Rest assured, you’re not alone. Help for Incontinent People (HIP), a not-for-profit organization in Union, South Carolina, estimates that at least 12 million, and perhaps as many as 20 million, people in the United States and Canada suffer with urinary incontinence, oftentimes in silence. Indeed, it’s a problem that’s only been recognized relatively recently in America as a treatable condition and not merely an unavoidable symptom of old age. As a matter of fact, other cultures in times past seemed to have been much more aware of the problem. The ancient Egyptians developed products for incontinence, and in Great Britain around the turn of the century, it was perfectly acceptable for a woman to hold what was called a “slipper” under her dress to relieve herself during a long church service.

The loss of bladder control is not a disease but a symptom with any of a host of causes. It can affect anyone at any age?from children to the elderly, both women and men. Women, however, are three times more likely than men to be incontinent, due in part to the physical stresses of childbearing and a decrease in estrogen after menopause. The cause of incontinence may be as minor as an infection triggered by a cold or the use of certain prescription or over-the-counter medications. Incontinence may also be the result of sagging pelvic-floor muscles. This set of muscles located at the bottom of the pelvis supports the lower internal organs and helps them maintain their shape and proper function. Childbirth and certain types of surgery, such as a hysterectomy in a woman (removal of the uterus) or a prostatectomy in a man (removal of the prostate gland), can cause these pelvic-floor muscles to become deficient.

Incontinence reveals itself in a number of ways, and one person can suffer from more than one form of it. Stress incontinence occurs from rigorous or spontaneous activity, like playing tennis or sneezing. Urge incontinence is marked by a sudden need to go but possibly not making it to the bathroom in time. Overflow incontinence is a full bladder that begins to dribble. And reflex incontinence is marked by an unawareness of the need to urinate (caused by an enlarged prostate gland, for example), which results in leakage. Here are ways to cope:

Keep a diary. “This is very helpful in establishing symptom patterns,” says Katherine Jeter, Ed.D, E.T., executive director of HIP. By maintaining a voiding diary, or uro-log, you’ll have a record of when you urinated and the circumstances causing it. The diary should include: the time of day of urination or leakage; the type and amount of fluid intake that preceded it; the amount voided in ounces (pharmacies carry measuring devices that fit right inside the toilet bowl); the amount of leakage (small, medium, or large); the activity engaged in when leakage occurred; and whether or not an urge to urinate was present. Keeping such a diary for at least four days, if not a full week, before you see a doctor can help him or her to determine what type of incontinence you have and the course of treatment. When you see a doctor, take along a list or the actual bottles of any prescription or over-the-counter medicines you have been taking, because some medications can cause incontinence.

Watch what you drink. Experts are not entirely sure why some beverages seem to irritate the bladder lining and, as a result, cause bladder leakage. But you may want to eliminate certain substances from your diet or at least decrease your intake of them?to see if your urine control improves. The caffeine in coffee, for instance, may irritate the bladder, and the ingredients that give coffee its distinct aroma (also found in decaffeinated varieties) can be irritating, too. Tea, another favorite breakfast drink, is not only a diuretic, which means it pulls more water from the kidneys as it passes through, but also a bladder irritant. (HIP recommends substituting hot grain beverages, found in your grocer’s coffee and tea aisle.) Citrus fruits and juices, such as grapefruit and tomato, can be a problem. Carbonated sodas may be irritating, too, according to HIP (you might be able to tolerate seltzer water, which is not as highly carbonated as sodas). And, finally, alcoholic beverages should be avoided. Your safest bet: water, perhaps with a twist of lemon for flavor (a few drops of lemon should not be enough citrus to cause or aggravate an incontinence problem).

Try these juices. Grape juice, cranberry juice, cherry juice, and apple juice are not irritating to the bladder and may, in fact, control the odor of your urine. And surprisingly, orange juice is not an irritant, because it is metabolized by the body into a more alkaline, or less acidic, fluid before it reaches the bladder, says Jeter.

Keep drinking. “Too often, people who suffer with incontinence limit their fluid intake, believing that the less they take in, the less they’ll urinate. But dehydration can occur,” warns Thelma Wells, Ph.D., R.N., F.A.A.N., F.R.C.N., a professor of nursing at the University of Rochester School of Nursing in Rochester, New York. Dehydration can lead to constipation, which in turn can irritate nearby nerves that will trigger the bladder to void. The result: incontinence. Instead of cutting back on how much you drink, schedule the time that you drink. Having liquids at set intervals during the day will keep your bladder from becoming too empty or too full. “The bladder becomes irritated if its fluid level is too low or too high,” explains Wells. A normal bladder holds about two cups of fluid; problem bladders may hold as little as half a cup or as much as a quart and a half. If you find?yourself constantly waking up in the middle of the night to go to the bathroom, you might try to taper off your fluid intake between dinner and bedtime, says Wells. Experts suggest an average total fluid intake of six to ten 8-ounce cups a day.

Watch what you eat. Again, experts are not sure why certain foods aggravate the bladder, but you may want to try cutting back on the following foods to see if it helps: hot spices and the foods they’re used in, such as curry powder and chili; tomato-based foods; sugars, such as honey and corn syrup; and chocolate.

Try a recipe for success. If you are constipated, adding fiber to your diet may relieve your constipation, and in turn, your?incontinence.

Here’s an?easy-to-make-snack recipe from HIP that may help. Combine one cup of applesauce, one cup of oat bran, and a quarter cup of prune juice. Store the mixture in your refrigerator, or freeze premeasured servings in sectioned ice-cube trays. Begin with two tablespoons every evening, followed by a six- to eight-ounce glass of water or juice (one of the acceptable varieties mentioned previously). After seven to ten days, increase this to three tablespoons. Then, at the end of the second or third week, increase your intake to four tablespoons. You should begin to see an improvement in your bowel habits in about two weeks. The extra fiber may cause increased gas or bloating, but this should decrease after a few weeks. Be sure to keep up your daily fluid intake in addition to using this fiber recipe.

Lose weight. Obesity can cause muscles to sag, including the pelvic-floor muscles, which aid in proper voiding.

Buy yourself some insurance. There are numerous products on the market today that will absorb any accidents, whether urine or a bowel movement, and at the same time, protect your clothing or bedding from wetness. Specially made disposable and reusable briefs, diapers, liners, inserts, and linen protectors can add a measure of confidence. For some people, sanitary napkins or panty liners may be an acceptable alternative that provides enough protection. And a new product may be on the market soon. “Within the next year or two, urethral plugs, which can block the flow of urine during everyday activities, will be available in the?United States,” says Peter K. Sand, M.D.,?associate professor of obstetrics and gynecology at Northwestern University School of Medicine and director of the Evanston Continence Center at Evanston Hospital in Evanston, Illinois. These plugs, now in use in Europe, can be inserted by the user and later removed by means of an attached string.

Be confident on the road. External collecting devices that are specially designed for use by females or males can make traveling a little more comfortable. These on-the-go urinals, which are also convenient for bedside use, are available at Go before you go. Empty your bladder before you take a trip of an hour or more, whether you have the urge to go or not.

Then go again. After voiding, stand up and sit down again. Then lean forward, which will compress the abdomen and put pressure on the bladder, to help empty the bladder completely, suggests Wells.

Weight for results. Resistive exercise?when force is exerted against a weight can be applied to the?sphincter muscles of the urethra and rectum, which are important to regaining continence, says Wells. Cones that are about the size of a tampon and that come in varying weights are designed for use in the vagina (women) or rectum (men). When a cone is inserted, the sphincter muscles must contract in order to hold the weight and not let it drop. “Over a few months and with progressive use of the varying weights, the pelvic-floor muscles should get stronger,” says Jeter. These weight sets are available from physicians, who can guide your use of the cones, or from medical-supply stores. Be?sure to carefully read and follow the accompanying?instructions on proper use for best results. Start by holding in the lightest weight for 15 minutes, two times a day. Once successful at that weight, try the next heaviest weight for the same amount of time. Some versions of these cones come with an electronic biofeedback system, called a perineometer, which reports on the amount of pressure you’re applying to the inserted cone.

Take control of your muscles every day. To prevent leakage, contract the pelvic-floor muscles when coughing or sneezing or when carrying or lifting something. Do so by standing close to the object to be lifted with your feet slightly apart, one foot just in front of the other. Then, bend your knees but keep your back straight. Lean forward slightly as you contract, or tighten, your pelvic muscles. Then lift the object.

Be wary of exercise gimmicks. Carefully investigate any exercise contraption that claims to help decrease incontinence. A company may promote the fact that its gadget will tone the pelvic-floor muscles, but the device may actually exercise an unrelated muscle group, if it does anything at all. An exerciser for use between the thighs, for instance, will not strengthen the pelvic-floor muscles. If you’re not sure if a certain exerciser will benefit your incontinence problem, don’t waste your time or money. Check first with your healthcare provider.

Acai Berries are considered to be the nutritious fruit, which grows in the Amazon valley located in rain forest of Northern Brazil. It composed various ingredients such as Amino acid, fatty acids and anti-oxidants other than iron products, fibers and vitamins. Acai berry is a very tasty berry, which seems like a grape and tastes like chocolates candy. Assorted nutrients and minerals are available in Acai Berry fruit.

Acai berries can help a person achieve weight loss by contributing its one most attractive property into the mix: that of providing high levels of antioxidants into the bloodstream. Incorporating an Acai Berry Cleanse in your diet can help the body eliminate free radicals. These free radicals are of course necessary in human development since these promote natural cell renewal. Natural cell renewal can be achieved by letting cells decay so that these can be replaced. Unfortunately, some cells decay too quick that other “new” cells have yet to be developed; or decay very slowly that others cells are much affected. Here is where antioxidants comes in.

Antioxidants help search off some or most of the free radicals that cause cell decay so that the body has time to develop the new cells that can replace them. At the same time, it can promote rapid cell regeneration by providing the body a balance between decaying cells and emerging cells. Once balance is achieved, the body basically returns or goes to a better state where the body can burn up as much calories as it should and “process” them properly. This is essentially why a healthy supply of antioxidants from food supplements like Acai Berry Diet products can also help make the skin look younger and the person’s energy level higher.

Acai berries also give essential amino acids, a good source of carbohydrates and fibers, healthy fatty acids, and phytosterols which can speed up the metabolism considerably. This makes detoxification from the body move much faster. Fiber is known to help move bowel wastes very swiftly – but it also means that the body is dispending the nutrients at a quicker rate. In turn, the body quickly assimilates those nutrients and turns these into caloric energy. This is where people say that drinking acai berry juice supplements essentially gives them a boost of energy.

That boost of energy, if you really want to exploit it properly, is necessary for a healthy lifestyle. That can be used to promote more regular exercises that can accelerate up the fat burning process. The healthier part of this deal is: the more you exercise, the better your muscle can burn off unnecessary fat, so that you can use up energy even while you are resting.

There are two basic types of glass fever thermometers, oral and rectal, with the only difference being in the shape of the bulb: thin and long on the oral and short and stubby on the rectal. Rectal temperatures are the most accurate; oral temperatures can be thrown off by breathing through the mouth, smoking, or having just had a drink of something hot or cold. Rectal readings are, in general, one degree Fahrenheit higher than oral temperatures. ( If neither of these methods is convenient, temperature can also be taken by placing an oral thermometer under the armpit for at least two minutes, which will give a reading about one degree Fahrenheit lower than an oral temperature. )

Glass thermometers have several disadvantages:They may break in handling or even in the mouth.

If a thermometer breaks in the mouth, don’t worry; there is only a tiny amount of mercury in the tube. Just be sure to remove any slivers of glass from the mouth. Glass thermometers also need to be shaken down to 96 degrees Fahrenheit in order to allow the body’s true temperature to register. On the other hand, glass thermometers have a big advantage: They are cheap, with most selling for about three dollars.

More convenient and somewhat more expensive ( costing about seven to ten dollars) are newer digital thermometers, which register temperatures accurately within a tenth of a degree. These thermometers are also fast. It takes less than a minute for the temperature to register as compared to three minutes with glass thermometers. Most digital thermometers run on a “button” (or hearing-aid type) battery that boasts a two- to three-year life under normal use.

Pharmacies generally carry a selection of both glass and digital thermometers.

Hypoglycemia, also called “sugar blues,” was a condition that appeared some years ago and was supposedly caused by eating excess sugar, which led to very high glucose levels followed by very low levels. More likely, says John Buse, M.D., Ph.D., the symptoms were caused by skipping meals, lack of sleep, or tension.

But hypoglycemia does, indeed, exist. Doctors have determined that there are two basic types. One, called fasting hypoglycemia, occurs after?missing one or more meals and develops slowly as the blood sugar gradually drops lower and lower. It commonly produces central nervous system symptoms, and its causes can be serious underlying disorders, such as tumors that produce insulin. Type I diabetics who take too much insulin for the amount of food they eat may experience the symptoms of fasting hypoglycemia.

The second type, reactive hypoglycemia, occurs about two to four hours after eating, especially if the meals are high in carbohydrates. The usual symptoms include shakiness, weakness, sweating, rapid heartbeat, and faintness, which indicate that the body is reacting to a sudden blood sugar drop by producing adrenaline, cortisol, and glucagon hormones that aim to bring blood sugar back to normal. People in the early stages of diabetes may rarely have this type of hypoglycemia, but it is?more common after extensive abdominal surgery or other surgery.

If you notice the early warning signs listed below or suspect that you may have diabetes, see your doctor.

?

Some of the early warning signs of Type I diabetes are:

? Frequent urination accompanied by unusual thirst

? Extreme hunger

? Rapid weight loss with easy tiring, weakness, and fatigue

? Irritability, nausea, and vomiting

Some of the early warning signs for Type II diabetes are:

? Frequent urination accompanied by unusual thirst

? Blurred vision or any change in sight

? Tingling or numbness in the legs, feet, or fingers

? Frequent skin infection or itchy skin

? Slow healing of cuts and bruises

? Drowsiness

? Vaginitis in women

? Erectile dysfunction in men

Because the initial symptoms (fatigue, weakness, frequent urination) are usually mild, half of all diabetics do not realize that they have the disease. And that’s a real shame, because with early diagnosis and treatment, the chances of living a long and productive life are higher than if the disease creeps along undetected until irreversible problems set in.

If you’d like some proof that diabetes is clearly a disease you can live with, take a look at these prolific diabetics: jazz musician Dizzy Gillespie, singer Ella Fitzgerald, actress Mary Tyler Moore, baseball Hall of Fame great Jim (Catfish) Hunter. Even before treatment was as sophisticated as it is today, author Ernest Hemingway and inventor Thomas Edison, both of whom were diabetic, managed to leave their marks on history.

If you are one of the lucky ones whose diabetes has been diagnosed by a doctor, you have an idea of what has gone awry in your body. The disorder stems from the way your body processes carbohydrates, which you take in through food. Normally, these foods are converted into a form of sugar called glucose, which floats along in the bloodstream until the pancreas, a large gland located behind the stomach, goes into action. The pancreas produces insulin, a hormone that signals body cells to soak up the glucose. Once inside the cell, the glucose is either used to produce heat or energy or is stored as fat.

A person with diabetes produces little or no insulin or else becomes resistant to the hormone’s action and can’t compensate. Either way, the glucose can’t get into the cells; it accumulates in the blood and is later expelled in the urine. In short, blood sugar rises while cells starve.

Only about one-tenth of all diabetics have the severe form of the disease, called Type I, which usually affects children and young adults and requires daily injections of insulin. Most have what doctors refer to as Type II, or adult-onset diabetes. While about one-third of  Type II diabetics do require insulin to control blood sugar, and another one-third use medications to increase insulin production, the remaining Type II diabetics rely on nonmedical measures (such as diet, weight loss, and exercise) alone to control their disease. No matter which group you fall into, you can benefit from taking an active role in your treatment. But don’t make a move without consulting your doctor first. He or she will call the shots; then it’s up to you to carry through.

Here’s how:

Dish up a special diet. “The goal of dietary intervention for Type I diabetes is to help minimize short- and long-term complications by normalizing blood sugar levels. The goal of dietary intervention in Type II diabetes is to help the patient achieve and maintain normal body weight,” says John Buse, M.D., Ph.D., assistant professor in the Department of Medicine, Section of Endocrinology, at the University of Chicago?and director of the Endocrinology Clinic at the University of Chicago Medical Center.

Both Type I and Type II diabetics should follow the guidelines offered by the American Diabetes Association (ADA), which were revised in 1986 based on new research findings.?

Know your carbohydrates. The traditional dogma for diabetics was this: Avoid simple carbohydrates, or simple sugars (such as table sugar), because they raise blood sugar quickly, and choose complex carbohydrates (such as the starches and fiber found in grains, potatoes, beans, and peas), because they raise blood sugar more slowly. But this dogma has given way recently to newer rules, which really aren’t rules at all in the strictest sense.

“Diabetic meal planning must account for many factors,” says Harold E. Lebovitz, M.D., professor of medicine, chief of the Division of Endocrinology and Diabetes, and director of the Clinical Research Center at State University of New York Health Science Center at Brooklyn. “A food eaten alone may affect blood sugar differently than when it is eaten with another food. The same variations can be noted with cooked foods versus raw foods and even with different brands of foods. And not least, different foods affect blood sugar differently in different people.”

Consequently, while complex carbohydrates like lentils, soy beans, peanuts, and kidney beans are still best for causing the slowest and lowest rise in blood sugar after a meal, present evidence suggests that sucrose (table sugar) may not be “off limits” for Type II diabetics if blood glucose levels stay normal after their ingestion. “Experimenting with `forbidden foods’ may be possible with a doctor’s consent,” says Lebovitz. “But before you start bingeing on bonbons, it’s important to be prepared?to see what happens in terms of the blood-glucose response.”

Get fond of fiber. The key to the effectiveness of complex carbohydrates may lie in the fiber content. “While the cause and effect of fiber in control of Type II diabetes has yet to be established, we do know that such foods are very satiating and can help enormously toward weight loss and maintenance,” says Buse.

Understand “sweet” talk. Actually, there are a number of different kinds of sugar, and each has a potentially different effect on blood sugar levels. “The most basic form of sugar is glucose, or dextrose, which will raise blood sugar levels faster than any other kind when swallowed,” says Ira J. Laufer, M.D.. clinical associate professor of medicine at New York University School of Medicine and medical director of The New York Eye and Ear Infirmary Diabetes Treatment Center in New York. “Sucrose also tends to raise blood sugar almost as quickly as dextrose. But fructose, sometimes called fruit sugar, generally has a very mild effect on blood sugar. If your diabetes is in good control, dietetic desserts and candies sweetened with pure fructose are not likely to raise your blood sugar levels very much,” he adds. On the other hand. fructose provides as many calories as other sugars. so it may not be the wisest choice for diabetics who need to lose weight.

Reduce your risks. To emphasize the fact that excess weight is a Type II diabetic’s most serious problem, experts on diabetes are fond of saying that if you want to find out if there’s a possibility of getting diabetes. just keep on eating and get fat. You can do other things. too, but the main thing is get fat. An estimated 80 percent of those with Type II diabetes are obese when diagnosed with the disease. Added weight can both accelerate the diabetes and bring on its complications, especially cardiovascular disease and stroke.

In contrast, even a modest weight loss can have dramatic effects: High insulin levels drop, the liver begins to secrete less glucose into the blood, and peripheral muscle tissues begin to respond to insulin and take up glucose better. Just as obesity leads to insulin resistance, so weight loss reverses the condition. When persons with Type II diabetes lose weight, they frequently are no longer diabetic “Type II diabetics may only need to get and stay at an ideal body weight,” says Buse. “And unless they do that, nothing else will work very well.?

Don’t “crash.” Too rapid weight loss rarely works in the long run and is potentially dangerous if undertaken without a doctor’s advice. Sometimes, a doctor will, in fact, prescribe a very-low-calorie diet to initiate weight loss, but only for a very short period of time. Generally, the best approach is to lose weight gradually with a low-fat, lower-calorie, nutritionally balanced diet combined with increased activity. Avoid the use of over-the- counter appetite suppressants that contain phenylpropanolamine (PPA).

Graze. Many experts believe that a Type II diabetic may more easily achieve normal blood sugar levels by not overloading with too much food at one time. “Three smaller meals a day?breakfast, lunch, and dinner plus two or three snack-type?meals in between is easier for the diabetic person’s insulin to handle. Just be sure that you don’t overshoot your calorie limit, however,” advises Lebovitz.

Get a firm foothold. Neuropathy, damage to the nerves, is a common problem for diabetics. It occurs most often in the feet and legs, and its signs include repeated burning, pain, or numbness.

“Neuropathy can be dangerous if it causes a loss of feeling, because then even a minor foot injury may go undiscovered?leading to serious infection, gangrene, and even amputation of the limb,” says Joseph C. D’Amico, D.P.M., a podiatrist in private practice in New York. Diabetics, therefore, need to be diligent about foot care.?

Be a sport. Regular exercise provides many benefits. It tones up the heart and other muscles. strengthens bones, lowers blood pressure, strengthens the respiratory system, helps raise HDL (good cholesterol), gives a sense of well-being, decreases tension, aids in weight control, enhances work capacity, and confers a sense of achievement. For those with diabetes,” says Laufer, “exercise bestows additional benefits. It promotes the movement of sugar from the bloodstream into cells, where it is burned for energy, and it improves the cells’ ability to respond to insulin, thus decreasing their need for the hormone.”

Watch your mouth. Diabetics must be extra careful about their teeth. “Good dental hygiene is important for everyone,” says Andrew Baron, D.D.S., a dentist and clinical associate professor at Lenox Hill Hospital in New York. “Because they are at increased risk for infection, diabetics should be super cautious about preventing tooth decay and periodontal disease.” Keep a supply of toothbrushes so you won’t have to deal with old, worn brushing aids. Brush and floss without fail after every meal and before bedtime. And see your dentist regularly for checkups and cleaning.

Check your dentures. III-fitting dentures or permanent bridgework cause frustration for anyone who has to live with them. For a diabetic, the consequences go far beyond annoyance. “Dentures that move around in your mouth can cause sores that don’t heal,” cautions Baron. “It’s a shame to suffer with such problems, especially when they are so easily remedied by a dentist.” If you notice sore spots in your mouth or find that your dentures are moving or slipping, see your dentist to have the problem corrected.

Take charge. How do you psych yourself up for a game that has no timeouts and that never ends? That’s the question diabetics face every day. One way is to learn all you can about your illness so that you can better control it. “Diabetics are?constantly learning and relearning lifestyle changes and behavior adjustments. It’s like studying for a master’s degree in diabetes?and, in this case, there is no graduation and no vacation,” says Laufer.

It’s a given that even in a diabetic whose disease appears to be totally under control, there will be occasional rapid and even violent swings in blood sugar levels, brought on by emotional or physical stresses, meals, medications, or even the time of day. But if they are anticipated and accepted, these episodes can be viewed as simply a bump in the road rather than a major detour.

Do something nice for yourself. While it’s important to learn as much as you can about your diabetes and stay with your treatment regimen, you also need to keep things in perspective. “It is a rare individual who takes time to ‘stop and smell the roses,’ as it were,” notes Laufer. “This is especially true for diabetics, who often get so caught up in their disease that it is difficult for them to focus on other, more-positive aspects of life.” Make a list of all the things you would like to do if you had the time?and then make the time to do at least some of them. Obviously, finishing a box of chocolates should not appear on this list. While staring into space may be an ideal uplifter for one person, and napping the afternoon away does the same for another, straightening out a messy closet may do the trick for a third.

Do something nice for someone else. It’s hard to think of your own problems when you are engaged in making another person’s life more pleasant. In any city or town in the country, there are those who are less well-off, with more-severe problems. “You can call your local hospital or library to inquire about volunteers,” says Laufer. “Or you can knock on the door of an elderly, housebound neighbor who might appreciate a visit.