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Living Well: Treating incontinence in women with urodynamics

Unless you or someone you know has urinary incontinence, you've probably never heard of the term urodynamics. It's a common phrase used by urologists and gynecologists, alike. Urodynamics simply refers to a series of tests that assess how well a person's bladder and urethra are working.

"I perform multichannel urodynamic tests to determine exactly what type of incontinence a woman has, because not all urinary incontinence is the same. Urodynamics give me an accurate diagnoses, which means I can tailor my treatment and get good results," said Dr. Scott Ellis, OB/GYN with Memorial Regional Health.

Women suffer from urinary incontinence more than men, partly due to giving birth. But it's a misperception that women have to simply accept leaking or loss of control.

"I refer to incontinence as the silent shame. Women don't like to reveal they have it, unless I ask. So, I make it a point to ask at every annual visit. Women who say they are incontinent often follow it with, 'I know there's nothing you can do about it.' That's simply not true," Ellis said.

You may assume the main solution to urinary incontinence is surgical, since the transvaginal sling for stress incontinence received a lot of attention in the past. Yet, treatment for urinary incontinence is rich and varied — with new options being developed regularly, including improved slings.

"Solutions may be surgical, but they may be medical and even sometimes physical, depending on the type and severity of urinary incontinence. While we might not be able to cure incontinence 100 percent, we can significantly improve a woman's quality of life," Ellis said.

Treatment options

MRH offers advanced laparoscopic surgeries for incontinence. Ellis has been performing laparoscopic surgeries — which promise a smaller incision and faster healing time than traditional surgery — for many years. The hospital offers all types of surgeries for incontinence and only needs to refer particularly complicated cases to urogynecologists in Denver.

Surgical options include the transvaginal slings for stress incontinence, with newer types that are less invasive, such as the single-incision mini-sling or the suprapubic sling. Sometimes, a few, well-placed stitches makes all the difference.

Ellis performs pelvic floor biofeedback at the hospital, and has introduced a new technique called sacral neuro-modulation for urge incontinence.

"With sacral neuro-modulation, we place a small, pacemaker-like device near the sacral nerve that stimulates the nerve with mild electrical pulses. This improves continence, since the nerve helps control the bladder and surrounding muscles during urination. It has been well-studied and shows good results for both urinary and rectal incontinence," Ellis stated.

Another exciting treatment option is periurethral collagen injections to help strengthen the muscles, connective tissue, and ligaments at the base of the bladder.   

"Without making an incision, I inject material in and around a woman's urethra to make it stronger and thicker so it can better hold the pressure of urine," Ellis said.

Sometimes, urinary incontinence can be controlled with medications that prevent bladder spasms or calm an overactive bladder. Other times, it can be treated with physical exercises that strengthen the pelvic floor.

"There is a fair amount of pelvic floor rehabilitation and special bladder retraining exercises that women can do to ease their symptoms," Ellis said.

Ellis likes to do a thorough workup with urodynamics when someone complains of incontinence, because sometimes, he finds a more serious underlying issue.

"Certain neurological disorders, such as multiple sclerosis, can cause incontinence. It's good to rule out more serious causes," he said.

Whether it is stress incontinence — that happens when you cough, sneeze, or laugh — or urge incontinence — a feeling that you have to go immediately due to spasms in your bladder — or another reason for incontinence, MRH can help.

"We have all the advanced equipment and training that we need to make a great impact here at MRH," Ellis said.

To explore treatment options, call MRH Women's Health & OB/GYN at 970-826-8230.

Lance Scranton: It’s not right!

Ever notice how much attention the things that just don't seem to be working correctly tend to get in the news and on social media?

How come the good things aren't reported on as naturally as the negative stuff that circulates throughout the news cycles every day? Why don't the regular people who go to work everyday and do what they should make the headlines each and every day instead of in a special insert, or monthly focus, or quarterly spotlight? Why do people clamor to justify the needs of people who want to enter our country and take advantage of the benefits we work so hard to provide while being OK with veterans who can't get the services they need or homeless people living on the streets who need our help, as well?

Maybe it isn't a red or blue problem, though that would be an easy answer, because then, we don't really have to do anything about it; Republicans and Democrats just see the world differently — right? Maybe not.

Maybe it is a fundamental American belief in helping people who are less fortunate, downtrodden, or subjected to unfair treatment that drives us each to try and find solutions. No, we don't all agree on the role of government in supporting specific needs (Amendment 73), but we do believe government has a role (city sales tax increase) in providing some services.

We, in Colorado specifically, appear to be socially liberal (our governor-elect) but fiscally conservative (most tax increase measures failed). It seems most people don't have big issues with how politicians live their lives, as long as they have the best interests of those who they serve in mind. This isn't really a Democrat/Republican thing as much as it is a statement about our society as a whole — that believe people should be left alone to make determinations about what is best for them (the Founding Fathers called it liberty).

It doesn't seem right that a Democrat is only identified as someone who wants to shut down power plants and coal mines, and litter the countryside with windmills and solar panels. It isn't right that Republicans are pigeon-holed as a bunch of gun-crazy, planet polluters who think smaller government means leaving them alone to do whatever they like.

I know it isn't right, because I know people from both sides of the political spectrum who love our country but have reasoned, well-thought-out differences of opinion as to how best achieve the American Dream. I'm not sure we will ever change the way Washington does business or how the media chooses to present caricatures of people who believe a certain way of living is best, but if we move forward, it will only be possible when we decide, as communities, that the answers might just be right here where we live — if we choose to look.

Lance Scranton is a teacher and coach at Moffat County High School.

Ed Wilkinson: Veterans service officer to stay

I would like to thank all the veterans of Moffat County that rallied behind me during the period of time in negotiations with the county commissioners.

The commissioners presented their side, and I presented mine.

We found out some information that had been missing for many years, and because of that finding, we came to an agreement that was satisfactory to them and myself.

So, to quell the many rumors that have been going around (good ole Craig!), I will be staying on as the veterans service officer.

Again, thank you fellow veterans!!!

Ed Wilkinson

Craig

The Bock’s Office: ‘Bohemian Rhapsody’ a regal rock biopic of one of music’s brightest stars

If even after dozens of sessions listening to six minutes of confusing, esoteric lyrics, you still don’t fully comprehend how keywords like Scaramouche and bismillah are interconnected, the film of the same name as one of rock’s most endearing tunes won’t give you much more insight.

What “Bohemian Rhapsody” will do, however, is recount how one of the genre’s most transcendent voices came to be a legend.

In 1970 London, twenty-something émigré Farroukh Bulsara (Rami Malek) is bursting with musical talent and no outlet to show it as a baggage handler at Heathrow Airport, though despite the misgivings of his conservative Zoroastrian family he’s on the hunt for a place to showcase his singing.

A vocalist opening in a small-time band called Smile gives him exactly what he needs to display his style, forming a quick bond with guitarist Brian May (Gwilym Lee) and drummer Roger Taylor (Ben Hardy), as well as newly recruited bassist John Deacon (Joe Mazzello).

The quartet becomes a hit thanks largely to their new singer’s explosive energy on stage, in addition to a couple name changes as the band slowly but surely accepts their frontman’s demands that they go by the moniker Queen while he morphs into the identity of one-of-a-kind Freddie Mercury.

As the group starts to take over the charts and gain fame in Britain and across the world, Freddie’s artistry keeps Queen rocketing toward bigger and better things but at the same time, his diva-like sensibilities continually create conflicts as he tends to eclipse everyone else.

Outside the band, his relationship with longtime girlfriend Mary Austin (Lucy Boynton) faces its own perils between constant touring and studio time as well as Freddie’s reluctance to admit truths about his sexuality that he has avoided for most of his life.

You don’t need a thermometer handy to know that Malek is every bit the 200 degrees Mercury sang of in the guise of Mr. Fahrenheit (while traveling at the speed of light). The “Mr. Robot” star shines in every facet as he dons prosthetics to recreate the rock star’s overly toothy grin — well-known for having four extra incisors — and treats the microphone as if it were a waltz partner, albeit not doing most of his own singing.

It’s when you look beyond the surface that you see the stronger performance as someone whose flamboyance immediately signals to everyone around him that he’ll be a gay icon for years to come even if he remains in denial for the sake of not hurting the love of his life.

While American Malek single-handedly steals the show, true Brits Lee and Hardy anchor him well as his original bandmates, who quickly realize who’s always going to be the center of attention. Maybe that’s why Mazzello, also American, tends to serve as the whipping boy of Queen, but Deacon’s bass riff for “Another One Bites the Dust” at the very least warrants respect.

As for the suits, it’s a peculiar progression through managers as Aiden Gillen plays John Reid, the man who helps catapult the group into the stratosphere only to be regularly disregarded in favor of lawyer Jim “Miami” Beach (Tom Hollander).

You’ll have to really focus to recognize Mike Myers in yet another chameleon role as EMI executive Ray Foster, who insists that a song called “Bohemian Rhapsody” will never be welcome on the radio leading to the first of many schisms between Queen and their record labels.

It’s not so much his lack of foresight about a tune so ahead of its time as it is his ultimatum that “I’m in Love with My Car” should be the lead single. Typical producer…

The long and difficult road to get a Freddie Mercury movie in theaters has involved Sacha Baron Cohen being attached originally, while much of the recent buzz has been around director Bryan Singer’s behind-the-scenes drama, and though he receives on-screen credit, it was Dexter Fletcher who brought the project to completion.

Anthony McCarten’s screenplay reworks the Queen chronology agreeably enough even if fans know full well the timeframe is off — “We Will Rock You” first came to fruition well before 1980, no matter what the film suggests — but the buildup to the band’s landmark performance at the 1985 charity concert Live Aid has exactly the rhythm and crescendos that would befit any of their greatest hits.

Most telling is the amount of time spent focusing on Freddie’s personal journey without languishing on his legacy as one of the first high-profile people to die of AIDS, which while a noteworthy detail of his history is hardly how he or anyone would want to be remembered.

The tongue-in-cheek tone of “Bohemian Rhapsody” is best summed up when it shows a flurry of negative reviews for its namesake song if for no other reason than to prove the doubters wrong and show just how little mainstream acceptance means. As a wise man once sang, “I’ve had my share of sand kicked in my face, but I’ve come through.”

Veterans: 100 years ago, 100 years from now

Editor’s note: On this Veterans Day, U.S. veterans number more than 1 million, more than 800 of them in Moffat County.

One-hundred years ago, the War to End All Wars ended. Soldiers sailed for home. Today, no living American possesses the memory of being one of the 3 million who crossed the Atlantic to fight against Germany and the Central Powers. War has not ended. What does it mean to remember?

Two-and-a-half centuries ago, the United States of America originated with conflict. The Revolution's Continental Soldiers lived to see their country divide under Generals Grant and Lee. In turn, their children, grandchildren, and great-grandchildren became combatants, soldiers dispatched by Congress to defend the growing nation. More than 1 million have died in faraway lands and seas. Survivors returned home; they became veterans.

Among us today, they live and work, their yesterdays a vital part of who they are. What about the rest of us? Five days ago, we the people spoke: leaders were elected. What's next?

Divided among ourselves about how to find the answer to that question, we forget — a lot — and the past blurs. Somehow, we have lost track of how we got here, to this day.

Americans have grown into a mix of peoples, some few descended from native tribes who inhabited North America before European settlers arrived, many descended from slaves transported by force from another continent. Through the years, refugees and builders have traveled over oceans and continents to the myths and truths of the American West, escapees from where there existed no chance of bettering themselves or where hunger and desperation were all that was. They sought to make life worthwhile.

Beneficiaries of their bravery and recipients of history, most of us, in order to become Americans, have needed only to be born. We have not offered up our lives to make citizenship happen. Are we slowly but surely slipping into the emptiness of cultural Alzheimer's? The debilitating disease can deplete our country as it does the individuals who have lost connection with time past. If history disappears, we shall exist in a morass of murky clouds, unable to differentiate between what was and what is.

Veterans know. In foxholes dug along hillsides of Iwo Jima, in outposts of middle eastern deserts, under attack from poison gas, downed by machine guns, and expelled into the sea from torpedoed ships ,they have learned about themselves and about the man or woman next to them. They have learned under fire the ultimate reason for fighting. Must we all face battlefield horrors before we figure out that we can work together to make our country what it needs to be — for each of us, for all of us? Our struggles have resulted in growth toward ideals of liberty and justice that two centuries ago were barely conceivable. Veterans stand as guideposts marking the intersections of history.

From one generation to the next, our young children experience what they cannot yet name when they reach up to shake the hands of veterans and sing the words: "You have our backs. You always do. You know that we rely on you."

One-hundred years ago, the United States abandoned neutrality, entering into a war that promised to "keep the world safe for democracy." First-generation immigrants numbered some 18 percent of the American military. They may not have spoken the language of their new country, but they claimed it as their own and returned home veterans. Remembering them, we can avoid the disability of forgetting. Recognizing their presence in our midst, we the people can begin to see and hear each other, strengthening the common ground we share.

One-hundred years from now is up to each of us, to all of us. Our veterans show us the way.

Harriet Freiberger has lived in the Elk River Valley since 1982.

Editorial: The fight’s not over

The 2018 midterm election is now in the history books; after months of rancorous debate and campaign rhetoric, the candidates have either won or lost, and the issues have either been embraced or rejected.

It's over.

And that includes Moffat County Referred Measure 1A.

We won't mince words; we were bitterly disappointed by the outcome on this issue. Measure 1A would have ensured Moffat County Libraries and the Museum of Northwest Colorado would continue their vital services to this community into the foreseeable future, free from the capricious stroke of the budgetary axe. And, it would have done this in return for a pretty insignificant increase in taxes. As we editorialized last month, we saw 1A as the most sensible path to preserving these two treasured local institutions.

But, the majority of county voters disagreed with us, and we respect and accept their decision.

Our purpose here is not to demonize a choice we happen not to agree with; instead, it is to propose a path forward in light of that choice.

During both the lead-up to and aftermath of Tuesday's vote, we caught a glimpse of the reasons so many of our neighbors felt 1A was not a good idea.

Some seemed to express opposition to any tax increase, whatsoever, for any reason, whatsoever.

Others said county and city leaders had not done enough to divert existing funds to the libraries and museum before approaching voters with a mill levy.

Still others stated they never visit the library or museum, anyway, and questioned why they should even care.

Yet, one of the most telling comments we read following 1A's defeat went something like this:

"A vote against Measure 1A was not a vote against the libraries or the museum; it was a vote against higher taxes when other options might be available," and we believe that wholeheartedly.

If the question had been: "Shall Moffat County starve the Moffat County Libraries and the Museum of Northwest Colorado of funding until they die," we seriously doubt the measure would have received a single "yes" vote.

This tells us most in the community share our conviction that the libraries and museum are irreplaceable community assets and that their closures would be a horrific blow to the economic, educational, and cultural well-being of Moffat County.

If this is the case — and we sincerely believe it is — then we challenge ourselves and our neighbors to turn our noble words into tangible action.

As we acknowledged, the 1A question is settled, but the financial crisis facing the libraries and the museum was not settled with it — on the contrary, it was exacerbated. If we fail to act, both will eventually be forced to close their doors.

The bottom line is this: If we truly value the enrichments we enjoy by having a vibrant, active library system and a world-class western museum in our community, then it is we who must fight to preserve them.

What can we do?

We can attend and speak up at meetings of our local governing bodies. We can call our local leaders. We can write letters. We can let the Powers that Be know, in no uncertain terms, that allowing the libraries and the museum to wither and die on the vine is not an option we're willing to accept. And, if we still see no meaningful action, we can fire our leaders at the ballot box and hire new ones who will fight for the things we hold dear.

But if we do none of this — if we instead simply give up on two community treasures like the libraries and the museum — then we WILL lose those treasures.

Even worse, we'll deserve to.

Ruth Greenwood: Reader appreciative of YVEA

Citizens of Craig and Moffat County: Please show your appreciation to Yampa Valley Electric Association for the remodel and opening of the Craig District office east of Craig.

The board of directors heard and responded to our request for a local office to take our bills, orders and concerns to. Please attend the open house at the office on Monday, Nov. 12, during working hours, meet the staff, and see what the newly refurbished offices look like.

Thank you, YVEA, for considering the needs of Craig and Moffat County citizens.

Gratefully,

Ruth Greenwood

Craig

Ann Anderson: Humane Society grateful for support

The Humane Society of Moffat County would like to thank all the businesses and individuals who contributed to our bowling Fundraiser on Sept. 22. We would like to give special thanks to Bank of Colorado and Thunders Rolls Bowling Center.

Thanks also to Don and Tina Williams, for your contribution to run the "thank you" ad that ran in the Craig Press listing all our supporters.

Our thanks also go to Kelly Hepworth and staff at Bear Creek Animal Hospital for your support!

It was a great success which included lots of prizes and great food. Thanks to our community for your support!

Ann Anderson

Humane Society of Moffat County

From Pipi’s Pasture: November reflections

At this writing, it is just turning daylight. The early morning sky is covered with scattered clouds, some of which are tinted pink. It's a pretty morning. When I first got up, I turned on the front porch light for our granddaughter Megan, who would be coming home from work soon. I pushed the three cat food pans out onto the porch and filled them with food. (We put them in at night to discourage the skunks.) Then, I took the dog out and poured myself a cup of coffee.

I enjoy the quiet of the morning, when the world is just waking up. Lyle enjoys a little more sleep before it's time to help feed the cows, and I wait until it is light enough to go to the corral. As I wait, I enjoy my coffee, plan my day, and reflect on things. This morning, I'm thinking that it's November already, and as I do at the beginning of every month, I reflect on the changes the new month brings.

It's Election Day, and we're thankful we have elections. Lyle and I both remember years past, when we visited with neighbors as we waited in line to vote. We looked forward to the day. This year, we have already voted — days ago. We are thankful that the political commercials — particularly distasteful this year — will be off the air.

Daylight Saving Time is gone for a few months. A few days ago, one of the news channels on television featured a report about the results of a study concerning the effects of changing from one time to another on the human body. I had no idea the changes might bring on a stroke or heart attack. What I do know is that, here at Pipi's Pasture, it takes a little time to get into a new feeding schedule. It's light enough to go to the corral by 7 a.m., but I have to arrange my away-from-home work appointments so I can do chores by 3 p.m. Otherwise, it's getting dark when I'm filling stock tanks. This November, however, it seems we have slipped into the time change more easily than usual.

We have weaned and sold the calves, and the cows have settled into a winter routine. The "bottle" calves have been weaned, too, and are eating grain. Ucky is gone, so there are fewer chores than usual at the corral, which leaves time to chop and remove ice from stock tanks. As we ease into using tank heaters, that chore will become easier, too.

This early morning, I'm marveling as to how much the trees look like skeletons, with their leaves covering the back and front lawns. A few apples and crabapples remain on the trees, food for the flock of winter birds that fly in groups around Pipi's Pasture. The garden looks sad and lonely.

The little bit of snow we've seen this past week is a warning that I need to buy some winter boots — that, and gifts for November birthdays and Christmas.

Reflections and planning — it's all about November, which has come in a hurry and and will go the same way.

Over a Cup of Coffee: Quick sandwich recipes

One night last week, when I was in a hurry to get supper, I decided to make Sloppy Joes. I usually make them using ground beef, pork and beans, and tomato sauce or ketchup, but this time, I decided to jazz up the recipe a little by adding some green bell pepper and onion. What I got was rather good Sloppy Joes. So, I'm including the recipe in this week's column, plus some other sandwiches. If you make the sloppy Joes, remember to use the pepper, onion, and ketchup for your taste.

Diane's Sloppy Joes

• 1 pound ground beef

• 1 can pork and beans

• About 1/4 of a green bell pepper, chopped

• About 1/4 medium onion, chopped

• Ketchup, to taste

• Seasonings

• Hamburger buns

In a skillet, brown the ground beef with the green pepper and onion. Add the pork and beans and stir. Season with salt and pepper to taste. Add ketchup to taste. (I did not measure the ketchup. I just added some to the mixture straight from the bottle, mixed everything up, and added a bit more until I liked the way it tasted.) When the mixture is heated through, serve it as filling in the hamburger buns. Add a salad, and you have a quick supper.

Easy Denver Sandwich

• 1/4 cup minced onion

• 1/4 cup minced green pepper

• 1 tablespoon butter

• 4 eggs

• 1/4 cup milk

• 1/2 cup minced cooked ham

• Salt and pepper

Sauté onion and green pepper slowly in hot butter until the onion is yellow. Beat eggs slightly with milk, and stir in ham, salt and pepper. Pour egg mixture into the skillet. Scramble gently with the onion-pepper mixture over low heat until just set. Spoon into hot toasted buns, or serve between buttered slices of bread or toast. Makes four sandwiches.

Club Sandwiches

Lightly toast three slices of bread for each sandwich. Top first buttered slice with cold sliced chicken. Top with second slice of bread buttered on each side. Top this slice with lettuce leaf, tomato, and two slices crisply-fried bacon. Put buttered third slice of bread on top. Use mayonnaise on chicken layer, if desired. Cut into halves or fourths or secure corners of sandwich with toothpicks.

These last two recipes are from my cookbook without a cover. Do you have recipes you would like to share with readers? If so, please call me at 970-824-8809 or write to me at PO Box 415, Craig, CO 81626.