Will US debt ceiling deadlock push capital to yuan market?

Illustration: Carlos Latuff

Expert: The role of the U.S. dollar declines

The US Government is BROKE | The 2023 Debt Ceiling

Every few years, there is a bipartisan political farce over the debt ceiling negotiations in the US. It may look like a routine political drama, but quantitative change can lead to a qualitative difference, especially at a time when a global de-dollarization trend is gaining momentum, that is to say, the US trick of raising the debt limit to mitigate its default risk may now be very close to pushing the US treasuries to a dangerous tipping point.

The de-dollarization caused by the US debt crisis and the abuse of the dollar hegemony created unprecedented opportunities for the yuan internationalization, with more and more countries expressing willingness to settle trade in the yuan, but China must proceed with caution.

With the US on track to default without a debt ceiling increase, US President Joe Biden's talks with House of Representatives Speaker Kevin McCarthy on Tuesday failed to make any meaningful progress, with political divides remaining between the two parties, Reuters reported. Biden even told the media that he has been looking at the 14th Amendment as a way to unilaterally work around the debt ceiling, though it will not be a viable short-term solution.

The political stalemate over raising the debt limit has already led to US Treasury Secretary Janet Yellen warning of an "economic catastrophe" if the US fails to meet all government payment obligations, which could happen "potentially as early as June 1."

So far, most people still believe that the two parties will eventually reach a deal to avoid an ugly sovereign default before the deadline, just like what happened every time in the past debt ceiling struggles.

But unlike in the past, a new question has been raised in the market, that is, are the US treasuries still highly liquid? The US dollar's credit is the cornerstone of US treasuries. Because the dollar is an international settlement currency and US treasuries have stable yields and are highly liquid, countries are willing to hold US debt, making the US the world's largest debtor.

Yet, things may be different now with countries accelerating their de-dollarization efforts. The past year saw growing number of countries and regions such as India, Brazil, and the EU trying to establish new settlement systems for their trade.

Under the influence of the de-dollarization wave, some countries have reduced their holdings of US treasuries. Japan, the world's largest holder of US debts, slashed its holdings by $224.5 billion and China by $173.2 billion in 2022.

Moreover, the US' unlimited expansion of the size of its debt has also upset the market with the risks in the US treasuries. According to Yellen's testimony in a congressional hearing in March, gross federal debt would swell to $51 trillion after a decade. The scale and speed of the debt expansion means the US is getting increasingly closer to a real explosion of a debt crisis.

Also, the root cause of the US banking crisis this year is the holding of a large number of US treasuries assets, which shrank significantly in value as interest rates continued to climb. That could be a warning to various governments and precipitated them to speed up the pace of de-dollarization. Since the collapse of the Silicon Valley Bank, international investors stepped up sell-off of treasuries, and prices of all kinds of safe-haven assets like gold have surged.

Of course, de-dollarization is likely to be a long-term process, but once it started, the US treasuries could lose its aura quickly, especially as the US government repeatedly raises debt ceiling or faces risk of default. In other words, as the world realizes that the US cannot and does not have the willingness to control or reduce the size of its debt, the credibility of the US debt as a safe-haven asset is collapsing rapidly.

It should be noted that amid the de-dollarization trend, the yuan internationalization has made a series of positive new developments and breakthroughs. The yuan's international status as a trading currency has been significantly improved recently.

To ensure future development of the yuan internationalization, China needs to ensure liquidity and maintain exchange rate stability. Thus, China's financial markets as well as the yuan's onshore and offshore markets need more preparation to adapt to the new needs. 

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'Anwar: The Untold Story' biopic premiere

 

Prime Minister Datuk Seri Anwar Ibrahim and his wife, Datuk Seri Dr Wan Azizah Wan Ismail appeared touched after watching the premier of 'Anwar: The Untold Story' - Bernama pic

PM pays loving tribute to wife

Anwar was sentenced to jail in 1999 after being charged with abuse of power. Four years after his release, he was accused of sodomising an aide in 2008.

He was imprisoned for sodomy in 2015 and released on May 16, 2018, upon receiving a royal pardon.

The film documents Anwar’s journey to battle corruption. It charts the period from when he was first appointed as Finance Minister in 1991 until his sacking from the Cabinet in 1998 and the “Reformasi” campaign, which led to his imprisonment later that year.

“It is difficult for me to comment much as I have tried very hard to forget certain episodes which were too hurtful for me to bear,” he told reporters.

He also said that although the film’s overall dialogue was not wholly accurate, the issues it raised were based on true events.

Despite going through so much, he made it clear during the media conference that he would not let the hardship stop him from campaigning for what’s right.

“The battle against corruption continues. As Prime Minister, I want to save this country, fight against corruption and fight it hard,” he said.

 

KUALA LUMPUR: Prime Minister Datuk Seri Anwar Ibrahim and his wife, Datuk Seri Dr Wan Azizah Wan Ismail appeared touched after watching the premiere of 'Anwar: The Untold Story' last night.

He said although some of the dialog and storyline may not be truly accurate, he acknowledged that it was not easy to put together years of incidents into the 90-minute long biopic.

"We were touched, it was surreal, the performances were great and extraordinary.

"The children asked how can I agree to the making of the movie which I have not watched. 

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"Agree or not is not important, this is not a movie by Anwar for Anwar.

"Also, whether this movie will have a political impact or not is secondary, because this is a story that needs to be told," he said, after the show at Dadi Cinema, Pavilion here.

The film was directed by Viva Westi of Indonesia, with Farid Kamil as Anwar, Tanda Putera actor Hasnul Rahmat as former prime minister Tun Dr Mahathir Mohamad and Indonesian actress Acha Septriasa as Wan Azizah.

The film attempted to chart the period from Anwar's appointment as finance minister in 1991 until his firing from the cabinet in 1998, as well as his Reformasi campaign which culminated in his jailing that year.

Anwar said while watching the movie, he identified some scenes that might not bode well with his siblings.

However, he said he has no plan to intervene and ask for it to be edited out and would leave the matter to the censorship board to decide.

"If they (siblings) are offended, then I will just have to make it up to them." he added.

Anwar said initially, he was hoping to listen to 'Menjaga Cintamu', the movie's theme song by pop queen Datuk Seri Siti Nurhaliza Taruddin but it was not included during the premier.

He hoped that the song, composed by Andi Rianto and written by Sekar Ayu Asmara, will be included in the final version of the movie which will be screened to public from May 18.

Also present during the premiere were director Viva Westi, executive producer Zulkiflee SM Anwar Ulhaque or better known as Zunar, and DMY chairman Datuk Mohamed Yusoff, the movie distributor. 

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China’s reusable spacecraft returned to earth

China’s reusable spacecraft returned to earh

 

China's reusable experimental spacecraft successfully lands after 276 days in orbit

 

Sitting atop the Long March-2F Y14 carrier rocket and carrying three taikonauts, China's Shenzhou-14 spaceship is launched successfully from the Jiuquan Satellite Launch Center in Northwest China's Gansu Province on June 5, 2022. Photo: VCG

After 276 days in orbit, China's reusable experimental spacecraft landed at its planned site at the Jiuquan Satellite Launch Center in Northwest China's Gansu Province on Monday, and Chinese space watchers said it was a milestone in China's efforts to develop a fully reusable space transportation system.

The success is an important breakthrough in China's research on reusable spacecraft technologies, which will provide more convenient and affordable round trips for the peaceful use of space, the Xinhua News Agency said on Monday.

China launched a reusable experimental spacecraft using its Long March-2F carrier rocket from the Jiuquan Satellite Launch Center on August 5, 2022, to test reusable technologies and in-orbit service technologies to support the peaceful use of space, Xinhua previously reported.

China tested the reusable experimental spacecraft in September 2020, and the spacecraft returned to the planned landing site after two days in orbit. The spacecraft was also launched with a Long March-2F carrier rocket.

Chinese authorities have disclosed few details about the craft's technology. So far, no images of the spacecraft or footage of its launch or landing have been disclosed.

Many space lovers compared it to the US Air Force's X-37B, an autonomous Boeing space plane that can remain in orbit for long periods before returning to Earth on its own, saying that the technology used in the experiment is "too advanced to show" on social media.

The reusable spacecraft's technology has evidently matured, considering how much longer it can stay in orbit, Chinese space watchers noted on Sunday.

Song Zhongping, a space expert and TV commentator, told the Global Times on Monday that the reusability of such spacecraft would drastically reduce costs. More importantly, the longer orbiting time means that the spacecraft can perform more complicated missions such as changing trajectory in near-Earth orbit and sending various payloads into orbit.

Judging from the rocket used in the launch, the Long March-2F carrier rocket - which is one of China's most advanced and reliable rockets for manned space flights - the reusable spacecraft may be used in future manned missions, said another space observer, speaking on condition of anonymity.

Given the payload launching capability of the Long March-2F, the spacecraft could weigh around 8 tons, which is very similar to the launch mass for the X-37B at around 5 tons, so that speculation about their similarity is not groundless, the observer said.

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China’s secret spacecraft returns to Earth after 9-month mission

 

 Experts believe the Chinese reusable unmanned spacecraft is likely to be similar in size and design to the US Air Force’s X-37B, pictured at a California military base. Photo: AP

 

Chinese space authorities  said a reusable uncrewed space vehicle returned to Earth on Monday morning after 276 days in orbit – more than 100 times longer than its maiden flight less than three years ago.

China Aerospace Science and Technology Corporation, the nation’s biggest space defence contractor, hailed the classified mission as a “complete success”, saying it “marks an important breakthrough” in China’s research into the technology.

Reusable spacecraft “will provide a more convenient and cost-effective way for peaceful use of space”, the company said.

China scientists carry out ‘rule-breaking’ AI experiment in space

Researchers from Wuhan University say they gave the technology full control of a satellite and set it free for 24 hours 

The artificial intelligence machine picked a few places and ordered the small near-Earth orbiter to take a closer look 

 

A small Chinese satellite was directed by artificial intelligence to observe sites in India and Japan, according to a research paper. Photo: Shutterstock 

 Chinese researchers say an artificial intelligence machine was given temporary full control of a satellite in near-Earth orbit, in a landmark experiment to test the technology’s behaviour in space.

For 24 hours the Qimingxing 1, a small Earth observation satellite, was directed by a ground-based AI, without any human order, assignment or intervention, according to a paper published in the journal Geomatics and Information Science of Wuhan University.

The research team, led by Wang Mi from the university’s State Key Laboratory of Information Engineering in Surveying, Mapping and Remote Sensing, said the aim of the experiment was to see what the AI would do of its own accord.

‘Red scare’ in US causes multi-year flood of refugees with PhDs to China

• OECD data shows China sustains net gain of scientists while US suffers net loss as ethnic Chinese researchers fear US government surveillance and prosecution

The United States may want to choke off vital supplies of hi-tech gear, especially advanced semiconductors, to China. But, thanks to a “red scare” about industrial espionage and intellectual property theft that has specifically targeted ethnic Chinese researchers, it is inadvertently repatriating scientific talent to the mainland on a massive scale.

It’s an influx of refugees all right, but with PhDs and other advanced degrees, and many even with tenures back in the US. Forget Beijing’s Thousand Talents Plan or Overseas High-Level Talent Recruitment Programmes. The US government is recruiting for China by creating a climate of fear among an ethnic group of researchers through selective prosecution, while casting hundreds under suspicion and killing the careers of many.

In a new analysis of Organisation for Economic Cooperation and Development (OECD) data, the conservative Cato Institute found that in 2021, the US lost published research scientists to other countries, while China gained more than 2,408.

“This was a remarkable turnaround from as recently as 2017 when the United States picked up 4,292 scientists and China picked up just 116,” it said. “The rest of the OECD and China have both surpassed the United States for net inflow of scientific authors.” 

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The institute concludes: “This is a disturbing trend … started before the pandemic. In fact, it appears to coincide with the Trump administration’s ‘China Initiative’ – more accurately titled the anti‐Chinese initiative.

“Launched in November 2018, the Department of Justice’s campaign was supposed to combat the overblown threat of intellectual property theft and espionage. In reality, it involved repeatedly intimidating institutions that employed scientists of Chinese heritage and attempting malicious failed prosecutions of scientists who worked with institutions in China.”

While the FBI and Justice Department have supposedly ended its “China initiative”, the US National Institutes of Health (NIH), the country’s single largest funding source of academic biomedical research, has been boasting about its high kill rates.

According to a March report in the prestigious peer-reviewed journal Science, in the past four years, the NIH asked about 100 US institutions it funded to carry out internal investigations into academic staff. Some 81 per cent of the scientists targeted identified themselves as Asian, and 91 per cent of the collaborations under investigations were linked to China.

Science reports that 103 of those scientists, or 42 per cent of the 246 targeted – most of them tenured faculty members – ended up losing their jobs. 

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Even today, top NIH management is proud of the work, having cited the high number of “successful” cases resulting in job termination. But, according to Science, some administrators might find it easier to sack an employee than fighting the powerful NIH.

“Others, including some of the scientists targeted and the university administrators involved in investigating them, say the tremendous power differential between NIH and its grantees may be a better explanation for why so many scientists have been axed,” the Science article said.

“NIH is by far the largest funder of academic biomedical research in the United States, and some medical centres receive hundreds of millions of dollars annually from the agency. So when senior administrators heard [Michael Lauer, head of NIH’s extramural research] say a targeted scientist ‘was not welcome in the NIH ecosystem’, they understood immediately what he meant – and that he was expecting action.”

Separately, a late 2021 survey by MIT Technology Review identified at least 77 criminal cases and more than 150 defendants, out of hundreds of investigations linked to the China Initiative targeting research institutes.

“The initiative was supposed to focus on economic espionage, but it has increasingly charged academics with ‘research integrity’ issues,” it said. Team behind extreme animal gene experiment eyes human nuclear resistance 29 Mar 2023

According to another survey by researchers at the University of Arizona, more than one in two scientists of Chinese descent feel considerable fear, anxiety, or both, about being surveilled by the US government, compared to 12 per cent of non-Chinese scientists.

The climate of fear noted by the Cato Institute study is hardly surprising. It warns: “If Chinese scientists are afraid to work in the United States, that means that the United States will not benefit from their discoveries as much or as quickly as China will.

“Although the Justice Department claims to have shut down its ‘China Initiative’, my colleagues doubt that Chinese scientists will be free from unjust scrutiny going forward.”

Beijing must love the irony. “Keep them coming, please,” it must be thinking.

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Relieve pain, relieve suffering

Tnterventional therapies include blocking nerves so that the pain sensation is not felt by the patient. — 123rf.com

 

Many cancer patients may experience pain, especially during the advanced stages of the disease, but there are various ways to relieve this debilitating symptom.

CERTAIN cancers are more painful than most.

And most types of cancer, especially in the later stages (stage 4), are painful.

Among the most painful types of cancer are bone cancer, head and neck cancer, and brain and spinal cord cancer.

The presence of pain depends mainly on the location of the cancer and the stage of the disease.

Pain in cancer may arise from a tumour compressing or infiltrating nearby body parts; treatments and diagnostic procedures; or changes to skin, nerves and other tissues caused by a hormone imbalance or immune response.

However, the pain from most types of cancer can be controlled.

While most cancer pain can be managed with pharmacological treatment (using drugs such as opioids, anti-neuropathics, anti-depressants, etc), about 10% to 20% of cancer pain would need other methods, such as interventional pain management techniques and other non-pharmacological techniques like psychosocial management, physiotherapy techniques, and traditional and complementary medicine.

Pain management is important in palliative care.

Palliative therapy represents active care for patients whose illness is not responding to the curative treatment.

It aims to provide comfort and prevent the suffering of patients, especially towards the end of their life.

Thus, treatment of the pain presents an important integral part of palliative care.

Proper pain management can achieve a better quality of life for patients and their families.

Meanwhile, poor pain management has been shown to increase complications and reduce a patient’s life expectancy.

Proper assessment required

Patients with cancer pain need to undergo a comprehensive assessment of their pain.

This is the first step to achieving successful cancer pain management.

Similar to other clinical assessments, a complete pain assessment requires a detailed medical history, physical examination and relevant investigations.

The assessment aims to determine the nature and pathophysiology of the pain, severity of the pain, impact of the pain on functions and quality of life, and the response to interventions.

From the assessment, a plan can be formulated to help treat the patient’s pain.

Methods of pain management

Managing cancer pain is highly complex.

It can be divided into pharmacological treatment, anticancer treatments, non-pharmacological methods and interventional techniques.

Pharmacological treatment includes using drugs such as opioids (e.g. morphine), drugs to treat neuropathic pain (anti-epileptics, antidepressants etc), and steroids.

Non-pharmacological methods include exercise therapy, psychosocial therapy, and traditional and complementary medicine (e.g. acupuncture).

Anti-cancer treatment includes radiotherapy and chemotherapy.

Meanwhile, there is a wide range of interventional techniques available for the relief of cancer pain.

These methods should be considered when conventional therapy, as mentioned above, fails to provide adequate pain control.

Examples of interventional techniques are nerve blocks, neurolysis, and insertion of an intrathecal morphine pump.

A nerve block is done by injecting local anaesthetics – sometimes combined with steroids – to block sensation to an area of the body.

For instance, if a patient has bone cancer of the arm, we would inject local anaesthetics around the nerve that supplies the arm in order to stop the pain sensation there.

However, the application of local anaesthetics may not last long due to the drugs’ limited time effect, thus, this is usually done for diagnostic purposes.

Neurolysis is a technique that is used to alleviate pain.

It is done either by using chemical agents (e.g. alcohol or phenol) or thermal techniques (e.g. radiofrequency ablation) on the nervous system.

Neurolysis is only used when the disease has progressed to a point where no other pain treatments are effective.

And an intrathecal pump is a device that delivers small quantities of pain medication such as morphine, directly to the spinal fluid.

When these drugs are used and delivered in smaller doses, it may minimise the side effects often experienced with larger oral doses of the same medications, and patients may also experience better pain relief.

Patients who should be considered for these interventions include those with significant pain from locallyadvanced disease, severe neuropathic pain, and severe pain on movement.

Challenges in pain management

There are barriers to effective pain management in cancer patients, including:

> Restrictive policies governing healthcare practice

> Regulatory scrutiny when prescribing controlled substances > Lack of knowledge among patients, healthcare providers and caregivers about cancer pain management

> The use of religious and cultural strategies to cope with pain. > Inadequate attention to pain in certain patient populations, and

> Patient concerns about addiction and the harmful effects of pain treatment.

Although effective cancer pain management is highly recommended, the patient’s cultural beliefs may ingrain a deep pain tolerance, thus discouraging effective treatment of cancer pain.

Some cultural and religious beliefs may discourage the use of certain pain management methods, such as medications, while others uphold alternative therapies or spiritual practices to cope with pain.

Some examples would be:  

>Belief in karma

In many cultures, pain and suffering are perceived as a result of past actions and may be necessary for spiritual growth.

This belief can result in patients not seeking treatment or not reporting their pain because they feel that it is deserved.

>Belief in spiritual healing

Spiritual practices such as prayer or meditation, are believed to be more effective at managing pain than medications.

While these practices can provide some relief, they may not be sufficient for more severe or chronic pain.

Some also believe that certain medications or medical procedures are “impure” or interfere with spiritual purity.

> Fear of addiction

Some cultures and religions view pain medications as addictive, and therefore, discourage its use.

This can result in patients not receiving adequate pain relief because they are afraid of becoming addicted to such medications.

Relieving the suffering

Expertise in pain management techniques is continuously growing.

Hence, healthcare professionals should be aware of their roles and appropriately refer their patients to specialists who are trained in pain management where available. 

To a cancer patient, the pain he or she feels can stand in the way of positive treatment outcomes.

When the pain is managed and becomes bearable – if not gone altogether – the patient’s focus can shift from one of suffering to one of hopefulness. 

The Star Malaysia, By Dr RUSHIN MARIA DASS 

Dr Rushin Maria Dass is a consultant anaesthetist. For more information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only, and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this article. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information. 

Managing the pain that is caused by cancer

 

https://www.thestar.com.my/lifestyle/health/2023/05/10/managing-the-pain-that-is-caused-by-cancer?utm_source=smt&utm_medium=email&utm_campaign=HFNL_May_11&utm_content=main_article&__sta=vhg.uosvpxjsmahjmkpob%7CHVUY&__stm_medium=email&__stm_source=smartech

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Nocturia: Symptoms, Diagnosis & Treatment

If you wake up more than one time each night to go to the bathroom, you may have nocturia. Sleep disruption from having to urinate during the night can impact your quality of life.

About 1 in 3 adults over the age of 30 experience nocturia. The rate of people affected increases with age. It can be caused by a lifestyle habit or an underlying health problem. Nocturia can be caused by:

• Polyuria: when your body makes too much urine in a 24-hour period 
•  Nocturnal polyuria: when your body makes too much urine during the night 
•  Bladder storage problems: when your bladder doesn't store or release urine well 
• Mixed nocturia: when more than one of these problems are happening

It helps to talk with your health care provider to learn why you make multiple trips to the bathroom at night. You may learn that your nocturia is fairly easy to treat, or you may find it's from something more serious. 

https://www.urologyhealth.org/urology-a-z/n/nocturia

How Does the Urinary Tract Normally Work?

See More  See Less 

The "urinary tract" includes the organs in your body that make, store and remove urine. Urine is liquid waste from your body. Urine forms when the kidneys clean your blood. Normally, the kidneys make about 1½ to 2 quarts of urine each day in an adult; less in children. Urine travels from the kidneys to the bladder through the ureters (the tubes that join them). The bladder holds urine until you are ready to empty it.

The brain and the bladder work together to control urinary function. The muscles in the lower part of the pelvis hold the bladder in place. The muscular neck (end) of the bladder stays closed to store urine. The urethra is a tube that carries urine from the bladder, out of the body. It is kept closed with sphincter muscles.

Parts of the bladder control system

Once you are ready to urinate, the brain sends a signal to the bladder. Then the bladder muscles contract. This pushes urine out of the bladder and through the urethra. The sphincter muscles then open and urine is released out of the body.

If you have to get up two or more times each night to go to the bathroom, it’s not normal. This is a clear sign of nocturia. We should be able to sleep for 6 to 8 hours during the night without needing to use the bathroom.

Waking to go to the bathroom obviously affects your quality of sleep, and your quality of life. Most people don’t function well without solid sleep. It makes us grumpy and less productive during the day. Over time, poor sleep can become a severe problem for many of us.

It’s important to remember that nocturia is a sign of something going on in our bodies. It is not a disease in and of itself.

Nocturia can be from a simple habit like drinking too much fluid (especially caffeine or alcohol) before bed. Or it could be from certain medication, illnesses or reduced bladder capacity. The following lifestyle habits are known to cause nocturia in either men or women:

• Drinking too much fluid before bedtime (especially caffeine or alcohol)
• Behavioral patterns (you've trained your body to wake up during the night to use the bathroom, even if you don't necessarily have to go)
• The timing or dose of medicines, such as: diuretic medicine (water pills), cardiac glycosides, demeclocycline, lithium, methoxyflurane, phenytoin, propoxyphene, and excessive vitamin D
• Sleep disorders, like insomnia or sleep apnea

Underlying health conditions can cause nocturia. For example:

• Diabetes 
• High blood pressure 
• Heart disease,
• vascular disease or congestive heart failure Bladder obstruction ((stones)), inflammation or other problems that affect bladder capacity (like bladder surgery or fibrosis from radiation)
• Overactive bladder  symptoms
• Prostate obstruction
• Vaginal prolapse
• Menopause Childbirth Pelvic prolapse
• Enlarged prostate (prostatic hyperplasia (BPH)
• Restless leg syndrome
• Edema in the lower limbs, or leg swelling
• Interstitial cystitis 
• Reduced bladder capacity
• Nocturnal polyuria (when your body produces too much urine at night for your bladder to hold)

Often, several of these issues may be going on at once.

You and your health care provider will want to learn the cause of your nocturia. You'll be asked about your symptoms and health history. Your health care provider may also ask you to keep a bladder diary in order to help with a diagnosis. This diary is used to keep track of things like the kind and amount of liquids you drink, trips to bathroom, etc. to track trends over a period of time which can lead to useful treatments.

Some questions your doctor may ask:

• When did your symptoms first start?
• How many times do you need to go to the bathroom each night?
• Is there a large or small amount of urine when you go?
• Has the amount of urine you make changed (increased or decreased)?
• How much caffeine or alcohol do you drink each day? When?
• Do you feel like you're getting enough sleep?
• Has your diet changed recently?
• Do you wake up wet? (Are you leaking?)

If your health care provider needs more information, you may have a:

• Urine cultureandurinalysis check for infection, unwanted blood, and other elements in your urine.
• Blood test: checks the kidney and thyroid, cholesterol levels and the presence of anemia, diabetes or other problems.
• Bladder scan shows how much urine is still in the bladder after you go to the bathroom.
• Cystoscopy: checks for a tumor or other causes of your symptoms by having the doctor insert a narrow tube with a tiny lens inside the bladder.
• Urodynamic testing: checks to see how well your lower urinary tract stores and releases urine.

Lifestyle changes

• Restrict fluid intake at night.
• Drink plenty of fluids during the day (especially water), but limit fluids 2-4 hours before you go to sleep. Be sure to limit alcohol and caffeine (soda, tea and coffee).
• Manage your use of diuretics.
• If you have to take a diuretic, then do so at least 6 hours before you go to sleep. This will help reduce the number of times you urinate during the night. Elevate your legs or use compression socks.
• Some people experience fluid build-up in their legs. When you elevate your legs, it helps to redistribute fluids back into the bloodstream, reducing the need to urinate. Elastic compression stockings help by putting pressure on your legs to prevent fluid build-up.
• Enjoy afternoon naps.
• When you sleep poorly, a nap can be help you feel better during the day. Naps can also allow liquids to be absorbed into the bloodstream. However, be careful not to nap too long or too often. You don't want to disrupt nighttime sleep patterns with naps.

Management

If you experience bed-wetting, there are several products to help keep you and your bed dry. For example, waterproof mattress covers, absorbent briefs and skincare products. Visit our  incontinence website article to learn more about managing leaks with products and devices.

Medicine 

If lifestyle changes alone don't help with your nocturia, some medicines may. Some people try one type, then another, until they find what works best for them. Not everyone benefits from prescription drug options, but it helps to know about them.

• Medicines to help the kidneys produce less urine. For example, Desmopressin (DDAVP®).
• Anticholinergic medicines to treat bladder muscle problems. They relax the bladder if it spasms. These are used to correct overactive bladder. For example, Darifenacin (Enablex®), Oxybutynin (Ditropan®), Tolterodine (Detrol®), Trospium Chloride (Sanctura®), or Solifenacin (VESIcare®).
• Diuretic medicines to regulate urine production and high blood pressure. For example, Bumetanide (Bumex®), Furosemide (Lasix®).

If an underlying illness leads to nocturia, then treating that illness will surely help. It's important to treat diabetes, high blood pressure, congestive heart failure, obstructive sleep apnea, and/or enlarged prostate (BPH). Changing the timing and dose of prescribed medicine may also help.

With long-term lifestyle changes and caring for other health problems, your symptoms should improve. You should be able to sleep well again.

Pay attention to the things that help you sleep through the night. Keep up with these changes to prevent nocturia in the future. Keep in touch with your health care provider to let him/her know if you don't improve over time.

• Do I need to see a specialist?
• If I need a specialist, can you give me a referral?
• Will I need to have tests to find the cause of my nocturia?
• What other problem could be causing my symptoms, and why?
• What treatments do you think are right for me and why?
• What are the pros and cons of each type of treatment?
• After I start treatment, are there problems I should I watch for?
• How soon after treatment will I feel better?
• When should I call you?
• Will I need treatment for the rest of my life? 
  

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Nocturia (Night time urination). Drinking water at night and how it helps.

Noctoria and heart problems are related. It is worth spending two minutes to read the information below.

An American doctor tells us that Nocturia, heart problem and cerebral infarction are related.

The most common symptom of middle-aged and elderly people is nocturia (waking up at night to urinate). Because of nocturnal urine, the elderly are afraid of drinking water before bedtime. They don't know that not drinking water before going to bed, getting up in the middle of the night to pee without drinking water is an important cause of early morning cerebral infarction in middle-aged and elderly people. In fact, nocturia is not a problem of bladder dysfunction. Nocturia is caused by the aging failure of the heart function in the elderly, and the inability of the right heart atrium to suck blood from the lower body.

During the day, we are all in a standing position, The blood will flow down. If the heart is not good, the blood volume of the heart is insufficient, the pressure on the lower body will increase, so middle-aged and elderly people will have lower body edema during the day. When they lie down at night, the pressure on the lower body will be relieved and a lot of water accumulate in the tissues. The water returns to the blood. If there is too much water, the kidneys will work hard to separate out the water and drain it to the bladder, causing nocturia.

Therefore, it usually takes about three or four hours after lying down to sleep to get up and go to the toilet for the first time. After that, the water in the blood continues to increase. So after another 3 hours, they will have to go to the toilet again.

Why is this an important cause of cerebral infarction and myocardial infarction? Because after two or three urinations, the water in the blood is greatly reduced. The body also continue to lose water through breathing. The blood then begins to become thick and sticky, and the heart rate slows down due to the low metabolism of the body during sleep. With thick blood and slow blood flow, the stenosis of the blood vessel is easily blocked... This is why the middle-aged and elderly people almost always have myocardial infarction or cerebral infarction at 5 or 6 in the morning. This situation will lead to death while asleep.

The first thing to tell everyone is that nocturia is not a malfunction of the bladder, but a problem of aging heart. The second thing to tell everyone is that you must drink some warm water before going to bed, and you must drink some warm water after you wake up in the middle of the night to pee. Don't be afraid of nocturia, because not drinking water may take your life.

The third thing is that you must exercise more in normal times to strengthen the function of the heart.

The human body is not a machine. A machine will wear out when used frequently, but the human body will be the opposite. It will become stronger when used frequently.

Do not eat unhealthy food, especially high starch and fried foods. 

 

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