Incontinence center fills need in Carroll Exercise offered as treatment CARROLL COUNTY HEALTH

December 15, 1992|By Donna E. Boller | Donna E. Boller,Staff Writer

Jane B. Bartel and Pamela A. Higgs help people who have been told there is no help for the embarrassing, socially awkward condition that afflicts them.

"We see people who have been told they have to live with it, whose doctors have said there is nothing that can be done, [who have been told], 'You've had children. What do you expect?' " Ms. Bartel said. "Those are all myths."

The condition is urinary incontinence. The restrictions it can impose on a sufferer's life are illustrated by the advertisements where grateful people thank 1940s movie star June Allyson for helping them discover adult diapers so they can go dancing or visit their grandchildren.

Ms. Bartel, a physical therapist and co-owner of Chesapeake Assessment and Treatment Center in Westminster, and Ms. Higgs, a physical therapist employed by the center, guessed that help with bladder control was an unmet need in the Carroll area.

They didn't know how strong the demand was until they began accepting patients 2 1/2 months ago. The center had to stop advertising because each therapist quickly filled her maximum caseload of 20 patients, Ms. Bartel said.

She says her treatment center is one of only a few she knows of in the metro area that offer physical therapy for urinary incontinence.

Incontinence can be difficult for people to discuss. "It's a sensitive issue," Ms. Bartel said. "They're hiding it, and they don't want to talk about it. People will literally tell me they're managing their lives around the bathroom. They know where every bathroom in the county is."

Arlene Long is able to talk about incontinence because she's getting better, without surgery. The 49-year-old Westminster resident told her gynecologist last year that coughing or sneezing triggered urine leakage.

Mrs. Long's gynecologist recommended surgery, but she had already been through two operations, each time having been assured that incontinence would not be a problem for her.

When she saw an ad for Chesapeake Assessment and Treatment Center, she decided to check it out as an alternative ** to surgery.

"I don't think women in general know there's a program like this," Mrs. Long said. She said her gynecologist never mentioned a therapy program, although he did say there were exercises she could do. He didn't tell her what they were or how to do them.

Kathy Sheridan didn't recall any of her physicians ever mentioning the subject, "but my friends would talk about it."

Ms. Sheridan wasn't suffering any major incontinence problems. But the coughing associated with an attack of bronchitis last spring produced some leakage. At 39, having had two children, she decided to attack the problem before it got worse.

She was impressed with Chesapeake's approach to treatment and the time Ms. Bartel spent listening to her and explaining the exercises.

The fact that the treatment is now being offered in Carroll County "is a terrific community service," Ms. Sheridan said. "Out of all the women I know, I don't know of any who knew that anything could be done."

Sometimes physicians tell their patients that exercises can help with incontinence. But unless the physicians explain what exercises to do and how to do them, a patient trying it on her own can make the problem worse, Ms. Bartel said.

The culprit in urinary incontinence is the pelvic floor muscle, which supports the bladder. When the muscle weakens because of childbirth or shrinks as muscles do with age, it can't close the bladder's "on-off" mechanism properly, so urine leaks.

There are two types of incontinence, Ms. Bartel said: stress incontinence, leakage when a person coughs or sneezes, and urge incontinence, where the sufferer cannot reach the bathroom before urination starts. Most people have a combination of the two types, she said.

Urinary incontinence is more common in women than in men, according to a 1990 Johns Hopkins Magazine article. An estimated one-third of all women and one-fifth of older men develop regular problems with bladder control.

But Ms. Bartel said the caseload at Chesapeake treatment center is evenly divided between the sexes. Her guess is that women, accustomed to wearing pads, are less likely to seek treatment. Men, finding an adult diaper uncomfortable, are more motivated to seek help.

Ms. Bartel said she's not trying to put June Allyson or her competitors out of business. But she points out that pads do nothing to help cure the condition.

Physical therapy cannot help individuals who have urinary infections or men with enlarged prostate glands. Patients whose problems can be helped go through tests to determine the number of times they can contract the pelvic floor muscle, how fast they can contract it and how long they can hold the contraction.

The therapists use information from the muscle tests to design individual exercise programs that make use of a biofeedback machine to answer the question, "How am I doing?"

The machine charts how well patients are contracting the pelvic floor muscle while relaxing the abdominal muscles to keep them from pressing down on the bladder.

xTC Ms. Bartel said treatment can last from about one to three months, depending on muscle control and how faithfully the patient follows the regimen of exercises at home.

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