Me and My Kegels (an article)

Me and My Kegels
from Health.com

by Christina Boufis

I'm at the front door, grocery bag on one hip, toddler on the other,
fishing for my keys and thinking, "I'm not going to make it." The
bathroom is a mere 6 feet away. Plunking my son and groceries on the
floor, I run but can't unzip in time. And I can't help thinking: "Do
we both need diapers?"

Two years after giving birth, I still can't control my bladder. I'm
one of 25 million Americans, the majority of them women, with
incontinence. More than half of healthy women ages 42 to 50-I'm 45-
have some form of chronic-peeing problem, usually linked to pregnancy
and childbirth, coughing, constipation, heavy lifting, or hormonal
changes. Yet, incredibly, 90 percent of us never seek treatment.

I decide I've got to do something. I don't seem to have any muscle
tone in my pelvic floor, and my OB-GYN thinks I'll need surgery. When
I ask about alternatives, she suggests physical therapy: my own
personal Kegel trainer.

I've known about, and done, Kegels for years-but not the right way,
apparently. Arnold Kegel, a University of Southern California
gynecologist, developed the exercise in the 1940s to help women with
postpartum incontinence. Experts say a good Kegel program can reduce
weekly incontinence episodes by 50 to 60 percent.

So, I figured, why not give therapy a try? And, like a woman on a
mission at the gym, I decide to track my progress with a diary.

Month 1: Anatomy lesson

I'm the only patient under 60 in the Urinary Incontinence and Pelvic
Pain Clinic of the Alta Bates-Summit Medical Center in Berkeley,
California. Am I in the right place?

"It sounds like you had a traumatic labor," Esther, a certified
physical therapist, says when I relate my 2-day back labor, hours of
pushing, and near C-section. She assures me that she sees patients of
all ages, not just the elderly. Using a plastic model of a female
pelvis, she shows how the pelvic floor supports the reproductive,
urinary, and digestive organs. But if this sling of muscles were on a
beach, mine would be the one getting sand kicked in its face.

Thankfully, because I don't have a painful medical problem, Esther
thinks strengthening my pelvic muscles can solve my incontinence. My
insurance company apparently agrees, having authorized eight sessions.
Esther does a pelvic exam to test my strength. She feels a little
something when I squeeze. For homework, I'm to do five 3-second Kegels
twice a day. Real Kegels.

Esther shows me that I had been just clenching my thigh and butt
muscles, not squeezing the ones that make up my pelvic floor. I'll
work up to 30 per day with 10-second holds, she promises. Esther also
asks me to track my fluid intake and urine out-put. I tell her that my
son has just started potty training. "Good," she says. "The two of you
can train your bladders together."

I see Esther twice the first week to make sure I'm doing Kegels
correctly. We talk about the best positions and techniques (like
exhaling while on my back with pillows under my butt), my history, and
my worries. Then I come back once a week, then every 2 weeks, and then
every 3. Within a month, accidents are becoming few and far between.

Month 2: Re-education

I'm amazed at how often I pee: 12 times a day. Normal is six to eight.
To control this urge, I distract myself, breathe deeply, then walk
casually to the bathroom. My goal: to gradually decrease bathroom
visits from every hour to every 2, then 3. "Hey!" I tell my bladder.
"I'm in control now."

Month 3: Going places

"Take your pelvic floor with you," Esther reminds me. In other words,
do Kegels whenever you can, and practice relaxation techniques to
avoid accidents. Now I do a Kegel every time I lift my son.

Month 4: Benefits galore!

I've been doing Kegels every day for months. The benefits? No accidents
-and amazingly better sex. My orgasms are stronger, longer, and more
intense. I tell Esther, but her reaction surprises me. "Orgasm is a
great workout for the pelvic floor," she says.

Wait. I thought it was the other way around: Pelvic-floor exercises
give you great orgasms. Turns out that's true. But Esther just wants
me to do any exercise that makes those muscles stronger-orgasm
included. Hmm. Why didn't she say so at the beginning?

By our last session. I'm no longer afraid of having an accident. "Just
think," Esther says, "you've learned a lot about a part of your
anatomy that most women don't even consider." It's true. For the rest
of my life, I'm taking my pelvic floor with me.

http://www.health.com/health/article...566679,00.html