The owner of a Texas medical supply company is charged with fraudulently billing the U.S. government for $1 million in adult diapers that customers never received, federal prosecutors said.
Ernest Hogan, who ran Shanet Medical Source in Houston, is accused of routinely billing the federal Medicaid program for adult urinary incontinence supplies, including diapers, underpads and pull-up briefs.
From June 2004 until March 2006, Hogan filed more than $1 million in false Medicaid claims and was paid $683,360 for those claims, according to the indictment handed down by a grand jury on Wednesday.
Hogan surrendered to investigators on Friday and was later released on a $100,000 bond, said a spokeswoman for the U.S. Attorney’s office in Houston.
Bladder control problems affect both men and women, but the causes usually differ. In most cases women develop incontinence when pelvic floor muscles, muscles that support the bladder, weaken. Sometimes after giving birth women can experience this problem, pelvic muscle exercises can help improve the situations, in some cases medication or surgery is needed.
For men, the problem is slightly different, the prostate gland enlarges as men age and presses on the bladder, squeezing the urethra and inhibiting urine to pass, in these individuals it is common to retain urine in the bladder even after urination. The retained urine can increase and stretch the bladder causing damage to muscles that control the bladder as well as the kidneys.
Men and women have similar incontinence symptoms but different treatments. In some cases urinary incontinence signals a larger health problem, so don’t be ashamed to talk to your doctor, only he or she can help you regain control of your bladder and diagnose any other health issue you might have.
Urge incontinence is when you get an urgent desire to pass urine and sometimes urine leaks before you have time to get to the toilet.
It is usually due to an ‘overactive bladder’, treatment with bladder retraining often cures the problem.
Urge incontinence is the second most common cause of incontinence. About 3 in 10 cases of incontinence are due to urge incontinence. It can occur at any age, but commonly first starts in early adult life and more often in women.
Things you can do to improve urge incontinence:
Bladder training aims to slowly stretch the bladder so that it can hold larger and larger volumes of urine. In time, the bladder muscle should become less overactive and you should become more in control of your bladder.
Drink less caffeine, because it acts as a diuretic which causes the need to urine more, therefore putting more pressure on your bladder.
And of course pelvic floor excercises.
Incontinence and bladder control problems are often issues women are too embarrassed to talk about, even with their doctors.
To help break the embarrassment barrier Physical Therapist Linda Yates from the US has developed a program to help women develop skills to manage and resolve incontinence. The program will encourage women to break down the barriers and help women request treatment to stop women from suffering in silence. The program will teach women skills to help them manage and in some cases resolve it completely.
The program also addresses other health issues, like osteoporosis, women who have shoulder tightness following a mastectomy and help women that are experiencing pelvic or back pain during or following pregnancy.
“The best part of this program is very private, which is good” stated Linda Yates.
Many believe the recession will encourage more people to consider social care as a career, potentially helping the sector’s recent improvement in recruitment to continue.
Resources leader for the Association of Directors of Adult Social Services, Sarah Pickup, said that at a time when other work opportunities are coming hard to come by, care would remain.
She says: ‘We can advertise the fact that we’ve got jobs on offer with NVQ training, and because of the downturn they will probably have more appeal.’
The director of adult social services at Gateshead Council said a workforce strategy to was being developed to identify clearer career paths and to introduce more stability and aspiration to the industry.
‘We’re looking at apprenticeships and a whole range of work to encourage more people into social care.’
The declining economy could also bring positive developments for children’s services.
Chief executive of Ecas, a charity created to improve the lives of people with disabilities says, carer budget cuts are humiliating to residents.
David Griffiths explains, we know that carers and nurses are doing all they can with the resources they have, and we are not criticising them, we are critical of the resources they have been given.
Research by the University of Glasgow has found that with rising costs and falling budgets, there has been a reduction in carers’ visits.
Mr Griffiths has also seen problems with the way some residents with incontinence are treated: ‘Ecas staff has seen, for example, an incontinent, but not elderly, client who is left in incontinence pads from 10am to 4pm, from 5pm to 9pm and from 10pm to 9am. She recently had diarrhoea. There are other examples where carers with too much to do in too short a time are forced to put their client in degrading situations.’
‘This needs a public debate to identify the minimum standard in a civilised society and then councillors may need to reprioritise their budget.’
A new study conducted by the UCSF, University of California at San Francisco, Brown University and the University of Alabama revealed that weight loss reduces stress incontinence in obese women.
The PRIDE, Program to Reduce Incontinence by Diet and Exercise, randomly assigned 338 obese women aged between 42 and 64 years of age with at least 10 episodes of stress incontinence per week.
These women were then divided into two groups, one was an intensive 6-month weight-loss program that included group diet, exercise, and behavioural modification sessions and the other was a control group who received weight loss information but no rigorous guidance.
Results were rather impressive, the control group had lost on average 3 pounds each while the guided group lost on average 17 pounds each; the control group experienced a 28% reduction in stress incontinence episodes while the guided group reported a 70% reduction in stress incontinence episodes not to mention a lower volume of urine leaked and, overall, less of a problem with incontinence.
As a conclusion, researchers stated that weight loss is extremely effective for the treatment of stress incontinence and that weight loos should be a first line of treatment for incontinence in obese and overweight women.
Continuing with our series of posts about Surgeries for Stress Incontinence, this final part offers detailed information on each surgical procedure.
As mentioned on What to Expect with Surgery for Stress Incontinence – Part 1, there are two types of surgical procedures for stress incontinence, surgery through the abdomen and surgery through the vagina,
Surgery for stress incontinence through the abdomen
If you’re having surgery through a cut in your lower abdomen, such as ‘open retropubic colposuspension’ or a sling. you will expect:
* a stay in hospital for several days.
* general anaesthetic during the operation.
* your operation to last one hour to two hours.
* a tube called a ‘catheter’ inserted to empty the bladder.
* the catheter to be removed after a day or so to pass urine normally.
* the pain to subside after a few days, but you’ll receive painkillers.
* recovery time of six to eight weeks.
* no driving or sex for 6 weeks.
* no exercise until your doctor has given you the green light.
If you had a type of surgery called the keyhole surgery you will be able to go home sooner.
Surgery for stress incontinence through the vagina
If you’re having a type of surgery called ‘anterior vaginal repair’ or ‘needle suspension’, you will expect:
* to stay in hospital for several days (not as long for open colposuspension due to the outside skin not being cut).
* a general anaesthetic (so you may sleep during the operation) or an anaesthetic into your spine (you stay awake but you can’t feel anything).
* the operation to take between 40 minutes and 60 minutes.
* a tube called a ‘catheter’ inserted to empty the bladder..
* the catheter to be removed after a day or so to pass urine normally.
* some pain after the operation, but you’ll receive painkillers.
* the pain to subside after a few days.
* recovery time of up to six weeks.
* no type of exercise until your doctor has given you the green light.
Surgery for stress incontinence aims to give more control over the bladder; however, it may not always cure the problem completely and having a surgical procedures for stress incontinence are not usually suitable if you still plan to have children, or think you might want to in the future. Not everyone with stress incontinence needs surgery, but if your problems persist, your doctor may suggest it.
We would like to hear from people who have received surgery for stress incontinence and would like to share their experience and success (or not) with others. Please comment below.