Masalah OAB

Kerap kencing tanda sakit

Ramai rahsiakan derita buang air kecil yang jadi petanda pundi kencing bermasalah

TAHUKAH anda, kekerapan membuang air kecil sebenarnya turut menentukan tahap kesihatan pundi kencing anda? Lebih sukar lagi, keinginan atau gesaan membuang air kecil bukan sekadar masalah kecil tetapi turut menjadi petanda anda berkemungkinan besar mengalami gejala dikenali pundi kencing terlalu aktif atau Overactive Bladder (OAB).

Apa yang dikesali, majoriti mereka yang mengalami masalah kesihatan ini lebih sanggup menderita dalam diam daripada berkongsi dengan rakan-rakan rapat, keluarga mahupun pakar kesihatan. Alasan mereka – malu atau menganggap ia sebahagian daripada kesan atau proses peningkatan usia. Masalah sukar kawal kencing (incontinent) atau inkontinens itu turut menjejaskan kehidupan seharian.

Ramai yang salah faham mengenai masalah ini apabila menganggap OAB sesuatu yang lumrah padahal ia sebenarnya boleh dirawat. Tindakan membiarkan masalah itu berlarutan sebaliknya boleh mengundang padah kerana ia menjejaskan kehidupan lelaki dan wanita pada semua peringkat umur.

Silap jika ada yang beranggapan masalah ini cuma dihadapi mereka di peringkat usia lanjut kerana gadis remaja pun tidak terkecuali. Kajian yang dilakukan ke atas wanita di 11 negara di Asia mendapati 53.1 peratus individu berusia di antara 29 hingga 59 dibelenggu masalah itu.

Apakah puncanya OAB ini? Ia disebabkan keadaan pundi kencing yang terlalu aktif sehingga menyebabkan pesakit perlu kerap ke tandas.

Tanda-tanda paling penting OAB adalah rasa terdesak untuk buang air kecil, diikuti kekerapan dan perlu bangun sehingga dua kali atau lebih pada waktu siang atau malam untuk kencing.

Bagaimanapun OAB juga wujud pada individu yang mempunyai sistem saraf yang normal. Sebagai contoh jangkitan saluran kencing, batu karang atau ketumbuhan pundi kencing boleh menyebabkan aktiviti melampau pada otot ‘detrusor’ yang membawa gejala OAB. Apapun, punca sebenar yang menyebabkan OAB masih tidak dapat dipastikan.

Pakar urologi dan Presiden Yayasan Kontinens Malaysia (CFM), Dr Peter Ng, menjelaskan OAB boleh dilihat berdasarkan tiga ciri utama iaitu kekerapan, terdesak/gesaan dan bangun malam (F.U.N Frequency Urgency and Nocturia).

“Kekerapan bermaksud pesakit OAB berulang ke tandas berkali-kali manakala terdesak/gesaan menjelaskan rasa terdesak untuk membuang air kencing yang sukar ditangguh. Bangun malam pula merujuk kepada perbuatan sering bangun malam untuk membuang air kecil. Antara semua tanda-tanda ini, kekerapan adalah gejala yang paling penting dalam membuat penilaian OAB.

“Keadaan ini bukan saja merimaskan malah menyusahkan pesakit. Bayangkan mereka terpaksa ke tandas sebegitu kerap. Malah rasa gelisah sering melanda apabila mereka terpaksa melakukan tugasan penting seperti bermesyuarat sedangkan mereka asyik ke tandas.

“Selain itu, tidur dan rehat pesakit dan pasangannya juga boleh terganggu kerana sering terbangun malam untuk buang air kecil,” katanya selepas pelancaran sejenis pil bagi melegakan OAB keluaran GlaxosmithKline (GSK) yang dikenali Vesicare (Solifenacin succinate), baru-baru ini.

Menurutnya, masalah itu menyebabkan penghidap OAB terpaksa remeh memikirkan lokasi tandas berhampiran tempat dituju.

“Akibatnya, mereka rasa tertekan, menyisihkan diri dan mengehadkan aktiviti yang menyebabkan kesejahteraan dan kualiti hidup terjejas,” katanya.

Jelas Dr Peter lagi, ramai yang menghidap OAB keberatan untuk mendapatkan rawatan walaupun sekian lama terganggu akibat desakan untuk ke tandas. Ada yang malu untuk membincangkan secara terbuka manakala ramai yang menyangka ia adalah sebahagian daripada proses penuaan dan tidak perlukan perhatian dari segi perubatan.

“OAB adalah penyakit yang disahkan dan boleh dirawat dengan bantuan perubatan. Malah amalan senaman yang betul seperti senaman Kegel untuk melatih otot pelvik; melatih otot vagina; stimulasi elektrikal lantai pelvik selain terapi untuk melatih tabiat buang air kecil yang lebih sistematik boleh membantu,” katanya.

Jenis ubatan yang digunakan untuk melegakan masalah kesihatan ini ialah Oxybutinin (Ditropan), Tolterodine, Darifenacin dan terbaru dalam kumpulannya ialah Solifenacin atau Vesicare.

Fakta: Faktor risiko OAB

# Usia yang lanjut (20 peratus populasi berusia 70 ke atas mungkin akan melaporkan tanda OAB)
# Strok
# Kecederaan saraf tunjang
# Dementia
# Penyakit Parkinson
# Diabetes
# Pembesaran prostat
# Pembedahan prostat
# Hamil kembar

INFO: Tip tangani OAB

# Ambil kira jumlah pengambilan cecair dan waktu pengambilannya.
# Jauhi minuman kafein.
# Amalkan pengambilan makanan yang kaya dengan serat atau ambillah makanan tambahan yang berserat.
# Latih pundi kencing untuk melewatkan sedikit gesaan ke tandas apabila terasa ingin kencing.
# Sesetengah orang berhadapan dengan masalah untuk mengosongkan pundi kencing dengan sepenuhnya. Justeru, tunggu beberapa minit selepas membuang air kecil untuk membuang air kecil kali kedua. Ini bagi memastikan pundi kencing benar-benar kosong.
# Jadualkan waktu untuk anda membuang air kecil setiap hari. Misalnya, setiap dua atau tiga jam sekali. Ia lebih baik daripada anda ke tandas hanya selepas terasa ingin membuang air kecil.
# Lakukan senaman otot lantai pelvik bagi menguatkan otot berkenaan dan saluran kencing anda.
# Pakai pelapik seluar dalam bagi mengelakkan anda terkucil.
# Kekalkan berat badan yang ideal.

Oleh Suzan Ahmad

Happy heart

The Secret to a Happy Heart

by Hillari Dowdle

Photography by: Thayer Allyson Gowdy

Your doctor knows the keys to preventing heart disease, and chances are so do you. They are straightforward and well publicized: eat a healthy diet, exercise often and reduce your stress load. Sounds easy. So why aren’t more of us making these changes? Why is heart disease still the leading cause of death among women in the United States? Put these questions to Thomas Yarema, M.D., a physician in Aptos, Calif., and he’ll give it to you straight: “The reason that the American Heart Association’s recommendations often don’t work is that many people simply don’t groove with them.”

To have a healthy heart, Yarema explains, you have to have a happy heart—and that means finding a way to make lifestyle changes in a way that brings well-being, rather than a feeling of deprivation or punishment. Yarema is also an Ayurvedic practitioner and says that the ancient Indian “science of life,” or Ayurveda, can help Americans navigate good heart health and lifestyle changes more joyfully.

In Ayurveda, your physical, mental and emotional characteristics clue you in to your dosha—one of the three energies that govern everyone and everything: vata (air), pitta (fire) and kapha (earth). Each of us is predominantly one “type,” and we see optimal results when we make changes that jibe with our tendencies. The standard recommendations on heart health—with its emphasis on a low-fat diet and vigorous exercise—is really aimed at only kaphas, Yarema says. “When you’re handing out the same lifestyle advice to everyone, you’re only hitting the mark one-third of the time.” Know your type, on the other hand, and you’ll be able to choose changes wisely—and focus on what will not only make you happiest, but also give you the best results.

VATA: THE CREATIVE TYPE

Body type: Ectomorph, thin, long and lean
Emotional tendency: Anxiety
Biggest heart risks: Arrhythmias, palpitations, tachycardia and vascular spasm
Heart-health focus: Stress reduction

You’re a vata if
Your energy comes and goes in quick bursts.
You’re prone to digestive issues like constipation or gas.
You love cold, dry, windy weather.
You feel anxious and fearful when you're stressed.
You have a hard time falling or staying asleep.
Your skin is dry, thin and prone to fine lines.
You sometimes forget to eat.

FOR ARTISTIC vata types, every moment is a new adventure. These expressive individuals are always on the move, traveling through life from one pursuit to another.

Vata’s motion-driven, highstrung nature has direct consequences for heart health. Research published in the Journal of the American College of Cardiology in 2008 found a direct link between anxiety and heart disease—men who tested high (in the top 15 percent of study participants) on four separate scales for anxiety had a 30 to 40 percent increase of risk for heart attack. Less is known about how anxious women fare, though the problem is likely to be as prevalent if not more so, since it’s well documented that women are more likely to suffer from anxiety than men. Indeed, many female heart attacks are misdiagnosed as panic attacks, says Jane Schauer, M.D., a cardiologist in Albuquerque, N.M. who has embraced Ayurveda as an adjunct to her practice. And women are far more likely than men to suffer from palpitations, arrhythmias, and the kind of vascular spasm that can lead to broken heart syndrome (a condition brought on by a surge of stress hormones).

The key to keeping these creative types healthy is to focus on creating calm. “The vata mind is like a pinball machine. Vatas love to be stimulated—but then it’s easy for them to get completely overwhelmed,” explains John Douillard, D.C., Ph.D., Ayurvedic practitioner and founder of LifeSpa in Boulder, Colo. “The most important thing vatas can do for themselves is get on a good quality routine and stick with it to create a little more regularity in their lives.”

Focus on stressing less
Ayurvedic experts agree: The single most important thing a vata type can do for heart health is to adopt a stress-reduction program. Learning new ways to deal with anxiety when it does come up can help a vata type handle it in stride. But don’t bother telling a vata to sit still and calm down—their restless nature will often resist, say, seated meditation. Better to give them something to do with all that nervous energy. Slow and gentle breathing exercises are perfect, explains Claudia Welch, D.O.M., an Ayurvedic practitioner and educator in New Mexico, because they calm the nervous system.

Alternate-nostril breathing:
1. Find a comfortable seated position in which you can sit upright without fidgeting. Establish a regular breathing rhythm—breathe deeply, but don’t force it.
2. Block the right nostril with your right thumb, and exhale deeply through the left nostril, then inhale deeply. Close the left nostril with the pinky finger of your right hand, and exhale completely through your right nostril.
3. Still holding the left nostril closed, inhale through the right nostril. Then block the right nostril with the thumb as you exhale through the left. Then inhale through the left, switch and exhale through the right.
4. Keep breathing in this pattern, alternating exhaling and inhaling with your left and right nostrils. Finish on an exhalation through the left nostril. Drop your hand, and relax deeply for several seconds before you get up and continue with your day.

Other heart-health moves for vata types:
FITNESS FIX: Get creative with your workouts Instead of hitting the gym five days a week, vatas should mix up their exercise routine by dancing. “A vata likes to be creative, emotionally expressive, and spiritually uplifted,” says Yarema. “Dance is perfect. Inwardly, vatas always know they need to dance, but sometimes you have to give them permission to do it. Once you do, they’ll say, ‘Yes! I’ve always wanted to do that.’ ” Sign up for salsa or ballroom dancing lessons, find a NIA or Zumba class, or join a local dance circle.

DIET DO’S: Reach for healthy fats
Surprisingly, vata types need food that can help weigh them down a little. In contrast with other types, they often benefit from adding more fats into their diet (choose healthy monounsaturated fats, such as olive or flaxseed oils, or use ghee, clarified butter). You should choose foods that are warm, soupy or heavy; root vegetables are especially grounding. Avoid the salad bar, especially when stressed, as it features cold, dry, rough foods that make a vata feel unbalanced.