Postpartum Incontinence

When most people think about changing diapers in the months after giving birth, they're probably thinking about their newborn. But a surprising number of women find themselves thinking about adult diapers, too. That's because most women experience incontinence to one degree or another following delivery. A new survey by Aeroflow Urology found that nearly 90% of new mothers experience incontinence - some of them, significantly. 

Today's guest is Aleece Fosnight, a board-certified physician assistant specializing in incontinence conditions and a medical advisor for Aeroflow Urology, and she shares insights from the survey along with valuable advice for those who are pregnant or thinking about becoming pregnant. 

To visit Aeroflow and learn more about the Diaper Divide, click here.
To visit the National Diaper Bank Network, click here.

To learn more about the National Association for Continence, click here, and be sure to follow us on Facebook, Instagram, Twitter and Pinterest.

Music:
Rainbows Kevin MacLeod (incompetech.com)
Licensed under Creative Commons: By Attribution 3.0 License
http://creativecommons.org/licenses/by/3.0/

Incontinence products are a necessity, but they can cost hundreds of dollars per month. That's why we’re partnering with Aeroflow Urology. They provide free, medical-grade continence supplies through eligible insurance. Plus, they'll send your supplies right to your doorstep with their discreet, monthly deliveries. To see if you or a loved one qualifies, visit aeroflowurology.com/NAFC.

Transcript

The following transcript was generated electronically. Please let us know if you see any transcribing errors and we'll get them corrected immediately. 

Bruce Kassover: Welcome to Life Without Leaks, a podcast by the National Association for Continence. NAFC is America's leading advocate for people with bladder and bowel conditions, with resources, connections to doctors, and a welcoming community of patients, physicians, and caregivers, all available at NAFC.org. 

Welcome back to another episode of Life Without Leaks. I'm your host, Bruce Kassover, and joining us today is Sarah Jenkins, the Executive Director for the National Association for Continence. Welcome, Sarah. 

Sarah Jenkins: Thank you. Glad to be here, Bruce. 

Bruce Kassover: Yeah, we're looking forward to it. Today our guest is Aleece Fosnight. She's a good friend of the podcast. You've probably known her from some of the other episodes we've done with her. We've talked about things like men's health and prostate and BPH. We've talked about mental health, anxiety, absorbents, the diaper gap, and she's a board certified Physician Assistant specializing in sexual medicine, women's health, urology, and she's also a medical advisor for Aeroflow Urology, which is a trusted partner for the National Association for Continence. So welcome, Aleece. Did I get everything right there?

Aleece Fosnight: You did great, Bruce. Thank you so much for that introduction. 

Bruce Kassover: Excellent. I'm glad to hear it. I'm glad I got something right today. So, now, I understand that you guys over at Aeroflow have recently done a big survey about postpartum conditions that women go through. Now, tell me this. What's the first word or first thing that people think of when they hear the word postpartum? 

Aleece Fosnight: I really do think for individuals, when people think about postpartum, I think a lot of it actually has to do with mental health. You know, we hear a lot about postpartum depression, postpartum anxiety is now becoming a bigger topic of conversation that we didn't necessarily discuss or have conversations with before.

And there is, I think, now we are having a lot more conversations around pelvic health and what that means for postpartum individuals. A lot of times there is changes that are occurring that people again, continue to think are, are normal. And if you've listened to me any times on these past, you know, podcasts, I always talk about the difference between something that's normal and something that's common.

And so the postpartum period really is up to, you know, a year after delivery. And so it's not just the six weeks that it is when you go back to your, you know, OB to make sure that uterus is getting down to the size that it needs to does and that you're not having any bleeding issues, but it's more beyond, it's beyond that.

And we need to do a much better job of incorporating more frequent postpartum visits with our OBGYN. You take your baby, right, to all of those visits within that first year, and that pediatrician is going to be able to do some screening for you as the parent, but really it goes beyond that, and we need to be doing better and having more conversations on the pelvic health front.

Bruce Kassover: Yeah, that's really interesting, because I would imagine that when most people hear ‘postpartum,’ the first thing that comes to mind is depression, and you know, occasionally you hear terrible stories that make the news about, you know, people who go through very, very significant things, episodes, but I would imagine that that far more common is a sort of acquired type of postpartum depression that, you know, affects people on a personal level, on a family level, but doesn't really go beyond that. I'm wondering, in your practice, do you, do you see a lot of women who are just dealing with that postpartum issue? 

Aleece Fosnight: So our practice, we actually don't see any obstetrics patients. But being a mom myself and having lots of colleagues that do work in that space, it is something that is really near and dear to my heart that I do want to pay attention to. And this is a silent condition and concern that so many women are dealing with. And so again, it's, it's, you know, again, beyond just, you know, depression, right? It's also some of these baby blues. It's mixed between depression and anxiety that people are feeling. And what again, we don't talk about as the incontinence or the overlap, and incontinence, too, that's actually worsening a lot of the depression and anxiety with these individuals as well. If you are struggling to also wear a diaper yourself and diaper your baby, that can be a big struggle and a mental health concern for so many individuals. 

Bruce Kassover: It's interesting to hear about postpartum anxiety as sort of a, a separate but related category. You know, what is it about that's different than when you think of typical postpartum depression?

Aleece Fosnight: So, the anxiety really comes from being able to take care of your kiddo, and the lack of support that women have after they have a baby contributes a lot to that. We do things pretty backwards here in the United States from different, other cultures and communities that are out there. There's a lot more community after somebody has had a baby in other countries and around the world. And we just don't see that here in the States. A lot of families are separated, right? And so you're not having like your mom or your, you know, other family, extended family members nearby that can come help you to make dinner for you to help with the other kiddos that you may have if you are in a partnership that your partner is working, right?

And so they're not there. They're out at their job. So there can be a lot of this overwhelm that those individuals are feeling in that postpartum timeframe and even having postpartum or, excuse me, anxiety during pregnancy can definitely happen to as this unknown of what's going to happen after you deliver, we definitely see that for moms that are, that are first time moms, but we also see this for repeat offenders who are having their second or even third babies that now this overwhelm is much greater and those kiddos are still some sometimes really little. So now, not only are you having to take care of a newborn, but you're also having to take care of the 2, 3, 4 year old that's there also – and take care of yourself at the same time, right? Especially if there has been surgery that has happened, we forget that a Caesarean  section is a big abdominal surgery and recovering from that is huge. 

Now you throw on if somebody is able to lactate or they are, you know, chest breastfeeding their child also, that's a whole other thing, you know, to think about mastitis, what about your milk supply? Am I going to be able to feed the baby? So, right. So this, this cycle of being able to go through all of these thoughts in your head is leading to that anxiety piece of it and knowing where to go for help, right?

You're going for your six-week postpartum checkup, that's it. Where do you go? Where, who are you supposed to call? Who are you supposed to talk to? And again, it's beyond just taking your baby to the pediatrician.  

Bruce Kassover: You know, as I, as I hear you sort of, you remind me of when, when I was a father for the first time also, all of the different things you have to worry about, and I, I'm sort of amazed, now that you think about it, that everybody who has a child doesn't have clinical anxiety, essentially. 

Aleece Fosnight: Yes, absolutely. Absolutely. 

Bruce Kassover: Yeah, and it would certainly be nice if we had something more like a European model where you have, you know, a year of maternity leave and paternity leave as well. I imagine that would be a big factor in helping to ease people's anxiety. But you know what? We have what we have. So I guess what we need to do is figure out the best way to deal with that. And that brings us to this poll that you guys did at Aeroflow. So what did you find about pelvic health and bladder health in women who've recently given birth?

Aleece Fosnight: So the Aeroflow survey went out and we were able to get just over a thousand respondents. So, female-identified individuals that filled out the survey. And these were individuals that had given birth within the past four years of completing the survey. And what is striking, right, is that nearly 90 percent of those respondents had experienced postpartum incontinence, right? So just, basically, so you're almost talking 100 percent, right, of respondents. So nearly 90%. I think it was like around 88 percent – or just over – the respondents had had postpartum incontinence with that. 

Bruce Kassover: That's really surprising. And I imagine that a lot of women are never even told that this is something that they're likely to experience, aren't they?

Aleece Fosnight: Oh, absolutely not. The focus is a lot on baby. And I don't, that's not a wrong thing to do, but I really encourage advocacy, self advocacy for yourself when you are talking to your provider, but a lot of times you don't know the questions to ask. And I am super big on prevention, right? And helping to implement services, techniques, appointments, caregiving teams ahead of time that potentially could support you through this process.

I'm a, I'm a mom of three. I'm, ten, eight, and five, and I will tell you that I was not immune to the lack of conversations and awareness. And I thought, me as a health care provider was going to just know all of this. And I think I got even more pissed off after I had my first baby that I was like, I'm sorry, why didn't we have this conversation?

Or why do I have to just wait six months to see if things are getting better? Why can't I do things now? What is, what is, what is wrong with that? They learned a lot after that first baby. And I think that that's one of the things that I really emphasis on anytime that I'm talking to anybody who's either getting ready to conceive, thinking about getting pregnant, I always tell them to go get a pelvic floor physical therapy assessment before you get pregnant. We do see a lot of pelvic floor dysfunction that happens. Even with somebody who's not been pregnant. So if we can, again, head this off and have these conversations ahead of time, and again, it doesn't have to be a long, drawn out process, but go get assessed by a pelvic floor therapist before you get pregnant, and then maybe see them a couple times during pregnancy, you're gonna be way ahead of the game.

And again, you talk about European models, right? In Europe, no matter what mode of delivery you had that baby, you get physical, you know, physiotherapy is what they call it over there, or pelvic floor physical therapy here in the States, you get that you automatically get that as part of your postpartum care, right?

And so we actually don't see the number of incontinence concerns over in those European countries like we do here in the States. And so that's just, again, an interesting thing to think about is implementing those services ahead of time and how important that is, as well. 

Bruce Kassover: Wow, that's, that's, that's really interesting. And I also understand that you learned a lot more from your survey beyond just how many women experience incontinence after giving birth. What were some of the other findings? 

Aleece Fosnight: Yep, absolutely. So, if we start to break down more of the details in that survey, you're going to look at almost 85 percent of those individuals that we surveyed experienced frequent bladder leaks, and 36 percent of those individuals share that they experienced bladder leakage on a daily basis, and 49 percent said they experienced it at least on a weekly basis.

So again, it's still a big chunk of individuals. Then when you think about a timing perspective, right? I told you, you know, earlier that that postpartum period is really a whole year after you've given birth. So now if you're looking at individuals kind of at that six month mark where a lot of things are really starting to balance out, you're starting to get more of that healing in place.

But we still saw 61% of those mothers struggling with incontinence at six months postpartum or after. So again. more than half of people are still struggling with this. And a lot of those individuals you talked about again, maternity leave or paternity leave. Those individuals are back at work. They're trying to hold down that career. They're holding everything down it at home, too. And now this is just another layer that they're having to navigate with is incontinence. 

Bruce Kassover: Now, is this largely or almost exclusively among women who've given birth vaginally or do women who have Caesarean  sections also find that they have incontinence issues?

Aleece Fosnight: Yeah, this is one of my most favorite myths to bust is that just because you had a Caesarean  section does not mean that that buys you a pass to urinary incontinence. We, when you look at the studies and you look at the data in the beginning part, postpartum, the majority of women that are experiencing urinary incontinence are from vaginal delivery.

But when you actually start looking several years out, that starts to even out with the number of women that are experiencing incontinence that had a Caesarean  section as well. So again, we have to think about, yes, mode of delivery, I think it's important. And it's the fact that you are just pregnant that actually puts you at a higher risk of urinary incontinence as well.

And we do see more of those Caesarean  women experiencing urge incontinence or overactive bladder incontinence versus stress incontinence that we would see for those individuals who were potentially having a vaginal delivery. So, right, stress incontinence is if you're exercising, you laugh, cough, sneeze, that's when you leak, versus urge incontinence or overactive bladder is that urgency and ‘I got to rush to go to the bathroom and I'm leaking on my way to the restroom.’

Bruce Kassover: Yeah, I guess that's not surprising considering that, you know, childbirth is traumatic and just carrying a baby, I mean, you squish all of your organs around inside of you. So, yeah, that's not a surprise. So, how long does this tend to last? 

Aleece Fosnight: For those individuals that are not getting some sort of assistance, we actually know that pelvic floor therapy – and I just actually looked this study up with another patient of mine earlier this week – but pelvic floor therapy can improve your urinary incontinence and almost cure it to the point where they are dry in 74 percent of women.

So that's huge. Pelvic floor therapy alone. So, but again, the majority of these individuals don't have either access to pelvic floor therapy, they can't take off of work to go to it in terms of costs, right? If insurance isn't covering it, that's another one to think about there too. So we're actually seeing continuation of that urinary incontinence, although it does decrease the longer out that you are from that delivery.

Bruce Kassover: One of the things I'm wondering that are we talking about pelvic floor therapy with a physical therapist specifically, or are we also talking about doing things like doing Kegel exercises at home and other forms of exercise and treatments and changes, behavioral changes that you can do on your own?

Aleece Fosnight: So there's some great resources and some free resources that are out there by different organizations or different pelvic floor therapists that are on social media that you can find. You may even be able to find some group classes in your area. But I, again, really highly encourage a lot of my patients or women that are experiencing this to specifically go to a pelvic floor physical therapist at least a handful of times in order to have something that is designed for you, right? Not everybody experiences the same vaginal delivery. Not everybody experiences the same C-section or this is repeat vaginal delivery or repeat Caesarean section that's actually happening. So being able to actually have somebody focus on those pelvic floor muscles as well as your core, which means your abdominals, your lower back, your hips, your adductors, your abductors. This is more than just pelvic floor related. Meaning that it goes beyond the Kegels, right? And actually, when pelvic floor therapists have evaluated individuals and to see if they're doing a Kegel the appropriate way, right, which is, like, to squeeze around the vagina, but also lift, like, towards the belly button, majority of those individuals don't do it either. They're not squeezing those muscles at all, or they're bulging out, which is the opposite thing of what you would want to do. So while I think it's great that we have these free resources, as well as these, you know, other resources that are out there that you could do a lot of things at home.

It's, to me, not as effective without having that other little piece. So maybe you go do a couple of sessions with your pelvic floor therapist, and then maybe you could start doing some of those things at home to make sure that you are doing things right. Appropriately. Also, during vaginal delivery, there could have been some additional trauma that maybe even wasn't caught by the obstetrician during that. So, separation of the pubic symphysis, right, which are the, you know, two, you know, bones that come together, right? It's loosey goosey during delivery, so accommodating baby as it's coming out the pelvic outlet. But that can have some trauma or injury to that as well. 

Bruce Kassover: You know, I love hearing what you're saying because it dovetails so nicely with the sort of guidance that we give at NAFC as well. I mean, we are always singing the praises of working with pelvic floor physical therapists because it's an area of therapy that a lot of people are just not aware of and the benefit is enormous. And at the same time, we provide, you know, lots of resources online to help women understand what a Kegel is and how to do a Kegel.

You know, Sarah, I'm wondering, can you tell us a little bit more in particular also about what the NAFC provides, particularly for women in pregnancy and after childbirth? 

Sarah Jenkins: Yeah, absolutely. Well, first of all, we, like Bruce said, we're huge, huge proponents of pelvic floor care and educating women about their pelvic floor.

We have a whole pelvic floor health center on our site where you can learn about what the pelvic floor does, how it functions. Like you said, all the muscles that are connected to it that really make this holistic program necessary and we actually developed a 6-week email series designed for women who are interested in learning a little bit more about PT. Maybe they, like you said, don't have access to a PT, don't live close to visit one every week. Maybe their insurance doesn't cover it. But this just gives a little bit of a taste of what they might expect at a PT appointment. So, you know, definitely doesn't replace an in-person exam. I think those are so valuable, but if you want to just get, you know, some information about things that you could do and tips that you can try and different exercises that might be beneficial, this is a great place to start.

Bruce Kassover: Yeah, that really is something that we encourage people to, to visit us and to learn more about, because there's so much information out there that's, you know, really designed to be easy for people to understand, digest, and implement. And, you know, that's the thing, is that it's putting things in place.

Your awareness is one thing, but execution is another. And, you know, at least that gets me thinking that beyond the Kegel exercises, there are probably behavioral changes and dietary changes and other things that might be helpful as well. What are your thoughts on those? 

Aleece Fosnight: Yeah, absolutely. And thanks, Sarah, so much for sharing all of the programs that y'all are doing. I always try to get some reputable resources for patients because it's, there's so much information, like you said, that's just inundated for those individuals. So keeping it simple is going to be the best thing and obviously supporting individuals and helping them to understand what to expect during those.

I think that's the biggest thing and question I get a lot of times is, well, what is pelvic floor physical therapy and how is that different than the physical therapy that I would go for my shoulder or my knee? So, yes, having that resource is awesome. So from a behavioral standpoint, I think anything, avoiding anything that's going to put extra pressure on your bladder and your pelvic floor until that area has healed as much as helping to get that support.

When we think about, especially again when the body is getting ready in preparation for delivery, the primary mode of delivery, right, is going to be that vaginal delivery. We know that not everybody is able to do that, which again, there's no right or wrong way to have a baby, but in terms of biology and what your body's getting ready to do, so the pelvic floor expands over 200%, right? And it takes time for that to get back to kind of baseline. So while that's happening, if you've got extra pressure that's putting on that pelvic floor, that can weaken it or cause more leaks to actually happen. So I encourage a lot of folks to just get out and walk, right?

Maybe we avoid any running or jumping at the beginning until that pelvic floor is a little bit stronger. And again, they've healed a little bit from that. I always tell people to, you know, you have to, rest is going to be the biggest thing and that's hard to do when you have a newborn that's getting you up every, you know, two to four hours to feed and eat and to play.

And so, while resting, you know, while baby is resting isn't always the easiest thing to do, being able to rest and not give yourself so much pressure, I think, is really important. Sleep and recovery are one of those top two things that I really encourage a lot of folks to really lean into with that. 

Mindfulness and meditation, I think, can help beyond just the urinary incontinence. You know, again, we've talked a lot about depression and anxiety, so being able to do that as well surrounding yourself with people and support can be really helpful to you. It can feel really lonely and isolating when you're at home recovering with baby. So being able to get out, if that feels good for you, is another one.

In terms of food and nourishment, I think it's really important to not limit too much of the things that you are wanting to consume unless it is causing some irritation with your bladder. So, water is my favorite. Just drinking a lot of a lot of water. I remember in my postpartum days, I could not get enough water. I was thirsty all the time. So that's gonna be really helpful, too, especially if somebody is lactating or breastfeeding, that that would be a good thing for them, too. Avoiding any bladder irritants any spicy foods, that's gonna help baby out, too. Again if you are nursing or breastfeeding, avoiding any increased caffeine can be really helpful. 

Avoiding alcohol. There is some mixed information out there about alcohol consumption and breastfeeding and the safety of it. I would highly recommend talking to a healthcare provider about that individually for you if that's something, but avoiding alcohol can be helpful to, to avoid bladder irritation, as well.

Thinking about, you know, avoiding sodas is going to be helpful. And then I think avoiding constipation is the other big thing. So again, if we're thinking about the pelvic floor. And what's happening in that area, especially if there has been trauma during delivery and the rectal area has been involved, bowel movements could be uncomfortable for that individual. And so again, we want to make sure that we're avoiding constipation, that will help to avoid any urinary incontinence as well. 

Sarah Jenkins: You know, you mentioned that women often don't know the right questions to ask, and they're so used to thinking this is a normal problem and I'm, of course, I'm going to leak after I have kids. What should they be asking their doctor? What is not, I mean, it's never normal, but what is what is not normal? And what should they be asking their doctor to make sure they're getting really the care that they need? 

Aleece Fosnight: The question is often posed from a patient perspective is that, again, is this normal and is this common? And it is really easy for providers to say, ‘Oh yeah, this is totally normal for something like this to happen,’ without going into more detail. So the way that I encourage patients to actually ask their questions is you don't even ask if it's normal, whatever else, it's happening to you. 

So I always tell people, like, if it's happening to you, and it's bothersome to you, we want to do something about it, right? And so going in talking to your provider and just saying, ‘I'm experiencing urinary incontinence and I want to know what resources are out there for me that I can make this better,’ right? Rather than saying, ‘Hey, I've got some urinary incontinence. Is this normal?’ Right? There's that ‘yes’ or ‘no’ option. And then the conversation just goes on. If you have an open ended, if question and you ask specifically for resources, like, ‘This is happening to me,’ you can say, ‘What are my, what are my resources out there that can help support me with this?’ So if you frame it that way, you aren't going to get dismissed in those conversations as often.

Sarah Jenkins: Yeah, that's great. You know, one other thing that I would just like to ask your thoughts on, too: A lot of women, as you said, may get better over time. They may see some improvements. But one thing that we have often heard is, even if you get better, when you're younger and maybe you don't experience any issues for 10, 15, 20 years, is this something that, if you don't treat early and kind of get a handle on it when it's first starting, that it can just get worse over time or create problems, say, when you start menopause, because your pelvic floor is already kind of weekend?

Aleece Fosnight: Absolutely. And this is an area that I would love more research on as I don't, I don't think that we really, I don't have enough research out there to specifically say what to expect down the road and when that happens. A lot of people, again, think that it's normal, but we just, again, we don't, we don't talk about it.

When you are postpartum, there is that time frame of hormonal shift, right, of your body's getting your hormones back into play. And then if you're lactating or breastfeeding on top of that, you're also delaying some of those changes of your menstrual cycle and your ovarian function to optimize. How it did prior to pregnancy, and so we can see decreases of estrogen and testosterone in the pelvic floor during that time frame.

So my question always is. How long is that, you know, going on? Is that happening? And is there a correlation with the amount of time that it's taking those individuals for their cycles to get back to normal for those estrogen, testosterone receptors to be turned back on and stimulated again in the pelvic floor?

Is there a correlation with that with the changes that happen and then during perimenopause and menopause when we think about the majority of individuals having, you know, kiddos, let's, you know, pretty much between the ages of, like, 25 and 35 and I'm a certified menopause practitioners, I’ve talked to a lot of women about this, too, is that perimenopause can happen 5 to 10 years before menopause actually occurs.

So it is not, it's so unrealistic for us to think that you're going to start having some of these hormonal changes into your late thirties, early forties, and you just gave birth, right? You just had babies. So now your body, it doesn't have as much time potentially to heal those tissues from now we're going to jump into another hormonal shift in your life.

And so, yes. to come back and answer your question, I do think that there is some correlation. If you don't start working on these pelvic floor muscles now having those conversations, understanding the functionality and coordination of those muscles, it's going to get more difficult for you as you get older.

And again, so prevention is going to be the biggest thing there too. The other thing to think about with urinary incontinence, especially if this is potentially hormonal changes, is you can use local hormone creams, especially like a vaginal estrogen cream, during lactation. And this is another, if anybody wants to do a research study with me, I would love to look at the healing changes in somebody who is lactating and having some urinary incontinence, the use of localized vaginal estrogen and the changes that are improving that urinary incontinence with the person that's using the local estrogen cream. There's a lot of controversy out there on if you can use a local hormone cream in the postpartum period if you are breastfeeding.

And I will say there is. And that it doesn't change the milk supply or get into the milk supply because it's all local. So, you know, worrying about baby and that sort of thing, but I've done an experiment with some of my patients postpartum that I saw that had incontinence and we started them on some local estrogen cream and not only does it help comfort, right, because there's a lot of vaginal dryness that occurs, especially same vaginal dryness and changes that we would see in the genitourinary syndrome of menopause. And we actually have a research paper that just came out later this past year on genital urinary syndrome of lactation. And so again, these changes that are happening in the pelvic floor and how that's contributing to urinary incontinence, and we have science, and we can do better and we can help support those women through that.

Bruce Kassover: So Aleece, I'm wondering how a lot of what you're talking about beyond the survey relates to Aeroflow and what Aeroflow offers to patients. Maybe you can tell us a little bit about that?

Aleece Fosnight: Yeah, absolutely. Aeroflow Urology is a wonderful company that is dedicated to supporting individuals and especially postpartum folks that are experiencing urinary incontinence. And the products that we are able to support individuals with are incontinence pads, incontinence diapers… The company works a lot with the insurance companies to help get coverage, right? These things are not cheap by any means, and they're continuing to get more expensive as things are going down the pipeline.

And we're also talking about delivery service, right? So if you're at home and you're taking care of a, an infant, new baby, it's hard to get out and to be able to go pick up a lot of these products. So being able to have it delivered directly to your house, you don't have to do anything. You can pick up the phone, you can call Aeroflow Urology and let them know like, ;Hey, I'm experiencing some urinary incontinence. I'm trying to figure out which products would be the best for me. How can you help?’ 

And we have top notch products. Customer service individuals that will be able to help guide those individuals to figure out what product is the best looking at your insurance, helping to fill out forms for you, to helping to also fill out forms that your health care provider may need to fill out, to making it super easy. As a health care provider that’s seeing lots of patients during the day, I mean, one more piece of paper seems like, ‘Oh, it's no big deal,’ but it's another thing on my task list.

So anything that can be super easy for me to just sign and go on and look over it and say, ‘Yes, this is It's totally fine,’ it makes it super easy and it creates less barriers for access for that individual as well. 

Bruce Kassover: Yeah, I love that. I mean, especially because one of the things is that anybody can go to any drugstore and get incontinence supplies if you want to just have a pick of, you know, a few brands and, you know, there's just sort-of off-the-shelf stuff.

But when it comes to actually getting, you know, a really good variety of products that are really made to fit particular conditions and also have somebody who can work with you on things like insurance and, you know, with good pricing, it's just a really great service for people that that goes well beyond the sort of run-of-the-mill thing Isn't it?

Aleece Fosnight: It is, and like I said, that's what I really, you know, love about Aeroflow Urology. I realize, you know, I’m, you know, a little biased because this is where I work and these are the people that I take care of. Being able to have that supportive community is just amazing. And I've actually met quite a few of the Aeroflow Urology team members, and they're awesome, and they're amazing, and they are just as passionate as a lot of the other folks within the area that are doing the surveys or posting about different things. They are those people on that ground floor that are having those conversations with the actual individual and they just love what they do and are so excited to be able to help somebody out.

And they follow up too. I think that's the other great thing too. It's more than just having somebody call and talk to you. And then like, what happens is you get your products. Are you happy with your products? Right? They do that follow up, too. And making sure, do you need more incontinence products? Do you have enough? Are you going through them too quick? Not quick enough? You know, what are those sorts of things? So being able to have that team and that support person at your fingertips is really nice. 

Bruce Kassover: Yeah, I love hearing that because, you know, when, when people look at the world of incontinence from the outside, you know, it's something that's easy for people to either, you know, make jokes about or to feel embarrassed about or just don't want to talk about, but when you find people who are really, you know, on the inside, who either experience it themselves or who work with people who experience it, you realize just how incredibly prevalent it is and how life altering it can be. And all of a sudden, something goes from either being embarrassing or sort of, you titter about it, you make a little joke about it, to something that's incredibly serious, and to hear that people have that passion and recognize that the work that it does really improves people's lives is really nice to hear. So that's great. I appreciate that. 

Aleece Fosnight: Oh yeah. You know, and again, reflecting back on the study, the survey that we did, right, you know, three out of four individuals said that their bladder leaks hindered their daily activities and that they noticed that they weren't doing the same things that they were doing before.

So by being able to provide a product and provide support and validate, right, like that's the other thing too, is I think validation is so key in this population. You're not alone. This is really common. We're here to help. These are the things that we can support you with. What else do you need? Right? I think keeping it open-ended like that, too, is going to be really helpful for those individuals to recognize that this isn't just it, that there's other resources and other ways that they can improve their lives outside of, you know, again, just what's happening in their household.

Bruce Kassover: Now, as you know, this is Life Without Leaks, and one of the things we always like people to do before we leave is to see if you have one little hint, tip, suggestion, bit of advice to help people who are listening live a life without leaks. So do you have one you might be able to share with us today?

Aleece Fosnight: Absolutely. And I pondered on this for the past week, Bruce, to figure out, because I've been on here multiple times, and I'm trying not to repeat myself in those, in those tips. And I think the biggest thing is for urinary incontinence, ask for help. Right? You don't have to be alone in this process.

And so, you know, going to the NAFC and looking at those resources and that's a great first step for a lot of people is utilizing those resources, but many times people don't know where to go or where to start. So starting, you know, with, again, these reputable places, you can even go to Aeroflow Urology. There's lots of good tips and tricks on there and places that we can set you up, so that, connect you with local individuals. And I believe, too, right on the National Association for Continence that you all actually have, like, find-a-provider on there, too. So finding somebody in your area can be really helpful.

Bruce Kassover: Indeed, we have a doctor finder. We encourage people to use it. It's completely free and it's a great tool to connect people with qualified, experienced health care providers that are near them. So, so yeah, thank you for mentioning that. And in fact, thank you for everything today. I really appreciate you being on the show, sharing insights that you've learned from the Aeroflow survey, and your expertise as well. We hope that it helps women who are pregnant – who are expecting now – and those who maybe recently just gave birth and those who may become pregnant down the road. So thank you very much. 

Aleece Fosnight: Absolutely. It is never too soon to think about your pelvic health. So start today.

Bruce Kassover: Life Without Leaks has been brought to you by the National Association for Continence. Our music is Rainbows by Kevin MacLeod and can be found online at incompetech.com. More information about NAFC is available online at NAFC.org.