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Lewes, Delaware
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April 4, 1997     Cape Gazette
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April 4, 1997

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CAPE GAZETTE, Friday, April 4. April 10, 1997 - 29 HEALTH & FITNESS Hospital gift shop busy providing cheer Something is available for everybody at the Beebe Medical Center Gift Shop. The gift shop is operated and staffed by the Beebe Medical Center Auxiliary. Thirty-five to 40 volunteers staff the shop Monday through Saturday, on three shifts, from 10 a.m. to 7 p.m. and on Sundays and holidays from noon to 4 p.m. From the manager, buyer and staff, the entire opera- tion is strictly volunteer and the gift shop averages a minimum of 100 customers per day. Items sold in the shop include Russell Stover candies, fresh cut and silk flower arrangements, Russ Berrie stuffed animals i and dolls, women's apparel, infant wOar, men's pajamas and accessories, sundries,- greeting cards, mylar balloons, magazines, candy bars, gum and Lifesavers, handbags, jewelry, and other seasonal items. Several new items have been added re- cently. Now the shop has a variety of col- lectibles, including porcelain dolls and Jeff EIIingsworth photo numbered and signed wooden collectiblcs. Something for everyone can be found at the Beebe Medical Center Gift Volunteer gift shop staffers are Nancy Shop. Operated and staffed by the Beebe Medical Center Auxiliary, the shop carries a wide variety of items including candy, fresh cut and silk floral Connor, manager; Martha Tutak, buyer; arrangements, stuffed animals, jewelry and greeting cards. Shown getting and staff members Barbara Allen, .nn ready to stock the store for spring (l-r) are Beebe Medical Center Auxiliary Baker, Marian Barr, Irene Bentley, Mary Gift Shop Manager Nancy Connor and volunteer gift shop staff members Lee Buchanan, Gloria Dill, Grace Crum, Gwen Fisher and Dee Williams. Ruth Deppe, Ruth Evans, Gwen Fisher, De-. lores Hogan, Nancy Grasing, Francis Ha- ley, Nancy Hallock, Betty Harant, Peggy Scheck, Madelon Kidwell, Doris Lauer, Dorothy Marshall, Edna Murphy, Elizabeth Noderer, Helen Shaffer, Marge Zayatz, .Barbara Peterson, Della D'Agostino, Marge Santoro, Betty Surbaugh and Marge Wiley. The gift shop also features a "used book" cart which is located outside the shop. Any- one wishing to donate books should drop them off during gift shop hours. The auxiliary is now selling chances for a three by five foot hand-hooked area rug to be raffled off at the organization's yearly luncheon on Tuesday, May 6 at Rehoboth Beach Yacht and Country Club. Auxiliary • member Gwen Fisher said the rug is worth between $1,200-$1,500. Raffle chances are $1 each or six for $5 and can be purchased by contacting an auxiliary member. The auxiliary was founded in i936 to promote and advance the welfare of Beebe Medical Center. Membership is open to both men and women, and meetings are held the first Tuesday of each month, Sep- tember through April, in the hospital con- ference rooms. For more information, or to become a member of the auxiliary, call 645-3344 or 645-3307. voluntarily commit themselves to a life sentence of house arrest. Their crime? Incontince. • "For a lot of women, inconti- nence has a greater social impact than diabetes or heart disease," said Urologist Delbert J. Kwan, M.D. "A person with diabetes can still go out and play golf and en- joy activities, but a person with in- continence often cannot." Incontinence imprisons more than 30 percent of women nation- wide, with an economic toll of an estimated $10 billion spent yearly on various products. Those who do venture outside their homes of- ten severely restrict their lifestyles. "They don't go on car trips or go out, and if they do, they be- come a 'connect-the-dot-to-the- bathroom' person," Kwan said. "They can tell you where every single bathroom is in the mall." Fortunately, there are effective treatments. Unfortunately, many women do not seek help because • they accept incontinence as an in- evitable part of aging or are too embarrassed to discuss the prob- lem with their doctors. "Physicians are now more sen- sitive and are asking, 'What about your* I bladder?' as part of a  routine exam," said  Gynecologist Vin-[ t-: I cent Killeen, M.D. KILLEEN Killeen said his practice sees many women suffering from stress incontinence - involuntary urination following sudden ab- ing, sneezing, or lifting - and not just during pregnancy. "We see 25 to 20 percent of reproductive age women experiencing stress incon- tinence. With post menopausal women, it jumps to almost 40 per- cent." "We know aging affects the body," Kwan said. "Certainly the decline of estrogen can play a part, but incontinence Should not be accepted as a natural conse- quence of aging." Kwan explained that while male and female incontinence have similar physiologies (the blad- der's inability to store urine and/or control its elimination), they have very different causes. Most male incontinence is related to the prostate, while female in- continence can usually be traced back to childbearing. The most important difference, he said, is social - men seek immediate med- ical treatment while women view incontinence as inevitable. "We use the analogy that women accept incontinence with age as men accept impotence with age," Kwan said. In addition to stress inconti- nence, patients may suffer from urge incontinence, when the sig- nal to void is sudden and uncon- trollable; from overflow inconti- nence, in which the patient has no urge to void but is constantly wet. Kwan said that although the largest percentage of female in- continence results from damage to pelvic muscles and ligaments dur- ing childbirth, especially when longed, there are usually multiple factors, so treatment begins with a very detailed ten-page history, in- eluding a 'voiding diary.' The questionnaire provides valuable clues, especially when incontinence is the result of com- bining prescription drugs (espe- cially anti-depressants, anti-hista- mines, antiarhythmics, and opi- ates), which can raise urine pro- duction, weaken muscle control or increase the urge to void. Changing medications and dosages may bring relief. Hor- mone replacement therapy can be prescribed when an estrogen defi- ciency has affected muscle tone. In some cases, incontinence is directly related to limited mobili- ty. A woman crippled by arthritis or a degenerative disease, for ex- ample, may not move quickly enough to reach a bathroom in time. Simply placing a portable commode within easy access may solve the problem. Incontinence may also be the result of scarring from prior surgery or radiation. Another cause is stress to abdominal mus- cles from obesity, occupations re- quiting heavy lifting, constipation or chronic coughing from smok- ing or pulmonary disease. "Just as incontinence has multi- ple factors, there are multiple treatments," Kwan said. It is important for women to un- derstand, he explained, that self- treatment can aggravate, rather than alleviate, incontinence• Many simply rely on external protection: feminine sanitary pads sold are used for incontinence and "adult diapers" are readily available. Most women with itcontinence Severely reduce their liquid in- take. Others limit their activity. Constant exposure to wet pads can cause skin irritation and even tissue damage. Restricting liquids can lead to dehydration or possi- ble kidney disease. Insufficient liquid intake con- centrates the urine,!making it more acidic and more :likely to ir- ritate the bladder, which in turn, increases the risk of infection. Re- ducing liquids and restricting ac- tivity leads to constipation, which can encourage incontinence by stressing bladder walls and pelvic support muscles. According to Kwan, women who curtail social activities be- cause of incontinence often suffer from clinical depression. Their fears of being "unclean" or of los- ing control cause many women to avoid all physical contact, which also contributes to depression. In- continence's impact on a woman's sex life is another factor. "We try to get at that impact on their lives," said Kwan. "Women can gain control of their lives and live as fully as possible." The first step is to rule out or treat infection, the second is to test for diabetes and kidney disease. Next, the doctor evaluates a pa- tent's voiding habits. "I tell women not to be a 'woman of the 40s' and hold their urine until they burst," said drink plenty of fluids and empty your bladder every two hours and keep it empty." Treatment also includes an • evaluation of the patient's diet. A balanced diet, which provides enough soluble fiber to relieve constipation, may also alleviate bladder dysfunction. Consuming enough water to di- lute the urine can minimize irrita- tion. Many people are aware that alcoholic beverages, citrus juices, caffeine and carbonated beverages irritate the urinary tract. Most do not know that rather than aiding bladder health, cran- berries and cranberry juice can ag- gravate an irritated bladder• Chocolate, very spicy foods, and nicotine are other irritants. Continued on page 31 HEALTH TOPICS DELBERT KWAN, M.D, Delbert Kwan, M.D., is an urologist practicing with R.U. Hosmane, M.D., on Sa- vannah Road in Lewes. Is incontinence a Woman's self-tmposed prison? Each year, thousands of women dominal pressure such as laugh- babies are large and labor is pro- it is estimated that 33 percent of Killeen. "For good bladder health,