Drs. Oz and Roizen
Q: I have a 75-year-old mother and a 5-year-old son — and both of them are wetting the bed. Double help! — Jean F., Boise, Idaho
A: Bed-wetting and incontinence are challenging problems for both those experiencing the trouble and the caretaker — YOU. Fortunately, with a little work, both conditions can be managed pretty well.
Your son is only 5, and occasional bed-wetting is common up to age 7; about 20 percent of 5-year-olds can't always stay dry at night. They may not have fully developed bladder control mechanisms, or they're not producing enough of the hormone vasopressin, which reduces urine production at night. Rarely is bedwetting a sign of illness.
Your best bet is:
• Use absorbent pads and underwear at night.
• Eliminate all caffeine-containing drinks (colas, for example).
• Make sure he urinates regularly during the day and right before bed.
• You also can use a moisture alarm that will wake him at the first sign of dampness. In six to 12 weeks, he may begin to recognize the feeling that he has to go and wake himself up.
For many older folks, incontinence is a problem. (In Japan, diaper sales for older folks exceed diaper sales for infants.) When it happens at night, it's usually from an overactive bladder — and leakage can happen with or without the sensation that you gotta go. Some medications trigger OAB, as can neurological disease, injury or infection, but much of the time the cause is unknown. Fortunately, there are potential solutions.
• Your mom can try pelvic floor muscle exercises (Kegels) and bladder retraining to increase her ability to hold in urine.
• Medications are effective. Check with her doc and ask about oxybutynin, which inhibits nerve impulses that cause leakage, and darifenacin, which reduces muscle spasms of the bladder and urinary tract.
• For severe cases, Dr. Mike's Cleveland Clinic suggests Interstim — a therapy that uses an implanted electrical stimulator to control the nerve that triggers urination; 76 percent of folks see significant improvement, and 52 percent see the end of leakage.
Q: When I had my hip replacement, I found out everything I could about the doctor, the hospital, the implant and the procedure before I had it done. A friend of mine who also got a new hip never even found out what kind of implant she was getting. Now she's having trouble, while I'm back to running around with no problems. Could just knowing what's going on have made the difference for me? — Terry H., New York
A: Knowledge is power, and when it comes to knowledge about your body and your medical treatments, it's the power to stay healthy! We know that if you're more knowledgeable about procedures before and after surgery, get a second opinion and search for the most competent doctor for any significant treatment or surgery, you'll have better health outcomes.
We realize some people are afraid to hear about surgical details, but it turns out the more informed you are, the more positive your attitude will be. And a positive attitude translates to better healing and rehabilitation. Also, eagerness to know what's happening is a clue that you're good at managing your day-to-day health — and that's been shown to lower health care costs.
As for your friend, we're sorry she is having trouble, but it's never too late to get proactive about wellness. Let her know that she can do a lot to make herself feel better and encourage her to become better informed. Help her write out a list of questions for her surgeon, primary care doctor and physical therapist (she does have one, doesn't she?). Suggest that she go to a reputable website (we like ours: ClevelandClinic.org and NewYorkPresbyterian.org) to find out about hip replacements. She can catch up on all the latest info, and that should make her feel more confident and more engaged the next time she goes in for a checkup or if she needs repair of her previous surgery.