Doc Ernie's Blog

This section is really intended for those with spinal cord injuries.  "Constitutional truths" in this case has absolutely nothing to do with what our forefathers generated over 200 years ago, nor anything pertaining to our countries politically misguided adventures or upcoming election.

Instead it speaks to catheters, suppositories, and how to best avoid UTI's.  These are a part of routine life those of us with SCI deal with, and others perhaps are inquisitive about.  The content that follows is really meant for those who have some dysfunction in elimination processes in hopes you may find a helpful hint or two.

As I have written previously, every person with an incomplete spinal cord injury is going to experience different abilities or functional changes in elimination processes, both in bowel and bladder function.  What follows is information about what has worked for this physician/patient.

I underwent urodynamic studies in January 2005.  While I can still say I don't feel much below my clavicles, I still had a sense that testing was being done somehow as I managed to have a significant vagal (aka fainting, or falling out) episode while 3 catheters were indwelling in 2 orifices below my umbilicus.  Fortunately as I fell from standing the alert nurse ran across the room and caught me just as I had fallen backwards onto the exam table.  I'll spare you any more details of the testing.  Basically the study showed I maintain high bladder pressures, even after voiding.  That I can only void about half of what is in my bladder.  Net conclusion = self-catheterization was necessary once per day to get my collecting system some time at zero pressure and spare my kidneys long term damage.  Being the non-compliant doctor, it only took me 9 months to begin this daily routine.  I think I still just wanted to be/thought I might be "normal" again someday (whatever "normal" is).

So since late fall 2005 I do self catheterize once per day, usually right before bedtime so that I get a bit more uninterrupted sleep before my small capacity bladder begs for a urinal.  I can say with certainty, that this is not a big deal at all.  I used to think it was, or that I'd never get used to it, but it is not a problem and would encourage anyone who has to do this not to hesitate, nor to fear it.  Yes, the first few times take some getting used to, and for me resulted in a couple of lightheaded episodes (enough that I wore my exercise heart rate monitor just to make sure my rate wasn't going too low - it wasn't); but shortly after that it became routine, a basic part of my life that really is no bother at all.

As for avoiding UTI's or urinary tract infections.  I have had several of these, but so far this routine is working well for me.  I use Lo-Fric Primo catheters which have the attached sterile water pouch.  I take 1000mg of Vitamin C over the course of the morning/early afternoon, and 2 tablets of Cranberry concentrate at 400mg each tablet at bedtime.  This has kept my urine acidic enough, and prevented all UTI's since being consistent with this regimen.

While a few with SCI will have regular bowel action, I do not, and require suppository use.  Without that, despite adequate fiber, fluids, visualization...  nothing will happen even after 3 days of no suppository use.  This is not a "sponsored" endorsement, but this doctor recommends The Magic Bullet - quick acting, effective and so forth.  All credit is due my wife for her creation of the new word "suppositate", which is defined as the reflective, thoughtful time one has whilst awaiting the action of said inserted medication.  Safe to say, The Magic Bullet does significantly reduce your suppositation time.