Breathing and kegel exercises

Posted by soli @soli, Jul 20 11:53am

In preparation for an upcoming prostate surgery within weeks, I have pro-actively started kegel exercises to minmize the impact and duration of incontinence post-surgery. Different instruction videos on the subject have contradictory instructions on the breathing aspect while doing the exercises. Many say, breath out, hold your breath and tighten the pelvic floor muscles. Others instruct, continue to breath normally while tightening the pelvic florr muscles (which is very diffcult to do). What is the right approach?

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Profile picture for jeff Marchi @jeffmarc

A physical therapist who specializes in strengthening the pelvic floor muscles would definitely add one thing to this.

Before doing all that tightening breathe in to your stomach, not your chest and then tighten.

Now it does say it’s a beginning lesson. What I mention is what I got taught when I went to a physical therapist who only sees people for pelvic floor problems. She even brought in her boss (another PT) to go over the breathing instructions, more closely along with the sit to stand instructions, for more advanced pelvic floor exercising.

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I also see a pt that specializes in males following prostatectomy,. She is great and she probably figured out I was a slow learner. a clencher. I hold my breath all the time when I should not. She even used visuals with me, explaining how my diaphragm and abdominal muscles contracted and expanded .

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Profile picture for edinmaryland @edinmaryland

Thanks for asking Surftohealth
I really hope you and as many out there as possible are doing OK
For me the glass is half full. I just had my second PSA since RARP in January and it is very low. that is the most important thing.

I see an experienced surgeon next week to see about possible hernia repair, Gallbladder removal and cyst on my abdominal wall I have no idea if I will have any surgery or a combination surgery

meanwhile, incontinence is improving but very slowly. I am a very slow learner. I have been going on walks every day usually between 2 and 8 miles every day total. I am not ready to try the exercise bike again especially sinoe I have been having some on again off again perineum pain. . I do fine with this ( a 3 mile early, perhaps a midday 3-4 mile and then a one or two mile near dinner time minor leakage minor pain near hernial area.

However, when I babysit after about just an hour or two I am leaking considerably and sometimes tender. what I am learning is that all the sudden movement, twisting, picking up things etc my pelvic floor muscles are not used to this quick activation and de-activation I cannot control what these one, two , three and four year olds will do. I love being around them and will not stop but it is an unpredictable environment

How are you doing? How long post RARP?.

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I am very happy to hear that there are considerable improvements - they look small to you, but if you read your posts of couple of months back you will see that you have a nice trend now : ) . I am sure once they fix hernia that your incontinence recovery will have even faster trajectory (of course after initial post surgery recovery period ).

You are VERY active and have very minor leaking unless you make sudden moves and that will improve with time and exercise too : ) . Please, please do not even think about picking up your grand-kids - I know that it is fun but you have to take care of yourself until you fix that hernia. If there are toys on a floor ask 4 year old to pick them up ; ), they should learn about cleanup at that age anyways.

Regarding RARP - my husband will have surgery done mid August and I am a nervous wreck, but I am trying very hard not to show it, so I am featuring "Mona Lisa smile" 24/7 XP. Thanks for asking < 3.

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I wish you good luck on your husband’s surgery. My prostatectomy is scheduled for September 2nd. I have pre-op next Monday. I am learning as much as I can on how to prepare for surgery, the week before, the day before, the day of, the morning after, home recovery etc. Based on the learnings, I am doing things I can do now ( e.g. starting kegel exercises, getting supplies, identifying potential home health resources near me etc.) which I hope will lead to a successful outcome.

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Profile picture for soli @soli

I wish you good luck on your husband’s surgery. My prostatectomy is scheduled for September 2nd. I have pre-op next Monday. I am learning as much as I can on how to prepare for surgery, the week before, the day before, the day of, the morning after, home recovery etc. Based on the learnings, I am doing things I can do now ( e.g. starting kegel exercises, getting supplies, identifying potential home health resources near me etc.) which I hope will lead to a successful outcome.

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Thank you very much Soli and I wish the same to you : )))
I think that you are doing great job with learning and preparing and I am sure that recovery will be much easier and faster because of that. All of this will hopefully soon be behind us and we will be able to concentrate on healing and going forward. : )

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Profile picture for surftohealth88 @surftohealth88

Thank you very much Soli and I wish the same to you : )))
I think that you are doing great job with learning and preparing and I am sure that recovery will be much easier and faster because of that. All of this will hopefully soon be behind us and we will be able to concentrate on healing and going forward. : )

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You are welcome @surftohealth88 .

I agree: at some point in the future, this will be all behind us. In addition, there maybe a silverlining for us to discover which - in my experience - always exists in every crisis. As a starter, the voiding disfunctions caused by an enlraged prostae will be gone, since the prostate will be gone. Granted the voiding disfunctions caused by the prostate will be replaced with incontinence, but for most people that will be temporary.

Will there be other silver linings?

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Profile picture for soli @soli

You are welcome @surftohealth88 .

I agree: at some point in the future, this will be all behind us. In addition, there maybe a silverlining for us to discover which - in my experience - always exists in every crisis. As a starter, the voiding disfunctions caused by an enlraged prostae will be gone, since the prostate will be gone. Granted the voiding disfunctions caused by the prostate will be replaced with incontinence, but for most people that will be temporary.

Will there be other silver linings?

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Ha ! You got me with this one , ha ha.
I am usually trying hard to stay in "Pollyanna"/"Terminator" hybrid mode to survive any crises but when cancer is in question it is really hard to look for a silver lining - I do not see it, no matter how hard I look *sigh. For us there is none BUT who has time to think about that ; ), - big fight is ahead so "hasta la vista" Soli ; ) , and may we beat this thing once and for all : ))) ! 🍀🍀🍀

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I hear you @surftohealth88 . Getting cancer is one of the worst things one can face. But I am a disciple of Yale Professor Dr. Laurie Santos who is an expert on Happiness. One of her important techings is - in facing difficult situatoin - one needs to "look for a silver lining". That is "to look for the positive aspects of a challenging situation". That is what I am trying to do. In fact, I have alread uncovered one major one. My primary doctor did not want to refer me to a cardiologist because she did not a see a reason to do so. But as part of the recent pre-op tests for surgery, a minor issue in its very early stage was discovered which I was not aware since there were no symptoms. This problem could have gotten progressively worse if I had not caught it in a very early stage as part of the surgery pre-op: I see this as a silver lining, and will continue to look for more. I am pretty confident I will find more since I have applied this principle to every horrible situation I have faced in the past. Clearly, none of this will change the terrifying cancer diagnosis, but it allows my mind to also focus on the positive aspects that are discovered.

I understand everyone faces challenges in their own respective ways: so I agree with the principle "to each his/her own."

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Profile picture for surftohealth88 @surftohealth88

Ha ! You got me with this one , ha ha.
I am usually trying hard to stay in "Pollyanna"/"Terminator" hybrid mode to survive any crises but when cancer is in question it is really hard to look for a silver lining - I do not see it, no matter how hard I look *sigh. For us there is none BUT who has time to think about that ; ), - big fight is ahead so "hasta la vista" Soli ; ) , and may we beat this thing once and for all : ))) ! 🍀🍀🍀

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Soli and surftohealth
I love it.
I am six months out, and it has been a trying six months but -- this is the big silver lining we are taking a big step to get rid of cancer. Decades ago, so many men just got cancer and did not live as long. Now, if we get early detection and then treatment, we stand a fair chance at good life expectancy.
I hope you and your husband surftohealth, get the surgery and then while recovering at least the PSA should be low. The catheter is not fun but it more or less short term, ( five days to two weeks it seems, I had a very conservative surgeon so I had it in for two weeks)
Incontinence and Ed ( and other less common things like infections, hernias, etc)
I wish my urologist had told me that the majority of men are incontinent and most take close to a year to get back to baseline (with lots of variance)/ I was told little and when I pressed I heard things like 'dome guys have no problem with incontinence," : some guys really turn a corner in a few weeks" "lots of guys go back to work in two weeks" I should have been shown the recommendations from the American Urological Association and told something like most men will have incontinence, it sucks but it is the price to pay to get rid of cancer expect a year of working on it and if it better then this then be pleasantly surprised.

Anyway, I want to know how both of you do in August ( your husband surftohealth)
IN my case it was a good decision, and I have no big regrets.

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Profile picture for edinmaryland @edinmaryland

Soli and surftohealth
I love it.
I am six months out, and it has been a trying six months but -- this is the big silver lining we are taking a big step to get rid of cancer. Decades ago, so many men just got cancer and did not live as long. Now, if we get early detection and then treatment, we stand a fair chance at good life expectancy.
I hope you and your husband surftohealth, get the surgery and then while recovering at least the PSA should be low. The catheter is not fun but it more or less short term, ( five days to two weeks it seems, I had a very conservative surgeon so I had it in for two weeks)
Incontinence and Ed ( and other less common things like infections, hernias, etc)
I wish my urologist had told me that the majority of men are incontinent and most take close to a year to get back to baseline (with lots of variance)/ I was told little and when I pressed I heard things like 'dome guys have no problem with incontinence," : some guys really turn a corner in a few weeks" "lots of guys go back to work in two weeks" I should have been shown the recommendations from the American Urological Association and told something like most men will have incontinence, it sucks but it is the price to pay to get rid of cancer expect a year of working on it and if it better then this then be pleasantly surprised.

Anyway, I want to know how both of you do in August ( your husband surftohealth)
IN my case it was a good decision, and I have no big regrets.

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I am glad the worst is behind you and the cancer is eliminated. And hopefully your side effects will wane over time with exercises and therapies. I have heard from a lot of people who have had surgery that the degree and duration of incontinence is all over the map.
So, that is one of the big unknowns for me, and I have already started Kegel exercises even though my surgery is in early September. Hope that helps.

Will keep everyone posted after the surgery.

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