SUI isn't a life sentence - effective, innovative treatments are here now

If you've had enough of leaking when you laugh or cough or sneeze, if you've spent enough on pads and products to help keep you dry, and if you're tired of just managing your condition rather than seeing real improvements, we have good news for you: Stress urinary incontinence can be treated.

Today's guest is Gloria Kolb, founder and CEO of Elidah, the medical device company behind Elitone and Elitone Urge. The Elitone family of products are the only FDA-cleared external solutions that tone your pelvic floor and calm your overactive bladder.

Gloria discusses what Stress Urinary Incontinence is in detail, explains why it's so common and addresses the full range of treatments that patients have available to them. 

To learn more about Elitone products, visit the website at Elitone.com. 

For more information 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/

TenderHeart Health Outcomes offers individualized care plans and superior products to meet your unique needs.  Their coaching focuses on asking the right questions, and their high-quality products prevent leaking, are comfortable and skin friendly. Plus, their trained staff focuses on your individual needs. Your total satisfaction is their goal and healthy living is their mission. Learn more at www.tenderheart.com or call 1-877-394-1860 today.</

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 as always is Sarah Jenkins, the Executive Director for the National Association for Continence. Welcome, Sarah. 

Sarah Jenkins: Thanks, Bruce. 

Bruce Kassover: Today is going to be a good one because we're talking with a friend of the podcast, we're going to be talking with Gloria Kolb, who you may remember from previous episodes.

She's the founder and CEO of Elidah, which is a company that makes a product called Elitone, which helps people address their incontinence issues and to address their leakage concerns. And she has a lot of good things that she's going to be talking with us about stress urinary incontinence and related issues.

But before we get into that, it all fits within the context of a broader campaign that we're doing that we think people are going to want to know about, The We Count campaign, which is something that we've started doing this year. Sarah, maybe you want to tell everybody a little bit about what We Count is and what it means for them and for the organization.

Sarah Jenkins: Yeah, of course. So we started We Count this year and really, it, our goal is to shed more light on incontinence, raise awareness, try to reduce the stigma. Over 80 million women in the U.S. suffer from some type of incontinence. So the goal of the campaign is really to kind of highlight these important facts and show women that we count and we deserve to have our incontinence treated and there are so many treatments available that many women don't know about. 

One of the things we're starting with our focus on is SUI, Stress urinary incontinence. It's the most common type of urinary incontinence out there and that's why we're so excited to talk to Gloria today because she has a great product that can really address SUI, so we're really excited to talk to her and to learn more about this treatment. 

Bruce Kassover: Yeah, and I can't really think of anybody who's going to be more informative for us to talk with today than Gloria, because I mean, she is an active entrepreneur in this space, and we're talking about a market of, you know, 80 million women.

If that number is really accurate, there's 325 million people in America, give or take. That means that there is about 160 million women. So only talking like half of all women may be facing incontinence issues. That's a crazy number. So, Gloria, what are you seeing out there in the market? 

Gloria Kolb: Wow, that number is higher than I have heard, but I do think that that is fairly accurate because I do think a lot of incontinence is unreported and a lot of women don't think they have incontinence, although they do have bladder leakage. So I do think that's very interesting and I think this campaign is great because it brings awareness to women who think they're alone. Even though that number is so large, so many women think that they're the only ones, which I think is very interesting. 

Bruce Kassover: Yeah, I think it's funny – that's a really good point that you're making about how a lot of people don't even want to admit or don't realize that they have incontinence or don't want to admit it to themselves because admitting that seems like a personal failure. Like they're doing something wrong or there's something that, like, there's a sense of control over their own bodies that they're missing. That really is hard for a lot of people to really want to face head on. 

Gloria Kolb: I agree. And so I do think that people deny that they have it. Or they, it also makes them feel very old. And so they don't want to feel old, you know? And they think of themselves as young, especially since a lot of times incontinence, especially stress incontinence, occurs right after childbirth. So when they're in their twenties, you know, they're in their thirties and you know, no way do they have incontinence, because incontinence is an old person's issue.

Bruce Kassover: Yeah. Unfortunately, though, it really isn't. I mean, what do you see? I mean, I suppose that with numbers as large as they are, there's no typical patient, but you're seeing patients as early as their twenties. Is that right?

Gloria Kolb: Actually, we've seen we teenagers, even, because stress incontinence often happens with sports and teenagers do a lot of high impact sports. You know, and I'm talking about like gymnastics, volleyball, running, a lot of high impact sports that causes that pounding on their pelvic floor, which can lead to incontinence. 

Bruce Kassover: Is that sort of like a sudden thing? You have like a, some sort of a traumatic collision or, and it just starts, or is it sort of built slowly, or is it some sort of combination just depending on the patient?

Gloria Kolb: Uh, it can be a combination. I mean, definitely it can be from some trauma. But often it is the slow pounding. What I, when you think about all that pelvic floor needs to do and to hold and to, you know, just contain, there's a lot of pressure on that pelvic floor to perform all the time. 

Bruce Kassover: You know, actually, it's probably a good point for us to even discuss what we're talking about here, because incontinence is a pretty big umbrella, and you're talking specifically about stress incontinence. Maybe you want to just sort of remind people or inform people who are not aware of what stress incontinence specifically is and how it's different than other forms of incontinence. 

Gloria Kolb: Absolutely. So stress incontinence is when the pelvic floor muscles – and the pelvic floor muscles is a whole bunch of layers of crisscrossing muscles that connect from your pubic bone to your tailbone, and it supports your organs above that.

So it supports not only your bladder, your uterus, and your rectum, but it really supports even the abdomen above that. Every step you take, all that weight above that pelvic floor, that muscle needs to contract and support it, so it's often likened to a hammock where it's tethered on the front and the back in between. It's just muscle trying to support everything, and so often when it gets weak, whether due to trauma or constant pressure, it tends to lengthen. It tends to stretch, and it tends to get weak. 

Bruce Kassover: That makes sense. I mean, I can understand that and I also think that if I'm not mistaken, and Sarah, you can correct me if I'm wrong, even though we are talking about how some women may experience it when they're younger, particularly from childbirth or high, you know, impact sports, things of that nature, most commonly people start to recognize these symptoms when they're probably in like their forties and fifties. Is that, is that probably right for the, in general…

Sarah Jenkins: I think it kind of depends. I mean, I think, like Gloria said, there are definitely younger women who this affects. And you know, one thing that probably a lot of people don't know is, even if they go through childbirth and everything seems fine, they may not even know that their pelvic floor has been kind of compromised. And then later down the road, once they start going through menopause and hormonal changes start affecting the tissues and the stability of the pelvic floor, then they can really start to see more problems. But that could have started, you know, after they had first had their children.

So that's why it's so important to really get that checked out and make sure you're strengthening even, you know, early and, and keeping your pelvic floor intact before there's even a problem. 

Bruce Kassover: So that's very interesting. So things like, like Kegel exercises and pelvic floor muscle exercises are recommended even if you don't think that there's any indication at the moment?

Sarah Jenkins: Yeah, for the most part. I mean, Kegels, you do have to be a little bit careful. Some women, they're not recommended for. But I think for the most part, you know, keeping a healthy pelvic floor is really important, even before you notice any symptoms because that can help prevent incontinence down the road.

Bruce Kassover: That makes sense. In fact, Gloria, I think that before we got started, you were talking about how there are some women in particular for whom Kegels are really not going to be recommended if their pelvic floor is too tight. Does that sound right? 

Gloria Kolb: Yeah. Well, let me back up a little bit. Often we think of stress incontinence as the incontinence that happens when you laugh, you sneeze, you cough, and it's that pressure that then the pelvic floor muscles aren't strong enough to keep that urine in, and that produces some leakage. So typically we say the pelvic floor muscles are too weak. However, not all women this presents because their pelvic floor muscles are too weak.

So there are some women that have hypertonic pelvic floor muscles, and unfortunately they kind of present with, it looks like stress incontinence because their pelvic floor muscles are tight all the time. Then the incontinence happens when they move and they get up, or they do some exercise as well because it's so tight that then when you have some movements, there's no give, so then you have some leakage. 

And we had a pelvic floor physical therapist in our office a couple of weeks ago recording some videos. Her name is Dr. Whitney Ellsworth, and she was awesome because she explained that some women, for whatever reason, and we don't really know what's the cause, they just hold tension in their pelvic floor. She explained it like some women hold tension in their neck and their shoulders all the time. Some women hold it in their pelvic floor, and for these women she recommends exercises that are more about lengthening and relaxing, and so I just want to bring that up because it is opposite of the contractions that we tell women to do to strengthen the muscles.

Bruce Kassover: Really fascinating. So now, if I were somebody who's experiencing symptoms that seem like they might be SUI, is there a way for me to tell if I have that hypertonic pelvic floor or if I'm experiencing more traditional SUI? Or is that something that I have to go to a doctor or a physical therapist to figure out?

Gloria Kolb: I think that's where pelvic floor physical therapists are perfect for the diagnosis. They can really do an examination and see if it's muscle weakness or muscle tightness. I guess you could do an internal examination yourself and see if those muscles just feel really loose or tight. Hypertonic muscles often present with some pelvic pain as well.

Bruce Kassover: I guess in the end it probably is the sort of thing that you're going to need to seek out help then. And we always recommend that the best first step is to go to a professional anyway. They've gone to school for it, they've seen people for it every single day… but you do as well. So tell me this, in your experience, what are the range of treatments that you find people generally consider nowadays?

Gloria Kolb: First line of treatment is always going to do be Kegel exercises or there are pelvic floor muscle exercises where you're just trying to strengthen those muscles, contract it as if you were going to a gym for any of your other muscles. You just want to do these exercises such as strengthen, hold, release, and you repeat that multiple times a day, actually doctors tell you three times a day, every single day.

There, there's a few problems with it, and one of them is that a quarter of women do them incorrectly because it's really hard to see. It's really hard to understand if you're doing it well. And for the rest, it's really hard to do it sufficiently just, you know, it's three times a day every day, women just forget, and it's hard to even do six minutes of it sometimes because their muscles get tired, but when they work well, they do work well.

Bruce Kassover: Now what about behavior modification in particular? I'm wondering about drinking water because I know that when a lot of people start to get some of these symptoms, the first thing they do is they limit how much water they drink. What do you, what do you think about that? 

Gloria Kolb: Oh, yes, that's I think, a natural instinct to limit the water. But you definitely don't want to, because, well, you need water for, so just general health for everything in your life and body, and you don't want to be dehydrated. And if you are dehydrated, that leads to constipation, which can make stress incontinence worse as there's a lot of pushing out. You know, in terms of behavior modification, I think one of the best ways is just movements in terms of physical exercise.

Being very conscious about eating the right foods that lead to good bowel movements, eating the right foods that are healthy. Just you know, in general health, I think there's a lot of other things. That can be done as well, and lots of times it's just remembering to tighten your muscles before you do an activity that is very common to produce stress incontinence. For example, remembering to tighten your muscles before you get out of a chair or get out of your car or go down the stairs. When you're younger, I think that's just very natural for some women. As they wear pads, they start to get lazier and forget about it and just let the pads catch everything instead of trying to tighten and hold it in.

Bruce Kassover: So I guess you got to put a rubber band around your wrist and snap it every once in a while to remind yourself.

Gloria Kolb: I guess that's one way. 

Bruce Kassover: That's one way. But another way is if you've tried doing some of these things on your own, you're working on your pelvic floor muscle exercises, you're watching and making sure that you're getting an appropriate amount of water, you're getting movement, all those things, and you're still experiencing symptoms. There are other sorts of interventions, medical interventions or devices and things like that. One, for example, is bulking agents. Can you tell me anything about that? 

Gloria Kolb: Yeah, bulking agents is an office procedure, or actually sometimes it's in an ambulatory center where the doctor goes in through urethra and then injects kind of like a gelatinous agent that goes around the urethra and it just physically closes the urethra, just taking up space and creating, I don't know how you would describe it, just closing around the urethra and that can often work well, but it's temporary. Sometimes they need to redo these bulking agents every six to 12 months. It can be expensive because you have to keep doing them, and it still doesn't necessarily get to the problem of strengthening the muscles, and so those muscles can still degrade over time. And then, you know, incontinence gets worse. 

Bruce Kassover: That makes sense. Now, are there other sorts of office procedures or surgeries or things like that that might be worth considering for some, some women?

Gloria Kolb: Well, the worst case, you know, they're still doing some mesh surgery, and I do think that's worst case because it is very invasive and it's very costly. Insurance covers some of it, depending on your insurance. It's very hard to undo it as well if it doesn't go well, and I believe it still doesn't work perfectly for everyone, so it's still a little bit risky. 

Bruce Kassover: Okay, that makes sense also, but your area of expertise is in devices using products that are not surgical and they're beyond just, you know, behavioral and lifestyle changes. Maybe tell us a little bit about what you offer and how that fits into the range of treatment options. 

Gloria Kolb: Sure. So what we saw was a big white space between doing Kegel exercises on your own and the surgeries and, you know, there's a lot of room where people want to try something minimally invasive. They want to try something that's not surgical, and everything we saw on the market tended to be vaginal. 

So these vaginal devices, often called Kegel exercisers, there's two types. We divide them into the trainers. The trainers are simply, they give you biofeedback in terms of, you squeeze and it'll light up something. It'll tell you on your mobile app if you are squeezing or not, and that helps you determine what muscles are the correct muscles to make this light up to know that you are exercising the right muscles. 

Then the second group are stimulating devices. So these are devices that either mechanically stimulate or electrically stimulate, and they can help contract the muscles by doing the work for you. So not only does it work on the correct muscles, but it does that work for you, which means you can do more of it. Instead of six minutes, you can do 20 minutes and get a better workout. The issue that I found with the vaginal devices is it takes your time, so you have to lock yourself behind a bedroom door in privacy, be flat on your back for 20 minutes and operate these devices. 

So our device, the Elitone, was created to be a wearable that you can place right on your perineal area where a pad would go and it does the stimulation for you. It does a hundred of these Kegel contractions in a 20-minute period. But the nice thing is, you can get dressed, you can walk around, you could, you know, not have to think about it. You can do what you need to do so it doesn't take up your time. We have so many women who said that they may have started with a vaginal device, but you know, it's sitting in a drawer somewhere because they just can't find time to do it. 

Bruce Kassover: That makes a lot of sense. And if I remember correctly, what I've seen on your website and, and before we go on, do you want to remind everybody what your website is so that they can go check it out themselves?

Gloria Kolb: Yeah, it's elitone.com, so that's E-L-I-T-O-N E.com. 

Bruce Kassover: Excellent. And when I visited the site and I saw what you have available, it looks sort of like it has the silhouette of maybe a traditional pad or something along those lines, but it's like electrodes that you just sort of stick to the general area. Is that about right or is there a better way to describe it?

Gloria Kolb: Uh, that's about right. It's about the length of a regular pad and it does need skin contact it. There's four conductive areas. Two areas are right on the pubic bone. Two areas are kind of inside the butt cheeks behind the anus, and what it does is, those four areas, it sends an electrical current through the muscle in between those four areas, and that is telling those muscles to contract.

When I say electrical current, it scares some people, but really electrical current is how the brain tells any of your muscles to contract. It's just working through the nerves, the nervous system to talk to these muscles. 

Bruce Kassover: And what does it feel like for a typical user? 

Gloria Kolb: They would feel some tingling on the surface to begin with. And then after a couple minutes, the surface, the skin gets a little numb. And then as they increase intensity and the user controls intensity entirely, they would feel this tightening on the inside. And it's just kind of a tightening for four seconds. There's actually some more signals that calm overactive bladder and then six seconds of rest, and that cycles through a hundred times.

Bruce Kassover: Okay, so how long does the whole session last for then? 

Gloria Kolb: 20 minutes. 

Bruce Kassover: That's not so bad. That sounds pretty straightforward and easy, and like you said, very nice and discreet as well. 

Gloria Kolb: Yeah, it actually goes by very fast there. We've actually had to put signals on the very end because women we're saying, oh, it's not 20 minutes. Do we go by so fast? And they thought it stopped early. 

Bruce Kassover: That's very good. So Gloria, if I understand correctly, Elitone is actually offered in a couple of different variations, is that correct? 

Gloria Kolb: That's correct. We actually have another product called Elitone Urge. This is a product that has that same ending signal that we mentioned in the Elitone stress and that it sends a lower frequency hertz. But the purpose of the Elitone urge is to only send the signals that calm overactive bladders, and the overactive bladder is when the muscles around the bladder is contracting when it doesn't necessarily, it shouldn't necessarily contract. So it is calming the nerves that attach to those muscles. What we find interesting is when we've talked to pelvic floor physical therapists and other doctors, they have found other uses for the Elitone urge and one of them is to actually calm hypertonic pelvic floor.

Bruce Kassover: Now that's the overt tightened muscles that we were talking about, right? 

Gloria Kolb: Correct. It's acting in a very similar way in that it's, you know, muscles that are too tense. It has a signal to just calm everything down. 

Bruce Kassover: Okay. So even though, even though this product may not necessarily be FDA-approved for that particular form of the condition, it's certainly something that a doctor could prescribe and a patient can use for those symptoms if they think it might be effective. Is that fair to say? 

Gloria Kolb: Yeah, that's fair. And when you see the mechanism of action of what it's doing and that the signals is, you know, just calming the nerves and muscles, then you can see how that can be useful for other areas. 

You know, we do get a question of, oh, what if I have both symptoms, you know, what should I get? And we do recommend if you have a little bit of stress and a little bit of overactive bladder, that you get the regular Elitone though, because that does send out both signals. It's just that the Elitone urge sends out just all the signals for calming. 

Bruce Kassover: So because these are available through the website, if that's something that makes sense to me, I could go and I could actually choose either of the Elitone products based on what I'm trying to look to get out of them. Is that about right also? 

Gloria Kolb: Yeah, that's exactly right. 

Bruce Kassover: Excellent. And what sort of results do you find that people are seeing when they use your device? 

Gloria Kolb: 95% improve, and this is based off six different clinical studies that we've done. So 95% of women improve. The average improvement is about, it ranged between 71 to 75% in a short, six-week period.

So we don't recommend, we don't necessarily say you have to use it every day. We recommend five times a week for a period of six weeks is the initial treatment. And then often, some women, especially if they waited a long time before they got treated, they need to go a little longer, maybe eight weeks, 12 weeks.

I do think this is incredibly fast, considering that on average these women were incontinent for 11 years before they sought any treatment. 

Bruce Kassover: That's not unexpected. We hear numbers that are also crazy, but it also is a little upsetting that people wind up suffering for so long with a condition that, like you said, they could see significant improvements in a matter of a few months, and all of a sudden their lives could literally be changed.

I guess that you're, you probably do see women who talk about how this is a genuinely life changing thing because, and maybe you want to talk a little bit about some of the reasons to act now and to seek out help and whatever your treatment path happens to be, to find help, because there really are some significant consequences from ignoring this beyond just dealing with leaks, aren't there?

Gloria Kolb: Yes. I mean, the longer you wait, the worse it often gets, because we're talking about muscle, and muscle ends up atrophying. The harder it is to get back to being leak free, the longer it'll take, the more work it'll take. And so we do… you know, I guess that's my big thing is, I've really am trying to encourage women to get treated early, get treated early, get treated early, because it's just so much easier. 

Women often after they use the Elitone, they're just like, “Why didn't I do this earlier? Why did I, for 10, 15 years, stopped exercising, stopped doing the things I love doing?” At least when they do get treated, then they can go back and really live their full lives.

Bruce Kassover: Well, I hope that people take advantage of it because that's really the whole impetus behind the We Count campaign, like Sarah was talking about earlier. We called it We Count because we want people to, well, first of all, we want to talk about some of the numbers behind incontinence so that people recognize that they're not alone.

When we talk about how incredibly common it is for people to see these figures and realize, “Wow, I really am part of a community and I don't have to be ashamed of it,” but also because this is something that has been dismissed, downplayed, ignored, and let women know that they do count and they are worth getting these sorts of treatments and delaying them does no favors for them. 

And so I really hope that, you know, people hear what you're saying today and take it to heart and do reach out. I thank you for the work and the effort you and everybody at all Elidah have been putting in to helping come up with solutions that are meaningful for women. It's got to be rewarding. 

Gloria Kolb: It's very rewarding and I love what you're doing and the awareness that you're bringing. I think it points to a, I don't know if it's called an emotion, but a lot of women don't give themselves permission to spend money on themselves or to take care of themselves. And so I think it's interesting because we often run promotions, but when we run a Mother's Day promotion or a New Year's promotion, those do better because it's almost like the women are giving themselves permission. “Oh, I am a mom. I can, I deserve this. You know, I deserve to take care of myself.” And I think it's a very subtle permission that you need to give yourself to, that you are worth it, and you should take care, care of yourself. And we've had women say, oh, you know, I wouldn't think twice to drop 500, $700 on treating my dog for whatever, you know, health condition the dog has, but you know, not spend money on themselves. Awareness is great. Every woman counts. 

Bruce Kassover: Okay, so you were talking about promotions and things. Maybe, I’m wondering, is this covered by Medicare? 

Gloria Kolb: Yes, it is covered by original Medicare. 

Bruce Kassover: Well that's very encouraging also. So I definitely hope that people go and visit you online, elitone.com, E-L-I-T-O-N E.com and check you out.

Gloria Kolb: That's right. Thank you so much, Bruce. 

Bruce Kassover: Now tell me this, there's one last thing before we go. We always like to ask our guests if they have any one little bit of advice, a hint, a tip or strategy to live a life without leaks. So maybe you have one you can share with us today. 

Gloria Kolb: I would just recommend that you see if you have stress incontinence, urge incontinence, mixed incontinence, or even hypertonic pelvic floor. It's so important to get diagnosed correctly and then get treated and don't delay. 

Bruce Kassover: Well, I appreciate it, Gloria. Thank you so much for sharing all of this information with us and our audience, and I hope that people get an enormous amount out of it. So thank you. 

Gloria Kolb: Well, thank you so much for having me. It's been a pleasure. 

Bruce Kassover: Life Without Leaks has been brought to you by the National Association for Continents. Our music is Rainbows by Kevin McLeod. More information about NAFC is available online at NAFC.org.