This fall is a great time to become involved and active in community resources that can help you learn more about how to preserve and enjoy your health and your family’s health. 

We hope you will all join Women Physicians Ob-Gyn at the Women’s Health Conference sponsored by The Health Trust on Saturday, October 21 at the San Jose McEnery Convention Center.  Between your visits to the many interesting talks, exhibits, and demonstrations, stop by to say hello to us at our booth.  The luncheon keynote speaker is the academy award winning actress, Marlee Matlin, who is also a mother of four and a health care activist.  Over the last 10 years, The Health Trust has provided over $100 million of benefit to the community through program services and grant making activity.  For more information, go to www.healthtrust.org or call (408) 559-5584. 

October is breast cancer awareness month and the Community Breast Health Project is sponsoring their third annual all day Breast Cancer Conference on Saturday, October 7 at the Decathlon Club in Santa Clara with an introduction by Dr. Robert Carlson, oncology professor at Stanford University Medical Center.  This should be a great program for anyone wanting to learn more about breast cancer.  CBHP is also sponsoring a talk on Sexuality and Breast Cancer on October 19 at 6:00 pm and a talk on Health Coverage and Insurance Benefits in California on November 7 at 6:30.  Throughout the year, CBHP offers a wealth of information and support.  Contact them at www.cbhp.org or call (650) 326-6686. 

And finally, the Children’s Health Council has begun their schedule of fall Parenting Classes.   Topics include Building Emotional Understanding (ages 2-11), Anger Management with the Explosive Child (ages 7-11), Medicating Young Minds (ages preschool through adolescence), Helping Your Child Sleep Through the Night (ages 1-4), I Hate Homework!  Help Your Child with Homework and Organizational Skills (grades 4th-8th), and Mothers and Daughters:  The Roller Coaster Years:  Letting Go and Staying Close (ages 10-14).  For more information, go to www.chconline.org or e-mail sgarber@chconline.org or call 650-326-5530.        

Vaccines aren’t just for children!  Adults can benefit from vaccines, too.  And this year we have 3 newly licensed vaccines that are being recommended for routine use in adults at certain times in their lives.  These new vaccines can protect women from cervical cancer, genital warts, pertussis, and herpes zoster (shingles).  The new pertussis vaccine for adults (Tdap) will also help protect infants from whooping cough when mothers and other family members are  vaccinated. 

Women Physicians Ob-Gyn has almost all the listed vaccines available.  Check to see if you need protection.  You can call us to schedule a vaccination even if you are not yet due for an appointment.  We can also administer many vaccines to family members even if they are not our patients.  

Influenza vaccination

Pneumococcal vaccination

Tetanus-, diphtheria-, and pertussis-containing vaccination

(e.g., DTP, DTaP, Tdap, or Td)

Hepatitis A vaccination

Hepatitis B vaccination

Measles-Mumps-Rubella (MMR) vaccination

Chickenpox (Varicella) vaccination

Meningococcal vaccination

Human papillomavirus vaccination

Shingles (zoster) vaccination

1.  Call your local travel clinic to find out if additional vaccines are recommended or check www.cdc.gov..

2.  Areas with high rates of hepatitis B include Africa, China, Korea, Southeast Asia including Indonesia and the Philippines, the Middle East except Israel, South and    Western Pacific Islands, interior Amazon Basin, and certain parts of the Caribbean (i.e., Haiti and the Dominican Republic). Areas with moderate rates include South Central and Southwest Asia, Israel, Japan, Eastern and Southern Europe, Russia, and most of Central and South America.

3.  Adults from these areas should be tested for hepatitis B when they receive the first dose of hepatitis B vaccine (during the same visit).

The goal of bladder drill is to break the cycle of frequency, urgency, and urge incontinence and to allow you to reestablish voluntary control over your bladder function. The bladder needs to be fooled into thinking it never has urine. The way in which this is done is to EMPTY the bladder before it senses the urge of being full. This is done by voiding frequently during the day before any urge. After a week of voiding very frequently before there is an urge to void, the guiding principle of bladder drill is to increase the time between voiding episodes gradually. In this way you relearn to suppress the voiding reflex and raise the volume threshold at which that reflex occurs.

1.         Begin your bladder retraining program with a time interval that you can manage successfully (even if this means voiding as often as every 30 minutes). If you are able, begin this process at hourly intervals.

2.         Empty your bladder every hour on the hour while you are awake; get up and go to the toilet as soon as you wake, then at 7 AM, at 8 AM, and so on throughout the day. (It is important that you go at these time and always at these times, whether you need to go or not). Thus, if it is 9 AM, and you do not feel the urge to urinate, go to the toilet and urinate anyway. (Remember the goal is to make your bladder do what you "tell" it to do and not to have your bladder control your life). For example, if you are desperate to urinate at 9:55 AM, try to wait 5 minutes and not go before 10 AM., even if you have considerable discomfort or even urinary leakage onto a protective pad.

3.         When you can manage a regimen like this for a week, increase the time interval by 30 minutes. This means you will now be voiding at 6 AM, 7:30 AM, 9:00 AM, 10:30 AM, etc. Do not get up every hour during the night; void only when you awaken from sleep and have to go.

4.         When you are able to maintain this schedule for a week, increase the time interval again. Keep increasing on a weekly basis until you are voiding approximately 7 times per day at intervals of approximately 3 hours.

5.         Some adjustments in scheduling must obviously be made to conform to "real-life" situations, particularly if you are a working woman.

Bladder retraining is used to improve both urge urinary incontinence and also stress urinary incontinence. If a woman has overflow incontinence (bladder too big) then bladder retraining with a double void technique is used. In that case urination void is performed on the same schedule as above but in addition, immediately after emptying the bladder as best as possible, you should stand up, briefly move around or wash your hands and then immediately sit down and try to void a second time to empty the bladder even more. After voiding a second time on 5-6 occasions and having no additional urine come out, you may revert to just the single void if you feel you are completely emptying the bladder.

This program works and works dramatically. The keys to success are self-motivation and gradual increases in the time interval between voids. If you try to progress too rapidly, you will exceed your capabilities and fail. This failure can be very demoralizing.

Bladder retraining will not be successful for everyone.  If your symptoms continue, please make an appointment with one of the physicians at Women Physicians Ob-Gyn.  You may be a candidate for medical treatment if you have urge incontinence or overactive bladder.  If you suffer from stress incontinence, Dr. Janet Pulskamp can evaluate you with urodynamics and may be able to offer the Monarc procedure, a safe, simple, and effective outpatient procedure.   For more information on this procedure, go to http://www.americanmedicalsystems.com/womens_overview_detail_objectname_female_monarc.html

Information on this website is for educational and reference purposes only and should not be interpreted as specific medical advice.

Copyright © 2009

Women Physicians

Ob-Gyn Medical Group

650.988.7550