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Overactive Bladder (Urinary Urgency/Frequency Syndrome):
With normal bladder function, when you feel your bladder is full you can control when you urinate by contracting a particular muscle in the bladder. In the case of an overactive bladder, the muscles receive the wrong nerve messages and contract unexpectedly, causing you to feel like you have to urinate right away or, in some cases, causing you to leak urine. Women who suffer from overactive bladder may experience voiding frequency >8 times a day, voiding frequency >2 times a night, sensation of incomplete bladder emptying, strong urge to urinate, and may suffer urinary leakage. There are many risk factors for overactive bladder including childbirth, pelvic surgery, neurologic diseases, aging, and certain medications. The workup for overactive bladder includes a complete medical history. Your doctor may require you to fill out a bladder diary. Most workups include an assessment for bladder infection, assessment for appropriate bladder emptying, and potentially complex bladder testing known as urodynamics. Treatments for overactive bladder include but are not limited to medications, pelvic floor therapy, Mona Lisa Touch Laser Therapy, Interstim bladder pacemaker, and botox.

Your best prevention strategies are nutritional and lifestyle oriented:

Stop smoking

Be active

Lose weight

Masks

Sanitizer

Social Distancing

Nasal irrigation nightly with distilled water

Supplementation with macronutrients and vitamins can significantly promote healthy immune function. The following is a core list of what to consider. There are many more add ons such as Tumeric, Omega 3 fish oil, higher amounts of vitamin C. However simplicity is important.

Core daily maintenance for ADULTS during this time is as follows:

Covid-19 Supplements

Zinc Gluconate or Zinc Picolinate

ALWAYS TAKE WITH FOOD.... balanced diet with nuts, veggies, fruit, etc to supply copper.

ADULTS
50 mg daily if over 125lbs

30 mg daily if between 100-125lbs

15 mg daily if less than 100lbs

10 mg daily for children

ONCE A PERSON HAS BEEN ON ZINC FOR 2-3 months it is ok to cut back to Monday-Friday and skip the weekends.

MELATONIN
1-2 mg nightly

VITAMIN D
5000 units daily with a meal or omega 3 fish oil.

MULTIVITAMIN
daily

Elderberry
250 mg 2-3 x a day.

AVOID
Ibuprofen, Motrin, Advil, or similar prescription medications if flu like symptoms develop.

May take Tylenol or acetaminophen

Everyone over 100 pounds and older than 25 yrs of age regardless of exposure should be taking the zinc & melatonin. If a person starts to have any cold or flu type symptoms including but not exclusively fever, cough, sore throat, or respiratory symptoms: increase zinc (30-50 mg capsules) to 1/hour for 4 doses over 4-8 hours (120-200mg total WITH FOOD) then skip the zinc for 3 days. Please remember Zinc can cause nausea and/or vomiting. Always spread the doses and take with a meal.

Children

Zinc 10 mg daily
Kids multivitamin

Most pediatric chewable vitamins contain 10 mg of Zinc.

Children already have lots of melatonin and are unlikely to get a significant infection. So add back Melatonin is unnecessary.

Humans...

Oral contraceptives, oral estrogen or the nuvaring contraceptive device all mildly increase the risk of thrombotic events. These risks increase potentially with smoking and/or obesity.

We are talking only about the above!
*****ORAL Estrogen or Nuvaring Birth Control Ring ***

Not anything else.

Topical Estrogens.... gels, creams, patches, troches, pellets and injections, rings for menopause, vaginal tablets or creams.................. DO NOT!!!!

Natural Progesterone or Progestin only Birth Control Pills DO NOT!!!!

IUDs of any type DO NOT!!

As more data accumulates about COVID-19 additional potential disease events become apparent.

The one that is germane relative to these forms of estrogen is the elevation in risk of micro-embolic events in COVID-19 patients.

A micro embolic event is when a very small clot forms in a blood vessel and then breaks off, travels, then occludes or blocks the end of a smaller blood vessel. This leads to a mini infarction/stroke of the tissue the blood vessel fed.

In older pts with COVID19 up to 70-80% with only mild symptoms; cold or flu stuff are having these occur. Unfortunately these micro-emboli are occurring in younger pts too.

If you are on an oral estrogen or nuvaring please consider notifying your Ob/Gyn or other provider if you get COVID19 to discuss this potential issue. Make them aware of the mild increased clot potential with your hormone therapy and the recent concerns with COVID infection for elevated thrombotic events. They will be able to determine any care plan changes if even warranted.

COVID19 is turning into a complex medical management nightmare across all medical specialties.

All the best!

Noel Williams