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 Post subject: Bowel evacuations
PostPosted: Fri Dec 29, 2017 11:44 am 
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Joined: Sat Mar 18, 2017 10:36 am
Posts: 15
An accident in 2013 left me with spinal injury causing paralysis below the chest and double incontinence. This is managed with a suprapubic catheter and bowel evacuation on alternate mornings by district nurses before I get out of bed. I spent 7 months in a specialist spinal injuries hospital before returning home.

I started to wear an incontinence pad about three months after returning home from hospital, following some accidents. Since then I have worn a pad all the time. These are available in many shapes and sizes and with different absorbencies. I wear Abri San Premium 6 (approx. £10 for 34). These are for moderate to heavy incontinence with an absorbency of up to 1,600 ml. Overall, mine 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 - Abena Abri Fix large (£4.00 - £5 for 5) or Allanda iD Expert Ultra Large £6.99 for 25. They are similar to women's full-sided net briefs without gusset. They can be washed many times and last more than a month. I rarely pass urine through my penis - 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. I am not sure why I have been prescribed a relatively high absorbency pad but I have never questioned it as I feel it is better safe than sorry. I buy a size larger than what would appear to be my size. At home I sleep wearing only pad and knickers; in hospital I slept in the nude.

At home, two nurses are needed for bowel evacuation (only one nurse or carer in hospital). One nurse takes my blood pressure and pulse rate. I am turned onto my left side and held there by the nurse. Then the other nurse, suitably gloved, pulls down my knickers, pulls my pad aside and inserts her finger into my lubricated anus and into my rectum. Despite having very little surface sensation below my chest, I can feel this clearly, although of course, I can not compare it with what I would have felt if it had been carried out before my spinal injury. She removes as much faeces as she can, inspects my bum for any developing pressure sores and cleans me up. Before replacing my pad and knickers, she inspects my penis and the site of my suprapubic catheter and cleans it if necessary. Some nurses feel my testicles for any abnormalities such as lumps. My blood pressure and pulse are taken again. Usually my blood pressure has increased and I have become very warm and sweaty because of nerve stimulation.

In hospital, bowel evacuation took place daily about half an hour after a nurse or carer had inserted a suppository in my rectum. In the final weeks of my stay in hospital, when preparing for life outside, I received instruction in the insertion of a suppository up my anus using a mirror. Because I have very little sensation or movement in my hands, depleted sensation in my bum and little body movement, insertion of a suppository by myself was very difficult, even with a nurse to position the mirror and part my cheeks. Suppositories were discontinued when I returned home.

My pad is normally changed each day, as part of getting up. Carers give me bed bath every day. Lying on my back, washing starts with my face and proceeds downwards. My carers remove my knickers and pull my legs apart to get better access to wash my scrotum and perineum. They fold my pad back so that they can wash my scrotum and penis with Proshield, leaving the back of the pad underneath my bum in case of leakage. My foreskin is permanently rolled back. Some carers who wash me thoroughly hold my penis, pressing gently around the base and pulling my foreskin with one hand and squeezing my testicles with the other as they wash my scrotum. This helps to increase my size, which helps washing under the glans. If I can get an orgasm that is a bonus.

I am then turned onto my right side. The carers wash my back, bum and legs, using Proshield 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.


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 Post subject: Re: Bowel evacuations
PostPosted: Sat Dec 30, 2017 10:25 am 
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Joined: Sat Mar 29, 2014 11:45 am
Posts: 1836
This reads as typical management for male spinal injury patients. I understand the embarrassment, but the alternative is too worse to even contemplate. I hope that medical researchers will soon discover, perhaps with stem cell therapy, a way to regenerate injured spinal nerves, which would soon relegate your situation to the not-so-good old days.


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