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An Interview with Author Mary Dierich.

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By April E. Clark

Incontinence is a condition affecting 10 million Americans, according to the National Kidney Foundation. It can strike anyone no matter their age, gender or medical background. That's a lesson Mary Dierich, author of [i]Overcoming Incontinence: A Straightforward Guide to Your Options[/i], learned early on her way to becoming a nurse.

Dierich first saw the impact of incontinence on those at a nursing home where she was a laundress, then on troubled kids as a camp counselor and eventually when treating patients as a nurse. "I understood how profoundly this problem affects all aspects of a person’s life from diet [and] exercise and sleep to sexual intimacy and choice of jobs," she says. Her experiences led her to write the book, Overcoming Incontinence, which she hopes will help those with incontinence to understand their options and lead active lives.

We sat down with Dierich, now a nurse practitioner and clinical nurse specialist at the University of Minnesota Medical School, to ask her a few questions, and here she offers her thoughts and advice on managing, treating and living with incontinence.

Why is incontinence an important subject to discuss in today’s society?
MD:
Not only is this a very common problem, it cuts across all ages and both genders. Although the type of incontinence changes somewhat as people age, the problem is not any less [troubling] for a 90-year-old than for a 20-year-old.

How can people positively approach the emotional issues associated with incontinence?
MD:
The first thing to remember is that incontinence is not your fault and it is a very common problem. You would not blame yourself for chronic back pain or having diabetes, yet people view this problem with shame because this is such a core function of how we define ourselves as adults in our society. Even as we potty train children, we tell them that they are big boys or girls when they pee in the toilet rather than in their pants. We even call training pants big people underwear. That loss of control is very hard to deal with.

I believe that people should find a doctor who is willing to work with them on this issue and to try a number of options to see what works best for the individual person. There have been very few times, when working in concert with a patient, that we haven't been able to find a reasonable improvement even when people have other factors like neurologic disease, diabetes or back problems that can severely impact the degree of incontinence.

Diagnosis of this problem is pretty simple, and treatments are becoming easier and safer all the time ... Probably the biggest predictor for success, however, is the person’s motivation to deal with the problem and their willingness to work through a treatment plan.

How can products such as absorbent garments help people manage incontinence?
MD:
Incontinence products allow people to regain a place in society. Also, for people who have an overactive bladder in which leaking situations are very unpredictable, absorbent garments can give a measure of psychological security, as well as physical protection.

In your book, you recommend keeping a diary. How can this help people manage their incontinence?
MD:
A diary allows people to see patterns ... so [it] will help verify if your frequency is due to high levels of fluid intake or if the problem is truly a bladder problem.

Also, a diary allows you to check to see if there are foods or medications or activities that aggravate the incontinence. Finally, a diary allows you to see just how bad the problem really is and allows you to track if you are improving once you begin treatment.

What myths continue to exist regarding incontinence?
MD:
Probably the biggest myth in my estimation is that surgery is risk free and permanent. The second biggest myth is that surgery is the only way to treat incontinence. The third biggest myth is that incontinence is a normal part of aging.

What do you hope readers will learn from your book?
MD:
I hope that people who read this book will know that incontinence is a very common problem and that all incontinence can be improved, if not cured. I also hope that if their doctor doesn’t raise the subject, that readers will have enough knowledge and understanding of the problem to discuss it openly. Finally, I hoped to give them the tools they need to evaluate the appropriateness of the care that they are receiving and to negotiate the health care and insurance maze.

[b]Dear Diary[/b]
You've probably heard of keeping a diary to jot down daily thoughts or future dreams and plans, but a diary about voiding? A Voiding Diary lets you to keep track of bathroom visits, meals, drinks, accidents and more, and over time, will allow you to see patterns. You might discover that whenever you drink caffeine you experience leaking or that you tend to have more accidents at night. By observing these patterns, you will better be able to manage your incontinence.

It is also a great tool to share with your health care provider to enable him or her to provide you with the best treatment plan.

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Bladder Leakage Facts and Figures
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7 Things to Tell Your Doctor on Your First Appointment for Bladder Leaks