DEAR DR. DONOHUE: You had an article on urge incontinence. My problem is stress incontinence. Do you have any recommendations for that? – E.S.

ANSWER:
Stress incontinence is loss of urine when people cough, sneeze or laugh, or when they strain to push a heavy chair or lift a bag of groceries from the floor to the counter. The “stress” is increased pressure on the bladder generated by those acts. The problem is that the muscles that keep the bladder closed have become weak.

One way to combat stress incontinence is to keep the volume of urine in the bladder below the threshold where the bladder begins to leak. People can achieve that by noting how long their usual interval between voidings is, and then shortening that interval.

Another effective way of handling stress incontinence is strengthening the muscles that support the bladder and keep it closed. Kegel exercises are designed to do just that.

While urinating, stop the stream. The muscles you contract to do that are the muscles you want to contract at times other than during urination. You can perform the contractions while watching TV, seated in a car, standing or in bed. You make 10 consecutive contractions. Alternate long-held contractions with short-held ones. Start with long-held contractions of five seconds and increase them to 10 seconds. Take a rest between contractions of the same length that you held the contraction. Repeat sets of 10 contractions four times a day. Do the final set when you are in bed for the night. You won’t obtain overnight success, but you should notice a big difference in about six weeks.

If your bladder has fallen, then part of the correction for stress incontinence entails surgically restoring the bladder to its normal position. Your doctor can tell you if you have a bladder that needs repositioning.

DEAR DR. DONOHUE: Every day, we are bombarded with ads on how to slim down. My question is, What can be done to put weight on? My wife, who is 79, has been losing several pounds a month. When we married 58 years ago, she weighed 118 pounds. Her weight has dropped to 111 pounds, and she has not tried to lose weight. How can she gain it back? – R.L.

ANSWER:
The first thing your wife must do is pay a visit to the family doctor. Unintentional weight loss, particularly at her age, can have ominous implications. She has to find the reason why she’s losing weight.

If it turns out that her weight loss is only a matter of not taking in enough calories, the solution is simple: eat more. She should eat calorie-dense foods, foods with small volumes but large numbers of calories. Fatty foods pack the most calories per gram, 9 calories for every gram. Carbohydrates and proteins have only 4 calories per gram. Fat calories are not just in obviously fatty foods. They’re in things like baked goods, which use a lot of shortening.

Fatty foods raise cholesterol, but someone like your wife can put the cholesterol issue on a back burner. She needs to gain a few pounds right now.

She might also try, before bedtime, a supplement like Ensure. Eight ounces of regular Ensure has 250 calories, and 8 ounces of Ensure Plus, 360 calories. Or if your wife likes milkshakes, they can put on weight if drunk on a daily basis.

DEAR DR. DONOHUE: I have what I call “eye spells.” A small blind spot appears that continues to enlarge. It has pulsating streaks surrounding it. The whole thing lasts about 20 minutes and then disappears. I have had these since childhood. What is this? – J.E.

ANSWER:
It fits the description of a migraine aura. An aura is a phenomenon that some people with migraine headaches get before they have the actual headache. Visual symptoms, just like the one you describe, are a common aura. People can also have an aura without ever getting the headache. I think that’s what you have.

Check this out with your doctor.

DEAR DR. DONOHUE: How many calories are in alcoholic drinks? I’m dieting and I drink quite a bit, so I thought I better watch those calories too, right? – M.D.

ANSWER:
Right.

An ounce and a half of 80-proof whiskey has 100 calories. Twelve ounces of beer has 150, and 5 ounces of wine has the same. The proof is twice the alcohol content of a beverage. If you are unsure of the exact nature of an alcoholic drink but you know the proof, you can obtain a rough approximation of calories by multiplying proof by the number of ounces drunk and then multiplying that result by 0.8.

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.

Readers may also order health newsletters from www.rbmamall.com


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