Saying Goodbye

The past few days have been sombre and reflective as the staff at Castle Medical Centre pay their goodbyes and last respects to Dr David Rapley, our previous partner, who passed away after a long illness. Dr Rapley dedicated an incredible 33 years to the practice. He was a rare, gifted medic who made the profession his vocation and used his clinical expertise in an inimitable style with huge doses of humour, kindness and common sense for treating his patients. He will be remembered fondly as a man of wisdom, an inspiring teacher, avid sports fan and a GP par excellence by his colleagues and patients. Teaching and training were his lifelong passion, David always said ‘make every opportunity a learning event for personal and professional development’.

As a small tribute to his enthusiasm for learning, below is an updated article which he taught us in the past and has much relevance today. May his spirit continue to guide us.

Bladder Incontinence

Bladder incontinence affects one in two women over 50, impacting daily activities and quality of life.

A bladder incontinence symptom is a urine leak due to laughing, running, coughing or jumping, the so-called stress incontinence. Women also have leakages due to an urgency to find a toilet, waking up multiple times in the night and always worried about finding a toilet in time when out and about. This is called urge incontinence where a specific muscle in the bladder goes into spasms initiating an urgency to pass urine. Some women have both stress and urge incontinence.

Most women do not present to their doctors as they see this as embarrassing. Although 60-80% of incontinence can be resolved easily without the need for invasive methods of management.

Conditions like chronic constipation, high body weight, poor pelvic floor tone due to childbirth or prolapse, excessive coughing, urinary infections, excessive caffeine or alcohol, diabetes and menopause are some of the major triggers of urinary leakage. And almost all the above conditions are remediable.

Check if you are drinking acidy or high sugary drinks daily, these irritate the bladder and cause overactivity leading to incontinence. If you have incontinence, try drinking only water. The NHS website on incontinence gives a list of bladder friendly fluids which includes milk if you are not dairy intolerant. Excess alcohol has the same effect of acting as a diuretic and can worsen incontinence.

Pelvic floor exercises help tremendously, especially under a pelvic physiotherapist guidance. The NHS Squeezy app is a helpful self-instructing pelvic floor exercise guide which can be downloaded to your phone or laptop, which has helped a growing number of women to become incontinence free. Pilates for pelvic floor toning is also helpful.

Avoiding constipation and maintaining a healthy body weight also resolves many episodes of urinary leakage. Hormone replacement therapy is also helpful for many women with incontinence.

Please contact your doctors if you have these symptoms.

Dr Suparna Behura FRCGP
Partner and Trainer

Monday-Friday – 8.00am-6.30pm
Tel – 01926 857331
www.castlemedicalcentre.co.uk
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Twitter – @Castle_Med
22 Bertie Road, Kenilworth, CV8 1JP