Thursday, February 5, 2026
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“Urinary leakage in men and women”

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As husband and wife urologists, we talk a lot about the urinary tract and how it affects our patients.

In women, the most common urinary concern is incontinence, or the involuntary leakage of urine. There are several causes and many treatment options exist depending on the type.

The two main types of urinary leakage in women are urge urinary incontinence and stress urinary incontinence. For women with urge incontinence, treatment is aimed at improving quality of life disrupted by overactive bladder. Overactive bladder is characterized by urinary urgency, frequency, waking up at night to urinate, with or without urge urinary incontinence. The most important first steps a patient can take to reduce bother include limiting caffeine intake, minimizing fluid intake (unless you have kidney stones, you do NOT need to drink 8 glasses of water a day), and urinating on a schedule every two hours or so while awake. The next step in treatment is medication. Many medications are no longer used due to unfavorable side effects of dry mouth, constipation and even dementia. Newer medications are much safer and better tolerated. Be sure to ask your doctor if your bladder medication is associated with an increased risk of memory loss and dementia.

If medications fail, third line therapy is available. This includes tibial nerve stimulation, Botox bladder injections and an outpatient procedure to place a neuromodulation device (think of this as a pacemaker for the bladder). Treatment duration with Botox can last up to 9-12 months and neuromodulation is typically effective for 10-15 years or more, at which point a battery will need to be replaced.

For women with stress incontinence, the mainstay of treatment is procedural, either with an in office urethral bulking agent or a surgically implanted mid-urethral sling. These procedures can be curative and greatly improve womens quality of life.

In men, the majority of leaking is due to prior prostate cancer surgery. This type of leakage with movement and activity is called male stress urinary incontinence. In addition to pelvic floor muscle exercises, procedural interventions exist as well. The mainstay of treatment is a procedure in which an artificial urinary sphincter is inserted. This is for men with the most severe leakage who are using many pads daily. It involves an inflatable cuff that encircles the urethra, a reservoir behind the pubic bone that stores the fluid when not around the urethral cuff and a pump placed in the scrotum to move the fluid from one location to another. Slings are also used in men with milder incontinence. In both instances, the goal is to get patients down to 1-2 light pads daily.

Men can also experience urge incontinence and treatments are similar as for women; however, some differences do exist which can relate to enlarged prostate.

The bottom line is, if you are suffering from urinary incontinence, many treatment options exist and we encourage you to speak with your doctor about these issues.

-D. Joseph Thum and Lauren Wood Thum are both board certified Urologists at Urology Specialists in Sioux Falls, SD. Dr. Joseph Thum also sees patients in Worthington. In their free time, they enjoy the outdoors and spending time with their sons and German Shepherds. Follow The Prairie Doc at www.prairiedoc.org and on Facebook featuring On Call with the Prairie Doc a medical Q&A show providing health information based on science, built on trust, streaming live on Facebook most Thursdays at 7 p.m. central.

Onions in the Giving Garden

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KSU horticulture

In the spring, we plant many onions in the Giving Garden in town. At last check they were looking great and soon it will be time to harvest. There are signs of this you can observe. As onion bulbs reach maturity, the tops fall over to the ground. When one-half of your crop of onions have tops that have fallen over it is time to harvest. Either dig or pull the onions from the ground, keeping the tops intact. Before storing, the onions need time to cure. Hang them in a warm location out of direct sunlight that has good airflow. In two to four weeks the tops should be dry. Cut the roots and tops so only 1/2 -inch remains. Store the bulbs in a container that allows air flow such as a mesh bag. The bulbs need to be kept in a room with cool temperatures (32-40 degrees F) and low humidity.

 

Hoping for a miracle to save the Ogallala Aquifer? Prepare for the new Dust Bowl.

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In the summer of 1894, a curious railway car plied the tracks of western Kansas, a chemical soup wafting to a sky ruled by a demon sun and chastened by moisture-devouring winds. At the helm of this experiment on wheels, owned by the Rock Island railroad, was a 32-year-old train dispatcher who had convinced railway officials and town leaders across the state that he had the secret to make it rain.

The aspiring rainmaker, Clayton B. Jewell, was an instant celebrity in a parched land thirsting for heroes. Rock Island officials were so confident of his ability they eventually designated three cars for his rain-making experiments, which by their count had succeeded in all of 52 attempts.

Jewell kept the concoction of chemicals he sent to the sky a closely held secret and scoffed at others who said they had achieved similar results with his method. In an 1895 letter to his hometown newspaper, the Topeka State Journal, he boasted that if only he had the necessary equipment he would “wager my life itself that I could produce rain in ten minutes in the clearest of skies.”

Jewell traversed western Kansas in his rainmaking car during the worst drought in Kansas that anybody could remember and the seventh straight year of crop failures. The drought had lasted an agonizing 20 months. The resulting economic chaos had ruined farmers and threatened the businesses, like railroads, that depended on profits from hauling and selling crops.

At Clay Center, W.I. Allen, assistant general manager of the Rock Island line, had in April sat in his private car at Clay Center, and surveyed the dry Kansas prairie.

“We will stop this thing,” Allen declared, as reported by the Kinsley Mercury. “We will send our rainmakers into southern and western Kansas, temper this heat and save the corn crop.”

But no relief was to come.

“The great Arkansas Valley, one of the richest west of the Missouri River, with its great underflow of water, is to-day a vast desolate waste,” reported the New York Times in August 1894. “Hundreds of square miles of fine crops have been burned up in less than three days, and the cornstalks are scarcely worth cutting for fodder, as all the blades will fall to pieces when handled.”

The harsh reality of agriculture beyond the 100th Meridian, which runs through Dodge City and roughly separates the arid western third of the state from its more humid majority, was already well known. John Wesley Powell, the Grand Canyon explorer and director of the U.S. Geological Survey during the late 19th century, had argued that plans for settlement and development west of the line should be different because of the lack of water. Powell’s warning was ignored, according to Wallace Stegner’s 1954 book on Powell and the West, “Beyond the Hundredth Meridian.”

After the Civil War, a myth took hold on the Great Plains that “rain follows the plow.” This phrase, which expanded on previous notions that once broken the sod would absorb rain like a sponge, was coined in 1881 by Charles Dana Wilber, a journalist and land speculator. Simply planting lush green crops, Wilber wrote, would cool the earth and attract showers.

Many homesteaders staked their futures on the belief that simply breaking ground for crops would attract enough precipitation to allow rain beyond the 100th Meridian, and for a few years it seemed to work. Then came trials that must have seemed Biblical in nature: the locusts and the periodic droughts and terrifying twisters. The economic spasms of bust and boom continued until the Dust Bowl of the 1930s wiped just about everyone out, with southwest Kansas and the Oklahoma panhandle at the center of the disaster.

The Dust Bowl was the result of severe drought, economic collapse, and poor soil conservation. It was an environmental crisis made worse by greed and bad decisions, and it prompted one of the largest migrations in American history. By 1940, some 2.5 million people had abandoned the plains states. Powell’s warning about settlement west of the 100th Meridian had proven true.

After World War II, technology provided a solution to the problem of farming in the arid West: irrigation.

In western Kansas and most of the Great Plains in the first decades of the last century, irrigation meant “flood irrigation.” It was an inefficient method of flooding cropland by diverting the flow of water from a river by way of a canal (or “ditch” as they are mostly called in the West). Ditches are still used to move water from one place to another, but by far the most water used in agriculture in western Kansas is groundwater from the Ogallala Aquifer. The aquifer is one of the world’s largest and lies beneath eight states, from South Dakota to Texas.

In the 1950s, it was thought the water in the aquifer was inexhaustible. More and more wells were drilled to reach the aquifer and new delivery methods, chiefly center point irrigation, revolutionized farming. But unlike surface water such as that found in a river, with a relatively quick recharge from rain and snow, the groundwater in the Ogallala Aquifer is prehistoric. It is recharged on a geological time scale. Now we know the aquifer is not inexhaustible. In some places, such as beneath the community of Jetmore, north of Dodge City, the aquifer is already nearing depletion. That depletion is accelerated by climate change and continued over pumping of water.

Once the water is gone, it’s gone for the rest of our lifetimes — and because geologic recharge is so slow, several hundred or perhaps thousands of lifetimes to come. Kansas Reflector’s Allison Kite, in partnership with Stateline reporter Kevin Hardy, reported in May that despite the grim prognosis, one of the state’s locally controlled water management districts has resisted adopting meaningful water conservation methods.

Southwest Kansas Groundwater Management District 3, perched just above the Oklahoma panhandle in the extreme southwest corner of Kansas, is under fire for its travel expenses, lack of a formal conversation policy and its alienation of farmers who would like to conserve water. Despite a budget of $1 million, it has spent little of it on conservation, although executive director Mark Rude argues everything the district does is in the name of conservation. But in contrast to other districts, District 3 is clearly lagging.

The state’s five groundwater management districts were established in the 1970s, according to the Kansas Geological Survey. In 2020, for example, Groundwater Management District 1 used a state law that allows for the creation of “Limited Enhanced Management Areas” to commit farmers to reduce consumption by 50% over seven years.

By 2026, according to a new state law, all districts — including District 3 — will be forced to submit reports to the Legislature and file a water conservation action plan with the state’s chief engineer.

Much of the resistance in District 3 is cultural. Locals like being in control, dislike being told what to do, and consider their legacy water rights sacred. On the district’s website you can read about how the district was organized to “provide for the stabilization of agriculture by establishing the right of local users to determine their own destiny with respect to the use of groundwater.”

Such declarations ignore the rest of us, who have a reasonable right to expect that prehistoric groundwater in the Ogallala Aquifer should belong to us all. But Kansas water rights are based on the “first in time — first in right” principle, which means the earliest users are given priority.

Perhaps the thinking of District 3 officials is best represented by a couple of stunts in which thousands of gallons of Missouri River water was trucked 400 miles to southwest Kansas. The project was meant to drum up support for an aqueduct that would take water from the Missouri River in northeast Kansas to a reservoir in Utica. Since water flows downhill, and taking water to the west in Kansas is literally an uphill battle, 15 pumping stations would be required. The ground-hugging aqueduct — really, just a glorified ditch — would cost an estimated $18 billion to build and another billion a year in ongoing costs.

The Kansas aqueduct is a nutty idea, but one that has taken root among some individuals in western Kansas desperate for a solution to continue irrigation after the depletion of the Ogallala Aquifer. Aside from its expense and impracticality, it is a regressive idea that harkens back to the days of ditches and avoids a conversation about us having squandered the resource beneath our feet. It also ignores any objections the folks on the other side of the Missouri River, in Iowa and Missouri, might have to say about us taking water from a river we share.

The aqueduct is something our 1890s rainmaker, Clayton B. Jewell, might have understood. At least, he might have appreciated how desperate some folks are to believe in a solution that doesn’t really address the problem.

The problem is that agriculture in the state is unsustainable beyond the 100th Meridian without irrigation. Instead of an anomaly, the magnitude of drought that drove the Dust Bowl can be expected to occur with alarming frequency.

“Paleoclimatic data collected for western Kansas indicate a drought as severe as the Dust Bowl occurs there, on average, three to four times a century, according to a Kansas Geological Survey circular. “Based on that probability, there is a 35% chance for a severe drought year in any decade, a 70% chance within a 20-year span, and a 100% chance over the estimated 40-year working lifetime of a western Kansas farmer.”

The new law that requires District 3 to deliver a water conservation action plan was passed in response to the Kansas Water Authority saying last year that the state’s longstanding policy of simply slowing depletion was insufficient to protect the Ogallala aquifer. The law is a step toward the state taking control of water management from local districts if consumption continues to outpace conservation.

The battle over the aquifer’s decline pits good policy against powerful agricultural and political interests. Add to the mix the independence that seems woven into the cultural fabric of southwestern Kansas, and you have the ingredients for a water war that might define the region for decades to come.

But this is one war we may already have lost.

We’ve already killed the Arkansas River in western Kansas, leaving just a dry bed behind. Every other river and stream and creek in that third of the state has also vanished. The natural recharge just isn’t enough to keep water in them. Worse, climate change appears to be driving the arid zone to the east, creating an even bigger water crisis.

About a third of Kansas counties are currently in a moderate to severe drought, with some of the worst conditions in the area served by District 3, according to the U.S. Drought Monitor. The drought puts pressure on farmers to pump more water instead of voluntarily committing to conserve. It’s difficult to get people to do the right thing when it’s against their economic interests.

If only Jewell’s apparatus had really worked.

The rainmaking railway car was inspected in 1892 by a newspaper reporter who described the mysteries within.

“Inside the laboratory part of the car a wide shelf about two feet from the floor extends from one end to the other,” the correspondent wrote. “On this are many curious-looking bottles and boxes said to contain the chemicals from which the rain producing gases are made.”

There were also pipes, bottles, other laboratory apparatus, and a 24-cell battery. Jewell said the gases produced would rise to 8,000 feet, then condense, creating a vacuum that would be filled with moisture — and produce rain.

“There are many thinking people in Kansas who believe absolutely in Jewell’s rain-making system, and they are encouraging him in every possible way,” wrote the observer. In other quarters, however, Jewell’s work was received with skepticism, and sometimes superstition, as those who prayed for rain regarded his apparatus as the work of the devil.

Jewell died in Coffeyville in 1906, aged 44, from pneumonia.

“For two or three seasons Mr. Jewell did little else besides operating this (rainmaking) car and apparatus,” noted his obituary in the Topeka Capital, “but it was finally abandoned.”

No rainmaker, no aqueduct, and no prayer will save western Kansas from the depletion of the Ogallala Aquifer. The best we can hope for is to reduce consumption, buy a little more time, and adjust to a changing climate and economy. It is time to heed the warning John Wesley Powell gave us so long ago — and prepare for the new Dust Bowl.

Max McCoy is an award-winning author and journalist. Through its opinion section, the Kansas Reflector works to amplify the voices of people who are affected by public policies or excluded from public debate. Find information, including how to submit your own commentary, here.

How long does my child need to sit in a booster seat in Kansas? What the law says Read more at: https://www.kansas.com/news/state/article289940804.html#storylink=cpy

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Before you hit the road in Kansas, make sure you have your children in the proper seat that’s safe for their age, height and weight.

A rite of passage in every child’s life is moving from the back seat to the front seat of a car. They’ll be able to see more than before as they look through the front windshield for the rest of time— until their sibling calls “shotgun” on a road trip.

But when is it safe to move your child to the front seat? And when are children able to graduate from a booster seat to sitting on their own? Are there age requirements, or do they have to reach a different milestone?

Data collected from the National Highway Traffic Safety Administration in 2022 said that child safety seats, like booster and car seats, have been shown to reduce fatal injury by 71% for kids under 1 year old and by 54% for kids 1 to 4 years old.

The data also says that seat belts, when used correctly, reduce the risk of fatal injury to front seat riders ages 5 and older by 45% and reduce the risk of moderate-to-critical injury by 50%.

Motor vehicle accidents are the leading cause of death for children up to the age of 14, according to the NHTSA. Many of these deaths occurred because the children were not properly restrained, the Kansas Department of Transportation said.

Here’s what Kansas law says about child safety and car seats. HOW LONG DOES A CHILD NEED TO BE IN A CAR SEAT?

All children ages 4 and under are legally required to ride in a car seat in Kansas, according to the state’s Child Passenger Safety Act.

Children under the age of 1 should ride in a rear-facing car seat, the Kansas Highway Patrol says. The highway patrol says you should keep your child in a rear-facing car seat as long as possible, but they’re able to ride in a front-facing car seat with a harness if necessary.

All children between the ages 4 and 7 are required to ride in a booster seat unless they meet one of these requirements, the highway patrol says:

The child weighs more than 80 pounds

The child is taller than 4 feet, 9 inches

Only a lap belt is available

The highway patrol says you should keep your child in a front-facing car seat with a harness until they reach the top height or weight limit allowed by the manufacturer of the car seat.

WHEN SHOULD CHILDREN BE IN BOOSTER SEATS?

After they outgrow the seat, you can upgrade them to a booster seat. The child must still sit in the back seat.

It’s recommended, but not required that children ages 8-12 ride in a booster seat until they’re big enough to fit in a seat belt without any help. Your child doesn’t need a booster seat when:

The lap belt lies snugly across the upper thighs, not the stomach.

The shoulder belt lies snugly across the shoulder and chest, and not across the neck or face.

BOOSTER SEAT VS CAR SEAT: WHAT’S THE DIFFERENCE?

Booster seat and car seat are sometimes used interchangeably in conversations, but there is a difference. A car seat must be installed and has high restraints to keep the child safe. A car seat also has a high back for extra head and neck support and protection, according to the NHTSA.

A booster seat is designed to boost the child’s height so the seat belt fits properly, the NHTSA says, but it doesn’t have protection in other areas or require a complicated installation.

OTHER CHILD SAFETY TIPS

It’s recommended that all children ages 12 and under ride in the back seat of the car since it’s safer. But Kansas law doesn’t include any particular age or size requirements.

The highway patrol says front seat airbags are designed to protect full-sized adults if there’s a crash. If deployed with kids in the front seat, the airbags can injure them.

Seat belts must be worn at all times by everyone. Kids between the ages of 14 and 17 can get fined $60 if they’re not wearing a seat belt.

Read more at: https://www.kansas.com/news/state/article289940804.html#storylink=cpy

 

Planning commission solar public hearing is July 29

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HUTCHINSON, Kan. — The main discussion on solar regulations in the zoned area of Reno County will happen on Monday, July 29.

“We’re talking about private solar and large scale solar,” said Reno County Public Works director Don Brittain. “Limited scale is already approved.”

The public hearing is to change the language for ground-mounted private solar and to discuss whether or not large scale solar will happen in the zoned areas of the county.

There is no current authority for the planning commission regarding solar or anything else other than wind in the unzoned area, which is one of the reasons the Board of County Commissioners wants to hear from the currently unzoned areas about whether or not they want zoning.

“We made that public hearing at 5:30 p.m., so that people wouldn’t have to take off work and stuff and we’ll get more of an audience, so that’s at 5:30 p.m. instead of 4:30 p.m.”

The other zoning related public meetings in the county are July 22 and 23, before the solar meeting on July 29.