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How Do You Sleep? How Do You Sleep?

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Unread 04-11-2003, 10:46 PM
How Do You Sleep?

I am having such difficulty sleeping. Getting to sleep - staying to sleep...etc.

I take 1 or 1 1/2 Xanax each nite along with calcium & magnesium....

What do you ladies do to get thru a night?

Anyone pace the floor going to and from the bathroom??? ANY IDEAS??

I HATE THE NITE - it's very loney.
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Unread 04-11-2003, 11:52 PM
How Do You Sleep?

Oh I would love some answers to that dilema myself! I'm up 3 times a night to visit the bathroom and can't get a solid amount of sleep in between . Seven weeks now since the surgery and desperate for some relief. Have headaches all day long due to sleep deprivation.

I know how you feel, sweety ...sorry I don't have an answer. I'm hoping that in time the body will settle back into it's 'old' routine.

Wishing you sweet dreams very soon!
Unread 04-12-2003, 09:26 AM
How Do You Sleep?


You don't mention whether you are on HRTs or not??

Here is one of the sites pull down information about hormone symptoms etc:

Curious as to whether it is hormone related or not? You might want to vist the and see if some ladies there have any more ideas for you.

I dealt with insomnia terribly for about 6 mos after my hyst but it sounds like you have some other issues that are complicating it with the bathroom runs etc.

It would definitely be worth a call to your , the lack of sleep can play havoc on your life and is definitely a medical issue that should be addressed if long term.

Please keep us posted,

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Unread 04-12-2003, 10:29 AM
How Do You Sleep?

Will check into it- Iam on the CLIMARA PATCH - estrogen.
Unread 04-12-2003, 11:22 AM
How Do You Sleep?

ladies! Sorry you are having problems sleeping. Been there done's awful!

(((Darlene))) has given you some awesome links. I do hope you will check them out, as well as talk to your doctor. There are many avenues to take that may offer you some relief.

I, too, dealt with sleep issues for awhile pre and post hyst. Taking Elavil @ bedtime has helped me a great deal. Others have found using the Rx sleep aid Ambien for short term use helpful. Some felt better once hormones were back in check. But since we are all different, what works for one may not be the best bet for another. Your doctor will be able to assess you situation most accurately. Good luck!
Unread 04-12-2003, 01:50 PM
How Do You Sleep?

When I am up peeing - it's usually about 5 times in 6 hrs...but on bad nites - its less than an hour is all I can last. UGH
Detrol and ditropan did nothing - neither did surgery.
Unread 04-12-2003, 04:53 PM
How Do You Sleep?

Sounds like yours is more of an issue with your bladder etc than actual insomnia. You said surgery or meds didn't help, what kind of surgery did you have? Are you currently seeing a URO doc??
If you are and are still having these problems, JMHO but I would seek out a second opinion. This is a matter of quality of your life and you deserve some answers and help. Someone will listen, please don't give up on getting the medical help you need and deserve.

Keep us posted, I am so sorry you haven't had much success so far with this issue we are here for you.

Unread 04-12-2003, 10:44 PM
How Do You Sleep?

I had the rectocele and cystocele - AP repair and a sling put in to support the bladder. I tried the meds but after awhile they no longer helped.
My bladder gives me grief most nites but other nites (like now) my stomach takes over (battling stomach ulcers) and other nites I just can't fall asleep or if I do - stay asleep.
I see the pain mgmt guy Wed for my back and in a few wks the uro-gyno - so we will see if there is any hope left.
Unread 04-13-2003, 07:24 AM
How Do You Sleep?

I'm glad you will be seeing a Pain Mgmt Dr..Good Luck I take Elavil at night as well & helps me sleep..I also take Clonazepam (Klonopin) for RLS, & helps w/ sleep as well It seems like if you were to take something that really helped you sleep, it might not be a good idea since you have these bladder issues( like NOT waking up to go ) Here is some info I have on Incontinence that might be of some help??

Making the decision about treatment for urinary incontinence in women:

Urinary Incontinence in Women:

Types of Urinary Incontinence:

Possible Causes of Urinary:

What You Can Do to Help Your Incontinence:

Treatment options:

Types of Urinary Incontinence in Women

Urinary Incontinence in Women--How it is diagnosed

Treatment: Pelvic floor exercises

The most important treatment for stress urinary incontinence. Regular contractions of the pelvic floor muscles which support the urethra, vagina and uterus can cure the condition. You do it correctly when you are able to stop the urinary flow towards the end. Cone shaped vaginal weights (Kegel cones) with different size and weight is a more technical way of doing the exercises. The weight is placed in vagina and retained by muscle contraction while walking around.
Biofeedback may also be useful in re-educating the pelvic floor muscles.
Kegel cones:
These vaginal pelvic floor training weights are made from silicone. They may be boiled and sterilized in an autoclave. They are cone shaped and are delivered in a set of 6 different sizes and weights. Start with the one you are able to retain in the vagina in one minute while walking around. Use it twice daily and increase the time gradually up to 20 minutes. When you are able to keep it inside the vagina for 20 minutes, shift to a heavier one which is slightly smaller in volume. Gradually your stress incontinence will improve as your pelvic floor muscles are strengthened.

These tissue friendly rings are made from silicone and should be placed intravaginally with the knob located suburethrally in order to support the urethra and bladder neck during straining and physical activity. It works immediately and can stop urinary stress incontinence completely when it is properly fitted. An incontinence-ring may also be used after unsuccessful surgical repair of stress incontience. There are different sizes and it is therefore important that the first ring is selected by a skilful physician. The ring can thereafter be inserted and removed by the patient herself whenever needed. It may also stay permanently in vagina, but it is adviceable to remove it once a year for cleaning. These rings may be boiled or sterilized by an autoclave
Electrical stimulation:
Low-frequency maximal pelvic floor stimulation, sacral stimulation or electroacupunture on special trigger points have been shown to induce relaxation of an overactive detrusor muscle, and may thereby cure or improve an overactive bladder.

Ovestin contains oestriol which is the the weakest form of oestrogen in the body. It is an OTC preparation in the form of cream or pessaries. Oestriol rebuilds atrophic mucosa in vagina,urethra and the bladder after menopause and will prohibit dryness, dyspareunia, dysuria, burning sensation, recurrent urinary tract infections, frequency and urgency. It should be used every evening for 2-3 weeks. Thereafter, application twice weekly is sufficient as lifelong maintenance treatment. If the treatment is stopped, the complaints will recur in 3-4 weeks. Vaginal Ovestin works locally and has no serious side effects.

Tolterodin is a muscarinreceptor antagonist with a high selectivity for the bladder. It induces a relaxation of the bladder muscle by improving the control mechanisms. Bladder capacity increases and the urge to micturate declines. The slow-release capsules can be taken once daily. _
Urologic Trauma :


Stress Incontinence ~Nonsurgical Treatment :
Kegel Exercise:
Kegel exercises strengthen the pelvic floor muscles (the pubococcygeous muscle group) to improve bladder control for people suffering from stress incontinence. Success of these exercises depends on their proper execution. First, the muscle group must be located by the patient:
Begin urinating and try to stop the flow of urine without tensing the leg muscles.
Slow or stop the stream of urine. The muscles holding the urine are the correct muscle group.
Squeeze the rectal are as if to prevent gas from passing. There are two types of Kegel exercise:
Quick contractions—rapidly tighten and relax the sphincter muscle
Slow contractions—contract the sphincter muscle and hold to a count of 3, gradually increasing to a count of 10 Exercises should be performed several times, every day. Whether the goal is to improve or to maintain bladder control, exercises must be done regularly over a period of 6 to 12 weeks to be effective. Exercises should not be performed while urinating, because urine could be retained. Weighted vaginal cones can help women isolate the pubococcygeous muscles and are held for 15 minutes twice daily, while walking or standing. Biofeedback
Biofeedback is practiced with Kegel exercise to reinforce proper technique. Patients visualize and identify the pelvic floor and abdominal muscles that are contracted during exercise. A simple instrument records small electrical signals that are produced when muscles contract. The signals are instantly converted into audio and/or visual signs that help patients gain greater control over urinary muscle activity. Weak muscles can be activated on demand, tense muscles can be relaxed, and muscle activity can be coordinated. Neuromuscular Electrical Stimulation (NMES)
This treatment is used to retrain and strengthen weak urinary muscles and improve bladder control. Electrical stimulation of the pudendal nerve causes pelvic floor and urethral sphincter muscles to contract. A probe is inserted into the vagina (when treating a woman) or the anus (when treating a man) and a current is passed through the probe at a level below the pain threshold, causing a contraction. The patient is instructed to squeeze the muscles when the current is on. After the contraction, the current is switched off for 5 to 10 seconds. Treatment sessions lasts approximately 20 to 30 minutes. NeoControl™
This therapy is beneficial for women with stress, urge, or mixed urinary incontinence caused by weak pelvic floor muscles. The treatment is delivered through pulsating magnetic fields in the seat of a chair designed by NeoTonus, Inc. Patients sit in the chair for 20 to 30 minutes, twice a week. The magnetic pulses are aimed at the pelvic floor muscles through the seat of the chair and the muscles contract and relax with each magnetic pulse, much like Kegel exercise. It takes about 8 weeks of therapy to achieve some degree of continence. Medication Patients suffering from stress incontinence may benefit from alpha-adrenergic agonists, which stimulate receptors that respond to norepinephrine, a hormone and neurotransmitter. These agents should be used with caution by patients with hypertension (high blood pressure), hyperthyroidism (overactive thyroid), arrhythymia (irregular heartbeat), or angina (heart pain caused by insufficient oxygen supply to the heart muscle). Pseudophedrine hydrochloride is also found in cough and cold preparations and antihistamines. Typical dosage is 15-30 mg, three times a day. Ephedrine, epinephrine, and norepinephrine are alpha-adrenergic agonists that have many effects throughout the body and must be used with caution. Significant side effects include hypertension, tachycardia (rapid heart rate), and arrhythmia (irregular heartbeat). Hormone replacement therapy (HRT) can restore the health of urethral tissues in postmenopausal women. HRT involves estrogen to heighten bladder outlet resistance by increasing blood flow, muscle tone, and nerve response in the urethra. Estrogen is given with progestin to avoid the risk for endometrial cancer. A typical dose is 0.3 to 1.25 mg per day. HRT may benefit patients with stress or mixed incontinence.
Overactive bladder:

Urination (micturition) involves physiological processes within the urinary tract and the brain. The slight need to urinate is sensed when urine volume reaches about one-half of the bladder's capacity. The brain suppresses this need until a person initiates urination. Neurons in the brain and in smooth muscle of the bladder govern the detrusor muscle (layered smooth muscle that surrounds the bladder); it is not controlled voluntarily. The nervous system stimulates the detrusor muscle to contract into a funnel shape and expel urine, once a person initiates urination. Pressure in the bladder increases and the detrusor remains contracted until the bladder empties. Once empty, pressure falls and the bladder relaxes and resumes its normal shape. If bladder pressure remains high while the bladder is filling, the bladder contracts erratically. Normally, the detrusor muscle contracts and relaxes according to the volume of urine in the bladder and the initiation of urination. In people with an overactive bladder, the detrusor muscle contracts spastically, sometimes without a known cause, which results in sustained, high bladder pressure. People with the condition typically experience the urgent need to urinate at inconvenient times and may lose control before reaching a toilet. Overactive bladder interferes with work, daily routine, and intimacy; causes embarrassment; and may diminish self-esteem and quality of life.

Incidence and Prevalence:
Overactive bladder affects men and women equally. Approximately 20 million people in the United States suffer from the condition. Though it is not necessarily a result of aging, it most often affects older people.

Malfunctioning detrusor muscle in the smooth muscle of the bladder causes overactive bladder. Identifiable underlying causes include the following:
Abdominal or pelvic trauma or surgery resulting in nerve damage
Bladder stones
Drug side effects
Neurological disease (e.g., multiple sclerosis, Parkinson's disease, stroke, spinal cord lesions) Other conditions can produce symptoms similar to those experienced with overactive bladder, the most common of which is urinary tract infection (UTI) in women.

Signs and Symptoms:
Three symptoms are associated with an overactive bladder:
Frequency (frequent urination)
Urgency (urgent need to urinate)
Urge incontinence (strong need to urinate followed by leaking or involuntary and complete voiding)

Treatment may include one or more of the following:
Bladder retraining
Oxybutynin transdermal system
Sacral Nerve Stimulation

Oxybutynin transdermal system:

Oxybutynin transdermal system (OXYTROL™) is a thin, flexible, clear patch that is applied to the skin of the abdomen or hip, twice weekly, to treat overactive bladder. This treatment delivers oxybutynin continuously through the skin into the bloodstream and relieves symptoms for up to 4 days. Patients who have urinary or gastric retention, uncontrolled narrow-angle glaucoma, and those with hypersensitivity to oxybutynin should not use the oxybutynin transdermal system. Side effects are usually mild and include adverse reactions at the site of application, dry mouth, and constipation. Sacral Nerve Stimulation
Interstim® Therapy for Urinary Control is a reversible treatment for people with urge incontinence caused by overactive bladder who do not respond to behavioral treatments or medication. Using an implanted neurostimulation system, InterStim Therapy sends mild electrical pulses to the sacral nerve, a nerve near the tailbone in the lower back that influences bladder control muscles. Stimulation of this nerve may relieve the symptoms related to urge incontinence. Prior to implantation, the effectiveness of the therapy is tested with an external device. For a period of 3 to 5 days, the patient records voiding patterns with the stimulation. The test is done on an outpatient basis and the diary is compared to patterns identified previously to determine if treatment is effective. Candidates for InterStim Therapy first undergo a test stimulation to determine how responsive they are to the therapy. The test provides information to determine if the device is a viable treatment option, such as the effect of sacral nerve stimulation on symptoms and how the patient experiences the stimulation. If the test is successful, a patient may receive an implanted InterStim System. The procedure requires general anesthesia. A lead (a special wire with electrical contacts) is placed near the sacral nerve and is passed under the skin to a neurostimulator, which is about the size of a stopwatch. The neurostimulator is placed under the skin in the upper buttock. Adjustments to the stimulation can be made at the doctor’s office, with a programming device that sends a radio signal through the skin to the neurostimulator. An additional programmer is given to the patient to allow further adjustments to the level of stimulation, and the system can be turned off at any time.

incontinence management devices:

There are several things patients can do to help improve continence. There are several things patients can do to help improve continence.
Avoid overconsumption of diuretics, antidepressants, antihistamines, and cough-cold preparations.
Perform Kegel exercises daily.
Practice double voiding (urinate, wait a few seconds, urinate again).
Eat fruits, vegetables, and whole grains daily to prevent constipation.
Retrain the bladder (urinate only every 3 to 6 hours).
Stop smoking (nicotine irritates the bladder). A number of protective devices are available to help manage accidental urination, including the following:
Bed pads
Combination pad-pant systems
Disposable or reusable adult diapers
Full-length absorbent undergarments
Male incontinence drip collectors
Underwear liners (pads, guards, shields, inserts) Early reliance on absorbent pads may cause the wearer to accept incontinence rather than seek diagnosis and treatment. These products should be applied correctly and changed often to prevent skin irritation and urinary tract infection.

Pelvic Support Problems:

Good Luck
Unread 04-13-2003, 08:34 AM
How Do You Sleep?

I can relate to having to get up several times a night to urinate. While I can fall asleep I am usually up 4-5 times a night. Most times the flow is unbelievable also. I try not to drink water before bedtime so I don't know where it's coming from. I have been to a uro-gyn and he told me that I just have an overactive bladder.

I'm sorry you're still having problems Laur Perhaps you should contact the doc who did the repairs.

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