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tv   In Good Shape  Deutsche Welle  April 12, 2019 2:30pm-3:00pm CEST

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so they can plant crops and find food. and drugs climate change become the main driver of mass migration you can write any apocalyptic scenarios you want and probably most of them will come to. exodus starts if you're curious on t w. welcome to in good shape here's what's coming up. radiation in the kitchen are microwave ovens a health risk. posed up problems the side effects of prostate surgery. and tightening up the pelvic floor to combat incontinence and here's your host dr. hello and welcome to in good shape. from
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a little close up. there some topics people don't like to talk about out in the open. but we in good shape we have no to bruce we talk about everything like today in going to talk about during every incontinence some people always with their pads and others just when the cough sneeze or laugh and what you can do about it this is what i'm going to talk about with dr to be here at the inventors clinic and. nobody should walk around with what trolls us for almost everyone who is incontinent the roof solution. you should always drink plenty of water but many of my patients are fraid to do so because they got. we are and what they're also
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afraid off is telling the doctor but. once in my life the false stand for the name when talking in front of the big. one chooses a physiotherapist helped forty three year old yvonne bush bell to strengthen her pelvic floor she had a baby ten months ago and sought help soon after but it didn't do enough urine would still leak from her bladder when she was out running. grass is on first child and at four and a half kilograms she was larger than average the bird stretched and strained the muscles in her mother's pelvic area this is just. you know. i'm a bit older so maybe that's why it happened also the length of the birth pushing for so many hours. i think that had something to do with it when the want to.
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target exercises can tighten up weakened pelvic floor muscles. this in china by making the most important thing is to be able to coordinate the pelvic floor to get it under control when patients first start learning they have to make a conscious effort when they're doing things like lifting bending sneezing coughing blowing their nose anything that creates pressure down there. and once you've learned. your brain remembers. just by shut off we sit up straight and stabilize from bottom to top from the sides from your back and abdomen. yvonne now has a pelvic floor muscles back under control along with her bladder and weak bladder is a more common problem than people think. i just feel or to many people only associate it with the elderly but that's incorrect. it also affects lots of young women especially after childbirth things like coughing sneezing laughing in jogging can
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make people urinate spontaneously and not getting appropriate treatment like physiotherapy can have long term consequences eventually surgery might be the only option but follow can demand and when all parties. are. like it klein is one of the patients who needed an operation as an incontinence clinic and bone surgeon successfully inserted a small band that supports the research from below when pressure is put on the pelvic floor it works like a hammock. all. the others use as many bunt is this small band helps replace the natural band structures you have in the pelvic floor and these natural bands normally keep the year we through a stable and ensure your and doesn't leak out but they can become damaged for a variety of reasons especially childbirth. what when you think about how extreme stretching years and the birth canal during birth you can
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imagine the body's own structures overstretching and losing function. like a klein has fond memories of her son's birth twenty five years ago but over time she became unable to cough or laugh or lift a laundry basket without urinating. the twenty minute operation has given her back control of her bladder and her freedom. you know my kind if i thought we don't spar now i can have fun again. and i don't have to worry about whether laughing will make me wet myself. what she knew was that. it's a happy ending for yvonne busch belle as well the physiotherapy has saved her from a life of chronic incontinence. and the work ethic. in the event is spinning in britain and i will talk to dr to be part
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of the rose department for reconstructive. we're going to talk about a week later but actually it's not the bladder which gets weak it's more like the fashion. in your old you talk about incontinence that the officer wrote off official catalog it's not by their weakness it's not perfect because all together the presidents are not working together but if the president of the bladder is higher than the president the perfect floor it will overflow and one will be incontinent one is using your in at a time it's not appropriate what how the fish is going and we get on there are three reasons especially in female patients first lots off deliveries both because of a child's head is good for the perfect floor and abiding it and the second one is hysterectomies women which have uterus removed have removed
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ligaments which are fixing the leather and the third thing is getting older getting older connective tissue the fresher they're getting weaker and weaker and it's not possible to train them we can train muscles but not professional and there are different types of incontinence yes there are two big groups of incontinence the first one as stress incontinence stresses. here the pressure stress not the not the psychic stress the stress which is produced by the pressure of the bladder and atomic incontinence and the other thing is urgent continence because of different sensations which are going to be discordant need to hold the brain doesn't feel exactly what the letter does and the other way around so if you suffer from those kinds of encounter then sewage should see a neurologist and especially women sometimes a freight of seeing this kind of doctor so to do in the same nation that it's
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everything not not painful. first you do is we make questionnaires together with the patients we have some questions which are very important to differentiate between the urgent continence and the stress incontinence we have to work down different question as for that the second thing is ultrasound we do more and more examinations by a song than in the years before because the devices for forceful not graphologists on the getting better and better and more and then the third step maybe. that's the thing where people are afraid of but today we use flexible instruments which can be with that which are very thin we make a nest of local anesthesia the of. it's not painful we get a picture of the problem and then we can treat it and holding it. in pure stress incontinence most women are treated to the so-called tapes this is a tape there's a pulley properly in tape but there are other types of. odd so there's
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a lot of women can be can be healed with a straight simple operation but there are even bigger operations to have to perform because in the summer in some cases it's not only the pelvic floor the refurbish was wrong but also the sink to muscle it serve its intrinsics think that efficiency in these patients want us to make artificial your notice figure in about this artificial urine there is. we continue our talk in just a moment because this implies to me to a don't like to speak the body during their symptoms but they suffer from it too especially after protecting the. prostate cancer is one of the most common cancers among men prostatectomy or surgical removal of the prostate can cause serious problems. since the operation i've been completely incontinent it's not pleasant in fruits of all there was a big shock it's not what you hoped for really hit my life hard. all three men became incontinent after
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a cross to take to me the rethread passes through the prostate gland the operation can damage both the re threat and the bladder sphincter which keeps the urine in the bladder till one chooses to your innate this damage can result in bladder control problems. on the basis of recent developments we're now operating on older men with aggressive tumors or chrissy from to move from kansas are in five to ten percent of all cases and continents. including and start with the artificial urinary sphincter is a treatment for severe incontinence it's a device comprised of a cough that goes around the rethread a chub a pump inserted into this quote him and a small balloon reservoir in the abdomen for the fluid that fills the cuff it takes a surgical procedure to install it all. the bleeding from these and the problem is that the patient has to operate it manually he has to work the pump in his scrotum
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to empty the cuff of the liquid that keeps it tight loosening the car then lets him pass water. for mild to moderate incontinence there are alternative treatments involving balloons slings and cushions. the script there's no one perfect solution it depends on the diagnosis that requires a psycho skippy to evaluate the damage or defect that. introduced about fifteen years ago involves artificial compression devices relates to burn has been kitted out with such a system to silicon balloons filled with liquid squeeze the you re threat to keep it closed and thus prevent leakage supply and i think if it's a minor procedure takes five or ten minutes under general anesthesia with a little gas this is usually enough to make the patient sufficiently consonant so that he's content quentin and some others it's if we. fear both
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food for all it takes four or five weeks for the balloons to take up position. so they exert the right pressure. after about three months i had almost no leakage. the first of. the pressure the balloons exert sometimes decreases but they can then be refilled with liquid in fitzgibbon's case one was displaced in a bike accident because of the risk that the balloons might tear or move they tend not to be the method of choice these days. this is. the problem of balloon failure can however be dealt with you simply replace it it's a minor procedure with little impact. i think it's certainly feasible. if you. been has undergone balloon replacement five times. with this method the patient just needs to push with
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a modest amount of effort in order to your innate a new a method uses a u.v. thrill sling and a cushion. trance camps which to that a year ago from balloons they proved not to be right for him. he said. i was disappointed because it had seemed so promising at the start it went very well. it turned out his you rethrow had shifted a sling of soft mesh repositions the rethrow a cushion exerts pressure on the muscle surrounding it and functions as a substitute sphincter darby that sits in my shoe these are the fonda for this is an excellent arch and because the sling moves the your rethrow back where it should be. i mean the thing continence remains an issue the question can be adjusted at any time. through a port liquid can be pumped into the cushion or it can be drained off to increase
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or reduce the pressure as needed. funds compass had such a device for a year and has now got used to it. it's a foreign body they put inside you but it's getting better and i'm quite pleased with the result. another option is a sling without a cushion here to the sling of mash restores the year rethread to its proper position that's often not enough to keep patients dry who have a problem with bladder control that night instead a sling plus cushion has proved more effective as in the case of manfred to unpack all their followers and we've been using this system for ten years for patients with moderate incontinence and. we found that they benefit from a sling system that also exerts pressure. of. in the months after the device was installed mantra durned that quint back to have
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the pressure in the cushion adjusted a couple of times. not. at night i remain almost dry during the day less so. i think that's normal i feel quite optimistic about the future. it's a prostate operation the most common cause for in canton in syria in. the us most men with an incontinent head of prostate surgery for want arms for the surgery for the benign prosthetic. the operation is done in the most cases endoscopic only and. twenty thirty years ago all these devices we had to use were. we had to look with our bare eyes through it today we have cameras we have huge screens where we can watch the surgery so we only have read only the condition that the
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patient is in condition after the benign prostate operation it's completely different of radical prostatectomy in prostate cancer because of his operations the prostate has to be removed completely and it has to be divided. from the sphincter muscle it's a part of the of the. junction between your rethrow and prostate and in some cases it's not possible to preserve it because the cancer is growing inside of the muscle then we have to remove it or it's a senseless operation but what can we do after this is that ok just to train the pelvic floor muscles that's routine there or it should be rude to you that every patient who has a prosthetic to me goes to rehabilitation in full for three to four weeks we can train muscles but we can train all the muscles not the connective tissue between the different stricter structures and so in some cases the muscle training does not work so this is when you need to operate again in to put in an artificial swing to
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that's right for these patients we have artificial uro's think those devices like these they have all the cuff around the rethrow are as though you read through a cuff of such an artificial you know. they have a system to produce pleasure like a balloon like a pump and they. well it's possible to end this discover fear that it's release of you and the patient. void the bladder is a lot of devices but this is more than one this is the one very different to show you here this one there's only two parts this is the. there's of the pump system which is in the scrotum and in other systems it's a little different like here you can see the pump of the scrotum. the cuff for the reef and two balloons to produce the pressure is
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a very difficult operation it's a special operation that said this is just below the skin saw it's not deep operation like gastric operation so the over of. the structures are very subtle one has to make a good preparation. for this we are specialized in these operations so it's better to go to a center who's doing a lot of aeration stuff go through let me know their. so-called high volume centers have better results than centers who do it only twice or three times a year and for those devices who remain in the body they remain between twelve and fifteen years and then the silicone is worked out it's going to hold someone then one has to replace it again and is it a problem the sexual activity after those implants. nor sexual activity maybe deteriorated by the prosthetic surgery. but that does not happen in all patients
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a lot of them are to have a normal. function and it's not. not deteriorate about implantation of a lot of you notice into things like to take for answer all my questions and if you suffer from any symptoms of incontinence don't be shy and go and see your doctor and don't be shy. and writers. on an upcoming show will be looking at fertility some couple struggle to have a baby what can stand in the way of conception and what treatments are there if you have a question send it to in good shape at g.w. dot com just right for tila to treatment in the subject line we look forward to hearing from you. i've no idea how this microwave oven works i'm a physician not a physicist and usually you can sap your food within minutes but as a doctor i'm interested in how michael waves dangerous for us is the relation
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harmful this is what we found out. about seventy percent of german households have a microwave the remaining thirty percent include many people who worry about microwave radiation are they right can microwave ovens harm your health. we paid a visit to saka decent to find out more the university of arkansas research is collecting all the available scientific studies that examine the connection between electromagnetic waves off field and human health as in kind of stored in because i'm not aware of any studies that show that microwave ovens are harmful to human health. but you do have to make sure that microwaves meet safety standards and don't exceed allowable radiation limits for god but there is a concept of. the controversy over the possible health effects of electromagnetic
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waves are nothing new but people are usually more worried about cell phones and electro smog from high voltage power lines and in that area the evidence of possible harm is more persuasive things is for life that want to see the difference might be that when you're talking on the phone you're holding the cell phone to your ear the entire time. so you're exposed to the microwaves for longer because that's been funneling out that site so if you're worried about electromagnetic radiation you might want to consider limiting your time on the cell phone. by comparison the risk of microwave ovens appears to be well within acceptable parameters contrary to what some people believe food heated in a microwave isn't irradiated only ionizing radiation such as x. rays or gamma rays can do that. microwaves are a type of non ionizing radiation actually we scientists when we're talking about microwaves refer to electromagnetic fields. so is food heated in
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a microwave healthy to eat. we are asked to answer that question she's a science writer and nutrition expert who works in the field of consumer protection . it depends on what kind of food you're preparing in the microwave microwave ovens aren't inherently good or bad. what happens when foods that are good for you are heated in a microwave like broccoli for example. one spanish study that's been circulating online reported that microwaving broccoli destroyed most of its flab annoyed if true that would be problematic. as it was that there is evidence that secondary fighter chemicals can help prevent cancer so of course we want to preserve them and for the. plants and i the karata know it's that give plants their vibrant colors
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are plentiful in fresh fruit and vegetables. and. asked to examine the study he's an expert on food processing at the university of geese and. studied exactly what happens to broccoli in a microwave oven. electromagnetic waves in a microwave supposedly only affect one component found in broccoli the water it contains. so does heating food in a microwave destroy certainly prince. and his research team found no evidence of that. but they did discover that broccoli heated in the microwave contains less fat soluble vitamins than if the vegetable is steamed or boiled the heating process that takes place during cooking releases the broccolis fat soluble vitamins and that doesn't happen even in a microwave. microwave energy is focused on areas where there's water wherever
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there's less water like deeper inside the food or in the thick broccoli stock it doesn't work quite as well for example a levels are higher when broccoli is steamed or boiled then when it's cooked in a microwave. that leaves us with one more question does food cooked in a microwave taste different in some way. after all microwaving food isn't usually considered the height of carbon or a refinement. so is there any truth to that or is it just snobbery. has also investigated how microwaving food affects its flavor and consistency to be uneven warming has an effect. on the surface there are spots where the broccoli is too dry or where it's overcooked no longer. looking at the color and texture and the mouthfeel microwaving food
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produces what you might call an acceptable result but certainly not an outstanding . but if you're just reheating food and not cooking it the microwave can be a good option and a practical one. when you want it fast a microwave oven is a good compromise but for optimal flavor you might want to cook the conventional way or just. well. i don't need it because i'm married but we do have to be set in the kitchen so my wife on t.v. . next week.
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the prison clear up that it's most it's a major and it's most exciting to a gets most of the bush clan trying to taste it you know they just really charming. the resistible. the book. on t w.
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i'm not laughing at that because sometimes i am but less than nothing which is that the german thinks the printer german culture looking at the stereotypes aquatics if you think the future of the country that i'm playing. the piano needed it's a ridiculous drama day out to me because it's all about. bach now by rachel join me for me for gemma from d.w. . post. or go by keep to seek for food. cut. separate draw and cook foods to avoid cross contamination. cooks thoroughly to kill microorganisms.
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keep food it safe temperatures. to prevent bacterial growth. use safe water and safe all materials to avoid content. producers are the ones primarily responsible for the safety of the food you buy but you can protect yourself and your family from diseases and home by plying the five keys to see food use them you also have a role to play. this
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is deja vu news coming to you live from berlin and protesters in sudan demand democracy now leaders of the protest movement to reject the military's councils up page off civilian drones within two years or so and out thousands of people gathered to fight if france outside army headquarters to keep the pressure up or change.


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