Tag Archives: enlarged prostate

Sleepless Nights

23 Jun

Getting up every night to use the toilet?  Often more than once?  Waking once or more during the night to urinate is referred to as nocturia.  As we get older, we seem to get up more frequently.

Some causes are gender specific.  For example, nocturia in men is often linked to an enlarged prostate that blocks the flow of urine from the bladder.  Such men fail to fully empty their bladder during the day, sending themselves to bed with a partially full bladder that soon sends a wake-up call to be emptied. This is helpful to understand because getting the prostate enlargement diagnosed and treated may allow the symptoms of nocturia to all but disappear.  The onset of nocturia in women is generally linked to the consequences from childbirth, menopause, and even pelvic organ prolapse.

It is often difficult to separate the cause of awakening from the tendency to get out of bed, once awakened, to use the toilet.  If the problem is at least partly due to sleep disorders including sleep apnea and restless leg syndrome, these problems need to be investigated and treated separately.  Sometimes nocturia is a symptom of a greater medical problem that alters the way in which the body functions during sleep.  If the problem is excessive nighttime urine production, the first step is to look for the cause.  Targets include:

  • Diabetes
  • High blood pressure
  • Heart disease/Congestive heart failure
  • Vascular disease/Varicose veins/Swelling due to fluid accumulation in lower extremities

There may be steps you can take on your own (to read more, visit http://www.nafc.org/bladder-bowel-health/nocturia/)

  • Eliminating caffeine and alcohol from the diet, especially 3 – 4 hours prior to bedtime
  • Taking prescribed diuretic medications about 6 hours before bedtime
  • Minimizing all fluid intake 2 – 3 hours before bedtime, including foods with high water content
  • Avoiding strenuous exercise within 3 hours of retiring for bed
  • Avoiding engaging mental activity or stressful dialogue within several hours of bedtime
  • Turning off the television
  • Darkening the bedroom and sleeping with blinders
  • Kicking your pet out of the bed!

Of course……fall prevention is of major concern with nocturia.  That’s the next blog just around the corner.

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Price’s Passing for HC

22 Feb

In January 2011, Reynolds Price, distinguished James B. Duke Professor of English at Duke University and longtime member of the American Academy of Arts and Letters, passed away at age 77. He had authored dozens of books, inspired thousands of students as well as colleagues and others on and beyond the Duke campus, and was revered as a highly skilled novelist, memorable Southern storyteller, and unmatched creative writer. A North Carolina native, Price graduated summa cum laude from Duke in 1955 and returned in 1958 after studying in Oxford as a Rhodes Scholar, with peers as notable as W. H. Auden, as a Duke University faculty member for the next 53 years.
Duke President Richard H. Brodhead commented upon his passing, “Reynolds was a part of the soul of Duke; he loved this university and always wanted to make it better. We can scarcely imagine Duke without Reynolds Price.”1
Price became confined to a wheelchair in 1984 when a cancerous tumor in his spinal cord left him paralyzed from the waist down. “The fact that my legs were subsequently paralyzed by 25 X-ray treatments … was a mere complexity in the ongoing narrative which God intended me to make of my life,” he was quoted as saying in an interview with a local newspaper reporter years later. Price’s account of cancer survival is captured poignantly in his 2003 book, “A Whole New Life: An Illness and a Healing.” Having read this book shortly after it was published, I retrieved it from my bookshelf when I heard the announcement of his death on NPR morning news because I wanted to reread Price’s account of his “mid-life collision with cancer and paralysis”. It is one man’s record – through a ten-year recollection – of how a person confronts a life-altering trial of unimaginable proportions and comes out of the experience transformed, with a new but very different life. He offers the book to those facing their own trials, those caring for someone who is undergoing such turmoil and stress, and those of us awaiting our own, yet unknown “devastation”. I highly recommend it to anyone.
Some people who lose control over their bladder or bowels may have found themselves in such circumstances because of a single event, such as in the immediate aftermath from surgical removal of a cancerous prostate. One day, you feel fairly normal as you’re getting along with life, and the next day you’re soiling your clothes because of the surgical trauma inflicted upon tissue, vessels, and nerves. For many others, it is not so sudden. The symptoms come on gradually, almost invisibly, until one day you realize that the symptoms of urgency or leakage are taking over your life instead of you controlling it. Knowing how others have maneuvered the road to wellness and mastery over symptoms, even if it’s just to be able to manage the symptoms rather than eliminate them, requires patience and perseverance. But it also takes the coaching and encouragement of others. In this book, Price writes of his friendships tenderly because they comfort him, they energize him, and they uplift him.
Online forums do that too. Find one that works for you. Let NAFC connect you. On the NAFC web site, there is a group just for men and another one for women. There’s even one just for those concerned with bowel control issues. It’s a private meeting place where you can get and give advice to comfort, energize, and uplift others. Working together, you can discover a whole new life, just as Reynolds Price did.
Nancy Muller, PhD

1 http://news.duke.edu/reynoldsprice/, accessed online 27 January 2010