Monday, June 11, 2007

Makcik batuk sampai terkencing...(for ladies)

"Seksa benar minggu ni nak...." said a 65 years old lady who came to see me.
"Batuk ni dah seminggu tak mau surut-surut. Habis sakit dada dan kepala makcik bila batuk tu datang" she continued.
"Yang susah tu batuk sampai terkencing-kencing...susah nak (me)nahan kau tau ke?" She was a bit embarassed and concerned when making this statement.

I assurred her there is nothing embarassing about it. I told her she did not on purpose pee in her panties.She can't help it. The pressure of repeated and continous coughing can do that to a woman(and man too).Especially if the sufferer is an elderly lady.

So what is her problem? And has that got to do with us bloggers? Well, a lot I would say.
She is suffering from stress incontinence.

Stress incontinence is an involuntary loss of urine occuring during physical activity such as coughing,sneezing,laughing and exercise.

Why does stress incontinence(SI) occur?

SI is a bladder storage problem in which the strenght of muscles to help control urination is reduced.The sphincter is unable to prevent urine flow when there is increased abdominal pressure. This muscle/sphincter is part of the pelvic floor.

What is the Pelvic floor?

The pelvic floor is the layers of muscle that stretches from your pubic bone in the front to your tailbone(coccyx) at the back. It is the main support structure for the pelvic organs(bladder,uterus and bowels).

A toned pelvic floor helps close off the bladder and bowels outlets to help prevent leakage( yes bocor).It can also contribute to sexual response and orgasm( ahh..I see the men are taking this more seriously).

Floppy Floor?
( no no its not floopy disc or Flop Poppy)

Several factors contribute to weakening of pelvic floor muscles.These include:
* pregnancy(especially frequent)
*Childbirth( especially prolonged labour and use of instrumentations or bag babies)
*Straining to empty the bladder or bowel with or without constipation
* Constipation
*Persistent heavy lifting
*Chronic cough(from smoking or asthma)
*Overweight
*Lack of general fitness.

This means almost any woman can have weak plevic floor muscles.It's a good thing that anyone,too,can do the exercises that strenghten these muscles.

A Firmer Floor.

The first step is to correctly indentify the muscles. Sit comfortably.Your tighs,buttocks and abdominal muscles should be relaxed.Lift and squeeze the muscles in your pelvis as if you are trying to hold back urine or flatulence( senang cerita, orang Melayu sebut Kemut! Ada faham?)

If you feel unsure wether you have indentified the correct muscles,try to stop your flow when passing urine,then restart it. Only do this to identify the correct muscles to use.This is JUST a test,NOT an exercise.

Let's get down and dirty.

Let's start the pelvic floor exercise. Its also called Kegel exercise

At first you may need to perform these exercises while sitting or lying down.As the muscles strenghten, you can progress to exercise standing up.As in any muscle training activity,start with what you can achieve and progress from there.

If you can feel the muscles working,exercise them by:

1- "Kemut"ing strongly for as long as you can(1 to 10 seconds). Keep breathing! Now release and relax.You should have a definite feeling of letting go.

2-Rest 10-20 seconds.Repeat step 1 and remember,it is important to rest.If you find it easy to hold your kemutan,hold it longer and repeat as many as you are able to.Work towards 12 long strong holds.

3-Now try 5-10 short,fast strong kemutans.

While you are exercising:
*Do NOT hold your breath
*Do NOT push down(meneran) instead of squeezing and lifting(kemut)
*Do NOT pull in your tummy tightly
*Do NOT tighten your buttock and tighs.

Try to set aside 5-10 minutes each day for the exercise routine and remember,QUALITY is important.A few good kemutans are more beneficials than many half-hearted ones.And good results take time and effort.

Remember to use the muscles when you needed them most: ALWAYS kemut before you cough,sneeze,lift,bend,get up from a chair or prolonged laughing,etc.

Getting Stronger.

Increase the lenght of time you kemut and the number of holds you do in succession before experiencing muscle fatigue.Increase the number of short,fast strong kemutans.Always do your maximum number of quality kemutan.

Some helpful hints:
# Seek medical advice for chronic coughing.
#Keep your weight within a healthy range for your haight and age.
#Develop a good bowel habits
#Improvement of the kemut exercise will take 3-6 months of regular training.

So, you ladies( and men)out there, do start doing the Kegel exercise from now.Don't you wait till you have the stress incontinence will you start. And hubby will like it too.

Kandungan posting mungkin ada kena mengena atau tidak dengan makhluk yang hidup atau yang telah tiada.Kalau sapa-sapa terasa nak buat macamana kan. Sapa makan cabai melaka dia pedaih laa

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