Last week the Chief Medical Officer, Sir Liam Donaldson announced that carers are to be included in the priority group for vaccinations against swine flu.

The news was received with great joy by Carers and Organisations like Carers UK. The announcement comes following the welcomed confirmation from the Minister for Public Health, Gillian Merron MP, that carers of people who are immuno-suppressed would be a priority for vaccinations. Although this would have included a number of carers, it excluded people caring for sons and daughters with learning disabilities and other conditions such as incontinence.

The Joint Committee on Vaccinations and Immunisations (JCVI) has advised that:

“Main carers for elderly or disabled people should be encouraged to take up vaccination. This is to protect the welfare of those being cared for who may be at risk if their carer falls ill. We will discuss the implementation of this advice with carers’ organisations, including a number of practical questions, such as how to identify the carers involved.”

Carers UK public affairs manager Emily Holzhausen said:

“We are delighted that Government has accepted our advice that carers should be considered a priority for vaccinations where they provide significant care.  We have received a great number of calls from carers concerned about what would happen to the person for whom they cared should they fall ill with swine flu.  We look forward to discussing how to reach carers with the Swine Flu ‘Tsar’ Sir Roy Taylor and his team.”

This an important step forward. Prior to this carers had expressed anger that professional care workers were to be offered the vaccine but not carers who are family or friends.

Created for veterinary use, ketamine was originally developed to knock-out horses, but became increasingly accessible to drug users throughout the 90s.

Like many drugs that became popular in the 90s, the extent of its long-term damage is only now – a decade or so later – becoming apparent.

Speaking to BBC’s Newsbeat, doctors reported an increase in new evidence that supports claims that the drug is causing symptoms ranging from serious stomach pains to incontinence among once-ketamine users

Doctor Angela Cottrell, who is researching the link between ketamine and bladder damage at the Bristol Urological Institute, said:

“People need to be more aware of this, the short-term effects can be severe enough but we just don’t know what the long term effects are.”

Right now, ketamine is considered a Class C drug, but there are speculations that it could be upgraded to Class B and studies like the one conducted by Dr. Angela could well help support this upgrade.

Ketamine use has reportedly doubled in a single year amongst 16-to-24 year olds who still consider it a “clean drug”. The common perception amongst young drug-takers is that Ketamine can’t ‘mess up your body’, but what they don’t realise is that, in extreme cases, the drug can cause lasting damage in the long-run.

A handful of ex-ketamine abusers have needed an operation to have their bladders removed leaving them incontinent for the rest of their life. Whilst a link hasn’t yet been scientifically proven, there is a worrying correlation between ex-users and people suffering bladder and incontinence problems. Enough to indicate that there is indeed a link between incontinence and the drug itself.

The psychosocial implications of incontinence are huge; often resulting in people becoming afraid to leave their home because they are worried that they will not be able to find a toilet and are fearful of being incontinent. This in turn, can lead to loss of mobility and depression. Incontinence is also known to be a cause of falls in older people.

Understanding the complex nature of incontinence in older people – and how to undertake a comprehensive and holistic assessment to identify the root of their incontinence – is one of the biggest challenges amongst doctors, nurses and carers.

Back in October Nursingtimes.net, the website of leading weekly magazine for nurses in the UK, published a detailed guide to assessing bladder function and urinary incontinence in older people.

The guide provides an overview of the causes of urinary incontinence in older people and the psychological factors that need to be taken into account when assessing and treating the condition within elderly sufferers.

Proving that a holistic assessment by a well-trained nurse or carer with a good understanding of the complex nature of incontinence in older people can result in a cure or improvement of their incontinence.

A clinical negligence specialist lawyer has obtained a £24,000 compensation for one of its clients after proving a problematic treatment for stress incontinence left her client with physical and psychological problems.

Mrs B underwent Tension-free Vaginal Tape (TVT) treatment and the negligence occurred during her aftercare and related to the use and monitoring of a catheter which caused her chronic pain and eventually chemical peritonitis.

This led Mrs B in need of a further operation and a prolonged recovery period as well as panic attacks, nightmares, reduced self-confidence as well as bladder problems.

After Mrs B’s problems were proved to be correlated to the negligent stress incontinence treatment, the court ordered that Mrs B to be compensated with the sum of £24,000.

People and entities’ names involved in this story have been omitted for privacy reasons.

Caring for Carers seems to be picking up momentum as a delegation of Carers UK members recently visited 10 Downing Street to hand in the Carers Poverty Charter.

The Carers Poverty Charter – launched on BBC Breakfast back in May – calls for urgent action to improve carer finances.

One of the Carers in charge of delivering the Poverty Charter to Number 10 was Don Brereton, Chair of Carers UK, who said:

“This Charter sends a message loud and clear to the Government. Warm words and promises are not enough – carers need action now to stop them falling into poverty as a result of caring.”

The next deliveries have already been shipped out and are going to Conservatives and Liberal Democrats, asking the government to set out a concrete timetable of actions to improve carers’ benefits.

There are many possible factors that could lead to incontinence, childbirth, bowl cancer surgery radiotherapy damage or a serious injury caused by a motor accident, and many could end up needing a colostomy bag. A colostomy bag is used in the worst cases of urinary or faecal incontinence when patients have no control what so ever of their bowel and sphincter muscles.

Up until now, patients requiring a colostomy bag were doomed to live it for the rest of their lives, but a revolutionary new surgical procedure can give back patients control over their bowel and sphincter muscles eliminating the need of the colostomy bag.

In a touching interview with Carol Davies from the Daily Mail, 55-year-old Ged Galvin, a project manager from Barnsley, Yorkshire who was one of the first UK patients to go through such operation. Ged was recovering from a motorbike accident that nearly cost him his life, when he was told by his surgeon he would have to live his colostomy bag for the rest of his life and this contributed to the end of his 30 year marriage.

But Ged didn’t give up and sought help from Professor Norman Williams, who agreed to operate on Ged using a procedure he’d pioneered ten years earlier, taking a muscle from Ged’s inner thigh – with its nerve and blood supply intact – and wrapping it around the anus to support the sphincter (the muscle that controls waste leaving the body).

The nerve leading to the implanted muscle would then receive and electrode which would be attached to a pacemaker in Ged’s abdomen. Once activated by a remote control, the pacemaker would send an electric impulse to the electrode to keep the sphincter closed; switching it off would make the sphincter open.

Cutting a long story short the operation was a success and Mr. Galvin was able to regain control of his lower body muscles and most importantly of his life.

Full Story here.

Looking after a patient with incontinence can have a significant emotional impact in on caregiver’s life, taking care of loved ones with incontinence is a strenuous job, 70% of caregivers are uncertain how to help make the situation better and in some cases, they find it even harder to talk about it.

According to survey released by Caring.com, the American equivalent to carers UK, in association with SCA and the makers of TENA Incontinence Products. The survey reveals that one in three carers prefer to avoid the conversation altogether.

The study found that incontinence can have a negative effect on a caregiver’s emotional wellbeing and influence home care and nursing decisions:

– 42% report dealing with their loved one’s incontinence sometimes leads to depression;

– 32% find it emotionally difficult to change their loved one’s incontinence products;

– 27% report incontinence has a negative impact on the relationship they have with their loved one;

– 31% are unable to go on holiday because of their loved one’ incontinence issues, and

– 18% have considered moving, or have moved their parent to a care facility or nursing home because of incontinence.

Despite the fact that this article reflects the problems faced by American carers, the aim of this article is to show UK carers that they are not alone and it is not un-natural to feel one or some of the above, other carers around the globe are facing the same problems when taking care of loved ones with incontinence.

According to the NHS, the number of elective Caesareans has doubled over the past 20 years, it seems that fears of incontinence following childbirth, have contributed to the increase in Caesareans.

There are three main clichés used to explain why women are asking to have their babies delivered by Caesareans section: Too posh to push; too busy to push; too scared to push.

Normally Caesarean sections are only carried out in emergency cases such as foetal distress, a prolapsed umbilical cord or failure to progress in labour, breach birth or other good medical reasons, like the baby lying in an awkward position, multiple pregnancy (twins, triplets, etc) and an abnormally positioned placenta.

But lately a growing number of women are requesting or opting for private Caesarean section because they cause less damage to pelvic floor which will reduce the incidence of incontinence and prolepses later in life.

Elected caesareans are the less traumatic and safest way to deliver a baby and the risk of developing incontinence in later life can be reduced, but that doesn’t mean that women are immune from trouble.

A recent research suggests that pregnancy itself increases the incidence of incontinence because it is considered to be a major risk factor for weakening of the pelvic floor. Women who have had a Caesarean are still likely, by one and a half times, to develop incontinence than someone who has never had a baby.

The renowned Journal of Urology published this month online version on a study that correlates psychiatric disorders and sexual trauma to female incontinence.

The study analyzed the answers of 121 women who completed two questionnaires, The Urogenital Distress Inventory-6 and Incontinence Impact Questionnaire-7 and also examined the women’s mental health, history of sexual trauma, age, race and obstetric history.

Leading researcher and Director of Neurology, Female Urology and Voiding Dysfunction at Virginia Commonwealth University Medical Centre, Dr. Adam P. Klausner wrote:

“This is the first study to our knowledge to characterize the association of psychiatric comorbidities and sexual trauma with the type, severity and quality-of-life impact of lower urinary tract symptoms in women using validated surveys. The prevalence of psychiatric comorbidities and sexual trauma is high in women veterans presenting for evaluation of lower urinary tract symptoms,”

Full details of the study linking psychiatric disorders and sexual trauma to female incontinence can be found at Journal of Urology.