Day 19 - physio and the outside world

An exciting day today - a trip into town to see the physio and then we're having lunch out as well. First time for a long time! 

The physio visit was very illuminating. After checking my pelvic floor action with an ultrasound it looks like I am overdoing it with my clench, which is probably tiring out the pelvic floor muscle. This is probably because I am doing whatever I can do prevent any leakage, whereas in reality I should be trying to exert the minimum work required to prevent leakage. Getting the balance right could lead to more leakage in the short term but will help manage control in the longer term. I understand that on a theoretical level but it's a hard one to implement. Now is the time to be trying it though as I am generally at home alone and have plentiful pads that I can change as required. 

Another reason for the small volumes could be due to bladder irritation. The muscles around the bladder detect movement in the bladder and send signals to the brain when it starts to get full, and if the bladder is irritated then it can send misleading movements to the muscles and lead to incorrect messages. What can cause irritation? Mainly caffeinated drinks, carbonated drinks & alcohol. What do I drink throughout the day? Coffee, tea and sparkling water (but no alcohol). So I need to cut back on the irritants and see how that effects things as the Soda Stream adverts on TV taunt me. It's not an 'all or nothing' change so I'll still stick with a couple of morning coffees but then I'll drink flat water all day (it can still be cold) and have decaffeinated tea or coffee if I fancy a hot drink. To add insult to injury, sour & spicy foods can also have a negative effect so I'll need to stop ladling hot chilli onto everything I eat. 

Because of this there's no need to look at bladder training right now, and in fact I should back off on my pelvic floor exercises and work on quality more than quantity. 

From a physical activity perspective I'm being as active as I should be right now in the recovery process (and probably a little bit more) so no major changes there.I was also given some pelvic floor relaxation stretches which look to be yoga-derived, and it's nice to be doing some gentle stretching  again. 

While I was there I also caught up with the prostate cancer nurse for a good conversation on how it's going mentally. She passed on some resources about erectile disfunction that I will dig into over the next few days - that will be the next battle on my list and possibly even harder to write about than the incontinence.

Lunch was lovely although I ended up drinking caffeinated green tea, fizzy soda and eating spicy food. I still didn't need to use the loo for a few hours afterwards, which I thought was strange until I realised we had been walking around up steep hills in the early afternoon sun. So that's another reason why you'll be using the loo a lot after surgery - you're not doing much to absorb the water into your body. If you're used to being physically active in your day-to-day life then you'll probably be used to drinking more water than you need during recovery and that will be flowing right through you.        

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