New incontinence treatment options exist for county women
TAMC’s Rachel M. Swartz, M.D., F.A.C.O.G., says that urinary incontinence, the involuntary leakage of urine, affects an estimated one out of three women. Women may suffer from urinary incontinence for a variety of reasons, not the least of which are pregnancy and vaginal childbirth, but there are other risk factors, as well.
“Being overweight also is a risk factor. Certain foods and drinks seem to be bladder irritants and can cause or worsen incontinence. Previous pelvic surgery, such as hysterectomy, increases risk,” she said. “Lastly, any conditions that damage the pelvic or sacral nerves increase the chance for urinary incontinence.”
There are multiple options for treatment and she encourages anyone with the condition to seek consultation to learn about their options. Treatments range from simple good bladder hygiene and Kegel exercises to medication and more complex surgical options, depending on the type of incontinence.
“Good bladder hygiene” includes frequent scheduled voiding, avoiding certain foods and drinks that are bladder irritants (such as citric food, spicy food, alcohol and caffeine), and avoiding both drinking and eating at least two to three hours before bedtime,” said Swartz.
Kegel exercises, or contracting the pelvic floor muscles, are a first line treatment for stress incontinence. Another option, which is available as close as Bangor, is pelvic physical therapy by a certified pelvic floor specialist.
Medication often improves urge urinary incontinence. When first line treatments fail to solve the problem, then doctors will explore more complex options.
“Surgery can be extremely helpful for women with stress urinary incontinence,” said Swartz, noting that most of those surgeries are in the category of midurethral sling.
For more information, call 768-5944.
Treatment available for patients with lymphedema
County residents suffering from lymphedema now have new options available for treatment since TAMC Physical Therapist Taryn Everett, PT, DPT, CLT, recently completed her certification in manual lymph drainage and complete decongestive therapy through the Academy of Lymphatic Studies.
Lymphedema is a high-protein swelling, usually of a person’s extremities. It can affect one or more of an individual’s arms or legs. Some people are born with the condition, while others develop lymphedema after their lymphatic system is affected by an illness or injury. A blockage in the lymphatic system causes excess fluid build-up and can create discomfort and restrictions in movement, among other symptoms and complications.
The most common cause for lymphedema in the United States is breast cancer; however, it can also occur as a result of radiation, infection, trauma or other co-morbidities.
“Lymphedema can happen to anyone, male or female, of any age,” said Everett. “Currently, there is no ‘cure’ for lymphedema, and it is a lifelong condition that must be managed, much like a diabetes patient. However, with treatment, lymphedema patients can keep their condition under control and managed, so that their condition does not interfere with their every day functional and recreational activities.”
TAMC is currently accepting patient referrals and will provide services in the physical therapy department at A.R. Gould Memorial Hospital in Presque Isle. This new service will enable patients to receive their treatments closer to home.
“Our new treatment service will offer extensive patient education regarding lymphedema and lifelong management of their condition. The therapist will help the patient in getting their swelling under control and to a manageable state through the use of various treatment techniques,” said Everett. “Patients will also be provided with self-techniques to carry on with when they are discharged from formal therapy services so that they can independently manage their swelling.”
Treatments include manual lymphatic drainage, skin care, decongestive exercises, and compression in the form of bandaging and garments.
To be seen by a lymphedema therapist, the patient must simply obtain a referral through their primary care physician or other referring physician who may deem the treatment appropriate. All inquiries can be directed to the TAMC rehab and therapy department at 768-4169.
Maternity care ranks among highest in Maine
A recent independent survey ranks TAMC among the top Maine hospitals in three measured categories related to maternity care.
Rankings from independent industry watchdog Leapfrog and the Maine Health Management Coalition Foundation (MHMC-F) show the Women and Children’s Unit at the Presque Isle hospital meets or exceeds industry standards in all three of the ranked categories — early elective delivery, episiotomy and maternity care processes.
“Early elective delivery discourages babies from being born before 39 weeks. Evidence supports that it is safest to deliver your baby after 39 weeks because important fetal development takes place for the baby’s brain and lungs even during the last week of pregnancy,” said Pamela Lilley, manager of Women and Children’s Health. “A due date can also be off by as much as two weeks, sometimes even making a difference between 35 weeks and 37 weeks gestation. These are crucial weeks of development for a baby.”
Senior Director of Hospital Ratings for Leapfrog Group Melissa Danforth said the national goal is to have an early elective rate of 5 percent or less and that TAMC’s below-target result of 3.4 percent is impressive for a rural hospital.
Another rating area — the episiotomy rating — is reported to monitor whether episiotomies are being done on a routine basis or are being done because an extensive vaginal repair seems likely, the baby is in a bad position, or whether or not the baby needs to be delivered quickly. This procedure can cause the mother to have increased discomfort along with increased risk for infection with no benefit to her or the baby if doctors perform it needlessly, according to Lilley.
“It is clear with the ‘Best’ ranking TAMC received in this area that we have the patient’s health and safety at the forefront during deliveries,” she said.
TAMC also received the “Best” ranking in the final category — Maternity Process Care. This category measures whether or not all newborns are screened for jaundice and whether or not precautions are taken to ensure that hospitals attempt to prevent the formation of blood clots in pregnant women undergoing cesarean section.
