Taking the pee

A new clinical service in my life

One of the consequences of the spinal cord not talking to the rest of the body properly, is the body and brain don’t always know what’s going on. Over the years my bladder, and to a lesser extent my bowels, have become increasingly affected by this. I’ve concluded that I’ve held off on blogging recently because I’ve been trying to deal with this. Of all the things my condition brings, having occasionally pissed myself in public as an adult, albeit thankfully discretely, my bladder problem is a topic I’ve avoided. It is something I am most uncomfortable talking about. However, if I am going to provide an accurate account of my condition, I have to tell it warts and all. Hmm warts – hopefully that won’t be something else I have to talk about! 😆

Some background for context

Probably not the best heading for this section given that I can’t actually remember when it started. Never mind! What I can say is that somewhere in the last 8 years I started to notice I was getting an urgency to pee. I hope you don’t mind that term, but I find it more palatable than talking about urination all the way through this. I digress. I noticed that I went from feeling like everything was fine to feeling I need a loo in the next few minutes or it will be too late. My bowels have been pretty messed up since I started taking the cocktail of medication. So many of them say that either diarrhoea or constipation are a common side effect. In an ideal world, one med would balance out the effect of the other, and I’d sit happily in the middle being perfectly normal. In reality, they all seem to give me constipation. Consequently, I take a couple of meds to help deal with these side effects. On the plus side though, I can’t remember the last time I’ve had cause to talk about my former IBS problem! Suffice to say I have only had a couple of instances that I can recall where I had to do what bears do in the woods (or New Forest in my case!) 😲

Back to the bladder then. I think it was probably somewhere between my two SCS implant surgeries that I noticed my bladder becoming a significant problem. It’s possible of course that this is partly down to my mobility worsening, and therefore becoming more aware of how important it is for me to know where the nearest toilet is.

Facing the problem head-on

That would have been the obvious thing to do right? And of course you know that I have very frequent contact with various medical professionals, so bringing this subject up was easy enough to do. Then again, I’m a bloke, so I kept it to myself and hoped it would resolve itself. 🤦‍♂️ I did venture as far as buying a few different external catheter products off the internet. Far from a resounding success though.

Seeking professional help

It was whilst I was in hospital for the replacement implant surgery in June that I decided to do something about this. The fact I was regularly being asked if I’d opened my bowels (I think it was day 5, for the record), and the fact I seemed to be constantly asking for more urine bottles probably nudged me into action. So I took the opportunity to ask the occupational therapist for advice. She suggested I did a self-referral to the Bladder and Bowel service when I was discharged. After a moderate wait for an appointment I went to see a nurse specialist from the service today. The advice for bowels was relatively straightforward; a) the medication to deal with constipation will be much more effective if I remember to take it regularly 🙈 and b) make a couple of slight tweaks to my diet. So far so good.

We talked at length about my pee problem, how it affected me, what I’d tried, what might help. A bladder scan showed that, despite it only having been an hour since I’d peed, there was still 300+ ml in my bladder. The concern therefore is that I am not properly emptying and so have an increased risk of urinary tract infections. This is despite me passing a normal amount. I was to measure intake and output for a few days, and have another scan at my next appointment. If I still have retention, then intermittent self-catheterisation might be required. I was given some links to some animations showing how this is done. In the meantime, I will be given an appointment with the team’s health care assistant to discuss options for external catheters, and identify the right one for me.

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