The Healthy Post Natal Body Podcast
The Healthy Post Natal Body Podcast
More than Kegels, Postpartum urinary health. Interview with Dr Nigel Brayer
This week I have the pleasure of talking to Dr Nigel Brayer DC, Ph.C., FIAMA about urinary health.
Very often we hear stories from women, either postpartum or not, who complain about bladder weakness and leakage.
There are a lot of supplements on the market that promise the world but always seem to under deliver and quite often "just doing your kegel exercises" isn't enough.
So I'm delighted that Nigel came onto the podcast to talk about urinary health, how common it is and to explain that a solution is usually actually available without surgery or drugs.
We cover a tremendous amount of ground in this episode and you definitely don't want to miss it!
As a little FreeBee you can download his Bladderhacks ebook for FREE here
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Playing us out this week; "Irreplaceable" by Neon Beach
Hey, welcome to the Healthy Postnatal Body Podcast with your postnatal expert, Peter Lap. That, as always, would be me. This is the podcast for the 2nd of Feb 2025, and you know that before. Music means I have a guest on. I'm talking to Dr Nigel Brayer and we are talking bladder health, urinary incontinence and all that sort of from middle leakage, and we're talking all the causes, whether there's some natural solutions that would help rather than surgery. Brain retraining, all the type of fun stuff Do kegels help? Do supplements help? All that type of thing. You're going to love this conversation. I really had a great time. So, without further ado, here we go. I know people don't like to talk about it, but how common is urinary incontinence really?
Nigel:Peter, that's interesting. You say that because the fact that you and I are even talking about this right now is profound, because most people won't bring this up to their close, or most ladies won't bring this up to their closest, or most ladies won't bring this up to their closest friends because of the embarrassment that goes along with it and there's a whole myriad of different mental, emotional challenges that it stems.
Nigel:So it's extremely common and the stats tell us between 60 to 70% of all females experience it for one time or another, and about 60% of the women over 50 have it on an ongoing schedule Not schedule so much, but a regular occurrence should I say, and so it's extremely common. What's interesting is, even though it's so common in women, men have it much less often but because of the correlation with prostate health as men age, they're much more likely to have conversations to have it addressed.
Peter:My specialty is female incontinence Right and to be honest about it, is only about 10 to 15 percent of women actually even share it with their primary doctor or their gynecologist or anything else like that well, that is remarkably low, although again not, not not completely, uh, unheard of, I know, as a, when I first started as a postpartum uh pt, I was always asking people all the questions, right Including do you experience any leakage? And the amount of women that would say no.
Peter:But the answer was actually yes, which I could tell because they just ran to the toilet right before the session started right Was much higher than you'd anticipate, Even for women that I'd and I'm pretty good at building trust relationships with people, or at least I like to think I am but even for women that have been training me 12, 14 sessions, that have been working with me for 12, 14 sessions, they were still reluctant to talk about that aspect of their postpartum recovery, especially.
Nigel:Yes, and that's not uncommon and and I appreciate you probe the question. Most don't even probe the question, but I always like to encourage people to look around them and I'm not a big tv watcher, but when people can watch the television and they can see that absorptive pads for adults are taking up some serious media space, we know that the market is there because it's necessary. The same reason, a lot of pharmaceutical commercials are there, right, so it's there. Somebody's having problems, but it's a lot easier to order some leakage pads from Amazon than it is to have a discussion of saying, hey, what are my options to resolve it?
Peter:Oh yeah, absolutely, and you've been doing this for a while, and maybe it's just me who notices it, but the leakage pad, or Tana Ladies, tends to be the commercial, the brand of choice, so to speak, for these commercials in the UK and in Europe. These commercials in the UK, um, and and and and. In Europe, um, they used to be, for they used to be filled with 70 80 year old granny type women right, because they peed themselves and whereas now you see a tremendous amount of commercials for women, that even the dentures commercials have older women in it than than than these things. So is it just a more common problem now, or are they? Has half these companies just figured out that actually there's a huge market here that we can sell to and almost normalize this condition?
Nigel:sure, and that's a good. I think there's two things going on here Now. The commercialization is always a big deal, so if there's a market, they're going to try to find a way to cultivate it.
Nigel:But also, let's even go back 30 years, let's say so. 30 years there was a lot different diet. There was a lot less toxins, there was better digestion, there was less GI problems. It really comes back to tissue and neurologic integrity. So you're familiar with this, peter is soft tissue, has elasticity and that's made up of amino acids and proteins. That's all based upon digestion. It's also based upon source.
Nigel:So people are eating proper things. That's one step. If they're absorbing good stuff, that's the second. Now you have breaks in both of those systems. So, culturally, um, the fast foodish world and the package business, a lot of those foods don't have the building blocks. And then the second thing with the advent of inflammation and in America we use still Roundup, which is glyphosate You've got all of these issues that can damage the gastrointestinal lining.
Nigel:So now you also have the lack of absorption of the amino acids and fats to build the nervous system and the tissue. So, twofold, we've got awareness is becoming more so and the markets capitalizing on that. And then you have 20 or 30 years of our food degrading in value, which is going to be a byproduct. When I talk to patients, I talk it this way is imagine you go into your basement you find an old baseball glove from like 40 years ago and you think that baseball glove looks perfect. And then somebody throws you a pitch and it goes right through. It's like, well, what's wrong? Well, that would be considered dry rot of leather. But when they get challenged which means life if they don't have the constituents of the proper elastin and fibrin and all the tissues that give it that support, then when it's challenged aka you're under stress, you're nervous, you've just had a baby and you're recovering those tissues don't have their natural tone.
Peter:So I think it's a twofer, for lack of a better word. Yeah, no, that's an excellent point because there is, like you said, there's, a lot happening, especially postpartum. Your body has just been through trauma. Even if you had a C-section, you had a tremendous amount of pressure sitting on your pelvic floor for at least five, six, seven months, or at least more pressure than your body's used to when you're not pregnant, more pressure than your body's used to when you're, when you're not pregnant. Um, and then I suppose you know obesity is, is contributes to this, to to a fairly large extent, I would say again, internal pressure and and all that sort of stuff and just general muscle weakness on top of that then exacerbates that that problem a fair bit, I would have thought.
Nigel:Yeah, and then, on that same note that you mentioned is let's look back a little bit more into how most people spend their working life. You know, most people spend their working life sitting. And again, peter, you've probably talked about this in various forms but when we sit, the abdominal musculature starts to break down, the hip flexors tighten the lumbosacral area, the low back arches, so you increase pressure. Pre-child, now, of course, child in the gravid uterus, and all that adds more pressure. So you see how all these things just contribute and build. Therefore, leakage is going to be a reasonable expectation after that.
Peter:Yeah, so okay, so we know it's going to happen. Like you said, 50%, 60% of all women will experience this at some stage. For postpartum women, I'm guessing, at least temporarily, that number is significantly higher. I would estimate definitely above 80%. In fact I'm almost surprised if women don't have any sort of leakage. But I'm going to discount the first four to six weeks a little bit, because everything's a mess during that stage.
Nigel:Understood, and that's valid, and that's valid.
Peter:So do you think, because the solution the health service tends to give and a lot of healthcare professionals tend to give in the UK at least the postpartum women is just do your Kegel exercises Right and you'll be fine. And I'm thinking that you probably agree with me that A that advice is not particularly specific as in how do you actually do one. Most women would have no idea.
Nigel:And secondly, it's probably not sufficient. That's absolutely correct. So there's a couple of things that I like to piggyback off that discussion is I always like to look at anatomy for at least a good part of the answers to the solution. And so if you kind of dig deep into the bladder and it's essentially a balloon, and obviously imagine a balloon with a straw at the end that you blow on, now obviously the straw of the man would be longer than the straw of a female. Um, but that straw is controlled only.
Nigel:The research shows that only about 30 percent of the sphincter so I think of it like a clamp on that straw. That's a valve and the valves like a sphincter they call it a sphincter is only 30 percent of that valve is consciously controlled. So that begs the question well, what's the other 70? And that becomes autonomic. And so, for those who aren't aware, autonomic is what's eating our heart, it's digesting our food, nothing we have to think about. And although we do have indirect control over it, none of us can really directly control our autonomic nervous system right now, without you know, years of meditation, let's say. So the question becomes is a Kegel is going to help support that 30%? But you're only dealing with the maximum of 30%. So let's go to your postpartum audience. They've disrupted that area.
Nigel:That's well established. That needs time, that needs healing. Most of the time that settles down nice nicely. In America they do episiotomies frequently. You know that creates more scarring, more trauma down there and you know, c-section that's a whole other can of worms. So letting everything settle is key.
Nigel:But now we have to look into the 70% of the autonomic nervous system. You've got the balloon that we were talking about earlier. There's also nerves and muscles that control the balloon. They're called the detrusor muscles and they're going to affect how that balloon's managing. So it's not just the balloon and the valve with you know that comes out, it's the nerve and the muscle of the balloon itself. So one of the big keys that I've established over the years is you have to address the autonomic components as well as start to rehab the pelvic floor, the pelvic floor itself. And you've got the levator ani muscles, which you might be familiar with. That's kind of like a sling that holds up the straw, if you like that analogy. So those tissues are important, but we're talking 30%. How do we establish a healthy, consistent way to rebuild the autonomic nervous system? And in my experience and through practice now for I guess almost 28 years, is we do specific techniques to reset the vagal nerve. So we've got vagal nerve technique as well as key acupuncture techniques. So what we're doing with that is it's helping to reset those neuropathways and that's where chronicity usually starts.
Nigel:Now you're in the physical therapy world and you realize how we get muscle memory right. So you do something inefficiently for decades, and I don't care how determined you are. You've built pathways of nerves. So I like to think of it like you've built electrical wires that become, you know, consistent. And there's this term called neuroplasticity, which means is those nervous nerves are changing. That old adage that a wire isn't changed is wrong.
Nigel:Well, that same thing happens with the bladder. So by by consistently stimulating the vagus nerve, what you're doing is you're not only reducing the sympathetic response, which is that tightening the fight flight which is very common down in the bladder, especially if somebody's anxious about leakage. What do they do is they tighten up more. And when you tighten up more you lose more control. And so is by calming down the sympathetic nervous system that allows you, kind of from the back door, to start to retrain the autonomic nervous system so that that bladder relaxes, which is kind of like martial arts, I guess. You have to relax to gain control and that happens deep on a subconscious level. And that's why those long-term physical therapy type things aren't a long-term solution, even though they might be short-term for someone like your audience, who this is a new trauma, but for chronicity it's not a new trauma. It's those neural pathways and those muscle memories, like we just mentioned, that are just chronically ingrained. Does that make sense?
Peter:yeah, no that makes a lot of sense. So so that then logically leads me, and I think logically leads with us, when you say 50 to 60 percent of women over the age of 50 experience this as an, as an ongoing issue. Right, women tend to have children between the age of, say, 25 to 43, something like that. That is the common. That's when the the initial air quote trauma happens with regards to, uh, at least the. That's where most women that I come across experience urinary incontinence for the first time after that.
Peter:So then, would it then not be beneficial to start that rewiring process, that neuroplasticity process, at that stage some say the age of 40, as a preventative measure rather than a, because we're quite reactive in the world of, of, of medicine, quite often might be going to see me when they have an injury, so to speak, and that's a reactive approach. Um, and, admittedly, for postpartum recovery, there's only so much you can do prenatal, right. But would there be a benefit for people listening to say I don't, I'm not experiencing this yet, I don't have any issues yet, but I'm 40 years old and this is coming up, so would there be a benefit to already starting to address something like this?
Nigel:Yeah, and I guess the question when you say it makes the answer quite obvious, right, so as a preventative practitioner is, it's much easier to change the direction of a ship you know a thousand miles down course, versus you know right about to hit something and so, yes, but on the same regard as human nature is we always handle the biggest fire first. So I, I get the. I get that most people are reactive, um, and when you can't hold your bladder today, that's pretty urgent, but if the prospect of it later isn't so dramatic. So there's not a lot of people that tend to do that, even though it would be wise for them to do so. But I think one of the big things is just having some understanding and some knowledge.
Nigel:So you know, I'm bald, peter, clearly you're bald. So both of us could say, if we were 25 years old and we've had a full head of hair, and somebody said, hey, you're going to be really bald when you're 50 years old, and they said, hey, if you do this couple of things now, you're going to keep a full head of hair, I would have been all over that. So I guess that's fair.
Nigel:Yeah, post postnatal type avenue is is when you lose bladder control. It really affects your life. So in my book I have several testimonials from women and it's astounding how people's lives become so isolated because of they don't know where the bathrooms are, they don't have confidence in their pads, or the fact is the pads are big and bulky and they have all these different things and it's really unfortunate. You see somebody who's active and living and just you know the world is their, their oyster, and all of a sudden it just starts to shut down. So when you know how traumatic it can be, it would be a very small first step, whether that be becoming aware of how kegels work and how to do that, being mindful of the function of the bladder and learning some simple techniques to help manage stress, because it kind of comes back to the stress reaction, and so this isn't an accurate statistic, but it's a common sense. One is the majority of all diseases are stress related. It can be bladder, it can be heart disease, it can be you know, gastrointestinal issues.
Nigel:So if we look into ways to manage our ongoing reaction to life, which the bladder is part of that, that would be a very, very good first step for everybody.
Peter:Yeah, no, that's an excellent point about stress management, Because for a long time the discussion just for anybody listening for a long time the discussion within the health air quotes sphere was very much about you need to preserve as much skeletal muscle as you can for longevity and all that type of stuff. And now even lane norton bio lane and I know a lot of my listeners will also have him on his podcast even he admits that the one thing for health, the one single thing you can do for health and longevity, is stress management. It is by far the biggest thing you can do for your health. Even if you don't do anything else, managing your stress levels is huge. Unfortunately, society doesn't necessarily make it easy for us, but you know we are where we are. So it's the interesting thing. There is what you mean and you're quite right. I'd already shaved my head by the time I was 25 because that was a battle that was lost by then.
Peter:But if you say that something is going to be really dramatic, 10 years down the line people might be more inclined to take serious action. Years down the line, people might be more inclined to to take serious action. And you're quite. I remember reading an article in the guardian by a lady, a female comedian, and I won't name her here because, um, she got some things wrong and correct and she said this is just the price I have to pay for having a baby. This will, this will never change. I sent her an email saying blah, blah, blah. We worked together a little bit and we fixed it. Unfortunately, she wasn't invited to write the follow up article saying that actually, it turns out it's fixable, but it's it's.
Peter:A lot of women are kind of told that this is just the price you have to pay. You do some cake and you'll never go to a comedy club again. Um, you can't go running again. Uh, all that type of stuff and and, like you said, it's, those are the, the easy examples, almost those are the. Yeah, you can, I can accept, right, it's a trade-off. You have a baby but you can't run anymore and, let's be honest, no one likes running that much anyways and or, and. You can't go to a comedy club anymore, that's a fair thing to give up. But when you tell people, yeah, you're gonna struggle on a two-hour car ride, you can't really see friends and family at christmas in a restaurant anymore because there might be a queue at the at the indicates much more in the world that a lot of women especially are actively living in right sure, yeah, and I guess you see how clearly it limits your life.
Nigel:So most folks aren't again looking into that. But let's go back to the. You know the stigma and I guess the dogma of the past is those general assumptions aren't correct and that's unfortunate, because a lot of these dogmatic assumptions people live their whole life thinking they're true and that's really unfortunate. So I'm really excited about what you're talking about today, because you're really opening the door to say that doesn't have to be your experience, kind of like aging has to be like. You know, you turn a certain age and all of a sudden you're not valuable or useful anymore, right? So a lot of elderly people have that idea too, which is clearly not true, but you can see how it really limits their life Absolutely.
Peter:Yeah, absolutely. And then when you're talking, so what are some of the things? Yeah, no, absolutely. And then when you're talking, so, so what are some of the things? Right Cause, so we've, we've established that you know you can, you can work with a professional, uh like yourself to retrain your brain, so to speak, and uh, and I do a lot of that. With regards to other other bits, I don't go anywhere near urinary incontinence. It's just not my area of expertise at all. But it's um, but you can, it's just not my area of expertise at all.
Peter:But you see, a lot of supplements are now being sold in the direction. I mean I covered one or two of them about a month or so ago. Pumpkin seeds and all that type of stuff is really popular, at least in the UK. Now, sure, we have the same. I know you have the program in the, the states. Uh, dragon's den right and, and this was one of those um, one of those ladies, and that invented the supplements was basically pumpkin seed and soybean or something like that, and she said this is magic, and they're now selling it for quite a high price. As you can imagine, with supplements, these things are never cheap, right?
Nigel:so what?
Peter:is. So what impact and we addressed it a little bit already what impact does food really have on the bladder? And and okay, we have issues with the food supply chain. We all accept that at least everyone listening to this but what can people do to make it a little bit easier for themselves or maybe even prevent this sort of thing by eating right?
Nigel:So perfect question is first, I want people to kind of wrap their head around. Food isn't something you just stuff in your mouth while you're busy watching TV, or whatever Food is actually chemistry, or whatever Food is actually chemistry. And so, if you think of it that way, is the pharmacy is chemistry, and it's usually synthetically made for some purpose or outcome. That's understood. But what you put in your mouth is chemistry. So, just like that pharmaceutical might have a more concentrated chemical reaction to your body, it's going to influence how you work. Food is exactly the same, and so the big thing I encourage people to do first is to just reduce irritants, things that are going to stir up the pot, and so obviously, caffeine is a stimulant that's going to stir up the pot.
Nigel:Tea is a stimulant. Plus, it has a lot of tannins, and so if, for those of you aren't familiar, as tannins are from twigs and leaves, so any plant leaf or bark is going to have tannins. I like to think of it like if you, if anyone, drinks wine, they drink red wine and their tongue feels. Or, or black tea, their tongue feels kind of rough. Yeah, that's the tan. The tannins break down mucus and mucus is a protector of linings. So in your mouth that mucus has a lot of factors, digest food and each other stuff, but it also protects the linings of the stomach, the throat, on the gi tract. So the, the bladder is another lining, the blood vessels are another lining, so those linings, the tannins, are going to affect that. So ongoing tea drinkers, black tea, green tea is less tannic, herbal tea is tannic, but there's various you know what the herb is will affect how tannic it is. So those things are generally irritants.
Nigel:Okay, then we talk about carbonation. In america, here where I am is, people are really into carbonated waters. I think they call them just bubble waters, lacroix's, and I think that's the brand here, um, and people say, oh, it's just water, but what happens is the carbon dioxide in that is also another irritant and when it's put in the gi tract it can also act as like a low-grade stimulant and that can create some some, you know, contractive issues when it comes to the muscles. It can cause some leaching of minerals. So reducing the stimulants and the irritants first, okay, um, secondarily, citrus can be irritating to some people.
Nigel:So I usually have have a list and say, hey, let's try to settle these ones down, and often that'll be a first easy step and then I take it to the next step. I kind of like what's called the common sense approach, is, if people think a tiny little bit, they can figure most things out on their own. But we've been so conditioned not to think but to just follow that we just say tell me what to do and I'll do it. Tell me what to take and I'll do it. And that's where the supplement um, I'm a big advocate for certain supplements, but that's where that industry is based upon is just take this and then I don't have to worry about all this stuff.
Nigel:Peter and Nigel are talking about right, and so supplements have value, but food is always the first supplement, or?
Peter:the first medicine.
Nigel:So then I look and say, okay, what does my body need? Well, most in your audience, the postnatal mother or the mother of a toddler or a three-year-old who's running around like Banshee is they don't have a lot of energy and they don't have a lot of time. So the objective would be to say what can I give my body? That's that's going to support me and chances are that quick things not going to be the one. So I encourage people to do protein, vegetables and healthy fats.
Nigel:Um, culturally, unfortunately, we've we've um demonized fats, but fats are so important, especially for healing. Now, not any fat, but saturated fats are not the devil. Hydrogenated fats are, which, of course, are seed fats that are pressurized with hydrogen to make them into solids like margarine. In America that would be margarine or Crisco or things like that. So healthy fats to build and that's the first step is if you start eating healthy protein, lots of vegetables and healthy fats, that in itself is going to take a huge leap in the right direction, with the next step of, or the first step of, reducing irritants and stimulants.
Peter:Yeah, there's a now. That sounds good. There's a lot of information there and I know half the audience listening to this will be like I'm not going to give up my cup of tea. And the other half is saying I'll never give up coffee. But you're not when you're. I always tell people just to clarify if you can't give it up, you just reduce, right. It's as I always say the dose makes the poison, so to speak. So it's you know, if you have 20 cups of coffee a day, to be fair, you'll be in the toilet anyway.
Peter:So you won't even notice whether you have any urinary incontinence or not. Be in the toilet anyways, you you won't even notice whether you you have any urinary incontinence or not. But if you cut that down to one, you're doing a huge uh, you're taking a huge step in in in the right direction. And it's interesting that you're then talking about foods, predominantly whole foods, and all that type of stuff that we kind of all instinctively like we know what's good for us. Right, we kind of all do, and I know that the food marketers are very, very good at telling us other things are good for us because they stick a green label on or it's called nature's valley or something like that. But we all kind of know, yeah, when we're so, it's kind of what you're talking about is breaking away from that, almost cognitive dissonance when we're shopping.
Nigel:That's kind of what we should be doing then yeah, and I would say is, and I have several four children, and part of parenting them over the years is pause before you do any choice. Well, if, if, if I had urinary incontinence and I have a lot of patients that do I simply have them pause for a moment and say is this supporting me or is it not? And we'll go back to the coffee. I'm a coffee drinker and I love coffee, but for me and for other patients I've worked with over the years is not all coffees are the same. So there's value in coffee and we know that there's values in tea also, and so finding that buffer zone. So, for example, organic based coffee has much less pesticides, has much less herbicides, it has much less toxicity.
Nigel:And I call, I call non-organic coffee and my wife always laughs at me, I call it pure pants coffee. I say, honey, let's go buy a cup of pure pants coffee. And she goes why? Because when I drink it it causes me to bladder spasm. Right, if I drink organic coffee, I don't have a problem at all and I drink a couple cups cups a day. And then the next thing goes with the tannins and the tea is even just understanding that it reduces mucus.
Nigel:I encourage people to have some food instead of having everything on an empty stomach, which causes more irritation to the linings and the GI tract and that affects your ability to absorb minerals. And kind of a cascade is if you, instead of having your cup of tea straight away, maybe you wait, you have a little bit of food and then you have it once or something in your stomach. So those little tweaks can make a big difference. So it's not a matter of you got to give up everything you love to do this. You got to make some changes and over time that'll evolve and the proof is in the pudding. As you start feeling better, then it's like oh well, my efforts are worth it.
Peter:So yeah, and and that's a good point, because what you touched on there is that these things are not general. Advice works for 90 percent of people, right? That's kind of how how it's how it all works. But always take a slightly personal approach. If you find coffee is fine for you, yeah, then coffee isn't a problem, or the coffee you drink is fine for you, then you don't have to change. But whatever coffee you're drinking, um, whereas I, for instance, you know, I'm I'm 50 years old and that means that the inevitable, you know, decline of, of, of of my body has begun, began 10 years ago. So, and I find that if I eat salty foods, I'm definitely up in the middle of the night, not even because I drink more water, because that would be the logical train of thought. That was my initial train of thought, as in it must mean I drink like a pint of water before going to bed. So I'll stop doing that, and it turns out I wasn't. It's just, if I eat salty foods, any salty snack instead of fruit is fine.
Peter:But if I have, a salty bit of food. Then I'm up at three o'clock in the morning to go to the toilet and then back again and in my case three dogs and a cat I wake up half the house. So we try to avoid that. When I cut that out, I don't have an issue at all. And is it like that for almost everybody that you have, that the trigger foods tend to be generally roundabout the same, but for each individual you make slightly different adaptations because you might be fine with some things rather than others.
Nigel:Yes, absolutely.
Nigel:But that all goes back, peter, to paying attention, and so so I'll just go back to how, let's say, if I had a patient in my practice and we're having this discussion, the first thing I'd have a person do would be starting to do a food journal, writing down everything they eat and drink, and start making some correlations.
Nigel:So that might be with incontinence, that might be with pain that they have, you know, whatever their biggest problem is or their condition, and so that paying attention helps to develop huge amounts of information. And then we talk about the common things. So we talked about the tannins, we talked about stimulants we talked about, and then, once a person has that basic understanding, they can look through that and they don't need a doctor to help them do this is they can look and say, oh my gosh, I, you know, I leaked five times today and dr nigel told me that these stimulants can be part of the cause. Well, I had seven of them today. Well, that would be a great place to start right, and so they can kind of play with this and on their own can find out a lot of good information, which in some cases would be enough to get them all the value that they would need.
Peter:Yeah, absolutely. I'm a big fan of anyone like yourself who just says listen, you don't need to see me for 100 weeks. I'm very much the same as you. I always compare myself to a conveyor belt type professional, as in, I want people to come in and I want rid of you as soon as possible so I can see other people and help other people. I'm not that interested in having clients for and I have some, but for years and years and years, because there are other people out there that need more help than than than you do. Um, so how long do you usually find because obviously this is, this is how long is a piece of string question which is inevitable, right in this type of discussion how long do you find it takes for for women, especially postpartum women, to get any sort of results that are tangible, um, at all? Is it like three, four weeks is take a bit longer? Can it be months? What is a reasonable expectation of of this stuff?
Nigel:so a reasonable expectation for the age range that we're discussing, which would be a younger demographic, is after the initial four to six weeks, is, with a little bit of and I'll just speak of my personal protocol that I developed, sure, it's based upon severity of incontinence. So, based upon the severity, is they perform the protocols anywhere between three times a day, which takes two to five minutes, to up to nine times a day if it was more severe? So I'll just make some assumptions that you have a 35-year-old woman who's three months postpartum and she's still having leakage when she laughs or she jumps or she picks up the baby. In her case we would expect, if she was to do our protocol three times a day, which takes two to five minutes, so we're looking at maximum 15 minutes a day to a minimum of six or seven, say. Um, within three to four weeks she should be fully um, full control of her bladder again because again is and it goes back to her longer.
Nigel:We don't have a lot of the neuroplasticity changes yet. And if, if now she's on her third or fourth baby and it's become incrementally progressive and you have, let's say, 10 or 15 years of this progression, well that that changes the variables because you've got neurologic shifts and you've got soft tissue chronicity. So you know there's other, but as we speak of a shorter, small, like a younger demographic, the response time is much quicker.
Peter:Yeah, and that's an excellent point. It is something that I always tell women. I've had women come to me in their 50s saying I last had a child 25 years ago. Can you still help? Yes, because this stuff is not inevitable Fundamentally. Like what ago and you still help?
Peter:Yes, because this stuff is not inevitable fundamentally, like look what you're talking about, you're dealing much more with neuroplasticity than than than I am, but what I always say is a lot of these problems, if they're muscular, we can fix them just by using the muscles in the correct way. Again, right, that is fundamentally. And and that that brain retraining element, that that, as I always, I always tell people is that you, you have to kind of teach your body in regards to postpartum recovery and diastasis recti, separation of the of the stomach muscles and all that type of stuff um, just have to teach your body to move again in the way that it's supposed to move, and that can take a little while. But just because you have had issues for 20 years doesn't mean you'll have issues for the rest of your life, right?
Nigel:Agreed and I get that question frequently, peter and so there's a couple of ways I like to help people embrace this idea. So there's a couple ways I like to help people embrace this idea is and this is kind of a generalized knowledge that most doctors and healthcare providers know is every cell in your body replaces itself in seven years, including your bones. So that begs the question is why do we have any disease at all? Right, because your bones are not the same bones as they were seven years ago. The cells that were there before are gone and new ones are in this place, and what's happening is obviously we're perpetuating cycles of the past that are pushing into the future. So what does all that mean? It means the capacity to change is always there, but because of our ideas and what our beliefs are and all this other stuff, we think that this is the path that we have to go.
Nigel:But tissue is a living organ by itself, irregardless of what's going on between our ears. It has its own entity so it can be changed, whether it be soft tissue. Neurologic tissue is tougher, but it can still be changed. Bone tissue, which is hard as rock, can still be changed. So that kind of helps open people's minds, because we think and and there's a lot of faults in the way we do things, but we've been led to believe through education that our body is what it is.
Nigel:It's like a rock. There it is, here's what happens to rocks after 80 years and deal with it, move along. But what's really true is, instead of a rock is you're a billions of cells that make up that, that, that shell, and each one of those cells has the capacity to change, and so that opens a lot of doors where that were previously closed. Yeah, does that make sense or not? But it's mostly trying to trying to get over that erroneous belief that it is what it is and that, in my case, is just bad and wrong information from the past yeah, no, I absolutely love that.
Peter:To be honest, I've not heard it put like that yet and I'm I'm stealing that and I probably won't even credit you, to be honest yeah, steal away it's, it's, it's one of those things that we, we spend a lot of time, indeed, stuck in our own heads with regards to this stuff.
Peter:Right, and and you'll, you'll come across this how many, how many people do you? Do you see that that that come to? You said I've had this problem for years and now I'm ready to do something about it. Right, it's, it's, it's so common this with. People have finally reached that threshold where they can't put up with it anymore, for, for want of a better phrase, yeah, so interesting story.
Nigel:I just talked to a patient yesterday and she asked me if she could do a testimonial for my website and for you know our different things that we do online, and I won't go into the depths of her story. But she had uterine cancer. She obviously had a little hysterectomy. They removed her ovaries. She's had radiation of the pelvic region. She's had three children she, I believe, just going off memory. She's in her 70s now.
Nigel:I met her two years ago, um, and for those who are interested, they can hear her story in the coming weeks. Um, but she went through the cycle, for we're talking decades. She did the beta blockers, which is a medication to manipulate the nervous system for various reasons, from heart to blood pressure, to whichever, but it also is used occasionally for the bladder. But she's went through a myriad of different things with no avail at all, and her anatomy has been permanently changed from radiation and trauma. She just doesn't even have parts and the scar tissue is so great.
Nigel:So back to my seven-year story is is it changeable? Yes, but she's had so much disruption there that the likelihood of her getting to where she wants to go isn't that great. In her case, we've seen about a 75% improvement. Her life went from in the house to the backyard. Her husband and family did grocery shopping. She wouldn't. She's been isolated to now she can go out in the yard. Now she can go and visit her friends. So that's a big change. Yeah, it's very, very doable. Um, but she was in my, not in my understanding was hopeless, but in her mind she was hopeless. But there's change, um, even if hope isn't, you know, high on the list, yeah, and and and it's, it's, it's the hope that kills you.
Peter:As you know I don't know if anybody listening watches ted lasso they must do. Um, and you know it's, it's a saying in the uk, it's a hope that kills you, but oh, no, it's, it's a hopelessness that does right. Yeah, um, that's absolutely true. So, on that happy note, was there anything else you wanted to touch on? Because we've touched on a tremendous amount of stuff.
Nigel:Yeah, first of all, I appreciate this opportunity to talk and, again, bladder health is kind of my specialty. But you and I if this conversation has kind of taken a full circle is you've probably all heard this saying what's good for the goose is good for the gander, and so it really has to be the whole body approach. And obviously what happens between our ears is one of the biggest steps. And so you know the mind, how we affect and we react to the stressors of life. That is key. And then the body follows suit. So you can't have one without the other.
Nigel:So if you want bladder health, you've got to kind of look at the bigger picture. Yes, it's, you got to get bladder control, because that limits your life. That's step one. But when I manage, you know, conditions like this is, yes, we want that. I call it the um. You know the fire. We got to put the fire out first, which in this case would be the leakage, but then we got to look into the bigger picture. What's your long-term health? How is the muscle tone? How's the neurologic function? How are you managing the stressors of? You know childbearing, parenting, relationships work, you know those all play a role. So it's, it's not a. This is one problem that needs to be fixed.
Peter:It's like the whole condition of living has to be addressed yeah, no, that's an excellent point because we touch on that a lot right, where you say the the benefit of all the things you have mentioned. Right, eating well, managing stress and all that type of stuff which includes sleep management and all that type of stuff. Muscle tone, which includes exercise, and all that sort of fun stuff um, it all leads to, overall, much better health outcomes because we all, all of a sudden, are doing the things that are good for us. This is quite often. It always takes me back to the, the example of one of the one of the examples of longevity that. That's one of the tests of longevity that people used to give. You know, if you can get up off the floor unassisted, you will likely live to 100 years old. That that nonsense, right, and and don't get me wrong, there's something to that, but that is mainly because the people that are capable of doing these things are likely taking the actions that enable them to do these things.
Nigel:They do it yeah.
Peter:It is not the exercise which is magic, because that's usually what you find right. If you can reach your toes, then that means you'll live to your 80. So people then start focusing on I can reach my toes, I'm going to live a long time.
Peter:Whereas they ignored a bit about the eating well and all the things that you mentioned. So that is beautiful. I'm not happy about it. I will press stop record here, and press stop record is exactly what I did. Thanks very much to Nigel for coming on. It was a great conversation. I will obviously link to his website where he has a free ebook that you can download, which is nice because I think I said I love these conversations where where you ask someone where the supplements help and their immediate answer is, yeah, I wouldn't go down supplements first thing. First thing I would be, instead of buying stuff is try something else, because that's my friends is almost inevitably the correct answer, and that's how you know you're talking to somebody who's not just trying to sell you expensive supplements. So love that, love that, love that. Next week I'm back talking to an expert on kids' eating disorders. You're going to love that conversation. It was eye-opening for me. Short but sweet, so it was. Anyways, you have a great week. You take care of yourself. Bye now.
Speaker 3:You said tomorrow, but you won't call me back.
Speaker 3:It's hard to swallow, don't know what to do today. I took the long road Cause I'm so afraid of Saying the wrong thing to you. We used to be in love and now you don't even want me around. But can I say one more thing? Baby, don't go Till that clock. I'm invisible. I'd do it all again, but we both know that I'm miserable. Maybe I'll go, know I'm irreplaceable. Can't wait to do it all again, but I know I'm irreplaceable. You said tomorrow Hope you won't call me back. It's hard to swallow, don't know why I lose it back. I took the long road Cause I'm so afraid of Saying the same thing to you. We used to be in love and now you don't even want me around. But can I say one more thing Baby, don't go. Don't let the calm invisible Do it all again, but we both know that I'm miserable. Maybe I'll go say I'm being difficult. You already do it all again, but I know I'm irreplaceable. I know I replace your power. Can't really do it all again, but I know me, replace your power.