):
But possibly there's a lot of factors that could be.
Speaker 2 (27:13):
Okay, tell you what, we need to take another break.
We'll be back in just a moment. By the way,
if you want to get in touch with Caitlin or
Team Unity Studios dot cur at INZ, you can go
and check it out with Caitlyn Fresh. He's a pelvic
health expert talking about any issue around bladder health, pelvic
floor health. Give us a call. I w eight one
hundred and eighty ten eighty will be back in a moment.
It's twenty three minutes to five.
Speaker 9 (27:35):
If now, yes, Welcome back to the Health Harp.
Speaker 2 (27:51):
We're with pelvic health physio Caitlin FORRISS and we're talking
about It's World Continence Week, so we're talking about pelvic
floor health and incontinents and bladder issues and your calls.
I eight hundred eighty ten eighty Suzan, Hello.
Speaker 10 (28:05):
Hian Caitlin. I'm wondering if you could tell me benefits please,
or how the actual TENS machine works and how long
amusen't thirty minutes weekly? And also the value of the
Overston cream changes how long before that I've noticed a difference.
I'm really envious of that lady who's over eighty and
they can't get up at all night.
Speaker 11 (28:25):
Thank you.
Speaker 4 (28:27):
Yeah, sure, I'm envious too. So the TENS machine, for
those of those who are listening you don't know what
it is. It's an electrical stimulation machine, which so it's
a little unit with batteries in it, and there's two
cords that come out of it and attached to two
skin electrodes you know the sticky pads for that they
put on your heart when they're tracking the activity. So
(28:48):
it has some really good research and is actually considered
first line treatment for bladder urgency. Now it sounds a
little bit strange, but you put it on your leg.
So you put the two electrodes on your bottom part
of your leg along the route of the posterior to
be nerve which runs down the back league into the foot.
The reason being is that that nerve root or the
(29:09):
nerve goes all the way up and comes from the
sacrum part of your spine, and the same so the
same nerve roots supply sensation to the bladder. So the
tens machine basically kind of distracts the other part of
the nerve that sends messages to and from the bladder
by stimulating the nerve further down the leg. Research shows
(29:30):
that you once a week is good. You will you
just need to put it on one leg thirty minutes. Absolutely,
once a week is good, but there is probably benefit
to doing it more time, so two or three times
a week and the best amount of benefit is found
between six to twelve weeks of doing it every week.
Oveston is the brand name for the estrogen cream. It
(29:53):
takes a few weeks to build the estrogen levels up,
and your prescription usually is about using every day for
a week and then once or twice a week from
then on. But it might be even more if the
tissues are needing a bit more estrogen, and again it
will could take a good six weeks to get those
estrogen levels up again. So yeah, keep at it, and
after about six weeks, if there's not enough improvement, I
(30:15):
probably go back to your doctor.
Speaker 10 (30:18):
Thanks.
Speaker 2 (30:18):
Thanks, thanks for your question. I really appreciate that. Rose.
Speaker 12 (30:21):
Hello, Hi, I was just wondering. Now I've listened to
the intro, I may have not got the right brief,
but I was wondering what the relationship is between urgency
of ladder control and bowel control and pairing menopause.
Speaker 4 (30:44):
Okay, not actually that related, even though it sounds similar.
The bladder urgency is usually a bladder organ and sensory problem,
so the nerves providing sensation to the bladder. Bowel urgency
is usually I mean, it could be multi factory, but
likely to be an injury to the muscle around the anus,
(31:06):
usually from birth or surgery or some neurological issues as well,
So actually quite different. The path of physicology of it
needs to be treated quite differently as well. During perimenopause,
what's happening is your estrogen levels are sort of spiking
up and down, but over time it's generally trending downwards.
All of the structures, most of the structures inside the pelvis,
(31:28):
particularly the bladder and the vaginal tract have lots of
estrogen receptors in it. So when we're in these lower
states of estrogen in our life, there's not much estrogen
binding to those structures, and that's they all get a
little bit weaken and a little bit irritable. So that's
why bladder urgency, bladder leakage, those kind of things can
happen in that season of our life.
Speaker 12 (31:49):
And so if you're on HRT, are just that help
or it doesn't make any different.
Speaker 4 (31:56):
I'm assuming you mean the patch or oral hrt our patch.
Speaker 12 (32:01):
Yes, an oral progesterone.
Speaker 4 (32:03):
Yeah, so that is a HRT, So it goes into
your blood stream and sort of affix the whole lot
of your body there is sort of mixed research on
how that affects your bladder control. But the vaginal estrogen
has really good effects on bladder control. I check with
your GP whether you can use both, but likely you'll
be able to. Vaginal estrogen is really safe and really effective,
(32:26):
and it doesn't actually go into the negligible volumes goes
into your blood streams. This stays quite local to the
vagina and the bladder.
Speaker 2 (32:34):
Okay, And so.
Speaker 12 (32:37):
If the bowel urgency is coming through, like through exercise,
what is there anything I could do with regard to that?
Speaker 4 (32:47):
Yeah, lots that would take up a whole appointment of visio,
I think, So.
Speaker 12 (32:51):
That was what I was going to ask. Is it
something that if I saw a woman's health for ZEO,
is that something they could help with or should I
see a doctor about that?
Speaker 4 (33:01):
Yes, we can help I'd probably the best sort of
gold standard b CUGP. There might be some sort of
medications and stuff that they can prescribe to help, but
also getting the structural changes and the muscles working a
bit better and get you also emptying better as well,
because an empty vessel doesn't leak that. There's lots of
things we can do to help you with that.
Speaker 2 (33:20):
Okay, Hey, thanks so much for your call. Ros quick question.
Does this again? It gets into sort of people forming
a judgments about whether when you should have a baby.
But do women tend to have problems if they have
their children later or does it not make any difference
whether you if you have children at a younger age
in terms of the possible problems that might arise in
continence wise.
Speaker 4 (33:40):
Yeah, you're more likely to have issues that, particularly if
you have your first baby later in life. It's sort
of a collagen makeup or the changes of our connective
tissues can make a difference on how things sort of
recover and recoil after bet.
Speaker 2 (33:53):
Okay, right, and oh, by the way, Bob says, was
that a yes or no to stopping you for urine
flow as an exercise? I don't think it was conclusive anyway,
was it, Caitlin?
Speaker 4 (34:02):
I'd say, see your pallic floor physio and get some
information from them.
Speaker 2 (34:06):
Yeah, could you ask you GP about that as well
if you're a guy going for a check up or something.
Speaker 4 (34:10):
By the way, yeah, yes, but they're likely to.
Speaker 2 (34:14):
Refer you to the excellent okay, excellent, right until in
fact I tell you what We'll take the break now
and come back with more calls. Times rushing by, but
we'll be back in just a moment. News Talk said
B eight hundred and eighty ten eighty thirteen minutes to five. Yes,
News Talk said be. We're with Caitlin Fresho's a pelvic
health physio. We're talking about it's World Continence Week, so
(34:34):
shedding a lot and incontinence and bladder health generally speaking,
more specifically Shelley, Hello, oh hello.
Speaker 13 (34:41):
How are you good?
Speaker 2 (34:42):
Thanks good.
Speaker 3 (34:44):
I am a chiropreactor in potty door and we've been
using magnetic training worth PALVIY power for people with public
floor health. And when Cauler Sally called before about her daughter,
I was wondering, Titlan, what your thoughts might be about
using something like that people with of retention of bladder.
Speaker 2 (35:09):
I actually haven't heard of magnetic electromagnetic stimulation you're talking.
Speaker 13 (35:13):
About, yes, well, so this is amazing. I'm actually very
excited about it. And we were introduced to it by
Nathan Scott from care Good Physio. But basically it's a
chair that has a magnetic coil in the feat that
can stimulate but also defense towze the pelvic floor to
(35:37):
get it, to train it but also relax it. But
it can do it in a session twenty five thousand times,
and so it's a really effective way of helping people
use and learn how to use their pelvic flow and
wake up the brain.
Speaker 2 (35:54):
Okay, well we might we haven't had time to deal
with that right now, because that's not something you're familiar with, Caitlin,
but I shall have a look at it, because we'll
get We'll get Caitlin on again. Sometimes we'll see we'll
have a look at that in more detail. We've got
to get Sprint through a few more calls before we
wrap it up. I actually do have one quickly about
the stigmatism about I mean the products that are available
for people who've got an issue within continents and I
(36:16):
mean I guess and going back years or decades, it
will be some bulky sort of pad and everything. And
thanks to Lulu Lemon, are there good products out there
these days?
Speaker 4 (36:27):
Yeah, I mean the engineering behind pads is actually really
interesting for like continence nerds like me. But they're like
some of them can be really thin and hold up
to like five hundred mills of urine. They're quite different
to menstrual pads. Menstrual pads are made to catch quite
viscous fluid and they won't actually catch much watery fluid
(36:48):
like urine, so buying continence pads is really important. You
can also get continents underwear, which is more environmentally friendly
and often a little bit nicer to wear for a
lot of people. So making sure you invest in some
good continence pads can help, like the image or your
concerns about smell, and they're actually really good at drawing
(37:10):
the you'urine away from the skin towards the bottom of
the pad for health reasons as well.
Speaker 2 (37:14):
Okay, right, so hello, oh hello.
Speaker 11 (37:19):
I was just screening to say that the core of
three three back.
Speaker 8 (37:24):
With her daughter.
Speaker 11 (37:25):
I had the same situation where I was concerned about
my allegic and I went and had an ultrust out.
I wasn't successful in what she wanted me to discharge,
so I had to go back, which I did, and yes,
(37:47):
there was an issue where my ladder wasn't emptying, so
she referred me to the hospital and I got exactly
the same letter as to what that lady said.
Speaker 2 (38:02):
Wasn't saying it wasn't urgent or something to sort out.
Speaker 11 (38:06):
Yes, yes, which I mean there is no pain associated
with it. But I'm just slightly concerned.
Speaker 2 (38:15):
Yeah, yeah, that is a difficult I don't know if
it's difficult to comment on individual cases really in that sense,
isn't it, Caitlin, Well it is.
Speaker 4 (38:22):
I mean you can if it's within your means to
see a private specialist, that's probably worth it. You can
also see a good pelvic health physio that will be
able to either rule in or rule out things like
a vaginal prolapse which can contribute to difficulties empty in
your bladder, give you some strategies on bladder emptying and
having a look with the ultrasound machine on your tummy
(38:43):
to make sure you are emptying properly. But yes, just
keep advocating for yourself through the public system if as
that's where you're going.
Speaker 2 (38:51):
I'm sorry, We've got to keep things moving through. But
thank you for your call. But I think the big
question we need to if people are talking about a
pelvic health physio, because there are physios specialized in all
sorts of things in body parts and knees and hips,
and so a pelvic floor physio I would obviously there's
you guys at what's your website? I guess address again
Unity Studios dot co.
Speaker 4 (39:11):
Do in the.
Speaker 2 (39:12):
Unity Studios dot cat and say if you want to
get in touch with Caitlin and her team. But if
they're generically speaking, if somebody's you know, you're one of many.
I'm guessing. But how would people find the right person?
Speaker 4 (39:22):
Yeah, they're all throughout the country. I would I mean
a quick Google search public health physio in your town
will come up with one. I would just make sure
that they have some really good experience. There are lots
of weekend courses out there for physios to do so
just two days, and I don't consider that good enough
to be rubbishing around a vagina after a weekend course.
(39:44):
So I would just say, see someone that has some
good post grade training and or some good mentoring from
a good senior public health physio. So they are there everywhere,
and they might.
Speaker 2 (39:54):
Need a reference from anyone. You don't need to go
to U referral. So that's the weird.
Speaker 4 (39:58):
Yeah, nope, you can go like any other physio. You
can just turn up and booken. They might be in
like normal physio sports physio clinics, or they might be
in their own special clinic. You can also go through
the public system. So as far as I know, most
DHBs in New Zealand do have a public health physio team,
(40:18):
but you need to referer from your GP for that.
Speaker 2 (40:21):
And of course you can go to Unity Studios dot
co dot nz on their website readily available in contact them. Hey, Caitlin,
thanks so much, gosh, we could have taken a truckload
more cause and text. Let's to get you back sometime. Okay,
thanks good stuff Caitlin for us from Unity Studios.
Speaker 9 (40:38):
We'll be back. We're talking money next.
Speaker 2 (40:40):
Tamus Paper from Harbor Asset Management is with us. It's
coming up to three to five News Talk SEDB.
Speaker 1 (40:46):
For more from the weekend collective, listen live to Newstalk
ZEDB weekends from three pm, or follow the podcast on
iHeartRadio
You're listening to the Weekend Collective podcast from News Talk ZB.
Speaker 2 (00:24):
Yes, welcome back to the Weekend Collective. By the way,
if you missed our politics, a couple of great interviews.
They're not just on the situation in the in the States,
but we also had a chat with chat with the
president of the Cork Islands Tourism Council around what's going
on with their funding and the reaction to Mark Brown's
handling of things to do with China and things. Quite
a fascinating, quite a fascinating hour actually, and Jeffrey Miller,
(00:45):
Juri political analyst as well on you know the madness
of what Trump's done. You can go and check that
out look for the Weekend Collective on iHeartRadio News Talk
z B. But right now we're shifting the topic completely
because this is the Health Hub and it is World
Continents Week, and so we're gonna have a chat about
(01:05):
one of those. Maybe let's just say it's probably a
stigmatized topic because it's not the sort of thing that
you just bring up in the middle of lunches. It's like,
I've got some problems within continents and bladder health. But
bladder issues can affect people at any age, with a
third of women over thirty five affected by a bladder leaks,
and so we can have a chat about that. And
we've got a pelvic health expert and physio. I think
(01:28):
that physio as well. Caitlin Friss?
Speaker 3 (01:30):
Is it?
Speaker 2 (01:31):
Do I get the pronunciation right there?
Speaker 4 (01:32):
At Caitlin My name Caitlin Fress.
Speaker 2 (01:35):
Yeah, I'm wondering if I mispronounced something else. Now I'm
going anyway, just a little bit about you. First, a
pelvic health expert, So you come from your physiotherapist, tell
us about the journey to ending up in this area
of medicine, and you know what's such a big deal.
Speaker 4 (01:53):
I graduated as what I call a normal physio, you know,
like backs and hips and knees. And then I went
and got a junior rotating job on an Auckland City
hospital on the woods. And I was working in Autho
at the time. And so lots of fractured hips, lots
of little old ladies coming in fracturing their hip, and
most of the time it's because they were trying to
(02:14):
get to the toilet too quickly, or they were getting
up at night and falling over and fracturing their hip.
The average life span after a hip fracture is about
six to twelve months because there's such a cascade of
medical issues that can happen, like the operations, really big
postop infections, lack of mobility, and then it's a pretty
(02:35):
high rate of mortality after something like that.
Speaker 2 (02:38):
So with that being so dark, it sort of ties
into the because we had a conversation with actually it
was just the other day on Martoiki we had Alex
Flint and we're talking about the danger of falls and
what a serious impact falls can be, and it was
about balance and testing your stability and things. And here
we are talking about that having in continence, a problem
(02:58):
with leaky bladder, sprint to the toilet, slip, whoop sea,
And then.
Speaker 4 (03:02):
Yeah, it's one of the biggest reasons why people need
higher level of care rest home or hospital level care.
And so if you're thinking about at like a public
health or a like public spin level, it's quite a
big issue when you think about it that way. But
what I found was that we were kind of like
slapping a pad on these women and kind of sitting
them off to their rest home without actually addressing their continents.
And that's when I started to think, oh, there's probably
(03:22):
more preventative measures that we can take on this, and
so I at the time there wasn't any post grade
training that you could do in New Zealand specific to that.
So I went over to Melbourne and did the postgrade
certificates through Melbourne UNI and then I've just worked a
women's health and public floor physio since then.
Speaker 2 (03:39):
The people it's look, is there a stigma with it?
Or are we better at talking about these issues? Do
you think? I mean, I guess if somebody walks in
the door to see you, they're ready to talk about
it because it's a problem. But I mean it's a
sort of broader observation around the stigma on these things.
Speaker 4 (03:56):
Yeah, I mean it's easy. You say, it's hard to
tell because everybody I talk about bladders all day every
day in bowels and sex and all those sort of
stigmatized issues. But even still to this day, I might
be the first person that someone mentions it too when
they walk into the door, or they often say like,
I wish I wouldn't have known earlier that there's something
(04:16):
I could do about this. We do know that yes,
one and three women over the edge of thirty five
have some sort of bladder leakage and that could be
like a small leak with a cough up to like
winning their pants all day every day into pads, So
a big range of bladder leakage. But we know that
about about two out of three of those women won't
seek help for it.
Speaker 2 (04:36):
So what actually can mean and what comes to mind
is Pelbert floor exercises and things like that. But I
don't know if I'm thinking of the wrong thing. Yeah, Kegels,
I guess yes, I don't think I've forgotten that. Well,
I wouldn't know too much about Keegel's being a bloke,
I guess would I. But you do have a pelvic
floor yeah, So how much is is it preventable? Because
(05:00):
you're a physio and I guess that you're a pelvic
health expert. Is that all to do with muscular tre
and structure rather than other sorts of diseases and things.
Speaker 4 (05:09):
The pelvic floor When we talk about treatmental management of incontinents,
the pelvic floor exercises are very small part of it.
Continence is actually really complex, like there's a lot of
stars that need to align in order for our palvispiel
to hold urine it and so there's it's there needs
(05:32):
to be lots of structural components in exactly the right angle.
There needs to be hormonal stuff going on. There needs
to be like what you're drinking, how you like, how
you mobilize, all that kind of stuff affixed your continent status.
So palpit floor exercise, yes, it's part of it, but
there's a huge other, mostly education and how you're drinking.
(05:52):
If we if we cure someone's constipation, their blooder liquor
draw often get better, So we might not even like
address their palpic floor, might just get their bowels a
bit better. How they're exercising. If they're doing lots of
like jumping on the trampoline, that can sort of make
leakage worse heavyweights.
Speaker 2 (06:08):
Okay, so actually there be exercises which intuitively I might
think I better get go practice jumping on the trampoline
because then I can start thinking about how to control
it and then I get better. But you might say, well,
actually that's not a helpful exercise.
Speaker 4 (06:21):
It will likely get worse over time if you do that.
Speaker 2 (06:23):
Yep, So no, okay, no bouncing on trampolines.
Speaker 4 (06:27):
So yes, powerful excise are a part of it, but there
is a lot more, lot more to it. Back pain
can affect it, and.
Speaker 2 (06:33):
Blokes as well. I mean, I know that the stats
are the stats are I mean a third of women
over thirty five, which I mean intuitively what you say
about so many stars having to align to be continent,
that stat would just tell you that it must be
easy for just one little thing to go wrong and
or hey, presto, then you've got something you need to address.
Speaker 4 (06:53):
Yeah, absolutely, and you actually, when you look at incontinents,
there's lots of different types, and it's really important to
tease out which type of incontinent somebody has, so somebody
might have stress. You're in your incontinence, which is the
leakage of urine on effort laughing, coughing, sneezing, jumping on
the trampoline. That's usually a structural issue where the bladder
and the urethra isn't being held correctly against the pubic bone.
(07:14):
Or they might be urge your own incontinence, which is
the sudden overwhelming urge to need to go to the toilet.
Rushing to get there, you might leak on the way,
and that there'll be people listening right now, like going yep,
nodding their head.
Speaker 2 (07:26):
Actually, I almost wonder I don't please don't text me
on this because sometimes you get how many people are
sitting there just gradually doing a few clenches, thinking how
is my I mean, it was one of those I'm
sitting here clenching, going okay, that's such and such. But
is that for men? For instance? What are the causes different?
In how different are the causes of incontinence with men?
Speaker 4 (07:47):
Yes, I mean the pelvis, the male palvis is not
actually that different to the female one. It's just one
less passage when you look thinking about the pelvic floor.
But there's often different issues that contribute to it. So prostatectomy,
when the prostate is removed from prostate cancer, there's a
really high rate of incontinents because they're one of the
continence mechanisms inside the urethra.
Speaker 2 (08:07):
That sort of, I mean, I guess, just on a
side issue, that's probably gives an example or a demonstration
of why people don't aren't recommended to necessarily have you
prostate removed if you've got some cancer, if they can
treat it otherwise that you die with prostate cancer because
the side effects of having a prostatectomy. Said it for
me prost detective, not as a prostetectom me. There we go.
(08:29):
It can be quite.
Speaker 4 (08:31):
Significant that yeah, Blader lukage erectarla's function. Yeah, absolutely, we'd.
Speaker 2 (08:36):
Love to take your calls on this. And look, I
know it's it's it's not like just talking about what
do you do when you're with some sort of basic
issue that we might talk about on talk back all
the time. But in contidence, if you've got any questions,
you might be asking for a friend. I know that
there are people who are nervous when they are when
they've conceived a child because of what pregnancy the effects
of pregnancy on continence, and what are the effects of
(08:59):
pregnancy on continence.
Speaker 4 (09:00):
So a lot of people think, I mean, a vaginal
birth is going to stretch all the structures and the palace,
so that's going to result in quite a lot of
incontinence in a lot of people. But pregnancy itself can
make a difference because you've got i mean, babies are
pretty heavy for your poor old palvic floor, and that's
sitting on there for nine months plus You've got the
hormonal changes of pregnancy, so the high estrogen state of
(09:22):
pregnancy makes everything a bit little bit lax and loose.
Speaker 2 (09:25):
Is it something that generally returns to normal or is
that the reason? I mean, if you look at the
stat of women over thirty five, most people are going
to have babies, I mean are probably done so by
their mid late thirties. So is that part of the
stat that women post childbirth are significantly represented in those stats? God,
that was a long way women have had babies. Are
(09:46):
they more much more at risk?
Speaker 5 (09:47):
Yes?
Speaker 4 (09:47):
Yeah, so more at risk after a vadinal birth, but
still at risk after a c section because you've had
a pregnancy on the palvic floor and on the structures
inside the palviace.
Speaker 2 (09:56):
Can you do anything during I mean, is it preventable
or mitigatable?
Speaker 4 (10:03):
You can reduce your risk of birth injuries which can
cause leakage. We've got some really good research on doing
your public floor exercises led by a physio, So not
just doing your squeezes every so often has to be
a sort of a prescribed set of exercises for your
public floor because everybody's palpt floor is different. But if
you do that every day right through your pregnancy, there's
a lower rate of and continence after birth, and it
(10:25):
also helps to reduce the leakage during pregnancy that might
happen too. There is also other things like exercising regularly
during pregnancy basically to keep the babies weight in the
average range. Obviously, bigger baby, more stretch or damage. And
also peranial message, which is a sort of pulvit floor
stretch that you can do or have somebody else do
(10:47):
to you in that last trimester of pregnancy. Yeah, your
face is priceless.
Speaker 2 (10:52):
I'm sorry, Well, I'm just yeah, that sounds fuller more
hands on? Should I say? Look, we want your cause
on this if you've got any questions around it, because
you know, this is an issue that affects so many people. Actually,
just one quick question. Why is it? Just it seems
(11:13):
intuitive that as you get older that certain functions you
can't take for granted. But is there I mean, can
you also as you get older? Is there why do
we suddenly have to get up in the middle of
the night.
Speaker 4 (11:26):
Yeah, so our kidney's actually change how it processes urine
as we get older. So over the age of sixty five,
it's normal to under the age of sixty five, it's
abnormal to get up to go to the toilet over
one time a night, and over the age of sixty
five it's abnormal to get up over two times a night.
So it does increase over time just with the kidney function,
(11:49):
but also that can be affected by things like, you know,
lots of cups of tea during the day or drinking
at night, or your quality of sleep or sleep ap near.
All these things can affect getting up a night as well.
Speaker 2 (12:02):
What's the difference between young people not noting thing? Is
it just your physicality that you you might have a
fair bit of liquid before you go to bed, but
somehow because a lot of people will wake up in
middle of the night because they have that sensation, why
are they getting that sensation They're needing to go even
though they're successfully holding it. In versus a young person
who doesn't even get the sensation of needing to go,
(12:23):
is because the muscles are starting to work, they.
Speaker 4 (12:25):
Probably have more bladder capacity, but also the kidneys aren't
producing as much your own overnight in a younger person.
Speaker 2 (12:31):
Okay, well there you go. So if you are getting
up in the middle of the night, I might have
missed that, but you might have said that earlier. Actually,
but yeah, there you go. Don't worry. It's not your
muscles giving way. It's just that your kidneys function, they
are producing more fluids. So there's an excuse for it.
And who cares what the excuse is. You want to
get it fixed? Eight hundred and eighty ten eighty. We're
going to take your cause and we'll do it right
now then.
Speaker 6 (12:51):
Now Hello, Hi, Hi timber Ridge. How are you good?
Speaker 2 (12:55):
Thanks?
Speaker 6 (12:57):
Yeah, I'm here. I'm just fascinated with the conversation that
is going on with regards to the public out and
expertise on yeh. Basically, I actually run a small ENO's
brand called Margocoro that offers a caffeine free coffee alternative
made from chicory root called Chai coffee. It has many
(13:22):
health benefits, but I have seen that some physiotherapy clients
says that reducing caffeine actually helps with bladder control. Can
can Kathleen explain us basically with regards to the caffeine
effects the bladders and.
Speaker 2 (13:39):
Our Yeah right, okay, you're caffeine bladders.
Speaker 4 (13:44):
Yeah, there's For some people, the caffeine can be a
bloody irritant, so it gets in when you drink it,
it gets into your bloodstream and then into your bladder
and irritates the lining of the bladder and then the
bladder muscle, So the bladder has a muscular wall, and
it starts to spasm and as a reaction to the
ritin that's inside it, So it sends you to the
toilet more often and with urgency. But everybody's sort of
(14:05):
has different sensitivities to caffeine, So some people are fine
and other people will be quite sensitive to it.
Speaker 2 (14:10):
Because you get people who I mean, they drink caffee
at the caffeine up to about nine o'clock at night,
then go sleep like a baby. I'm like, what's with that?
Either that it's very weak coffee?
Speaker 4 (14:19):
Yeah, exactly.
Speaker 2 (14:20):
OK, let's take some more calls A Sally Hello.
Speaker 5 (14:25):
Hello, I've just forgotten the name of It's I'm gonna.
Speaker 2 (14:30):
It's Caitlin, and you're Sally, and I'm Tim. Where you go?
Speaker 5 (14:37):
Apparently people were getting treatment for the bladder the same
that they put on the wrinkles on their face.
Speaker 2 (14:47):
What's that called botox?
Speaker 5 (14:50):
Botox? But I was told that it only lasts for
nine months and it's got to be done again and
also that you get a lot of infection if you've
been treated with botox something new that surely there's something
new that they can put a plug in the head
(15:13):
stop the drips.
Speaker 2 (15:15):
Well, I mean intuitively, Mike, think if it's if there's
a leak that you plug it. But I'm not sure that.
I'm not sure that's going to be what Caitlin's going
to tell us. What do you reckon, Kaitlyn.
Speaker 4 (15:23):
There are quite a few procedures out there for bladder
in continents it is for most people. Most urologists and
eurogyonocologists will say get the natural continent mechanisms going again,
so that would be address your palvic floor and also
something like vaginal estrogen cream, which you'd speak to your
GP about. Vaginal estrogen cream can be just as effective
(15:46):
as a lot of bladder medications out there. So if
you've tried that, then it's time to speak to a
urologist or eurogynecologist. Is plenty of different it's changing all
the time. Actually, yes, botox into the bladder muscle, but yes,
it does wear off after about nine months, and it's
something that needs to be redone again and it's not
effective for everyone. But it is effective for some people.
(16:08):
There's also like a filler, you know, like a filler
that you put in your face. Not botox, but a filler.
I think it might be collagen, but I'm not sure
what the substrate is. But it can go into the
urethra and that's quite new as well. Not enough research
to say how helpful that is, but there's a lot
of there's a lot of people doing some pretty interesting
stuff out there. It'd be a conversation with your GP
(16:28):
and a specialist about that.
Speaker 2 (16:30):
Thanks for your call, Sally. I've got a question. Somebody's
asking what are kegel exercises and what's the difference between
kegels for men and women.
Speaker 4 (16:41):
Keegle exercise is just another term for public floor muscle exercises.
Should I go through a set?
Speaker 3 (16:47):
Now?
Speaker 2 (16:48):
Okay? Well, go through a set, yep? I mean describe them? Okay, yeah,
So you're.
Speaker 4 (16:53):
Going to join me, Tim sitting upright in your chair, right, yep.
I want you to make sure that your weight is
down through the sipbones and like those bony bets on
each but chet yet so you're not tip forward or
back or side to side. You're a nice neutral in
the palvist. I want you to imagine your palvic floor
being a diamond shape, so from the front, your pubic
bone at the front to your tailbone at the back,
and then you're so like a hammock or a bowl
(17:16):
at the base of your palvist a. Right on top
of that bowl of muscle sits your two palvic organs.
Women have three, so bladder at the front, uterus for
women in the middle, and then the rectum at the back.
And there's three passages that run through the center, so
the urethra or the urine tube at the front, the
vagina's in the middle, and then the anus through the back. There,
So your pelvic floor when you squeeze them, you want
(17:38):
to think of the two sides of the palvic floor
and your three passages in the middle. They squeeze together,
they block off those two or three passages, they lift
up inside of you and they pull forward towards your
pubic So.
Speaker 2 (17:49):
You've got to do that sort of like close everything
off and then think about lifting them up.
Speaker 4 (17:53):
Yes, but I just saw you squeeze your glutes because
you bobbed up in the chair. That's not your palvic floor.
I should be able to not be able to tell
that you're doing it from the outside, so it's quite internal.
I'm going to use. It's a que that might work
for males and females. I want you to imagine that
you've got a big fart brewing, and you're in an
elevator full of people.
Speaker 2 (18:14):
And I do not want them to know.
Speaker 4 (18:16):
And you do not want them to know, so they're
all looking at you. Oh, you squeeze around the back
passage that ring a muscle around the anus, lift it
up inside of you and towards your pubic bone. It
might also feel like you're lifting everything up away from
the curic asset of your underwear.
Speaker 2 (18:29):
It's actually quite hard work, it is. Yeah, I get
to release it as well.
Speaker 4 (18:32):
You're allowed to relax it now, let it or go.
You're also meant to keep breathing. Okay, I think I'm
sweating and I'm doing it too, So you actually be able
to talk as well.
Speaker 2 (18:41):
Well. I couldn't notice except you did change your posture there,
well done, You did it very well. So and do
you just so it's basically and do you pretend you're
also trying to stop wieing? Yes, so you do both
of them.
Speaker 4 (18:53):
And both passages lifting up inside of you, and a.
Speaker 2 (18:56):
Woman would have a different sensation of doing that, would
they because of vagina?
Speaker 4 (18:59):
Yeah, kind of like I might just use a different que,
but I'd use that back passage queue for women as well.
But the thing is that everybody's palvot floor is different.
So some people might need to work on strength of
their palvot floor, so lifting up that actual max strength
capacity of your public floor. Some people need to work
on relaxing it. And having an overactive or a two
tight palvic floor can contribute to a week sorry, mimic
(19:20):
a week public floor and cause leakage. So actually strengthening
an overactive or a tight palblot floor can make things
weaker over time or make things worse over time. Sorry.
Some people need to work on endurance. Some people need
to work on coordinations, so palvot floor exercises.
Speaker 2 (19:32):
So if they're not, just so, you've just given me
some kegle exercises and everyone else is listening. Wonder how
many people are clinching right now? But hopefully milliar but
how many? How many? So do you just hold it
for a few seconds and they relax and do that?
What a dozen times? Or something or what.
Speaker 4 (19:46):
Well, it's different for everyone. So again, when I do
an assessment of a palvot floor, I'll see what they
can manage and I'll be working them to fatigue. Well,
write that down and make them do that like three
times a day.
Speaker 2 (19:55):
If somebody's got a problem with incontinence, is are those helpful? Exercise?
How helpful are those particular sides? Because it's something that's
to do with sexual function as well, a whole bunch
of things, isn't it.
Speaker 4 (20:03):
Yeah, So again public flow weeks is there only a
part of like the management of incontinents, but as about
seventy percent of people with leakage will be able to
cure or significantly improve their symptoms with conservative management.
Speaker 2 (20:15):
Okay, look, we'd love your calls as well. If you've
got any questions. You might just be asking for a
friend as well, who's expressed you know somebody's I don't know,
people share these problems with them with each other. Give
us a call. Eight hundred eighty ten eighty. My guest
is Caitlin Frist. She is a pelvic health physio. Actually,
by the way, where do people track you down? I
(20:35):
mean I didn't put that the right way I work.
Speaker 4 (20:39):
I co own a physio and pilarate studio called Unity Studios.
We have three in Auckland, so you can visit www
dot Unity Studios dot co doz.
Speaker 2 (20:49):
Actually I've got lots of questions, but I do need
to take a break, so you can. You can call
with yours break on eight hundred eighty ten eighty hopepilly
not twenty seven past four. Yes, welcome back. This is
(21:18):
the week in Collective the Health Harbor that we're doing
a I don't want to say we're doing a special,
but it is a World Continents week and we're shining
a light on in continence and bladder health and taking
your calls on anything you've got. My guests Caitlin Friss,
she is a pelvic health physio and Peter Hello.
Speaker 3 (21:35):
Hi.
Speaker 7 (21:36):
There was a gynecologist, I think it was in the
seventies or eighties in christ Church Hospital who believed I
should pee and then stop their p and start again
to keep exercising going. I don't know if that applied
to women as well. Then the issue is food like
turmeric and garlic and other things. And then I've heard
(21:57):
other stories about trampoline's doing other things for lots of
other issues. So is there any anthing cranberry of urine infection?
Speaker 2 (22:07):
Okay, we've got three questions there, Peter, I think that
we've we've touched on the trampolining, which is not necessarily helpful,
although intuitively it might be, Caitlin, hang on a second week,
just turn your microphone on there, We thank you.
Speaker 4 (22:20):
Yeah, trampolining often will make things worse rather than better.
The what was the first stopping?
Speaker 2 (22:29):
Stopping which is actually I don't have that's an old
it's a sexist ter my wive's tale, but an old myth.
Is it true or not that it helps stopping starting
while you're going?
Speaker 6 (22:39):
Well?
Speaker 4 (22:40):
Interesting, there's been a bit of a trend up until
recently it was said not to do that because it
might contribute to urinary tract infections, but we don't actually
know that for sure. And interestingly, there was a really
good study in China recently that got men after a prostatectomy,
so taken their prostrate out, they were incontinent, and they
made them stop the flow of urine in halfway through
(23:02):
the w every week that they did, and they had
a really significant improvement in continence scores. Compared to the
group that didn't do that. So that's all very new research,
so it might be helpful. I usually say to my women,
probably don't do it every week because we don't want
to risk a U tony, but once or twice a
day might be quite helpful to train that internal urethrial
(23:24):
sphincter muscle.
Speaker 2 (23:25):
Is your retention? Is that something that you just don't
manage to evacuate everything when you go wheeze.
Speaker 4 (23:31):
Yeah, it's usually a sort of almost like a paralysis
of the bladder where it doesn't we out and it
can be really dangerous.
Speaker 2 (23:38):
Is why Is that why you talk about the kegels
for some things? But there are other ways of also
trying to learn to relax the muscles because it's almost
like you've got to let it. There's some sort of
I don't know, mental sort of zen approach to just
letting yourself go to the loop.
Speaker 4 (23:53):
Yeah, yeah, absolutely. And post operations or catheter removal, there's
a really big issue they called a failed truck or
a failed trial of removal of catheter where they take
the catheter out and then you go to the toilet
and you just cannot we even though you want to
even though you have the urge you sit on, the
toilets just not coming. And one of the theories behind
that is that the muscles just aren't relaxing, aren't letting go,
(24:16):
and so having really good control and awareness around your
public floor contraction and relaxation can help help with that problem.
Speaker 2 (24:24):
Right, Let's take some more calls Sally, Hello, helloly Hi, Yeah.
Speaker 8 (24:30):
Hi, Yes, that's what you were talking about there, that retention.
I've got a thirty two year old besh on their daughter.
She had major surgery in January for an ovary that Luckily,
she was able to tell me there was something wrong
just because she wouldn't lean forward on the toilet after
going toilet. So we went and had surgery and had
(24:52):
the ovary removed with the big blown uptists in it,
and so then she had a catheter. They took the
catheter out, and I wouldn't leave the hospital until she
did go toilet naturally.
Speaker 7 (25:06):
But that was in.
Speaker 8 (25:06):
January and we're now nearly July. She can hold on
for hours, she can sit on the toilet and nothing happens.
She doesn't go, so because she's special needs, she can't
tell me if she wants to. But it won't come out,
or if it just won't come so she sits on
the toilet eve in the morning and nothing. She won't
(25:29):
up petill one o'clock in the afternoon, and then she
has enough just before bed and that's it.
Speaker 4 (25:36):
Yeah, that's tricky. Even one significant stretch of the bladder wall,
so one episode of urinary retention can contribute to almost
like a like a floppy bladder muscle, which means that
it will you will really struggle to empty. So that's
why it's really important to do timed toileting with something
like someone like that. So setting a timer for three
hours where you can, if possible, to empty the bladder
(26:00):
even if she feels like she doesn't want to.
Speaker 8 (26:02):
Okay, I know, but I take it here and she
sits there. So when we left the hospital, the gynecologist said,
this is a eurology problem, another gynecology problem, so we
don't come home. But then the Eurology department wrote and said,
we've reviewed your cases. It's not urgent enough. So I
only how that can justify that when we don't know what.
Speaker 4 (26:23):
The cause is.
Speaker 2 (26:24):
That's a difficult one, isn't it an Any further comment
on that Caitlin.
Speaker 3 (26:28):
Really.
Speaker 2 (26:28):
I mean, I guess she's in the system being seen
by gynecologists neurologists.
Speaker 4 (26:31):
But yeah, I just keept pushing with the specialists for sure.
Speaker 2 (26:34):
Advocacy is probably the thing you've got to keep up with.
They're selling. I'm sure you're doing great job with that. Hey.
One person just says your confidence discussion concerns me. I'm
eighty and I sleep through without any toilet break. Should
I be concerned given that I should probably have at
least one?
Speaker 4 (26:49):
No, celebrate it.
Speaker 2 (26:52):
There you go, John Victory. For John, that is that abnormal?
Speaker 4 (26:57):
No, I mean it's normal to go once or twice,
like there's a range over. But I'd be started if
I was eighty. I'm not getting up at night.
Speaker 2 (27:04):
I mean, I guess what it raised questions about whether
someone's maybe not hydrating enough during the day, which is
why they're not going, And that's I don't know.
Speaker 4 (27:11):
But possibly there's a lot of factors that could be.
Speaker 2 (27:13):
Okay, tell you what, we need to take another break.
We'll be back in just a moment. By the way,
if you want to get in touch with Caitlin or
Team Unity Studios dot cur at INZ, you can go
and check it out with Caitlyn Fresh. He's a pelvic
health expert talking about any issue around bladder health, pelvic
floor health. Give us a call. I w eight one
hundred and eighty ten eighty will be back in a moment.
It's twenty three minutes to five.
Speaker 9 (27:35):
If now, yes, Welcome back to the Health Harp.
Speaker 2 (27:51):
We're with pelvic health physio Caitlin FORRISS and we're talking
about It's World Continence Week, so we're talking about pelvic
floor health and incontinents and bladder issues and your calls.
I eight hundred eighty ten eighty Suzan, Hello.
Speaker 10 (28:05):
Hian Caitlin. I'm wondering if you could tell me benefits please,
or how the actual TENS machine works and how long
amusen't thirty minutes weekly? And also the value of the
Overston cream changes how long before that I've noticed a difference.
I'm really envious of that lady who's over eighty and
they can't get up at all night.
Speaker 11 (28:25):
Thank you.
Speaker 4 (28:27):
Yeah, sure, I'm envious too. So the TENS machine, for
those of those who are listening you don't know what
it is. It's an electrical stimulation machine, which so it's
a little unit with batteries in it, and there's two
cords that come out of it and attached to two
skin electrodes you know the sticky pads for that they
put on your heart when they're tracking the activity. So
(28:48):
it has some really good research and is actually considered
first line treatment for bladder urgency. Now it sounds a
little bit strange, but you put it on your leg.
So you put the two electrodes on your bottom part
of your leg along the route of the posterior to
be nerve which runs down the back league into the foot.
The reason being is that that nerve root or the
(29:09):
nerve goes all the way up and comes from the
sacrum part of your spine, and the same so the
same nerve roots supply sensation to the bladder. So the
tens machine basically kind of distracts the other part of
the nerve that sends messages to and from the bladder
by stimulating the nerve further down the leg. Research shows
(29:30):
that you once a week is good. You will you
just need to put it on one leg thirty minutes. Absolutely,
once a week is good, but there is probably benefit
to doing it more time, so two or three times
a week and the best amount of benefit is found
between six to twelve weeks of doing it every week.
Oveston is the brand name for the estrogen cream. It
(29:53):
takes a few weeks to build the estrogen levels up,
and your prescription usually is about using every day for
a week and then once or twice a week from
then on. But it might be even more if the
tissues are needing a bit more estrogen, and again it
will could take a good six weeks to get those
estrogen levels up again. So yeah, keep at it, and
after about six weeks, if there's not enough improvement, I
(30:15):
probably go back to your doctor.
Speaker 10 (30:18):
Thanks.
Speaker 2 (30:18):
Thanks, thanks for your question. I really appreciate that. Rose.
Speaker 12 (30:21):
Hello, Hi, I was just wondering. Now I've listened to
the intro, I may have not got the right brief,
but I was wondering what the relationship is between urgency
of ladder control and bowel control and pairing menopause.
Speaker 4 (30:44):
Okay, not actually that related, even though it sounds similar.
The bladder urgency is usually a bladder organ and sensory problem,
so the nerves providing sensation to the bladder. Bowel urgency
is usually I mean, it could be multi factory, but
likely to be an injury to the muscle around the anus,
(31:06):
usually from birth or surgery or some neurological issues as well,
So actually quite different. The path of physicology of it
needs to be treated quite differently as well. During perimenopause,
what's happening is your estrogen levels are sort of spiking
up and down, but over time it's generally trending downwards.
All of the structures, most of the structures inside the pelvis,
(31:28):
particularly the bladder and the vaginal tract have lots of
estrogen receptors in it. So when we're in these lower
states of estrogen in our life, there's not much estrogen
binding to those structures, and that's they all get a
little bit weaken and a little bit irritable. So that's
why bladder urgency, bladder leakage, those kind of things can
happen in that season of our life.
Speaker 12 (31:49):
And so if you're on HRT, are just that help
or it doesn't make any different.
Speaker 4 (31:56):
I'm assuming you mean the patch or oral hrt our patch.
Speaker 12 (32:01):
Yes, an oral progesterone.
Speaker 4 (32:03):
Yeah, so that is a HRT, So it goes into
your blood stream and sort of affix the whole lot
of your body there is sort of mixed research on
how that affects your bladder control. But the vaginal estrogen
has really good effects on bladder control. I check with
your GP whether you can use both, but likely you'll
be able to. Vaginal estrogen is really safe and really effective,
(32:26):
and it doesn't actually go into the negligible volumes goes
into your blood streams. This stays quite local to the
vagina and the bladder.
Speaker 2 (32:34):
Okay, And so.
Speaker 12 (32:37):
If the bowel urgency is coming through, like through exercise,
what is there anything I could do with regard to that?
Speaker 4 (32:47):
Yeah, lots that would take up a whole appointment of visio,
I think, So.
Speaker 12 (32:51):
That was what I was going to ask. Is it
something that if I saw a woman's health for ZEO,
is that something they could help with or should I
see a doctor about that?
Speaker 4 (33:01):
Yes, we can help I'd probably the best sort of
gold standard b CUGP. There might be some sort of
medications and stuff that they can prescribe to help, but
also getting the structural changes and the muscles working a
bit better and get you also emptying better as well,
because an empty vessel doesn't leak that. There's lots of
things we can do to help you with that.
Speaker 2 (33:20):
Okay, Hey, thanks so much for your call. Ros quick question.
Does this again? It gets into sort of people forming
a judgments about whether when you should have a baby.
But do women tend to have problems if they have
their children later or does it not make any difference
whether you if you have children at a younger age
in terms of the possible problems that might arise in
continence wise.
Speaker 4 (33:40):
Yeah, you're more likely to have issues that, particularly if
you have your first baby later in life. It's sort
of a collagen makeup or the changes of our connective
tissues can make a difference on how things sort of
recover and recoil after bet.
Speaker 2 (33:53):
Okay, right, and oh, by the way, Bob says, was
that a yes or no to stopping you for urine
flow as an exercise? I don't think it was conclusive anyway,
was it, Caitlin?
Speaker 4 (34:02):
I'd say, see your pallic floor physio and get some
information from them.
Speaker 2 (34:06):
Yeah, could you ask you GP about that as well
if you're a guy going for a check up or something.
Speaker 4 (34:10):
By the way, yeah, yes, but they're likely to.
Speaker 2 (34:14):
Refer you to the excellent okay, excellent, right until in
fact I tell you what We'll take the break now
and come back with more calls. Times rushing by, but
we'll be back in just a moment. News Talk said
B eight hundred and eighty ten eighty thirteen minutes to five. Yes,
News Talk said be. We're with Caitlin Fresho's a pelvic
health physio. We're talking about it's World Continence Week, so
(34:34):
shedding a lot and incontinence and bladder health generally speaking,
more specifically Shelley, Hello, oh hello.
Speaker 13 (34:41):
How are you good?
Speaker 2 (34:42):
Thanks good.
Speaker 3 (34:44):
I am a chiropreactor in potty door and we've been
using magnetic training worth PALVIY power for people with public
floor health. And when Cauler Sally called before about her daughter,
I was wondering, Titlan, what your thoughts might be about
using something like that people with of retention of bladder.
Speaker 2 (35:09):
I actually haven't heard of magnetic electromagnetic stimulation you're talking.
Speaker 13 (35:13):
About, yes, well, so this is amazing. I'm actually very
excited about it. And we were introduced to it by
Nathan Scott from care Good Physio. But basically it's a
chair that has a magnetic coil in the feat that
can stimulate but also defense towze the pelvic floor to
(35:37):
get it, to train it but also relax it. But
it can do it in a session twenty five thousand times,
and so it's a really effective way of helping people
use and learn how to use their pelvic flow and
wake up the brain.
Speaker 2 (35:54):
Okay, well we might we haven't had time to deal
with that right now, because that's not something you're familiar with, Caitlin,
but I shall have a look at it, because we'll
get We'll get Caitlin on again. Sometimes we'll see we'll
have a look at that in more detail. We've got
to get Sprint through a few more calls before we
wrap it up. I actually do have one quickly about
the stigmatism about I mean the products that are available
for people who've got an issue within continents and I
(36:16):
mean I guess and going back years or decades, it
will be some bulky sort of pad and everything. And
thanks to Lulu Lemon, are there good products out there
these days?
Speaker 4 (36:27):
Yeah, I mean the engineering behind pads is actually really
interesting for like continence nerds like me. But they're like
some of them can be really thin and hold up
to like five hundred mills of urine. They're quite different
to menstrual pads. Menstrual pads are made to catch quite
viscous fluid and they won't actually catch much watery fluid
(36:48):
like urine, so buying continence pads is really important. You
can also get continents underwear, which is more environmentally friendly
and often a little bit nicer to wear for a
lot of people. So making sure you invest in some
good continence pads can help, like the image or your
concerns about smell, and they're actually really good at drawing
(37:10):
the you'urine away from the skin towards the bottom of
the pad for health reasons as well.
Speaker 2 (37:14):
Okay, right, so hello, oh hello.
Speaker 11 (37:19):
I was just screening to say that the core of
three three back.
Speaker 8 (37:24):
With her daughter.
Speaker 11 (37:25):
I had the same situation where I was concerned about
my allegic and I went and had an ultrust out.
I wasn't successful in what she wanted me to discharge,
so I had to go back, which I did, and yes,
(37:47):
there was an issue where my ladder wasn't emptying, so
she referred me to the hospital and I got exactly
the same letter as to what that lady said.
Speaker 2 (38:02):
Wasn't saying it wasn't urgent or something to sort out.
Speaker 11 (38:06):
Yes, yes, which I mean there is no pain associated
with it. But I'm just slightly concerned.
Speaker 2 (38:15):
Yeah, yeah, that is a difficult I don't know if
it's difficult to comment on individual cases really in that sense,
isn't it, Caitlin, Well it is.
Speaker 4 (38:22):
I mean you can if it's within your means to
see a private specialist, that's probably worth it. You can
also see a good pelvic health physio that will be
able to either rule in or rule out things like
a vaginal prolapse which can contribute to difficulties empty in
your bladder, give you some strategies on bladder emptying and
having a look with the ultrasound machine on your tummy
(38:43):
to make sure you are emptying properly. But yes, just
keep advocating for yourself through the public system if as
that's where you're going.
Speaker 2 (38:51):
I'm sorry, We've got to keep things moving through. But
thank you for your call. But I think the big
question we need to if people are talking about a
pelvic health physio, because there are physios specialized in all
sorts of things in body parts and knees and hips,
and so a pelvic floor physio I would obviously there's
you guys at what's your website? I guess address again
Unity Studios dot co.
Speaker 4 (39:11):
Do in the.
Speaker 2 (39:12):
Unity Studios dot cat and say if you want to
get in touch with Caitlin and her team. But if
they're generically speaking, if somebody's you know, you're one of many.
I'm guessing. But how would people find the right person?
Speaker 4 (39:22):
Yeah, they're all throughout the country. I would I mean
a quick Google search public health physio in your town
will come up with one. I would just make sure
that they have some really good experience. There are lots
of weekend courses out there for physios to do so
just two days, and I don't consider that good enough
to be rubbishing around a vagina after a weekend course.
(39:44):
So I would just say, see someone that has some
good post grade training and or some good mentoring from
a good senior public health physio. So they are there everywhere,
and they might.
Speaker 2 (39:54):
Need a reference from anyone. You don't need to go
to U referral. So that's the weird.
Speaker 4 (39:58):
Yeah, nope, you can go like any other physio. You
can just turn up and booken. They might be in
like normal physio sports physio clinics, or they might be
in their own special clinic. You can also go through
the public system. So as far as I know, most
DHBs in New Zealand do have a public health physio team,
(40:18):
but you need to referer from your GP for that.
Speaker 2 (40:21):
And of course you can go to Unity Studios dot
co dot nz on their website readily available in contact them. Hey, Caitlin,
thanks so much, gosh, we could have taken a truckload
more cause and text. Let's to get you back sometime. Okay,
thanks good stuff Caitlin for us from Unity Studios.
Speaker 9 (40:38):
We'll be back. We're talking money next.
Speaker 2 (40:40):
Tamus Paper from Harbor Asset Management is with us. It's
coming up to three to five News Talk SEDB.
Speaker 1 (40:46):
For more from the weekend collective, listen live to Newstalk
ZEDB weekends from three pm, or follow the podcast on
iHeartRadio
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