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Urology and Catheter Care!

So why do i have to do ISC (Intermittent Self Catheterisation)

Back in 1993 when i had my rectum removed there was some nerve damage done to the bladder.

This didn't happen straight away though..it wasn't until 3 years later that i started to develop the odd UTI (urinary tract infection).     Suddenly one day i went into retention and i went a full 24 hours unable to pass urine and eventually ended up in A+E.

A catheter was inserted and the pain just vanished within seconds and I drained 2 litre's of urine in the space of 30 minutes.

I was kept in hospital for a week and various tests carried out and thats when i first found out i had a problem with fully emptying my bladder.

Although i could still pass urine the normal way i was asked if i would consider doing ISC.   At this stage i refused and said if things get worse in the future i would might think about it again.

Over the following years i was getting about 2 -3 infections a year and yearly bladder flow tests, which are very undignified.

This is where they insert a catheter into the bladder and also a thin tube into the back passage (however as i don't have one it goes into the stoma).   A machine then fills the bladder up with saline until the bladder is full to its maximum capacity and then you pass solution into a machine and it measure the flow.   Very high tech but like i say undignified.

These results started showing my bladder muscle's were starting to weaken and not open as much every time i pass urine.  

My infections started to become more regular,,having at least one a month,  I was on and off antibiotics all the time.    It was then in 2011 i took a turn for the worse and was admitted to the renal ward for the worst infection i had ever had, kidney and uti.    I was immediately started on IV antibiotics for 2 weeks.

Whilst i was in there was lots of talks going on between the renal team and urology team working out which would be the best way forward.      I was approached and told the only way to go now was to start the self catheterisation.   My reaction to this was no way, i had too many other issues and couldn't cope with something else new.

I was left to think about it for a couple of days, then one day on the ward a specialist urology nurse turned up and said she was here to start the ISC.  

This totally caught me off guard and went into panic mode.   I had no support over the previous days to talk about starting this and i felt i had been cornered and bullied into it.

I listened to what the specialist nurse had to say and this is when my journey to self catheterise started.   I was in hospital a further week to be trained up.

I have to admit 7 years on I still hate having to do it.   At first it was only twice a day.  Morning and night to drain the excess urine in the bottom of the bladder.

Today i am doing it every 4 hours.

The only way i can cope with it is to block it out of my mind..I hate doing, my team know this but i know it has to be done.

Over the years the infection have become more regular and I have had to start having bladder washouts.

This flushes out any gunk out of the bladder and puts a protective line around the bladder wall.  I have this done once a week by the district nurse.

I am now fully dependant on catheters and because i have been doing this for so long the bladder has become weak that sometimes it leaks.   I have no warning whats so ever and suddenly i am wet.  It can be even worse during the night as i don't get the message to the brain to say i need to wake up and pass urine.

I find this so embarrassing, so my urology team suggested I have botox injections into the bladder to see if this helps.

What this does is enlarges the muscles at the bottom of the bladder so they can't open up and causing leaks.   And the only way to pass urine is via the catheter.

I have been having this treatment for 5 years now and it used to be every 6 months.  But lately the symptoms have been returning quicker so it was decided that i have this done every 4 months.

My next botox is actually next week 15 June.    However I do have to be admitted the day before and have to spend at least 3 days as inpatient because of all my other medical issues.

Although i do have this done on a regular basis and i am always on the same ward it does not get any easier each time.
















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