What should you do if you have an overactive bladder?

Overactive bladder, also known as OAB, is a condition where sudden involuntary contractions of the urinary bladder's muscular walls cause bladder storage dysfunction. It leads to sudden and frequent urges to urinate (urinary urgency), as well as unintentional leakage or urine (urinary incontinence).

This is a condition that affects both men and women and causes tremendous discomfort in nearly every aspect of daily life. The specific causes of OAB vary from case to case but it is generally attributed to infection of the urinary tract or dysfunction of the nervous system. The symptoms are intensified by unhealthy lifestyle choices such as overindulging in caffeinated drinks, spicy foods, and alcohol.

There are several ways in which you can deal with the problem of OAB, depending on the nature of the case. It is necessary for you to consult a urologist for a detailed diagnosis to formulate the best treatment option.

Following are the most effective remedies to treat an overactive bladder:

1. Lifestyle Modifications

Also known as behavioral therapy, this is the first step in the treatment of OAB. It involves inculcating simple changes into everyday habits such as avoiding food and drinks that irritate the bladder, scheduling (and in some cases, practice delaying) bathroom visits, exercising the pelvic floor and bladder muscles, keeping a record of urinating habits in a 'bladder diary' for better understanding the problem, etc. You can incorporate these habits into everyday activities for an easy alleviation of the problem with absolutely no side effects.

2. Medication and Surgery

There are several different kinds of medicines and drugs that can treat the problem of OAB. The most common types are muscle relaxants that loosen the muscles of the urinary bladder to prevent involuntary contractions, and antibiotics and anti-inflammatory drugs that treat urinary tract infections. Many types of implants are surgically set into the pelvic area to act as electrical nerve stimulators for neuromodulation therapy. Reconstructive bladder surgery is another remedial option.

3. Devices and Products

Urinary urgency and incontinence can be managed through the external use of various devices and products which collect and hold urine or absorb leakages. These include indwelling catheters, condom catheters (for men), urine drainage bags, absorbent pads and adult diapers, and toilet substitutes such as bedpans and bedside urinals.



What Should You Do if You Have an Overactive Bladder?

Nephropathy is also known as renal disease. It is any type of damage or disease relating to the kidneys. Though not everyone with diabetes has nephropathy, however, diabetic nephropathy can cause kidney failure.

How does diabetes affect the kidney?
Kidneys are responsible for taking waste out from your blood. They have a lot of tiny blood vessels to do this. High blood sugar may kill such blood vessels. Once these blood vessels are destroyed, the kidneys may not function as well or it may even lead to kidney failure.

What increases your risk of getting diabetic nephropathy?
There are several factors which increase your risk of getting diabetic nephropathy including: \
1. High blood pressure
2. High cholesterol
3. Smoking
4. Being native american, african american or of hispanic origin, for whom risk factors have proved to be magnified
5. If you have family history of diabetic nephropathy

Symptoms and diagnosis:
There are very few noticeable symptoms, which appear when you have diabetic nephropathy, except swelling in your arms and legs. The diagnosis is done by checking for a type of protein in your urine known as albumin, which is not supposed to be there. Getting the diagnosis done early is crucial.

Preventive measures
You can prevent kidney damage by doing the following:
1. Keeping your blood sugar levels under control - keep hba1c &lt; 6-7%
2. Keeping your blood pressure under control in the range of 130/80
3. Eating healthy food
4. Exercising regularly
5. Not eating too much protein
6. Not eating too much salt
7. Reducing smoke or excessive tobacco usage

Medicines for treatment
If you do get diabetic nephropathy, here are some medicines, which can help cure it
1. Ace inhibitors which are also called angiotensin-converting enzyme inhibitors
2. Angiotensin ii receptor blockers (arbs)

Possible complications
1. Blood pressure may rise
2. Triglyceride levels and cholesterol levels may rise.

All About Diabetic Nephropathy

Diabetes is a lifestyle disease that is very prevalent in the current generation. According to a report by the World Health Organisation (WHO), the number of people with diabetes has risen from 108 million in 1980 to 422 million in 2014. The global prevalence of diabetes among adults over 18 years of age has risen from 4.7% to 8.5% from 1980 to 2014. Diabetes should not be taken lightly as it can affect other body organs besides the pancreas, such as the kidneys. Diabetic nephropathy refers to damage to your kidneys caused by diabetes, and may also lead to kidney failure in various cases.

Causes of diabetic nephropathy
Not everyone who suffers from diabetes will suffer from diabetic nephropathy. The main function of the kidneys is to filter waste from your blood. However, this is not always the case. Due to high a concentration of blood sugar caused by diabetes, several blood vessels in the kidney are destroyed, thereby, preventing the kidneys from carrying out its job. Over time, the kidneys may stop working altogether, resulting in kidney failure. If you are diabetic, the probability of you suffering from diabetic nephropathy will increase if you smoke or have high blood pressure or high cholesterol.

Catching it early
Today, diabetic nephropathy is the leading cause of chronic kidney disease in the US and other western countries. Since the symptoms of this condition aren t visible in its early stages, you need to undergo urine tests on a regular basis. If detected early, the effects of diabetic nephropathy can be reversed. Common symptoms of this disease include the following:

Swelling in legs and feet
Detection of albumin in urine
Decline in glomerular filtration rate (GFR)
Elevated arterial blood pressure
What are the treatment options?
Medication to lower the blood pressure is the most commonly prescribed form of treatment suggested by doctors to prevent or slow the damage to your kidneys. There are other lifestyle changes that you may have to undertake in order to keep a check on the condition:

Limit sugar intake and keep blood sugar levels within the target range
Exercise regularly and work towards keeping your heart healthy
Limit protein intake, as it could put extra pressure on your kidneys
Limit salt intake to control blood pressure
Quit smoking and drinking
Diabetes is an unfortunate condition to have to live with. But don t let it bog you down! With these simple lifestyle changes and taking care of your general well-being, you can beat the disease and emerge a winner!

Diabetic Nephropathy - Who is at Risk of Acquiring it?

What is Chronic Kidney Disease?

Chronic Kidney Disease (also known as Chronic Renal Failure) is the progressive loss of kidney function occurring over a span of several months to several years and is characterised by the replacement of kidney architecture with interstitial fibrosis.

Chronic kidney disease is classified into five stages on the basis or proteinuria (presence of protein in large amounts in the urine) or Glomerular Filtration Rate (GFR) - 1 being the mildest with no distinct symptoms and 5 being end stage renal failure.

Causes and Risk Factors of Chronic Kidney Disease-

The various reasons (called risk factors) that can increase chances of Chronic Kidney Diseases are:

Diabetes mellitus, hyperlipidemia (excess fat proteins in the blood)
Hypertension

Family history heritable renal disease

Older age, smoking

Autoimmune disease

Past episodes of acute renal disease

The direct causes of Chronic Kidney Diseases are-

Diabetic nephropathy (leading cause)

Hypertensive nephropathy

Glomerulonephritis (swelling of the glomerulus in the kidneys)

Reno-vascular disease (ischemic nephropathy)

Polycystic kidney disease

HIV-associated nephropathy

Transplant allograft failure

Exposure to drugs and toxins

Diet that you must maintain in Chronic Kidney Disease-

It is essential to make dietary as well as lifestyle amends once you are diagnosed with CKD. The main purpose of this diet is to maintain the levels of carbohydrates, fluids and minerals. This is done to prevent the buildup of waste products in the body as the kidneys are unable to fulfil its function properly.

It is recommended to refer a dietician who can make you a diet chart that helps you adhere to your diet.

Here is a list of food items that you may avoid or may consume if you are suffering from Chronic Kidney Disease:

Carbohydrates : Carbohydrates are a good source of energy. If the intake of protein has been restricted, then it is recommended to replace that with carbohydrates as a source of energy. Fruits, vegetables, grains and bread can be consumed as they are rich source of fibres, minerals and various types of vitamins. You can indulge in some hard candies or sweets as well.

Fats: Fats can provide a good amount of calories as well. Ensure that you only stick to healthy fats such as the monounsaturated and polyunsaturated fats that are good for your cardiac health. 

Reduce your phosphorus intake: A diet with no more than 800 mg of phosphorus can help reduce the risk of too much phosphorus building up in your blood.  Limit intake of foods with high levels of phosphate or phosphate additives such as organ meats, whole grain breads, processed foods, cola beverages, cheese, dried beans, liver, peanut butter, dairy products and chocolate. Many beverages and processed foods have these additives. Other high-phosphorus foods to limit include: 

Cheese
Chocolate
Ice cream
Legumes
Milk
Nuts
Seeds
Yogurt
Monitor your potassium levels: Usually, potassium is not restricted in stage 3 CKD unless lab tests show potassium is too high. Your doctor may make medication changes or prescribe a low-potassium diet. Reduce an elevated potassium level by limiting some high-potassium foods and potassium chloride (found in salt substitute and many low-sodium processed foods), such as avocado, bananas, cantaloupe, honeydew, legumes, milk, nuts, potatoes, seeds, tomato products and yogurt. Some high-potassium foods to limit or avoid include: 
Avocado
Bananas
Cantaloupe and honeydew melon
Dried fruit
Legumes
Milk
Nuts and seeds
Oranges and orange juice
Potatoes
Pumpkin and winter squash
Tomato products (juices, sauces, paste)
Yogurt
Proteins: Usually, before undergoing dialysis, it is recommended to adhere to a low-protein intake diet. However when you are undergoing dialysis, it is necessary to consume a certain amount of protein. This detailed information can be obtained from your dietician.
Fluids: In the early stages of CKD, your fluid intake is not monitored. But as the disease progresses, you need to check your intake of fluids as too much fluids may accumulate in your body and create pressure on your kidneys.

Sodium Or Salt Intake: Keeping a check on your salt intake reduces the risks of high blood pressure. Also, having food low on salt can reduce your thirst and prevent fluid retention in your body.

Diet In Chronic Kidney Disease

A kidney stone may not be as big as the stones in your garden, but can be quite a pain. Kidney stones are actually mineral crystals that are usually a combination of calcium and phosphates. The size of a kidney stone ranges from the size of a sugar crystal to a ping pong ball. While some kidney stones pass out of the body along with urine, others can block the urethra and become painful. 

In addition to being painful, a kidney stone can cause permanent damage to your kidneys. Since large kidney stones are usually painful, they rarely go undiagnosed. However, if a kidney stone is left untreated, it could cause the kidney to atrophy and lower the functionality of the kidney. Kidney stones that are related to an infection can also lead to chronic urinary tract infections and damage the kidney through scarring and inflammation. This could eventually lead to kidney failure.
 
Not all kidney stones need to be treated with surgery. If the kidney stone is very small, your doctor may prescribe plenty of water and medication to treat the pain. With plenty of water, you should be able to pass the stone in your urine. Ideally, you should take plenty of rest until the stone is passed. 

Larger kidney stones may need you to be hospitalized for treatment. These are:
- extracorporeal shock wave lithotripsy (eswl)
To begin this of treatment, a painkiller is administered. Ultrasonic waves are used to determine the location of the kidney stone. Shock waves are then passed through the kidney stone to break it into smaller pieces, which can then pass out of the body through urine.
- ureteroscopy
This is also called retrograde intrarenal surgery and is performed when the kidney stone is stuck in the ureter. A ureteroscope is passed through the urethra and bladder into the ureter. Laser energy may then be used to break the stone into smaller pieces to unblock the ureter. 
- percutaneous nephrolithotomy (pcnl)
This surgery is performed under general anesthesia. It involves a small incision being made in the back and a nephroscope passed into the kidney through it. Laser or pneumatic energy is then used to break up the stone into smaller pieces and pull them out. 

- open surgery
Open surgery is performed only in the case of an abnormally large stone or abnormal anatomy of the person. An incision is made in the back that allows the doctor to access the kidney and manually remove the stone.

Kidney Stones- Should It Be Removed

There can be no better way to maintain a healthy lifestyle other than a regular exercise and fitness routine. Sometimes even after surgeries, doctors recommend exercise to the patients for a speedy recovery. A kidney transplant is one such surgery that requires you to follow a strict fitness regime after the operation process.

Importance of Exercise after a Kidney Transplant:

Exercise, as recommended by the doctor, should be an integral part of the lives of kidney transplant patients. The variations of exercise may differ depending on the age and general physical health of the patient. The need for exercise after a transplant is as follows  

  Helps to increase energy levels
  Increases overall physical strength and immunity
  Helps maintain a standard weight as an obese body is very harmful for patients suffering from kidney ailments
  Reduces stress, anxiety and depression
  Prevents after effects of kidney transplant like high blood pressure and cholesterol level
  Helps to strengthen bones
  Helps tone muscles and increases balance and joint flexibility
  Strengthens the heart and overall cardiovascular system
  Helps the patient to sleep better
  Boosts self-image and increases confidence

Types of Exercises that can be done:

  Stretching   Consistent stretching before any exercise helps increase muscle strength. It also prevents muscle strain and injury.
  Aerobic   Aerobic or cardiovascular exercises are generally recommended for younger patients. It includes moderately heavy exercises involving a greater number of muscles. This kind of exercise strengthens the heart and lungs and improves breathing. Aerobic exercises include walking, jogging, jumping rope, bicycling, skating, rowing and water aerobics. However, for most patients, brisk walking or jogging is recommended.
Ideally one should exercise for a minimum period of 20 minutes at least four times a week.

Things to Remember:

  It has been medically proved that patients who exercise regularly following a kidney transplant procedure are more likely to survive healthily for the upcoming 5 years compared to patients who lead a sedentary life.
  However one should not resort to heavy and strenuous exercises immediately after the surgery. It is advisable to start with mild forms of exercise like walking and increase the levels gradually depending on one s age.
  One should not eat a heavy meal just before exercising.
  It is important to stop for breaks in between exercise. The patient should not over exert himself.
  It is advisable to avoid lifting heavy weights like dumbbells.
  Stop exercising immediately if you experience chest pain, lightheadedness or pressure in chest, neck or arm.
  Consult the doctor for the kinds of exercises you can do depending on your condition.

With a healthy diet and regular exercise, there are fewer chances of reoccurrence of kidney ailments.

Fitness/Exercise/Games After Kidney Transplant!

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