Nurse Maureen‘s Health Show
Welcome to Nurse Maureen's Health Show Podcast where we dive deep into all things health, sex, menopause, relationships, parenting, communication and more! Hosted by a passionate nurse with years of frontline experience, we bring you expert interviews, real-life stories, and the latest insights on staying healthy aging. Nothing is off limits as we delve into overall health, sexual health, mental health, and sexual health. Whether we’re breaking down medical myths, discussing cutting-edge treatments, or chatting with top health professionals, this show is your go-to for practical advice and inspiring conversations.
Nurse Maureen‘s Health Show
The Kegel Throne Revolution: A Nurse's Journey to Bladder Control
Good evening and welcome to another episode of Nurse Maureen's Health Show podcast. As you know, I'm a registered nurse and a nurse continence advisor, which is why I'm very excited to have my next guest on. Lisa Kirk has been a registered nurse for over 30 years, with a background in acute care from emergency nursing, interventional radiology and a medical clinical nurse educator. She's on the faculty at Douglas College in Vancouver, british Columbia, training new nurses to work in our ever-changing healthcare system. Her expertise is in simulation and she is currently in doctoral studies in healthcare education. She's also married with two sons and two four-legged pups. Good evening, lisa. How are you?
Speaker 2:I'm great, maureen. Thank you, nice to be here.
Speaker 1:Yeah, thanks so much for coming on and talking to me about urinary incontinence. It's such a shameful subject and stigmatized, yet so many people experience it and I know you see it a lot in the acute care setting where you work, and not to mention you know, I'm sure, out in the public health arena as well, and certain friends have also talked about it. So let's start by I'll ask you to explain for the listeners what exactly urinary incontinence is and what causes it.
Speaker 2:Okay, well, from basically from the nursing side, urinary incontinence is an uncontrolled loss of urine that is of sufficient magnitude that it actually becomes a problem, and there are many causes.
Speaker 2:So we know that there are some causes of urinary incontinence that can be transient, you know, they can come and go by causing it, and some of those can be confusion, depression, infection medications, sometimes with restricted mobility, or even with constipation. So we know that those are some of the transient causes of urinary incontinence. And then, of course, we have more types of incontinence that have a medical basis, for which could be things like stress incontinence, which probably more in your field, maureen, is probably one of the more common causes of incontinence, especially with women and men, and, of course, everything from urge incontinence, overflow, reflex incontinence. A lot of people also suffer from incontinence after trauma or surgery, and then some from functional incontinence, just with that loss of mobility and being able to function with their activities of daily living. So there's lots of different causes. So we always think that it's very narrowed and it's down to one, but it actually has multiple causes out there for people anywhere from age six to the older adult?
Speaker 1:Absolutely, and I think the one thing is that there are treatments which we're going to be talking about tonight. Also, you know we mentioned stress, urinary incontinence, very common for women after they've had a vaginal birth. But you don't necessarily have to have had a vaginal birth or any children to have experienced urinary incontinence. Especially, you know, when you get increased intra-abdominal pressure then you leak urine and you'd get that with cough or sneeze or that type of thing or exercise. Lisa, how common is urinary incontinence and who does it typically affect, although you mentioned anyone from age six to 96 or 106.
Speaker 2:Right, absolutely. You know from my experience and I think also from looking at some of the literature here, it predominantly affects women and, let's face it, middle age to older, perimenopause, menopause, postmenopause, and men usually over 60. But that primary group is women who are basically suffer from urinary incontinence. So yeah, that is the group.
Speaker 1:Yeah, it is mainly, but we're also seeing men, especially men who've had prostate surgery. They often will experience urinary incontinence afterward. We're also seeing men who have had prostate surgery or prostate cancer treatments. They will experience urinary incontinence afterward as well, and it's typically a stress urinary incontinence afterward as well, and it's typically a stress urinary incontinence. Yes, also, you know, many women think that urinary incontinence is just a normal part of aging, or they just think it's normal to leak when you cough or sneeze. Is that true?
Speaker 2:No, it is absolutely not true and that is definitely proven that there that is not a normal aspect of aging, even though sometimes we think in society it's it is. It is not.
Speaker 1:Absolutely. What are some of the biggest challenges people with urinary incontinence face and I want you to talk about in their daily lives, but also in the hospital setting, in the acute care setting, you know.
Speaker 2:I think one of the biggest challenges is that it's one of those things that we don't like to talk about and it's not really in the discussion. And even when you think about people who get admitted to hospital you know we do histories, you know maybe you know you're here for a surgery we go through, you know a little bit of a systems assessment with you or you're here for an outpatient procedure, but I can honestly say there is nothing on that form or that states do you suffer from urinary incontinence and if you do, what are some of the strategies or interventions that you need from us to help you while you're with us or in the hospital? Like to talk about it? It's definitely not on the assessment and even looking now at nursing education, I have to sit and I have to think and go. Where is that actually taught in our program? And at this very moment I can't recall.
Speaker 1:Yeah, I don't think it's taught?
Speaker 2:No, I don't either. We talk about catheters, catheter care, you know, routine toileting, those kinds of things, but we actually don't talk about it.
Speaker 1:And it's such a common problem. And you know when people are admitted to the hospital, they can be admitted continent and then be discharged with incontinence and that can really change their lives, whether they can live independently any longer. You know whether they need to be admitted to long term care. It increases the you know whether they need to be admitted to long-term care. It increases the you know has a financial impact on them because they might need pads and diapers, cause they think that those are the only treatments for urinary incontinence. They have extra laundry, they need caregivers, and so it really changes the game for a lot of people. How about people in their everyday lives that are walking around? You know? Middle-aged, young, active leaking urine.
Speaker 2:Leaking urine, and that's just it. And you know, and actually it's funny it's I was walking in the mall and I walked past an older adult and I could smell urine and I kind of went okay. So of course in my nursing mind I'm going okay. So maybe some you know stress, incontinence, you know incontinence, maybe not wanting to wear a pad right, like what kind of you know resources does that individual have? So just that whole piece. So I can't help but think about it, what that means. And we know that a lot of women will. We're used to buying sanitary pads, sanitary napkins. So for a woman to go and buy some pads to use if they're dribbling a little bit, absolutely. But what about for a man? What is that stigma? For them to actually walk in and, you know, buy pads right that they can use to for urinary incontinence, and I would think that that would be a really big stigma that that might be faced right.
Speaker 1:Oh, absolutely. People feel a lot older. They gain weight, they stop exercising. They actually age a bit faster as well. When they feel like they're aging a bit faster, they feel like they're older. I've heard 40-year-old women tell me they feel like they're grandmothers because they're leaking urine and, as you mentioned, there's often embarrassment or stigma. People worry that their homes are going to smell. Long-term care facilities may have a scent as well. How do you help patients overcome that to seek treatment?
Speaker 2:how do you help patients overcome that to seek treatment? That and you know, I think that's the biggest question right now is that how do we, when we bring them into hospital, the incontinence, I think you, as you stated, they change and evolve when they're in there, because maybe now they're in bed, we're not getting them up as often, right, and maybe they're incontinent once because maybe they can't get up to the bathroom. Now, all of a sudden, we put a pad on them and then we put a liner in that pad, so they're like in a tens and we put them on these individuals. So what are we telling, you know, these patients that, oh, here, just pee in the pad and? And as a nurse, I have to be honest and as a nurse educator, I find that to be one of the most disturbing things that we do for people that are in hospital, when we just tell them to just pee in their pads. Right, we need those resources, we need to get them up. Do we always have the resources to do that?
Speaker 2:Sometimes we don't, right, the wards are busy and other things are going on and we know that with urinary incontinence, it's good when people can get up and basically use the washroom to pee every two to three hours, right, like, get on that routine, follow that pattern, right. But how do we do that in hospital when there's so many other things going on? So I think that's a really big question. But that seems to be the trend of care. Is that, especially for our older folks, that we just put pads on them right? That everybody normally incontinent? Just because you're older, you're incontinent. So I think that is a little bit of ageism.
Speaker 1:there right People can be admitted with urinary tract infections and I know that's a very costly situation for hospitals because somebody can present to emerge with confusion and they end up having a urinary tract infection. They may be incontinent as well, the you know more chronic wards and then need to be admitted to long-term care when you know we could have addressed that in the emergency department with some of the lifestyle changes and strategies like localized estrogen, for example, for perimenopausal, menopausal, especially postmenopausal women. But what are some of those lifestyle changes that women can use and men can also use to treat urinary incontinence?
Speaker 2:Well, I have to be honest, one of the biggest things that I always hear and I've heard this from the urologists as well is always number one if you smoke, stop, because we know that the smoking definitely leads to that.
Speaker 2:And I've heard more than more times says stop the caffeine. You know the heavy coffee, the heavy tea drinkers, and you know I think that's maybe why nurses are so bad with some of the times we drink a lot of coffee and a lot of tea, right, caffeine, and and I have. I have a good friend and she says to me she says, honestly, I haven't had kids, but you know, if I cough, I leak urine, if I I can't jump on a trampoline, I got to be careful how long I'm out for a walk for. And she says I never, I haven't even had kids. And then I'm dealing with this and and you know she's, she's skinny, she's thin. So, once again, weight reduction and, you know, losing that extra weight or another way as well. But, yeah, like it, it happens to all of us, right, and the chances are.
Speaker 1:And and those are a bit of a fallacy that only women who've had babies leak urine. Also, you know, women and men cut back on their water-based fluids as well, because they think if I don't drink water then I won't leak or I won't have to go to the bathroom. But it causes concentrated urine which can be more irritating to the bladder. And you mentioned caffeine and alcohol and citrus and they can all irritate the bladder. All the things we love can be bad, you know the traditional or the conventional wisdom?
Speaker 1:the traditional advice has been pelvic floor exercises like Kegels. Are they enough to manage incontinence or do most patients need additional support?
Speaker 2:Well, for me, I think, for somebody who is maybe you know at home that perimenopausal, menopausal or active lifestyle, who can do those exercises. I think that's, you know, still something we should still be doing. Time could be a factor, but when you get into older adults or people with limited mobility, I mean that is probably not going to be an option for somebody, right depending. But yeah, I think that. And then taking the time to do them you know what I mean. That's like you do them properly.
Speaker 1:You know a lot of people haven't been taught how to do them. I'll tell. I'll explain it like squeeze the rectal muscle, the muscle that prevents you from passing gas, that's the one. Or you know you can also use it for bladder retraining or urge suppression. So do them quickly if you get an overwhelming urge to go to the bathroom. But, but mostly women will come to me after a year, year and a half, of trying Kegels. They'll say they Kegel to death, they Kegel until the cows come home and it didn't work. And it's not going to work for stress, urinary incontinence, or. You know there's a lot of people turn to social media influencers who are trying to sell programs or supplements or whatever you know to support bladder health. Not going to work. But you know there's a very interesting device that's on the market which is called the Emcella or the Kegelthrone and that's gaining wide attention as a non-invasive treatment for urinary incontinence. Can you explain how it works and who would be a good candidate?
Speaker 2:Well, you know I'll do my best to explain how it works, but I have used it. So, basically, when I know it first came out and I was suffering from urinary incontinence I will be honest, just more stress, incontinence with coughing, had to be careful with activities. I'd had two vaginal bursts, but also with episiotomy and other things that went with that. So I had some challenges. So, even though doing the Kegel exercises tried to keep my weight down and I love my coffee, it's really bad. I really love my coffee.
Speaker 2:So that was something I wasn't going to give up as a nurse. So when I was introduced to the lovely machine I said, okay, let's give it a try. So I did the initial like six sessions and even after two sessions I don't know how to explain it. You're sort of sitting on this throne, and that's a good word for it. You're sitting on this throne and they adjust the power which is providing like a Kegel type response, or or what do you want to call it, maureen, you know like it's stimulation like it's zapping it's zapping me down there, so it's like it's doing these lovely little zaps.
Speaker 2:it's zapping me down there so it's like it's doing these lovely little zaps that are like equivalent to these kegel exercises, but of course multifold. And after two sessions and two 30-minute sessions I actually noticed a difference, so it actually helped like I could. I could sneeze, I could cough and go. Hmm, I'm okay, right. I didn't have to worry about that. And then after six sessions it was like, okay, I'm good, I actually got on my little mini trampoline. Perfectly fine, it was amazing. Yeah, it was a really good response.
Speaker 1:That is awesome. Yeah, I hear that from a lot of patients, that it you know that it starts working before the six, but the six treatments are recommended for sure. So that's awesome. So you have your own personal experience with it and it's dignified. You're sitting on the chair with your clothes on.
Speaker 2:There's no legs up in the stirrup on the M-Cellar or the Kegel throne, which is what women really don't love.
Speaker 1:You know, it's like oh, I got to go to the gynecologist Like it can be one of the worst days of a woman's life, especially if she works with the gynecologist anyway.
Speaker 2:Exactly, it can be so bad, that's right. And then it's just that whole. You know, I always what did one woman say to me? She goes how come every time I need something for female health, my feet are in stirrups? I said that's a good question. Right, that is a good question.
Speaker 1:So not with the M cell or the Kegel throne, and so that's what's just so nice about it, and also you can go back to work, you can do it on your lunch hour. It takes like 28 minutes per session, absolutely Six sessions over two or three weeks, as long as there's 48 hours in between. And so what kind of results can patients expect from the Emcella or the Kegel Throne, and how would you say it compares to other treatments?
Speaker 2:Well, I think you know, when you think about the need to do all those repeat exercises, if you're doing them on your own and all the diet modifications that I think are still important. But this machine, like, really gives you the opportunity that you can make that appointment. You can go in, you can sit on the machine for like, your 28 minutes, read your magazine absolutely no phones or electronics, right. So you're right, you have to actually sit and relax for a little bit and think about things and then you just stand up and you walk away, right, right, and that's a huge piece, it's, it's, it's easy. Yes, we need the appointments and there's probably a limited access to them out there, but I can't help but wonder how, if this is part of, you know, rehabilitation for somebody's, you know incontinence, why don't we have them in some of the hospitals? Why?
Speaker 2:is that not part of the treatment for some of these older adults? We have physio, we have OT. Why can't we have this type of machine available that somebody who's suffering from? The urinary incontinence, can actually get a session in healthcare, like in an acute care setting for it.
Speaker 1:I couldn't agree with you more, and you know what Urinary incontinence really it's, so undignified, it really impacts a person's quality of life. It can lead to isolation, depression, feelings of exclusion, increased laundry. It's a financial impact, especially for people as they age and maybe on a fixed income. They're having to buy these expensive pads and diapers which can cost $1,000 a year on average. So it's a great option and I do feel it should be part of the treatment options that are offered, and you know, at the moment, oftentimes nothing is offered to patients. It's more like can you put up with it? Or you know there's a procedure for that, but that procedure, you know, involves, you know, taking time off from work, recovery over a two to six week period, and you know whereas this, can you know, benefit so many people. The Kegel Throne is just an awesome device and I'm so glad that you tried it and that you had a good experience with it. And do you go back every year for like one or two?
Speaker 2:Yeah, I do one or two little repeat sessions and I've referred a couple, a couple of my friends you know, along the way and say go give it a try, I've had some good success with it as well. It's just making sure that you do those follow up right, those follow up sessions really do help.
Speaker 2:That's a big piece, so yeah, I think it's definitely, definitely something that I think and maybe I mean, maybe this is bad to say, but you know women's health, I think sometimes women get labeled as complainers. Right, you know you're complaining and you know, just accept it. This is just part of this is just part of your aging, this is just part of menopause. But it's not right.
Speaker 1:This is not normal no absolutely, and the M-Cella increases blood flow and actually strengthens the pelvic floor muscles, and so it helps with lubrication. Many women report better orgasms, and it just can overall change a person's life, and it's for men and women, and for women who might have a pessary in situ for a pelvic organ prolapse, you can still use the Kegel Throne or the Emcella.
Speaker 1:Yeah, yeah, it's just if you're pregnant or have a pacemaker, you know there are some contraindications to it, but it's very important that you share your medical history with your healthcare provider who's providing the Emcella service to you, and you know. So metal hips or any metal implants, that kind of thing are contraindicated as well. Yeah, but otherwise, you know it's a great option for most people, as you mentioned, and I'm so glad that you know you're not leaking urine, you're just carrying on and you don't have any other surgery to look forward to or admissions to hospital.
Speaker 2:Admissions to hospital and just, you know, think about like even just the wait list for some of these procedures. And you know, the more we talk about this, it's like okay, so why can't some of these urologists have these in their office?
Speaker 1:Yeah, exactly.
Speaker 2:Like why can't I have a seat on? The Kegel throne while you wait for me.
Speaker 1:Exactly, I'm going to be about an hour, so you know 30 minutes on there, exactly, grab some lunch, read a book.
Speaker 2:We'll put something up on the screen for you to watch and while you're in here, and maybe that needs to be normalized right.
Speaker 1:Of course, of course. And Lisa, what advice would you give to somebody? Because there's still a shame and a stigma associated with it? But what advice would you give to somebody Because there's still a shame and a stigma associated with it? But what advice would you give to someone struggling with urinary incontinence but hesitant to seek help?
Speaker 2:You know, I think I would say to someone you know what this isn't?
Speaker 2:it's not normal, and it's normal to feel stigmatized and that it isn't normal, but it actually is a normal process that can happen and we need to get out of that shame and seek out some help, and maybe that's where we need to have more. You know you have your podcast. Maybe we need more, some online site where patients can go and ask questions right, when can a patient go and you know, type in that question or talk to somebody to get some answers. I don't know what the nurse line has, or is it passed down by word of mouth, Because I tend to pass my information about the mCELLA down to people I've met or women I've talked to, or in the hospital. I might pass that on, pass that on right, so by word of mouth. But you're right, I think we need more continence advisors. I think it needs to be another area of nursing that maybe we look at as having more of right, Absolutely.
Speaker 1:Instead of less of Exactly, they cut those positions. Yeah, it's great that you mentioned you know where can people get more information, because for more information about the Amcella or the Keglethron you can go to btlestheticscom, that's b-t-l-a-e-s-t-h-e-t-i-c-scom. Lisa, thanks so much for joining the podcast.
Speaker 2:Thank you very much, maureen, for having me. This has been great. And just to you know, when I first was introduced to the Amcella, it was like, oh, this is very interesting. I had no idea any this even existed. And then, after doing it, it was like, okay, this is good. Like more, more people who suffer need to use this device. I think it's amazing. So Absolutely.
Speaker 1:Thank you so much, lisa. That's awesome advice. Lisa Kirk is a registered nurse. She's been one for over 30 years and she works in acute care and emergency nursing, interventional radiology, and she is also a medical clinical nurse educator. She's on the faculty at Douglas College training new nurses to work in our ever in healthcare education. She is a busy person.
Speaker 1:If you think that somebody you know might benefit from tuning into this episode, feel free to share. You can always text or email the show. My email is nursetalkathotmailcom and you can text at 604-765-9287. I'm Maureen McGrath and you have been listening to Nurse Maureen's Health Show Podcast. Thanks so much for tuning in. I'm Maureen McGrath and you have been listening to the Sunday Night Health Show Podcast. If you want to hear this podcast or any other segment again, feel free to go to iTunes, spotify or Google Play or wherever you listen to your favorite podcasts. You can always email me, nursetalk at hotmailcom or text the show 604-765-9287. That's 604-765-9287. Or head on over to my website for more information.
Speaker 1:Maureenmcgrathcom, it's been my pleasure to spend this time with you. Did you know that a weak pelvic floor can lead to urinary leaks, discomfort and even impact your confidence in the bedroom, whether you're a woman dealing with bladder control issues or a man looking to improve performance and blood flow, btl-m-cella is the solution. This non-invasive treatment delivers thousands of pelvic floor contractions in just one session, like doing 11,800 Kegels, without the effort, stronger muscles, better control and enhanced wellness without surgery or downtime. Take the first step toward a stronger you. For more information or to find a provider, go to btlastheticscom. That's btlastheticscom.