Thursday, December 17, 2009

I Have A Secret

By Shawn Vuong

There are times when practitioners and patients get caught up in the world of pharmaceuticals.  It's human nature to want the 'pill' that solves it all.  Truth is that sometimes pills aren't always the right answer.

A good primary care doctor knows this.  The good family practice doctor knows when to just suggest that chicken noodle soup for the flu, the relaxation methods for insomnia, or the many many others.  In this post Dr. Holm talks about such a technique.  


By Richard P. Holm MD

I have a secret way to prevent loss of control of bowel and bladder, which costs nothing, is under-used, and works.  Let me explain.

The muscles between the pubic bone, in the front of the pelvis, and the tailbone, in the back, are called the pelvic floor muscles.
  They act like a hammock to keep all the organs of the abdomen from falling out.  These muscles also control the release of urine and feces, which most people prefer to do in a private place and in a sanitary way.  To accomplish such control, however requires the pelvic floor muscles to work well. 

Although this topic is almost verboten in proper public forums, if you think about it, anyone who eats and drinks also has to discharge waste products.  There is nothing secret about that.

In 1948 an OB-GYN doctor Arnold Kegel developed exercises to strengthen the pelvic floor muscles in order to help fix urinary incontinence in women after childbirth.  Since then his ideas have spread.
  The exercises have also been recommended for helping with bowel and bladder control for men as well as women; for conditioning muscles to make birthing easier; for rehab following prostate surgery; even for improving sexual enjoyment in women and men.

All that considered, what has been repeatedly proven by scientific study is that men or women with urinary incontinence who actually do the exercises over more than a month experience significant improvement in their symptoms.  It works.
  I believe Kegel exercises must be considered as a solution for incontinence before contemplating drug or surgical solutions.

Kegel exercises are simple to do.  Find these pelvic muscles by starting and stopping the flow of urine without using your stomach, leg, or buttock muscles.   Simply tighten and relax the pelvic muscles about 200 times a day.  There are many variations and even devices to encourage the strengthening of the pelvic floor muscles, but the key to success is to simply do it.  To say it again, the benefits come with tightening the muscles 200 times a day, and making that a habit.

Kegels are something you can do quietly, while just sitting there, without anyone else knowing.  It’s a secret habit worth having.

Thursday, December 10, 2009


By Shawn Vuong

The human stress response is a balance of two delicate systems, the sympathetic and the parasympathetic nervous systems.  The sympathetic system gives us that boost of energy and anxiousness we get before something big is about to happen or if we are surprised.  Our hearts beat quicker, we breathe faster, our pupils dilate, and our muscles prime for action.  This is the acute stress response that has helped us through our hunting and gathering years.  After that stress our parasympathetic response takes over.  It is known as the rest and digest system.  Usually after a big meal you'll feel pretty tired, that's your parasympathetic response at work.  

The problem becomes when stresses become a long-term issue.  Money, work, kids, relationships, and time all can add up and continuously stress us out.  This is bad, because this stimulates our sympathetic nervous system for a long period of time.  This system was not meant to be chronically simulated, and because of this we see the harmful effects of stress on the body. 


By Richard P. Holm MD

Whose life is not stressful? The one who says she or he is not stressed has blindfolds on, or hasn’t lived long enough. A definition for stress is needed. What is stress? The dictionary says that it is a state of mental, emotional, or physical strain resulting from adverse or demanding situations.

The other evening I turned and asked my wife what she thought was the most stressful thing. We both agreed that it is to watch our children (and parents, for that matter) individually struggle with their own challenges in life… as we stand helplessly on the sideline, without the ability, or the right, to intervene or fix what’s happening. I know that at some point children should be left to learn from their own mistakes.

Knowing when to or NOT to step in is addressed in the Serenity Prayer: God grant me the serenity to accept the things I cannot change; courage to change the things I can; and wisdom to know the difference. The prayer makes it seems so clear but the difficult part of the serenity prayer is the wisdom comment. When do you take the challenge to change something versus when do you leave it alone?

In the same vein, a recent study showed that men who bottle up their anger over unfair treatment at work and who are unable or not allowed to express their resentment over conflicts, are more than twice as likely to have a heart attack and/or die than those who can vent or manage such work-stress. I would never suggest people should let anger and temper rage, but unhappy-at-work people should either try to make appropriate changes there or switch jobs. No job is worth holding emotions in and dying young.

Whether it is children or a job that is making life stressful, may we all discover serenity and find the wisdom to change what we can, and let go when we must.