Dealing with incontinence

Started by Anonymous, 23rd November 2017 at 3:18 pm

Home Page Forums Living With Spinal Cord Injury Continence Matters Dealing with incontinence

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    <p style=”margin: 5pt 0cm; mso-layout-grid-align: none;”><span lang=”EN-US” style=”font-family: Consolas; font-size: 14pt; mso-bidi-font-size: 12.0pt; mso-ansi-language: EN-US;”><span style=”color: #000000;”>An accident in 2013 left me with spinal injury and double incontinence.<span style=”mso-spacerun: yes;”>  </span>I spent 7 months in a spinal injuries hospital before returning home. My incontinence is managed with a suprapubic catheter and bowel evacuation on alternate days by district nurses.<span style=”mso-spacerun: yes;”>  </span></span></span></p>
     
    <p style=”background: white;”><span style=”color: black; font-family: Consolas; font-size: 14pt; mso-bidi-font-size: 12.0pt;”>I used intermittent urethral catheters for four months after my accident when they were replaced with a suprapubic catheter. </span></p>
     
    <p style=”background: white;”><span style=”color: black; font-family: Consolas; font-size: 14pt; mso-bidi-font-size: 12.0pt;”>They were replaced for several reasons. They were used at intervals of 3-4 hours, a problem especially overnight, even in hospital.<span style=”mso-spacerun: yes;”>  </span>Even at these intervals, I had 3 or 4 substantial leakages of urine from my urethra.<span style=”mso-spacerun: yes;”>  </span>I guess that gaining access to insert a catheter was a reason why underwear was not encouraged in hospital, which was not very pleasant and added to my feeling of abnormality.</span></p>
     
    <p style=”background: white;”><span style=”color: black; font-family: Consolas; font-size: 14pt; mso-bidi-font-size: 12.0pt;”>Drinking plenty of fluids is widely recommended, especially among catheter users, to reduce the chances of urinary tract infections.<span style=”mso-spacerun: yes;”>  </span>My urine output from 9.30am, when my leg bag is empty, to 4.30pm is typically around 600ml but can be up to a litre.<span style=”mso-spacerun: yes;”>  </span>From 4.30pm to 9pm, 500ml is usual, but from 9pm to 9.30am output is nearly always more than a litre, often nearly 2 litres.<span style=”mso-spacerun: yes;”>  </span>This would make a urethral catheter a big problem, especially overnight.</span></p>
     
    <p style=”margin: 5pt 0cm; mso-layout-grid-align: none;”><span style=”color: black; font-family: Consolas; font-size: 14pt; mso-bidi-font-size: 12.0pt;”>Added to these reasons for changing to a suprapubic catheter, my spinal injury has left me with only very limited use of my hands.<span style=”mso-spacerun: yes;”>  </span>In hospital, I practised inserting urethral catheters but found it difficult to clean my urethral opening adequately and to avoid touching anything which might infect the tip of the catheter.<span style=”mso-spacerun: yes;”>  </span>Usually I needed help from a nurse.<span style=”mso-spacerun: yes;”>  </span></span></p>
     
    <p style=”margin: 5pt 0cm; mso-layout-grid-align: none;”><span lang=”EN-US” style=”font-family: Consolas; font-size: 14pt; mso-bidi-font-size: 12.0pt; mso-ansi-language: EN-US;”><span style=”color: #000000;”>I started to wear an incontinence pad about three months after returning home from hospital, following some unfortunate accidents.<span style=”mso-spacerun: yes;”>  </span>Since then I have worn a pad all the time.<span style=”mso-spacerun: yes;”>  </span>These are available in many shapes and sizes and with different absorbencies.<span style=”mso-spacerun: yes;”>  </span>Mine are for moderate to heavy incontinence with an absorbency of up to 1,600 ml.<span style=”mso-spacerun: yes;”>  </span>Overall, they measure 63x30cm.<span style=”mso-spacerun: yes;”>  </span>The absorbent part is about 55cm. in length and 18cm. wide, widening to 25cm at the front and back.<span style=”mso-spacerun: yes;”>  </span>Inside are two elasticated expanding pockets about 2.5cm.deep 18cm. apart extending the whole length of the absorbent area to prevent spillage.<span style=”mso-spacerun: yes;”>  </span>The absorbent area is surrounded by a strong margin 2.5cm. wide for gripping to adjust the position of the pad.</span></span></p>
     
    <p style=”margin: 5pt 0cm; mso-layout-grid-align: none;”><span lang=”EN-US” style=”font-family: Consolas; font-size: 14pt; mso-bidi-font-size: 12.0pt; mso-ansi-language: EN-US;”><span style=”color: #000000;”>The pad is held in place by unisex net fixation knickers.<span style=”mso-spacerun: yes;”>  </span>They are similar to women’s full-sided net briefs with no gusset.<span style=”mso-spacerun: yes;”>  </span>Because the legs tend to be tight, I buy a large size. I rarely pass urine through my urethra – occasionally just a small amount which is soaked up by the pad.<span style=”mso-spacerun: yes;”>  </span>I have faecal leakage only occasionally, most usually immediately after a bowel evacuation which has not fully emptied my bowel.<span style=”mso-spacerun: yes;”>  </span></span></span></p>
     
    <p style=”margin: 5pt 0cm; mso-layout-grid-align: none;”><span lang=”EN-US” style=”font-family: Consolas; font-size: 14pt; mso-bidi-font-size: 12.0pt; mso-ansi-language: EN-US;”><span style=”color: #000000;”>My pad is normally changed each day when getting up.<span style=”mso-spacerun: yes;”>  </span>Carers give me bed bath every day.<span style=”mso-spacerun: yes;”>  </span>I sleep wearing only my knickers and pad (in hospital I wore nothing at all).<span style=”mso-spacerun: yes;”>  </span>Lying on my back, washing starts with my face and proceeds downwards.<span style=”mso-spacerun: yes;”>  </span>My carers remove my knickers.<span style=”mso-spacerun: yes;”>  </span>They fold my pad back so that they can wash my scrotum and penis and spray with an incontinence body cleanser, leaving the back of the pad underneath my bum.<span style=”mso-spacerun: yes;”>  </span>My foreskin is permanently rolled back.<span style=”mso-spacerun: yes;”>  </span>I am then turned onto my (right) side.<span style=”mso-spacerun: yes;”>  </span>The carers wash my back, bum and legs, using incontinence body cleanser around my anus.<span style=”mso-spacerun: yes;”>  </span>A clean pad is placed on my bottom and pulled through my legs.<span style=”mso-spacerun: yes;”>  </span>My knickers are then replaced and I am partially dressed before being hoisted into my wheelchair.</span></span></p>
     
    <p style=”margin: 5pt 0cm; mso-layout-grid-align: none;”><span lang=”EN-US” style=”font-family: Consolas; font-size: 14pt; mso-bidi-font-size: 12.0pt; mso-ansi-language: EN-US;”><span style=”color: #000000;”>This regime has worked quite well for me.<span style=”mso-spacerun: yes;”>  </span>My suprapubic catheter probably contributed to the urinary tract infections I used to get, which caused catheter blockages between January and July 2016 but these problems have been solved (so far!).<span style=”mso-spacerun: yes;”>  </span></span></span></p>
     
    <p style=”margin: 5pt 0cm; mso-layout-grid-align: none;”><span lang=”EN-US” style=”font-family: Consolas; font-size: 14pt; mso-bidi-font-size: 12.0pt; mso-ansi-language: EN-US;”><span style=”color: #000000;”>I get a small amount of leakage where the catheter enters into me so I wear a paper towel there.</span></span></p>
     
    <p style=”margin: 5pt 0cm; mso-layout-grid-align: none;”><span lang=”EN-US” style=”font-family: Consolas; font-size: 14pt; mso-bidi-font-size: 12.0pt; mso-ansi-language: EN-US;”><span style=”color: #000000;”>My incontinence pads are rarely more than slightly soiled.</span></span></p>
     
    <p style=”background: white; margin: 0cm 0cm 0pt;”><span style=”color: black; font-family: Consolas; font-size: 14pt; mso-bidi-font-size: 12.0pt;”>EMOTIONAL ISSUES</span></p>
     
    <p style=”background: white; margin: 0cm 0cm 0pt;”><span style=”color: black; font-family: Consolas; font-size: 14pt; mso-bidi-font-size: 12.0pt;”>Spinal injury, paralysis and incontinence have been severe blows to my lifestyle, mood and self-esteem.</span></p>
     
    <p style=”background: white; margin: 0cm 0cm 0pt;”><span style=”color: black; font-family: Consolas; font-size: 14pt; mso-bidi-font-size: 12.0pt;”>Such injuries are not compatible with privacy.<span style=”mso-spacerun: yes;”>  </span>Loss of privacy was not as embarrassing as it might have been – before my accident I had occasionally worked as an artists’ nude model.<span style=”mso-spacerun: yes;”>  </span>Even so, I do sometimes feel ashamed by my incontinence.<span style=”mso-spacerun: yes;”>  </span>I do feel guilt for imposing bowel evacuation on the nurses.<span style=”mso-spacerun: yes;”>  </span>Even worse, some of the nurses sometimes leave without having completed the job thoroughly: there is faecal leakage for the carers to clean.<span style=”mso-spacerun: yes;”>  </span>Emptying my leg bag is not a task I like to impose on carers or anyone else.</span></p>
     
    <p style=”background: white; margin: 0cm 0cm 0pt;”><span style=”color: black; font-family: Consolas; font-size: 14pt; mso-bidi-font-size: 12.0pt;”>I do not feel embarrassed by being naked but I am concerned that some of the carers are.<span style=”mso-spacerun: yes;”>  </span>Some younger carers, in particular those from different cultural heritages, stand frozen or leave the room to make breakfast as another carer gives me a strip wash.</span></p>
     
    <p style=”background: white; margin: 0cm 0cm 0pt;”><span lang=”EN” style=”color: black; font-family: Consolas; font-size: 14pt; mso-bidi-font-size: 12.0pt; mso-ansi-language: EN;”>I am unsure what those who do not show clear signs of embarrassment are thinking as they attend to me.<span style=”mso-spacerun: yes;”>  </span>Some just get on with the job to finish as soon as they can.<span style=”mso-spacerun: yes;”>  </span>A few do appear to enjoy what they do.</span></p>
     

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