Update on micturition dysfunction

Well it has been some time since I updated this section.  I am doing so to share my experiences and to encourage others that though these changes are quite different from "normal life", they are no longer problematic and in fact are somewhat freeing - less stress and anxiety about planning the next pit stop.

Again, what follows is primarily for those with spinal cord injuries or bladder dysfunction who require intermittent catheterization......

In the summer of 2010, six years post injury I finally saw a Urologist that clarified what I needed to be doing the rest of my days on this earth, well, at least in regard to voiding.  In summary, my bladder capacity is 500-550 cc (roughly 16-18 oz).   When I try to empty my bladder like 99.99% of the world's population does, I am still left with generally 300 cc AND that 10 oz is under high pressure.  Since the pressure in this plumbing system is seeking a place go, it also puts pressure on my kidneys.  This over time can lead to hydronephrosis, or distended, bloated and generally very unhappy kidneys.  Untreated the final result would almost inevitably be renal damage and the risk for renal failure and dialysis.....  No, I don't want to go there!  The other problem has been with my altered sensation, I never feel like my bladder is nearing capacity until the volume gets to roughly 475 cc; and then suddenly - wow, I need to find a place to go or run for the bushes.

The solution?  Simply catheterize 4-5 times per day to get my bladder volume back to zero and therefore my system pressure back to zero.  This is a good thing!!

Yes, fortunately I remain completely continent.  The unanticipated huge benefit for me is I no longer spend much of my day figuring out where the next accessible public restroom is - especially while bicycling and when traveling by car.  So I am now among the many with spinal cord injuries who self-catheterize 4-5 times per day.

Shortly after figuring this all out, I decided to sample a variety of catheters and options to determine what I should use for the duration.  I sampled just about every product out there as most manufacturers would appreciate your business and loyalty for the years ahead.  My Urologist preferred I use red rubber caths that could then be washed and re-used over and over, sparing the dump from unnecessary waste.  I was not so sure of this.  Doing required laundry every day, rinsing, washing, drying catheters.  Fortunately my wife is quite understanding, so she does not seem to mind several caths draped over paper towels drying in our bathtub.

One of the hydrophilic single use catheter varieties I considered came with an extra incentive; "try our catheters and we will send you a $10 gift card to use at Amazon.com".  Sign me up!  Well, let me tell you what happened.  This super flexible catheter was so soft, it actually kinked inside my urethra, buckling in such a way as to cause a urethral tear and bleeding.  It never did make it into my bladder.  So as much as you would think a soft, compliant catheter is a good thing - at least for me, it was too soft and flimsy, which caused the catheter to lose its sense of direction and purpose.  With altered sensation (meaning I did not feel any of the urethral tear occurring), before I realized what was happening I had done some major damage which even now, almost 18 months later, is still occasionally a problem.  The net result being I have an area just prior to the passage through the prostate that is a bit tight and seems to have a small blind alternate passage.  I now must use Coude catheters which have a narrow bent tip I can direct to avoid the trouble spot.  Fortunately the Bard red rubber Coude catheters work well, yet I still must say I prefer the single use disposable Lo-Fric Primo Coude catheters.  These are especially handy for any travel; doing catheter laundry just does not work when you are on the road.  To be honest, I would prefer to use the Astra Lo-Fric caths all the time however I just recently found out (due to a billing mistake by my Medicare supplemental plan; they were paying 100% of my catheter costs, then suddenly realized they should only cover 80%) I still need to pay out of pocket just over $200 per month for catheters.  After over 8 months of no catheter charges, I received in one single day bills for 6 months times $200.  Argh!!  So as of this writing, I am back to doing my daily catheter laundry and reserving my Lo-Fric Primo caths for travel. 

My wife suggested perhaps I could become a "sponsored" catheter user!  You know, like those who endorse certain product lines - pro athletes or celebrities, who are then supplied with product.  Gwen even suggested she could envision me in a pair of Astra Tech Lo-Fric Lycra cycling shorts complete with logos down the thighs!  What a strange reality we now survive and attempt to thrive in.

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