Whenever my bladder is full, I tremble and leak, is there a remedy for this?

Dr Flo,

I am interested in expert advice on the effects of diabetes and high blood pressure.

Regards, David

Dear David,

A blood pressure reading is a measure of the force at which your heart is pumping blood, and the resistance to the blood flow within the blood vessels. These two measures give the two figures we use in blood pressure readings. Normal blood pressure is between 90/60mmhg and 140/90mmhg. Anything above 140/90mmhg is considered high blood pressure.

In a few people, about 5 to 10 per cent of those with high blood pressure, there is an exact cause for it, such as kidney disease, hormonal disorders, pregnancy, anaemia, tumours, drugs or some medications. For this people, once the cause has been identified and dealt with, then the blood pressure can be sorted out.

In a majority of the people, about 90 to 95 per cent of those with high blood pressure, there is no known cause. It goes higher with age, and by the time it is being said to be high, it has been rising slowly over many years.

There are some things that are associated with this rise in pressure, including age (being over 40), being male, being African, having a close relative with high blood pressure, high-salt, high-calorie, high-fat diet, lack of exercise, obesity, taking too much alcohol, smoking and a stressful lifestyle.

Unfortunately, most of the time, you cannot tell that your blood pressure is high unless it is measured. Therefore, you may be feeling fine, but the blood pressure is high and it continues to cause damage to the blood vessels, which can lead strokes, heart disease, kidney failure, reduced blood flow to your legs and hands, and even loss of vision.

To prevent these long-term effects, you are put on medicine to lower the blood pressure to normal levels. If the blood pressure readings are normal, then the medicine is working. If you stop the medicine, the blood pressure goes back up, which is why it is very important for you to keep taking the medicine. In addition to that, reduce the amount of salt, fat and starch in your diet, reduce alcohol intake, stop smoking, cut weight, exercise, eat a lot of vegetables and fruits, have enough sleep and manage stress.

On the other hand, diabetes is a condition in which there are high blood sugar levels because the body does not make enough insulin or is not able to use the insulin well.

Insulin is a hormone made in the pancreas that helps the body to utilise sugar. If the blood sugar is very high, you may experience increased thirst, urine, hunger and weight loss, blurry vision and excessive fatigue. In extreme cases, you can even go into a coma, requiring intensive care.

If the sugar is not well controlled for a long time, your immune system does not work very well, you may get recurrent infections, have wounds that do not heal, and damage to blood vessels which can lead to stroke, heart attack, kidney damage, erectile dysfunction, nerve damage, hearing loss, eye damage and reduced blood supply to legs and fingers that can lead to amputation.

In type 1 diabetes, the immune system attacks the pancreas and the body is unable to make enough insulin. This is more common in children and young adults.

Diabetes in adults (type 2) occurs when your body is resistant to insulin and usually develops as a result of an interplay of genetics and lifestyle factors like being obese, high calorie diets and inactivity. There is also gestational diabetes which occurs during pregnancy.

To manage diabetes, you have to take the prescribed medication, whether oral or injectable, or a combination of both. You also need to adhere to the lifestyle and dietary recommendations given by your doctor and dietician and closely monitor your sugar levels.

Dear Flo,

I am 51 years old. I have a problem with urine leakage. I have had this issue since childhood. Whenever my bladder is full, I can’t concentrate on anything. I keep on trembling/shaking and at the same time it leaks, thereby wetting my pants. This makes me reek urine almost all the time. Is there a remedy for this problem?

JO

Dear JO,

What you have is called urge incontinence. This means that you get a sudden urge to pass urine and then urine leaks involuntarily. It usually happens because of an overactive bladder with unstable bladder muscles or muscle spasms (involuntary contractions).

Sometimes there is no identifiable cause of the problem, while at other times it may be a result of a blockage in the urinary system, infection, inflammatory conditions or nerve problems affecting the bladder. Anxiety can also trigger and perpetuate the urine leakage.

Since you have had it for a long time and it is affecting you, it is advisable for you to see a doctor. You will be examined, and may have some tests done to check the strength of your muscles, as well as check for any blockage, urine flow and bladder function, and infections. Depending on what is found, the treatment may include medication, bladder training exercises or other more advanced treatments.

Dear doctor,

Can you explain how to calculate days when to get a boy or a girl if you have a cycle of 28 days?

Sy-carter

Dear Sy-Carter,

While there are many theories about how to determine your child’s gender, they do not have any scientific backing, and I cannot recommend any with confidence.

The Shettles method suggests that because male sperm (Y sperm) are smaller and faster, but do not last long, to conceive a boy, you need to have sex closest to ovulation, which is when the egg is released. This requires that you buy a specialised thermometer to keep track of your body temperature and also get luteinising hormone test kits so that you can keep close track of your cycle. This method has been disputed by many scientists.

The only scientific way to determine gender is through sperm sorting or gender selection during in vitro fertilisation (IVF), which is quite expensive, and the sperm sorting does not give 100 per cent guarantee. This also has ethical issues that accompany it.

Natural conception gives a 50-50 chance, which should be good enough.