Hello and welcome to in good shape. There are some topics people dont like to talk about out in the open. But we in good shape we have no to we talk about everything like today im going to talk about during every incontinence some people always with their pads and others just when the cough sneeze or laugh and what you can do about it this is what im going to talk about. Here at the event. Nobody should walk around of the trolls us for almost everyone who is incontinent the roof solution. You should always drink plenty of water but many of my patients are afraid to do so because theyve got a week later and what they are also afraid off is telling their doctor but theres. The false standard for the name when talking in front of the big arm. When choosing a physiotherapist helped forty three year old yvonne bush tell to strengthen her pelvic floor she had a baby ten months ago and sought help soon after but it didnt do enough urine would still leak from her bladder when she was out running. Grass is on his first child and at four and a half kilograms she was larger than average the birth stretched and strained the muscles in her mothers pelvic area. Just a few. You know. Im a bit older so maybe thats why it happened also the length of the birth pushing for so many hours. I think that had something to do with it when the want to. Target exercises can tighten up weakened pelvic floor muscles. This in china by making the most important thing is to be able to coordinate the pelvic floor to get it under control when patients first start learning they have to make a conscious effort when theyre doing things like lifting bending sneezing coughing blowing their nose anything that creates pressure down there. And once youve learned that your brain remembers. This fire shut off we sit up straight and stabilize from bottom to top but from the sides from your back and abdomen. Yvonne now has her pelvic floor muscles back under control along with her bladder and weak bladder is a more common problem than people think. I would just feed a lot to many. People only associate it with the elderly but thats incorrect it also affects lots of young women especially after childbirth things like coughing sneezing laughing and jogging can make people urinate spontaneously and not getting appropriate treatment like physiotherapy can have long term consequences eventually surgery might be the only option but follow can demand an all party feel. Like a klein is one of the patients who needed an operation as an incontinence clinic and bone surgeon successfully inserted a small band that supports the research from below when pressure is put on the pelvic floor it works like a hammock you know you dont. Use as many bond is this small band helps replace the natural band structures you have in the pelvic floor and these natural bands normally keep the your rethrow stable and ensure your and doesnt leak out but they can become damaged for a variety of reasons especially childbirth. What when you think about how extreme stretching is and the birth canal during birth you can imagine the bodys own structures overstretching and losing function. Like a client has fond memories of her sons birth twenty five years ago but over time she became unable to cough or laugh or lift a Laundry Basket without youre an aging. The twenty minute operation has given her back from troll of her bladder and her freedom. You know my kind its i thought we dont spar now i can have fun again. And i dont have to worry about whether laughing will make me wet myself to get side what she knew was that. Its a happy ending for Yvonne Busch Belle as well the physiotherapy the safe from a life of chronic incontinence. And more perfect. In the inventors clinic in berlin and i will talk to dr to be part and head of the Rose Department for reconstructing iraq were going to talk about a week later but actually its not the bill letter which gets weak its more like the fashion. In your old you talk about incontinence that the officer wrote off catalog its not the weakness its not perfect for weakness its all together the president s are not working together if the president of the bladder is higher than the president the perfect floor it will overflow and one will be incontinent one is using your in at a time its not appropriate what about the fish is growing and we could all there are three reasons especially in female patients first lots off deliveries both because of a childs head is good for the perfect florence abiding it and the second one is hysterectomies women which have a uterus removed have removed some ligaments which are fixing the leather and the third thing is getting older getting older connective tissue the fresher theyre getting weaker and weaker and its not possible to train them we can train muscles but not the fish and there are different types of incontinence yes there are two big groups of incontinence the first one as stress incontinence stresses. Youre the pressure stress not the earth not the psychic stress the stress which is produced by the pressure of the bladder and atomic incontinence and the other thing is urgent continence because of different sensations which are going to be discord you need to hold the brain doesnt feel exactly what the bladder does and the other way around so if you suffer from those kinds of encountered in syria should see a neurologist and especially women sometimes afraid of seeing this kind of doctor so what do you do in the same nation that its everything not not painful. First we do is we make questionnaires together with the patients we have some questions which are very important to differentiate between the urgent continence and the stress incontinence we have to work down different question as for that the second thing is ultrasound we do more and more examinations by ultrasound than in the years before because of the devices for force. On the Getting Better and better and more and then the third step maybe. Thats the thing where people are afraid of today we use flexible instruments which can be very thin we make. Local anesthesia the of the. Its not painful we get a picture of the problem and then we can treat it and holding it. In pure stress incontinence most women are treated with so called tapes this is a tape theres a pulley properly in tape but there are other types of tissue also theres a lot of women can be can be healed with this simple operation but there are even bigger operation spear to perform because in the summer in some cases its not only the pelvic floor the refurbish was wrong but also the sink the muscle it surveyed socalled intrinsics think that efficiency in these Patients Want us to make artificial your notice figure and about this artificial during their use. We continue our talk in just a moment because this is applies to men too they dont like to speak the body symptoms but they suffer from it too especially after protectively. Prostate cancer is one of the most common cancers among men across the tech to male surgical removal of the prostate can cause Serious Problems with me since the operation ive been completely incontinent its not pleasant in fruits of all there was a big shock its not what you hoped for really hit my life hard. All three men became incontinent after a cross to take to me the rethread passes through the prostate gland the operation can damage both the you re threat and the blood just think which keeps the un in the bladder till one chooses to hear an eight this damage can result in bladder control problems. On the basis of recent developments were now operating on older men with aggressive tumors. From kansas are in five to ten percent of all cases and continents and including and. The artificial urinary sphincter is a treatment for severe incontinence its a device comprised of a cough that goes around the rethread a chub a pump inserted into the scrotum and a small balloon reservoir in the abdomen for the fluid that fills the cuff it takes a surgical procedure to install it all. The bleeding from these and the problem is that the patient has to operated manually he has to work the pump in his scrotum to empty the cuff of the liquid that keeps the tide loosening the car then lets him pass water. For mild to moderate incontinence there are alternative treatments involving balloons slings and cushions. The script theres no one perfect solution it depends on the diagnosis that requires a psycho skippy to evaluate the damage or defect that. Introduced about fifteen years ago involves artificial compression devices lets has been kitted out with such a system to silicon balloons filled with liquid squeeze the year rethread to keep it closed and thus prevent leakage. If its a minor procedure takes five or ten minutes under general anesthesia with a little gas this is usually enough to make the patient sufficiently consonant so that hes content quentin and some others its afraid this. Fear with food for women takes four or five weeks for the balloons to take up position. So they exert the right pressure. After about three months i had almost no leakage. First of all. The pressure the balloons exert sometimes decreases they can then be refilled with liquid in fitzgibbons case one was displaced in a bike accident because of the risk that the balloons might tear or move they tend not to be the method of choice these days. This is. The problem of balloon failure can however be dealt worth you simply replace it its a minor procedure with little impact. When i think its certainly feasible. To fuel. And has undergone balloon replacement five times. With this method the patient just needs to push with a modest amount of effort in order to your innate. A new method uses a u. V. Thrill sling and a cushion. Trance camps which to that a year ago from balloons they proved not to be right for him. He said no i dont really i was disappointed because it had seemed so promising at the start it went very well. It turned out his you rethrow had shifted a sling of soft mesh repositions the rethrow a cushion exerts pressure on the muscles surrounding it and functions as a substitute sphincter. To my shoe these are the fonder for this is an excellent arch and because the sling moves the your rethrow back where it should be. I mean that if incontinence remains an issue the question can be adjusted at any time. Through a port liquid can be pumped into the cushion or it can be drained off to increase or reduce the pressure as needed. Compass had such a device for a year and has now got used to it. Its a foreign body they put inside you but its Getting Better and im quite pleased with the result. Another option is a sling without a cushion here to the sling of mash restores the year rethread to its proper position thats often not enough to keep patients dry who have a problem with bladder control at night instead a sling plus cushion has proved more effective as in the case of man fed to unpack all their followers and weve been using this system for ten years for patients with moderate incontinence and. We found that they benefit from a sling system that also exerts pressure. In the months after the device was installed mantra do and that when back to have the pressure in the cushion adjusted a couple of times. Not. Night i remain almost dry. During the day less so. I was i think thats normal i feel quite optimistic about the future. Is a prostate operation the most common cause for incontinence hearing men. Has most men with an incontinent head of prostate surgery for want arms for the surgery for the b. Nine prosthetic hyperplasia but this operation is done in the most cases endoscopic only. Twenty thirty years ago all these devices we have to use were not so comfortable we had to look with our bare eyes through it today we have cameras we have huge screens where we can watch the surgery so we only have rare and leave the condition that the patient is incontinent after the benign prostate operation its completely different after radical prostatectomy and Prostate Cancer because of his operations the prostate has to be removed completely and it has to be divided. From the sphincter muscle its a part of the of the. Junction between your rethrow and prostate and in some cases its not possible to preserve it because the cancer is growing inside of the muscle then we have to remove it or its a senseless operation but what can we do after this is that ok just to train the pelvic floor muscles thats routine though it should be rude to you that every patient who had a prosthetic to me goes through rehabilitation camp for for three to four weeks we can train muscles but we can train all the muscles not the connective tissue between the different stricter structures and so in some cases the muscle training does not work so in this is when you need to operate again in to put in an artificial swing to thats right for these patients we have artificial urine or is filters these are devices like these they have all. Cuff around the wreath rugs there you rethrow the cuff of such not every noise they have a system to produce pleasure like a balloon like a pump and they have a problem. Where its possible to empty this fear that its release of you and the patient. Void the bladder is a lot of devices but this is more than one of more than one very different i show you here the. Only two parts this is the. This is the pump tank system which is in the straw to him and another system is its a little different like here you can see the pump of the scrotum. The cuff for the reef and two balloons to produce the treasure is a very difficult operation its a special operation that said like this is just below the skin so its not deep operation like gastric operations a little over is a. Very. Good preparation. For this we are specialized in these operations so its better to go to a center whos doing a lot of aeration go through let me know that. The socalled high Volume Centers have better results the centers will only twice or three times a year and for those devices who remain in the body they remain between twelve and fifteen years and then the silicone is worked out and its going to hold someone then one has to replace it again and this is a problem the Sexual Activity after this implant. Nor Sexual Activity maybe deteriorated by the prosthetic surgery. But that does not happen in all patients a lot of them have a normal. Function and its not. Not due to your rate about the importation of. A lot of you know those winter things are to protect for answer all my questions and if you suffer from any symptoms of incontinence dont be shy and go and see your doctor and dont be shy and writers. On an upcoming show will be looking at fertility some couple struggle to have a baby what can stand in the way of conception and what treatments are there if you have a question send it to in good shape at e. W. Dot com just right for til that he treatment in the subject line we look forward to hearing from you. Ive no idea how this microwave oven works im a physician not a physicist and usually you can sap your food within minutes but as a doctor im interested in how michael waifs dangerous for us is really asian harmful this is what we found out. About seventy percent of german households have a microwave the remaining thirty percent include many people who worry about microwave radiation are they right can microwave ovens harm your health. We paid a visit to soccer decent to find out more the university of arkansas researcher is collecting all the available scientific studies that examine the connection between electromagnetic waves of fields and human health as a kind of story and because im not aware of any studies that show that microwave ovens are harmful to human health i think most mind that you do have to make sure that microwaves meet Safety Standards and dont exceed allowable radiation limits for god but there is a concept of. Controversy over the possible Health Effects of electromagnetic waves are nothing new but people are usually more worried about cell phones and electro smoke from high voltage power lines and in that area the evidence. Of possible is more persuasive things for life that the difference might be that when youre talking on the phone youre holding the cell phone to your ear the entire time so youre exposed to the microwaves for longer because thats been for the length of that site so if youre worried about electromagnetic radiation you might want to consider limiting your time on the cell phone by comparison the risk of microwave ovens appears to be well within acceptable parameters contrary to what some people believe food heated in a microwave isnt irradiated only ionizing radiation such as x. Rays or gamma rays can do that. Microwaves are a type of non ionizing radiation actually we scientists when were talking about microwaves refer to electromagnetic fields. So is food heated in a microwave healthy to eat. We asked god to answer that question shes a Science Writer and nutrition expert who works in the field of consumer protection. It depends on what kind of food youre preparing in the microwave microwave ovens arent inherently good or bad. What happens when foods that are good for you a heated in a microwave like broccoli for example. One spanish study thats been circulating online reported that microwaving broccoli destroyed most of its flab annoyed if true that would be problematic. As it was that there is evidence that secondary fighter chemicals can help prevent cancer so of course we want to preserve them in foods. Or plants and how the karata know its that give plants their vibrant colors are plentiful and fresh fruit and vegetables. And. Asked to examine the study hes an expert on Food Processing at the university of decent. Study exactly what happens to broccoli in a microwave oven. Electromagnetic waves in a microwave supposedly only affect one component found in broccoli the water it contains. So does heating food in a microwave destroy certain new trends. And his Research Team found no evidence of that. But they did discover that broccoli heated in the microwave contains less fat soluble vitamins than if the vegetable is steamed or boiled the heating process that takes place during cooking releases the broccolis fat soluble vitamins and that doesnt happen even early in the microwave. Microwave energy is focused on areas where theres water wherever theres less water like deeper inside the food or in the thick broccoli stock it doesnt work quite as well for example a levels are higher when broccoli is steamed or boiled than when its cooked in a microwave. That leaves us with one more question does food cooked in a microwave taste different in some way. After all microwaving food isnt usually considered the height of color in a refinement. So is there any truth to that or is it just snobbery. Has also investigated how microwaving food affects its flavor and consistency to be on even warming has an effect. On the surface there are spots where the broccoli is too dry or where its overcooked and no longer. Looking at the color and texture around the mouth microwaving food produces what you might call an acceptable result but certainly not an outstanding. But if youre just reheating food and not cooking it the microwave can be a good option and a practical one. When you want it fast a microwave oven is a good compromise but for optimal flavor you might want to cook the conventional way or just. Well. I dont need it because im married. To my wife on t. V. Thing. I felt robotic m. L. Keep learning merge to reality wait a second we want the whole picture i expect some sort of make idea shift deliver us. From a measure to reality to cryptocurrency your topics for live in an ever changing Digital World lets talk to devise a sure fire shift. D. W. To. Recycle the right way. Ghanas biggest electronics term cat has just gotten green. With german assistance its introduced recycling lead. 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