Standing and sitting next to a table filled with wine glasses

Last night was a wine tasting, southern hemisphere wines, led by a sommelier, 9 bottles for 13 people. The table was covered with champagne flutes, regular wine glasses and water glasses.  I needed to move seats which considering that I usually still need to use my right arm to push off the chair, that would leave my dangerous left arm free to swing wildly and knock over loads of glasses. So in order not to crash glasses I have to pivot my chair parallel to the table so I can grab my left hand with my right hand and use the swing your upper body over your legs method to stand up.  I've gotten so good at this I can do it even after more than a couple of glasses of wine. Luckily my friends keep me supplied with water so I don't have to leave the table for that. My bladder control is much much better than the first year.   See my quotes from Anthony Bourdain and Hunter S. Thompson for how I'm living my life to the fullest.

Brain Mechanisms Underlying Urge Incontinence and its Response to Pelvic Floor Muscle Training

This took me a while to get under control. I absolutely hated having to figure out where the bathrooms were anytime I entered a new building.  Road trips were hell. I guess men do not have this problem.
http://www.sciencedirect.com/science/article/pii/S0022534715035661

• Derek Griffiths,
• Becky Clarkson,
• Stasa D. Tadic,
• Neil M. Resnick

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doi:10.1016/j.juro.2015.03.102

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Abstract

Aims

Urge urinary incontinence (UUI) is a major problem, especially in the elderly, and the underlying mechanisms of disease and therapy are unknown. We used biofeedback-assisted pelvic floor muscle training (PFMT) and functional brain imaging (fMRI) to investigate cerebral mechanisms, aiming to improve understanding of brain-bladder control and therapy.

Methods

Before receiving PFMT, functionally intact, older, community-dwelling women with UUI—as well as normal controls—underwent comprehensive clinical and bladder-diary evaluation, urodynamic testing, and brain fMRI; the evaluation was repeated post-PFMT in those with UUI. fMRI was used to determine brain reaction to rapid bladder filling with urgency.

Results

28 of 65 UUI subjects responded to PFMT with >50% improvement of UUI frequency on diary. However, responders and non-responders displayed 2 different patterns of brain reaction. Pattern 1 (Responders): pre-PFMT, the dorsal anterior cingulate cortex (dACC) and adjacent supplementary motor area (SMA) were activated as was the insula. Following PFMT, dACC/SMA activation diminished, and there was a trend to mPFC deactivation. Pattern 2 (non-responders): pre-PFMT, the medial prefrontal cortex (mPFC) was deactivated and this changed little following PFMT.

Conclusions

In older women with UUI, there appear to be two patterns of brain reaction to bladder filling and they seem to predict response and non-response to PFMT. Moreover, diminished cingulate activation appears to be a consequence of PFMT-induced UUI improvement, whereas prefrontal deactivation may be a mechanism contributing to success of PFMT. In non-responders this latter mechanism is unavailable; this may explain why another form of therapy is required.