No replies to this topic

[freedom]

Switch from condom drainage to intermittent catheterization:

I am a 38 year old, C 5-6 SCI incomplete quad, 23 years post injury. I have recently successfully made the switch from external cath/leg bag, to intermittent catheterization. I decided that after dealing with three or four major bladder infections over the past couple of years that I needed to investigate an alternative way of emptying my bladder. My old method of emptying, was to tap my bladder when it was full to cause a bladder spasm. This worked great basically up until about two years ago. In the last couple of years I've noticed that the amount of each void is less and less. For the last year or so I have only been able to void only 250-300 cc’s per occurance, never fully emptying. As a result of this poor performing method of emptying my bladder, I was fatigued all the time, wasting a lot of time dealing with the actual process of emptying my bladder, and not enjoying good night sleeps. As many of you know, a bladder that does not totally empty is a breeding ground for infections, similar to stagnate pond water as a breeding ground for flies.

Since the switch, depending of course on my liquid intake volume, I can go anywhere from 4-6 hours in between caths, with each cath yielding between 500 and 750 cc’s. This clearly indicates that I was nowhere near emptying my bladder using my old method, and perpetuating what was most likely the same infection for the past two years.

One of the first challenges was to trial through the various brands of catheters available, and then find the right size. So far I've settled on using the Coloplast “Speedicath” product, as the simplest most effective for my needs and ability. The only downside to this product, is the expense. But unfortunately, how do you put a price on good health and freedom?

I am careful to manage my fluid intake from 5pm onward, in order to limit the overnight output. Most nights, by cathing just before going to bed at approximately 10 p.m., I am able to get through the night until approximately 7 a.m. The old routine had me awake at least every two hours to take the pressure off my bladder was the “tapping” routine. Over the years I certainly got used to that I suppose, but I've certainly quickly gotten used to a full nights sleep, largely uninterrupted. The worst-case scenario is that I need to do a cath once in the early morning hours between 3 and 5 a.m., then quickly falling back asleep until the alarm clock sounds. Of course careful set up in preparation of supplies enables me to execute this routine in bed without waking my partner.

In the absence of external urinary appliances there are certainly other additional overnight (or anytime) benefits related to whatever spontaneous activity that you and your partner may want to engage in!

One of the challenges that I've had to quickly get used to, is the logistical side of the setup and execution of the intermittent catheterization routine. As a C5-6 incomplete SCI, with limited finger dexterity and no triceps, it is of the utmost importance to have the materials and adaptive equipment close by at all times and easily accessible. This is accomplished simply by using one of my wife's old pencil case sized cosmetic bags to carry the necessary supplies in my backpack, and ensuring that it is well stocked at the beginning of each day. As with most anything that I go to do, necessity being the mother of invention, has led to the creation of two key pieces of adaptive equipment. Both of which are extremely simple, but extremely important to the successful execution of the task.

It was also a matter of building my confidence in terms of my newfound freedom from external urinary collection devices, while traveling outside of the safe confines of my own fully accessible home and washroom. Basically, 23 years of using a condom/leg bag scenario had gotten me used to being able to empty my bladder anytime anywhere, no the matter what the circumstances. Obviously now I need to ensure that I am aware at all times of where I can go to an accessible washroom, or at the very least, somewhere accessible that is private to carry out the cath when the need arises. In most cases I have found so far this is simply a matter of careful planning of my day as it relates to where I'm going, and when I last emptied my bladder.

Through some careful trial and error experimenting, and talking with peers who have done the same, a viable set up and execution routine soon evolved. It was only a matter of days until my confidence was regained in terms of my ability to travel worry free out and about, and carry on my regular activities of daily living and work, being fully confident that I would not have any accidents, and would be able to perform the catheterization routine when, and where necessary.

By far, the biggest advantage so far has been my increased level of energy, and my general state of improved health. This includes decreasing by 50% the level of Clonidine (muscle relaxer) that I have been taking on a prescription basis to control muscle tone and spasms for the past 22 years. In short, I have never felt better. Strangely, to put it another way, I have never felt more “normal”. To further build on this recent improvement in my lifestyle and overall health and well-being, I have been able to go for several consecutive days with no clonidine at all, by incorporating other natural activities into my daily routine. I would be happy to elaborate on the details if anyone wants to e-mail me directly.

In closing, I am a firm believer that knowledge is power, and that we as SCI peers have an obligation to share information with each other in an effort to improve our collective and individual quality of life. Without the opportunity to visit forums like this to investigate information on the topics that affect us in our daily living (both positive and negative), I most likely would not have been able to take advantage of this life-changing routine. Thanks to all who post, and share their experiences with various SCI related issues. My hope is this information will help someone else encountering the same issues, or considering making the change.