An accident in 2013 left me with spinal injury and double incontinence. 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.
I used intermittent urethral catheters for four months after my accident when they were replaced with a suprapubic catheter.
They were replaced for several reasons. They were used at intervals of 3-4 hours, a problem especially overnight, even in hospital. Even at these intervals, I had 3 or 4 substantial leakages of urine from my urethra. 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.
Drinking plenty of fluids is widely recommended, especially among catheter users, to reduce the chances of urinary tract infections. 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. 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. This would make a urethral catheter a big problem, especially overnight.
Added to these reasons for changing to a suprapubic catheter, my spinal injury has left me with only very limited use of my hands. 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. Usually I needed help from a nurse.
I started to wear an incontinence pad about three months after returning home from hospital, following some unfortunate accidents. Since then I have worn a pad all the time. These are available in many shapes and sizes and with different absorbencies. Mine are for moderate to heavy incontinence with an absorbency of up to 1,600 ml. Overall, they measure 63x30cm. The absorbent part is about 55cm. in length and 18cm. wide, widening to 25cm at the front and back. Inside are two elasticated expanding pockets about 2.5cm.deep 18cm. apart extending the whole length of the absorbent area to prevent spillage. The absorbent area is surrounded by a strong margin 2.5cm. wide for gripping to adjust the position of the pad.
The pad is held in place by unisex net fixation knickers. They are similar to women's full-sided net briefs with no gusset. 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. I have faecal leakage only occasionally, most usually immediately after a bowel evacuation which has not fully emptied my bowel.
My pad is normally changed each day when getting up. Carers give me bed bath every day. I sleep wearing only my knickers and pad (in hospital I wore nothing at all). Lying on my back, washing starts with my face and proceeds downwards. My carers remove my knickers. 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. My foreskin is permanently rolled back. I am then turned onto my (right) side. The carers wash my back, bum and legs, using incontinence body cleanser around my anus. A clean pad is placed on my bottom and pulled through my legs. My knickers are then replaced and I am partially dressed before being hoisted into my wheelchair.
This regime has worked quite well for me. 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!).
viewtopic.php?f=25&t=2571&p=23905#p23905 I get a small amount of leakage where the catheter enters into me so I wear a paper towel there.
My incontinence pads are rarely more than slightly soiled.
EMOTIONAL ISSUES
Spinal injury, paralysis and incontinence have been severe blows to my lifestyle, mood and self-esteem.
Such injuries are not compatible with privacy. Loss of privacy was not as embarrassing as it might have been - before my accident I had occasionally worked as an artists' nude model. Even so, I do sometimes feel ashamed by my incontinence. I do feel guilt for imposing bowel evacuation on the nurses. Even worse, some of the nurses sometimes leave without having completed the job thoroughly: there is faecal leakage for the carers to clean. Emptying my leg bag is not a task I like to impose on carers or anyone else.
I do not feel embarrassed by being naked but I am concerned that some of the carers are. 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.
I am unsure what those who do not show clear signs of embarrassment are thinking as they attend to me. Some just get on with the job to finish as soon as they can. A few do appear to enjoy what they do.
Login
Register
FAQ
Search
