while allowing
the nurse to determine the maximum duration
of Ms. Spencer's muscle contractions, so as to
appropriately tailor the first month’s PFMT exercises
(the number of slow and fast pelvic floor muscle
contractions), which would be incrementally increased
in the second month. Ms. Spencer determined
that she could perform the PFMT exercises
four times a day (before getting out of bed, at lunchtime,
after dinner, and at bedtime) in two positions
(lying down and sitting). When the nurse mentioned
that coffee was both a diuretic (because of its caffeine
content) and a bladder irritant (even when
decaffeinated), Ms. Spencer agreed to gradually
reduce her coffee intake, with the goal of eliminating
it from her diet over a two-week period, replacing
it with drinks that contain no caffeine, such as
hot fruit infusions.