Breast Cancer Awareness Month and the Caregiver

Sometimes life takes an interesting turn of fate. For this supplier of caregiving products the twist comes in the fact that I am sitting in a room with my wife getting chemotherapy for breast cancer on the first day of Breast Cancer Awareness Month 2014. Here’s a brief synopsis of her story and the life journey we are taking.

My wife is a healthy and active 48 year old women. 7 Years ago she was diagnosed with Ductal Carcinoman in Situ (DCIS). She had a lumpectomy in the breast and follow up radiation. She recovered and we moved on with our normal lives under the care and supervision of doctors. Fast forward 7 years later and her doctor noticed lots of little things that were new in her annual mammogram taken late in May 2014. Not good, but not necessarily bad at this point because nothing was clearly seen, understood or defined yet. 

This started a series of tests and agonizing waits for results including an MRI and biopsies. Unfortunately there were cancer cells and after review with doctors it was determined that a mastectomy on one side would be the best course of action. This leads us to the genetic DNA testing to see if she carried the BRCA1 and/or BRCA2 genes which indicate a high propensity for cancer in the other breast or ovaries in the future. If positive results come back on this test it would be prudent to have a double mastectomy. Luckily for her these tests results came back negative and she did not have a higher risk for there cancers as indicated by these results.

With this information in hand we consulted with the doctors and scheduled her surgery in mid July 2014. The surgery would remove one breast, remove a couple of sentinel lymph nodes for testing and get the reconstructive plastic surgery started by having a spacer implant installed. The lymph nodes are sent for testing to see if there are any cancer cells in them indicating any spread of cancer. They also sent the tumor off for Oncotype DX testing to determine how effective chemotherapy would be in helping to sterilize the blood of any cancer cells that might be hiding out in the blood stream. 

Luckily the lymph nodes came back cancer free. The tumor was larger than could be seen on the MRI and mammogram so the Oncotype testing became an important part of the test to determine if chemo was needed. These test results indicated that chemotherapy would increase her 10 year survivability rate by an additional 7-8%, which in medical survivability is substantial.

So the end result of her journey was a mastectomy followed by 4 sessions of chemotherapy. Radiation was not included in her treatment as it was determined to not increase survivability and or reduce spread of the cancer. 

As a caregiver, supporter and partner in this breast cancer journey I have learned more than I ever wanted to learn. Here are some of these highlights:

• There are lots of tests with agonizing waits for results
• Every test that comes back, good or bad, leads to more tests or treatment plans
• Everyone is different so one person may have a completely different treatment plan than another
• Cancer is physically, mentally and emotionally draining for the survivor and the caregiver
• Try not to do random research on the internet - always contact your doctor(s) for information and guidance 
• Remember to be patient with the survivor. This is a roller coaster ride of emotions and thoughts
• A woman losing her hair is emotionally damaging and one of the most feared and apprehensive parts of the process. Remember to tell her she is beautiful!
• Be as prepared as you can to help the survivor in advance so that you are not scrambling around for products to help care for the survivor or make them comfortable

Here are some items that we found very helpful on our journey:

• A comfortable reclining chair 
• A bed rest booster for use to sit up in bed
• Lots of pillows in various sizes to prop up and support all kinds of body parts
• Rinse-free skin and hair cleaners (we found Aloe Vesta Bathing Cloths to be awesome)
• Skin moisturizing creams and lotions. Chemo does a number on skin (we found Sween 24 Moisturizing Cream to be a household favorite)
• Cold packs to place on hot spots during heat flashes. We use reusable cold packs that can be placed on forehead, under neck and on feet during hot flash episodes
• Medical grade room deodorizer with limited scent or unscented to cover up nasty chemo induced bathroom smells. We found ByeBye Odor to work well and not overpower the room with fragrance 
• Hand Sanitizers to help avoid spreading germs - we have pump bottles in the house and even have one right by the front door so folks that stop by to visit can sanitize their hands on the way in. 

Any item(s) that we use have been cleared with our doctors to ensure we were not causing any complications. We learned that when in doubt, call a doctor. They are more than happy to take calls (even those at 2 am and the pain seems to be escalating and fear growing). We have been blessed with an awesome team of compassionate doctors that have been so incredibly helpful. We can only hope that anyone going through this has the level of fantastic care.

Our journey continued on as she fights the good fight. Her prognosis is good and we know that there are many women having a much more difficult time and will have longer treatments. She is fighting the fight, but I am right there by her side with hugs, glasses of water, back massages or whatever she needs. My caregiver job has quickly become the ability to anticipate what she may need in advance or react quickly when she needs something. 

I love my wife and hate to see her going through this process. I am so proud of her for her spirit, courage and strength. Mostly I love her newly adopted slogan - Fight Like a Girl. So to all of you who may be going through this in your life I wish you the very best and alway remember to Fight Like a Girl!

Introducing Prevail Per-Fit Gender Specific Protective Underwear

Prevail Per-Fit Underwear for men and women are specifically designed for customized protection, comfort and discretion. These all new disposable underwear look even more like regular underwear while providing moderate incontinence protection. Since they look, fit and feel like regular underwear men and women that are on the go can securely and discreetly maintain their own protection and independence! 

Prevail Per-FitGender Specific Protective Underwear Features:

• Pull on and off just like regular underwear
• Odor Guard protection with targeted absorbency zones to rapidly pull and lock away moisture and neutralize ammonia odor
• Breathable waist area with ventilated waist allows to freely migrate to the wearer
• Cloth like fabric and design that looks and feels more like regular underwear. Fabric has QUICK WICK with MaxSoft Technology that provides softness and rapid liquid acquisition speed

Per-Fit for Women are designed and fitted specifically for women. They are lavender in color and feature a form fitting shape and stretchable waist for the ultimate in comfort and discretion. They provide a superior and inconspicuous fit. Available for waist sizes ranging from 34” up-to 64”. 

Per-Fit for Men are made just for men and are form fitted with a stretch material for the ultimate in cool and comfortable protection. The branded elastic waistband and printed stitching make them look and feel just like regular man’s underwear. Available for waist sizes ranging from 34”-64”.

Prevail Per-Fit Gender Specific Protective Underwear are shipping now. Click here for men and here for women.

Bath and Shower Safety

The bathroom can be a very dangerous room in the house for accidental injuries according to the CDC Report Nonfatal Bathroom Injuries Among Persons ≥15 Years — United States, 2008* found that there were over 234,000 nonfatal bathroom injuries. Of those 81.1% we caused by falls with the highest rate of injury happening in or around the tub or shower. 37.3% of injury accidents happened while getting out of the tub or shower and 2.2% occurred while getting in. The report also showed that injuries and accidents increased with age.

There are many great products to help reduce and/or eliminate accidents in and around the tub and shower. There are grab bars that can be installed in the area to help provide support, chairs and seats to use to to avoid slipping and falling and handheld shower heads that allow the bather to brig the water to them. The following information is provided to help understand some of the key items available to help make the tub or shower a safer place.

Grab Bars and Tub Rails

Grab bars are hand rails that are installed in the tub or shower area on the wall to provide a person a handle to hold on to while getting in or out. There are options available that include permanent bars that are screwed or bolted into the wall as well as suction cup products that can be moved or taken with you while traveling. The permanently mounted bars are considered more secure as they won’t become accidentally unattached to the wall if there is a problem with the suction cups.

Tub Rails are bars that attach to the side of the tub to provide a handle to help the individual steady themselves when getting in or out. These are clamped on to the side of the tub.

Shower Chairs and Transfer Benches

A shower chair is a waterproof chair that is designed to sit in the tub or shower to give the user a place to sit while bathing. Shower chairs come in a number of configurations and are made of a number of different non-rusting materials. Shower chairs may have a seat only or may include and backrest and/or arms. Some are even designed to be folded for easy storage or transport. 

A transfer bench is like a long shower chair that has two legs that sit in the tub and the other two legs sit outside of the tub. The user can sit on the bench, swing their legs into the tub and then slide over on the bench to position themselves to bathe. 

Handheld Shower Heads

A Handheld Shower Head mounts to the spout where water comes out of the regular shower head. There are many features that make this an easy way for the user to bring the water to them, rather than move around in the tub or shower to get under the water. Many Handheld Shower heads allow the user to switch the water flow with a valve so that water comes out of the handheld unit and not the regular shower head. Some also include a button to allow the user to only allow water through the handheld shower head when they want it. The shower heads normally include a long nylon hose to allow the user plenty of range in the tub or shower. 

In addition to these products there are items such as the Carex Bath Mat that provides a slip resistant surface in the bottom of the tub. Since these use suction cups to adhere to the tub or shower floor they can be easily removed for cleaning or transport. 

Some people may find that use of some no-rinse cleansers and wipes might help clean ups between baths or showers a safe and convenient option. Click here to go to our previous article to learn more about in-bed bathing techniques and products - Tips on Sponge Bathing - also known as In-Bed Bathing. 

A few simple products can help make the bath tub or shower more safe. We hope that you find this information about bath tub and shower safety beneficial. 

* Center for Disease Control, Morbidity and Mortality Weekly Report (MMWR), Nonfatal Bathroom Injuries Among Persons Aged ≥15 Years - - - United States, 2008, June 10, 2011 

Male Incontinence Causes

Male incontinence may occur for many reasons. Essentially, incontinence is when there is an accidental leakage of urine and may happen when the sphincter is too weak, the bladder muscles contract too strongly or the bladder is too full.

The male urinary tract consists of the kidneys that produce urine, the urinary bladder that stores urine, and the urethra tube that leads urine from the bladder through the prostate and out the penis. The urinary sphincter is a ring of muscle around the urethra that controls the flow of urine. Nerve signals tell the sphincter to stay squeezed shut to prevent. The nerves and the muscles work together to prevent urinary leakage.

Incontinence in men may result from a number of issues ranging from conditions such as constipation, infections, and prostrate issues. Prostate issues and treatments are a major cause of urinary incontinence in men. Any disease, condition, or injury that damages nerves can lead to male urinary incontinence.

The prostate gland is a male gland about the size and shape of a walnut. It surrounds the urethra just blow the bladder where it adds fluid to semen before ejaculation. It commonly becomes enlarged as a man ages. This condition is called benign prostatic hyperplasia or BPH.  As the prostate enlarges it may squeeze the urethra, which affects the flow of the urinary stream. 

Prostate Treatment Related Incontinence Issues:

• Short-term incontinence caused by prostrate surgery. This may go away with time. In some cases this may last up to a year.
• Stress Incontinence – often a result after prostate removal (radical prostatectomy) or radiation being used as treatment for prostate cancer. Improvements in surgical techniques are helping make this type of incontinence less common.
• Some treatments for an enlarged prostrate can cause incontinence. These treatments are for conditions such as benign prostate hyperplasia (BPH).

There are also many causes of Urge Incontinence. These conditions include:

• Urinary tract infection (UTI)
• Constipation
• Painful infection of the prostate gland known as Prostatitis
• Multiple Sclerosis, Parkinson’s disease or stroke
• Kidney or bladder stones
• Blockage from prostate cancer or benign prostatic hyperplasia (BPH)

Overflow Incontinence in men may be caused blockage of the urethra from BPH or prostate cancer. 

Other causes may include:

• Stricture – narrowing of the urethra
• Medicines such as antihistamines and decongestants
• Diabetes, multiple sclerosis or other nerve conditions

Many people, men included, may have more than one type of incontinence and each type may have an additional cause. There are many products available that are designed specifically for use with Male Incontinence. Click here to see all products specifically designed for men that are dealing with incontinence.

Supplies Needed in Addition to Incontinence Garments or Adult Diapers

Many individuals and new caregivers ask us what kind of products are needed for caring for incontinent adults in addition to their adult diapers or incontinence garments. While everyone may have different needs a few of the more common items include skin cleansers, skin care lotions and creams, room deodorizers and disposable gloves. All of these items will help maintain a healthy and pleasant environment for all people involved.

Skin Cleansers

Skin Cleansing products specifically used for incontinence are designed to be gentle on skin while cleaning away urine and feces. This is the basis of continued skin health and comfort. There are many varieties of skin cleansers to help fill this need including:

• Body Wash & Shampoo - these are available as no-rinse cleansing solutions to use all over the body for clean up. They can be used with regular washcloths to disposable washcloths. Simply use the cleansers as directed and gently dry skin with a clean cloth. This will help keep skin smooth, soft, non-irritated and healthy. 
• Skin Cleansing Foams - Similar to body wash & shampoo except that these cleansers are foam which make them easy to apply and spread on skin for cleansing. 
• Wipes & Washcloths - these disposable cloths allow the user to easily and gently cleans the skin and then dispose of the cloth after use. Adult sized wipes help with adult sized clean up. Disposable washcloths are thicker than wipes and are generally used for all over body in-bed bathing, although many people use them specifically for incontinence skin cleansing because they prefer the thicker cloths.

Skin Care Products

Skin care products include lotions, creams, ointments and powders. Lotions are more liquid and absorb rapidly in skin to replace moisture and protect from irritation. Skin Care Products include:

• Lotions - low to medium thickness and can be easily spread over large areas of skin.
• Creams- thicker than lotions and leave a thin film to help moisturize and protect sensitive skin.
• Ointments are thicker and generally do not absorb easily into the skin. They tend to be greasy and stay on the surface of the skin to help promote healing 

Moisture barriers are available in these products lines to soothe irritated skin and provide maximum protection from damaging moisture.

Room Deodorizers

Room deodorizers help keep the air fresh and clean which keeps everyone more happy. They are available in unscented or scented varieties. Quality room deodorizers will actually absorb odors rather than cover them up with other fragrances.

Gloves

Gloves are available to act as a barrier between caregiver and patient. Many varieties of gloves are available, but the most common used disposable glove for incontinence care are the vinyl variety. They are inexpensive and available in sizes to fit virtually all hand sizes. 

These are just a few examples of the most common items needed by caregivers when caring for incontinent adults to ensure comfort and health. 

Drugs that Contribute to Urinary Incontinence

Urinary incontinence is often the result of medicines being taken for other health issues. These medicines may cause incontinence or worsen existing incontinence. If you suspect you are experiencing incontinence or worsening incontinence it is very important to consult your physician to determine next steps. Never stop taking medicine without consulting your doctor.

When considering medication induced incontinence be sure to think of both prescription medicines and any over-the-counter medicines you may be taking. 

Here are some common drugs that may worsen or cause urinary incontinence:

High Blood Pressure Medicines

These drugs include alpha-adrenergic antagonists or alpha-blockers including Cardura, Minipress, Hytrin, doxazosin mesylate, prazosin hydrochloride and terazosin hydrochloride. These drugs work by dilating blood vessels to reduce blood pressure. In doing this they may also relax the bladder along with the blood vessels. 

They are some times prescribed to men to help with urinary problems such as enlarged prostate, benign prostatic hyperplasia (BPH). Alpha-blockers help relax the muscles in the bladder neck which allows urine to flow more easily and improving symptoms of BPH.

These drugs may lead to stress incontinence, which is leakage that occurs during strain such as sneezing, laughing, coughing, or physical exercise.

Antidepressant Drugs 

Antidepressant drugs may worsen incontinence in some people. These drugs include Nopramin, Cogentin, Haldol, Risperdal, Elavin, Prolixin (fluphenazine), Hadol (haloperidol), nortripramine, amitriptyline, desipramine, benztropine, halperidol, and risperidone.

These drugs can impair the ability of the bladder to contract resulting in an inability to empty (or void) the bladder completely. This may lead to overflow incontinence. Some antidepressant drugs may decrease your awareness of the need to go to the bathroom until it is too late to get to the toilet.

Diuretics

Diuretics are also known as water pills. They work in the kidneys to reduce blood pressure by flushing excess water and salt out of the body. Essentially, they cause the body to produce more urine. This translates to more trips to the toilet and possible worsening of incontinence. 

These drugs include any medicine prescribed as a diuretic including Bumex, Lasix (Furosemide), Aldactone, bumetanide, Hyrdodiuril (Hydrochlorothiazide HCTZ), Maxzide (HCTZ - triameterene), spironolactone, furosemide, theophyline and hydrochlorothalizide (and other “thalazides” which are common medications for hypertension).

Sleeping Pills 

Sleeping pills may create a problem for those with incontinence at night because the user don’t or can’t wake up when their bladder is full. These drugs include any sedative or sleeping aid that relaxes muscles and make you sleeping including Ativan (lorazepam), Valium (diazepam), Lunesta, Ambien, Librium (chlordiazepoxide), diazepam, flurazepam, lorazepam, eszopiclone and zolpidem. 

These drugs slow reflexes which may result in not recognizing the signal that it is time to go. They may put you in such a deep sleep that you miss the body alert to get up and use the toilet. Bed wetting effects approximately 10% of people with incontinence. 

Hormone Therapy Drugs

Hormone therapy including oral estrogen-only or combination estrogen and progesterone pills may cause or worsen urinary incontinence. At one time it was thought that these medicines helped incontinence symptoms, but they are now known to trigger or worsen both stress and urge incontinence. 

Decongestants and Antihistamines

These drugs may contain pseudoephederine which may tighten the urinary sphincter causing urinary retention. These drugs include Sudafed, Contac, Benadryl pseudoephedrine, and diphenhydramine.

For women this is frequently followed by sudden overflow incontinence. However, men who have leakage after prostate surgery may be using these drugs to temporarily clamp down on the bladder muscles to help prevent bladder leakage. 

Narcotics and Painkillers

These drugs are opium based painkillers that may interfere with the bladder’s ability to contract fully. This can lead to urine retention and overflow incontinence. They may also cause constipation and studies show that constipation desensitizes the bladder and worsens urge incontinence. These drugs include any opium-based pain medicine including OxyContin, MS-Contin, Oramorph, Percocet, Demerol, codeine, morphine and oxycodone.

Understanding that these types of drugs may cause or worsen incontinence is a key to opening a dialog with your doctor. Under the doctors supervision changes to drugs, behavior or physical activity amy help improve your condition. Being prepared for this conversation will help the dialog be open and beneficial as it is often uncomfortable. Keep in mind the following when speaking with your doctor:

• How long ago/ when did the incontinence begin?
• Did you have incontinence before taking these medicines? Was there a change? 
• What drugs are you taking (prescription and over-the-counter) and when did you start taking them? 

Please realize that there are many drugs that may not have been included on this list that may cause or contribute to urinary incontinence. It is very important to speak with your doctor about all medications you take in order for them to identify best options for your optimal care. 

What is Incontinence?

Incontinence is the involuntary loss of bladder and/or bowel control. Loss of bladder control is also known as urinary incontinence and loss of bowel control is also known as fecal incontinence. It is a common problem the effects both men and women of all ages. 

There are many causes of incontinence including surgery, child birth, menopause, birth defect, injuries to areas such as pelvic area or spine, disease, infection, certain medications, and chronic conditions such as asthma, diabetes or arthritis. Certain beverages including alcohol or caffeinated drinks may also contribute. In this article we will focus on urinary incontinence.

Urinary incontinence is almost always a result from an underlying medical condition. Incontinence can occur when any part of the urinary system malfunctions or is compromised. Urinary incontinence can range in severity from drops or small leaks to complete loss of bladder control. This system includes the kidneys, ureters, bladder, sphincter and urethra. In the normal situation the bladder will store urine until it is time to urinate or void the bladder. Urinary incontinence can happen when any part of the urinary system is not functioning correctly.

Voiding or void is a medical term often used to describe the process of urination i.e. voiding the bladder. Some individuals may not be able to void completely which can also cause problems such as bladder infection. This is often found with people that have certain diseases or spinal cord injuries. 

The types of urinary incontinence are - stress incontinence, urge incontinence, overflow incontinence, & functional incontinence. Here is a brief description of each:

Stress Incontinence - may happen when there is an increase in abdominal pressure from situations such as laughing, exercising, sneezing, or coughing. The urine leaks due to weakened pelvic floor muscles and tissue. This may be caused by childbirth, being overweight or obese (bariatric), having had prostate surgery, and certain medications. 

Urge Incontinence - also known as overactive bladder. This is the incontinence that describes when there is a sudden urgent need to urinate and not having time to get to the bathroom or toilet. This type of incontinence is often caused by damage to the bladder’s nerves, damage to the nervous system or damage to muscles. Conditions such as multiple sclerosis, Parkinson’s disease, diabetes and stroke can affect nerves resulting in urge incontinence. There other other conditions that can lead to urge incontinence such as bladder infections, bladder stones, and use of certain medications. 

Note: some women have both stress and urge incontinence which may be referred to as “mixed urinary incontinence”

Overflow Incontinence - this type of incontinence that describes when a person is not able to empty their bladder completely and as a result may experience leakage when the bladder is full. This is something that many men experience in the form of frequent dribbling of urine.  Overflow Incontinence is caused by weak bladder muscles, blockage of the urethra cause by situations such as an enlarged prostate, tumors and constipation. 

Functional Incontinence - incontinence caused by physical problems such as arthritis or cognitive problems. The problems such as dementia may prevent a person from getting to the bathroom in time. 

Many more women experience urinary incontinence than men, but it does still effect men. Since there are many possible causes of incontinence it is important to obtain a medical diagnosis to determine possible treatment options. Many times urinary incontinence can be cured or improved so it is important to consult with your doctor. For example, sometimes changes to diet, behavior, or medicines or diet can help improve the situation. Any changes that are made to any of these, especially medicine should be done only under the care and supervision of your doctor. 

In some cases surgical treatment may be performed after receiving a medical evaluation and exhausting nonsurgical treatment options. 

During evaluation and treatment there are many options for products to help manage and maintain comfort, health, dryness and dignity. These products include garnets such as adult diapers, protective pull up underwear and underwear pads and liners. Click on this link of you would like to check out any of the large variety of incontinence products available on our web site.