DEAR DR. DONOHUE: My entire day is preoccupied with mad dashes to the bathroom to urinate. If I don’t make it in time, I lose control. A friend tells me there is a skin patch that can solve this problem. What is it? I need the information desperately. – E.W.

ANSWER: Oxytrol is a thin, flexible, clear patch usually worn on the abdomen, hips or buttocks. It is not effective for every variety of bladder control loss (incontinence), but it can help the variety called urge incontinence. You have described that variety well. A woman or man with the condition is suddenly stricken with the need to empty the bladder quickly and frequently, or there is loss of urine.

Urge incontinence comes from powerful and inappropriate contractions of the bladder muscle. The medicine in the patch helps control those uncontrollable bladder muscle contractions. The Oxytrol patch is only one example of such medicine. The fact that it needs to be applied only every three or four days is something that many patients find liberating.

Making a few changes in your life might eliminate bladder muscle spasms. Don’t drink any alcoholic beverages. Stay away from caffeinated and soft drinks. Avoid citrus fruit and juices and all spicy foods. Some people find that eliminating artificial sweeteners and any foods or drinks containing corn syrup helps them control their spastic bladders.

When the urge strikes, try to resist it for a few minutes or more by relaxing and taking deep breaths.

Putting yourself on a bladder-emptying schedule can retrain the bladder. Start with a 60-minute interval and gradually increase the time between visits to the bathroom by five to 10 minutes every four days.

Urge incontinence is not the only kind of incontinence. Loss of urine when a person coughs, laughs, sneezes or strains to lift something heavy is stress incontinence, and its treatment is entirely different.

DEAR DR. DONOHUE: There seems to be a difference of opinion about Pap smears. I know women of my age, 72, who no longer have them. I still have a yearly one. What gives? – J.S.

ANSWER. Dr. George Papanicolaou made an enormous contribution to women’s health when he devised the Pap smear test. (He didn’t call it the Pap smear; others did in his honor.) Thanks to this test, there has been a 70 percent reduction in cervical cancer deaths in the past 50 years.

Different cancer organizations have different guidelines for the frequency of Pap smears and the time for discontinuing them. One widely used set of guidelines goes like this: Women should begin to have Pap smears within three years after first having intercourse or at age 21 and continue to have them yearly until age 30. If, at that age, three consecutive annual tests have been negative, then the interval for testing can be lengthened to every two or three years. Pap smears can be discontinued at age 70 after three negative tests in the prior 10 years. (Some set the age for discontinuing at 65.)

Cervical cancer and Pap smears are explained in the pamphlet on those topics. Readers can obtain a copy by writing: Dr. Donohue – No. 1102, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6.50 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: What are the true dangers of cocaine? I don’t want any scary stuff, and no preaching, please. – K.L.

ANSWER: Sniffing cocaine can lead to a hole in the partition between the two nostrils. At the height of a cocaine high, the heart can beat erratically, blood pressure can rise and heart attacks can occur. The heart attacks result from constriction of heart arteries, with the resultant loss of blood flow to heart muscle.

These consequences don’t happen often, but they occur enough that they should give every user pause.

Is this too preachy or scary?

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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