August
2004 Journal of the Section on Women's Health American
Physical Therapy Association (APTA) Volume 28, Number 2
Book Reviews
By K. Lynne Odom, PT, MOMT
I Laughed So Hard I Peed My
Pants! A Woman’s Essential Guide for Improved Bladder
Control. Berzuk, Kelli. Winnipeg, Manitoba, Canada: IPPC-Incontinence & Pelvic Pain Clinic (division of Nova Physiotherapy & Sports Fitness Clinic); 2002, Soft cover, 208 pages, $29.99.
I Laughed So Hard I Peed My
Pants! Written by Physiotherapist, Kelli Berzuk, is an
easy to read, self-help guide for women ages 16 and over. It
is divided into 29 brief and informative chapters. Each
chapter concludes with a summary of key points and a “Did You
Know?” section. Chapter 1 briefly introduces the signs of
incontinence and also addresses common fallacies about this
condition such as “incontinence is a normal consequence of
childbirth…and aging… and something you have to live with”.
Chapter 2 describes the epidemiology of incontinence. Chapters
3-5 review the anatomy of the urinary and nervous systems. The
role of the pelvic floor muscles is also presented in those
chapters in easy-to-understand terminology. Good illustrations
support the information presented in those chapters. Chapters
6 and 7 discuss types of urinary incontinence and pelvic organ
prolapse. Chapter 8 covers the role of the pelvic floor in
sexual function. Chapter 9 reviews the factors contributing to
incontinence such as pregnancy, vaginal delivery, diastasis
recti, aging, medications, and recurrent urinary tract
infections. Chapters 10-13 contain self-help instructions on
how to control incontinence including detailed exercise
progressions. Chapter 13 also covers information on how to be
sure exercises are performed correctly. Chapter 14 discusses
the Red Dot Program as an assisted way to remember when to do
the exercises. Chapters 15-16 cover bladder irritants and
bladder diaries with a bladder diary that is easily followed
and copied. Chapter 18 discusses urgency and urge delay
techniques including a brief mention of pediatric urinary
incontinence. Chapter 19 emphasizes the importance of
relaxation techniques as an important part of calming the
nervous system. Toileting postures are reviewed in Chapter 20.
Chapters 21 and 22 cover pelvic floor exercise progression and
the importance of progressing to accessory muscle exercises.
Chapter 23 educates women on how to recognize when they have
regained bladder control including a detailed check list of
improvements to look for and why the exercises should be
continued after continence is achieved. The remaining chapters
cover available treatment options including physical therapy,
pharmacological treatment, bladder function testing, and
surgical intervention. The book includes an extensive list of
references and resources including the books own website, www.ilaughedsohard.com .
I Laughed So Hard I Peed My
Pants! does a good job of covering detailed information about the urinary system and role of the pelvic floor in a format that is easy to understand. It provides clear explanation of exercise progression as well an overview of diet and lifestyle modifications often used in incontinence management. Some chapters include helpful client examples. Overall the book is a good self-help tool that can assist in empowering women with incontinence , and also be beneficial as a source of information for preventative health of the pelvic floor. Physical therapists will find this book a useful adjunct to their clinical management of incontinence.
K. Lynne Odom, PT, MOMT Nashville, TN
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