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Incontinence Support Blog

Men's Liberty's Big Questions: Why Does Running Water Make You Need to Pee?

Posted by Mens Liberty

Jan 26, 2016 10:00:00 AM

What’s worse than needing a pee when you can’t get to a toilet? The sound of running water, that’s what. Be it from a tap or the rain outside, the soft trickle-trickle noise can seem like it’s mocking your bladder. Quite why the sound makes us even more desperate to pee is uncertain, but we can filter it down to a couple of likely reasons.

 

This week's blog comes to us from Michael McKenna at AskAGuru.com - a great site that tackles some of the biggest and oddest science lifestyle questions on the web.

When you or I take the time to relieve ourselves, urine from our full bladder flows out through a narrow tube called the urethra. This stream is controlled by two sets of sphincters – rings of muscle – that can clamp down on the tube like taps. The first (internal) sphincter is at the top of the urethra, next to the bladder, and is controlled automatically by our nervous system. When our bladder is full, a message is sent to the internal sphincter, telling it to relax and open the floodgates. But to stop us wetting our seats on the bus, the second (external) sphincter is under our conscious control, allowing us to keep the tide at bay, overriding the body’s demand to urinate willy-nilly.

The part of our nervous system that automatically controls the internal sphincter is called the parasympathetic nervous system (PNS). The PNS tends to be most active at times of calm and rest, when it encourages the first tap (internal sphincter) to open. It is probable, therefore, that the calming sounds of running water relaxes us enough to cause the PNS to send more messages to the internal sphincter, telling it to be opened wide. It’s worth knowing that opposite to the PNS is the sympathetic nervous system (SNS). This separate nervous control system is behind the so-called ‘fight or flight’ response, when our heart rate increases, our skin goes pale and we get goose bumps in response to fear. It affects the contraction of the internal sphincter, telling it to stay shut – perfect for those moments when you have to run for the train (or when a sabre-tooth cat is nearby).

The second possible explanation for why running water sound makes us want to pee will be familiar to anyone who has heard of Pavlov’s dogs. In the 1890s, a Russian psychiatrist called Ivan Pavlov carried out famous experiments with dogs, showing how animals’ bodies unconsciously learn to anticipate something important. In his experiment, Pavlov rang a bell just before feeding his dogs some meat powder (I bet you’re drooling just thinking of it). He observed that, after repeating the ring-food routine, the dogs would begin to salivate as soon as the bell rang – even if he didn’t bring any food. The dogs had learned an automatic response, associating the sound of a bell with the arrival of food. (This is called ‘classical conditioning’.) In much the same way, we learn, through our experience, to associate the sound of water with urination and so, like a dog thinking of a bone, we find it difficult to think of little else when we hear that trickle.

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Topics: urinary management, Interesting Articles, incontinence

‘Twas the Night Before Christmas… with Men’s Liberty 2015

Posted by Sarah Woodward

Dec 24, 2015 10:00:00 AM

'Twas the week before Christmas, when all through the store

Not an item was discounted, not even a drawer;

The stockings were hung by the chimney with care,

In hopes that St. Nicholas soon would be there;

The children were waiting all snug in their threads,

While visions of X-boxes danced in their heads;

And mamma in her 'kerchief, and I in my cap,

Had just settled down for a Christmas shopper’s nap,

When up on the riser there arose such a clatter,

I sprang from the line to see what was the matter.

Up to the display I flew like a flash,

Tore past the elves and knocked down the sash.

The lights on the piles of the fake-plastic snow

Gave the lustre of mid-day to objects below,

When, what to my wondering eyes should appear,

But a miniature sleigh, and eight tiny reindeer,

With a little old driver, so sluggish and thick,

I knew it must be the mall’s incontinent St. Nick.

More rapid than eagles his options they came,

And he whistled, and shouted, and called them by name;

"Now, Foley! now, Texas! now, Tena and Depends!

On, Condom! on Corman! on, Poise and Attends!

To the top of the porch! to the top of the wall!

Now dash away! dash away! dash away all!"

So up to the mall-top the coursers they flew,

With the sleigh full of pee, and St. Nicholas too.

As I drew in my head, and was turning around,

Down the hall a new St. Nicholas came with a bound.

He was dressed all in fur, from his head to his foot,

And his clothes were all burnished with ashes and soot;

A bundle of toys he had flung on his back,

And he looked like a peddler just opening his pack.

His eyes -- how they twinkled! his dimples how merry!

His cheeks were like roses, his nose like a cherry!

His droll little mouth was drawn up like a bow,

And the beard of his chin was as white as the snow;

He had a broad face and a little round belly,

That shook, when he laughed like a bowlful of jelly.

He was chubby and plump, a right jolly old elf,

And I laughed when I saw him, in spite of myself;

A wink of his eye and a twist of his crown,

Gave me to know there was a better option in town;

He spoke not a word, but went straight to his seat,

And welcomed the children; who asked for a sweet,

Calling me closer, he told me his quest,

‘Forget about diapers, opt for the best;

‘Men’s Liberty’s the key to sitting for hours,

No leaks at all and no more wet trousers!


And I heard him exclaim, ‘ere we walked out of sight,

 "Merry Christmas to all, and to all a dry-night."

 

Topics: urinary management, bladder control, diaper alternatives

Tips & Tricks: How to Use the Bedside Bag

Posted by Mens Liberty

Nov 20, 2015 10:00:00 AM


We’ve seen a new question popping up over the last few weeks and I wanted to take a few minutes here with all of you to answer! It seems like we’ve got a little confusion out there about some of the related products that can be provided alongside your Men’s Liberty.


The first of these products is a bed bag. It looks just like this one <<hold one up>>. This is designed for overnight use and attaches to the small plug at the base of the Men’s Liberty pouch. It holds up to 64 ounces of fluid and is covered by Medicare and most insurance plans.

So when you’re ready for bed – this is what you want to do:

  • Sit down on your bed, place the empty bed bag on the floor next to your bed or hook it to your bedframe. It doesn’t matter which of these you do – you just want to make sure that the bag is resting below your bladder so that gravity will make sure it drains.
  • Next, take off the blue cap on the end of the bed bag tubing. Remove the plug from the bottom of your Men’s Liberty pouch and push the bed bag adaptor into the plug hole on the pouch firmly. Keep pushing the adaptor in there until it’s secure. Pull up your boxers or other pjs and then you’re ready to get a restful night’s sleep. In the morning, remove the adaptor and replug your Liberty. Empty the bed bag into the toilet and put it somewhere safe for tomorrow night.
  • One other tip, if your bed bag has a bit of a smell to it after a few nights, you can rinse the bag with a solution of 2 parts white vinegar and 3 parts water or 1 tablespoon of chlorine bleach and about a cup of water. Pour this into the bag and swish it around for about 30 seconds. Drain the bag and allow to dry.  This will totally get rid of the smell and keep your bed bag daisy fresh.

The bed bag is supposed to be re-used for up to two weeks. That’s why we give you two bed bags with each month’s supply of Men’s Liberty. If you don’t wear the Liberty at night – just tell us and you can skip the bed bags.


I hope this is helpful – if you have any other product questions – please let us know in the comments or send us an email to CustomerCare@MensLiberty.com – we want to hear from you!


 

Topics: urinary management, Medicare, how to

Three Unexpected Causes for Urinary Incontinence in Men

Posted by Mens Liberty

Nov 17, 2015 4:00:00 PM


Welcome back – this week we’re going to be tackling a very practical issue. For men with urinary incontinence or at risk of urinary incontinence, it can be hard to know what to do to minimize risks and improve our bladder control. So this week, I’m going to share three surprising things that could be contributing to your incontinence – how many of these did you know about?


The first surprise – weightlifting can cause urinary incontinence. It seems that regular lifting of heavy weights or high-impact activities like jumping can strain the pelvic floor muscles. Fortunately, you don’t have to give up – just make sure you all work those pelvic floor muscles. These muscles can be strengthened with specific exercises called Kegel exercises. Click here to view our guide to Kegel exercises.

The second risk factor is one we’ve covered before – obesity. Again links in the description box below. Carrying extra body weight stretches the muscles that hold up the abdominal organs. These muscles, known as the pelvic floor, help close the urinary and anal sphincters. Over-stretching them compromises their ability to shut off the sphincters, which are critical for maintaining continence.

But not all hope is lost for those of you with a bit of a belly - research has shown losing 5 to 10 per cent of body weight reduces the incidence of urinary incontinence by around 70 per cent. 

And this last one was a huge shock to me. It makes sense but I’d just never thought about it this way. Research has shown that regularly straining on the toilet has a similar impact on the pelvic floor to obesity.

In addition, a full, impacted bowel can press on the bladder and increase the risk of urinary urgency.  A severely impacted bowel can also cause soiling that looks like diarrhoea but is actually faecal overflow. Wow – that was more than even I wanted to know!


As with most things, the best option is prevention – making sure you get adequate fibre and fluid can help And make sure you don’t “hold it” since responding to the urge to defecate quickly can help prevent muscle strain.

So that’s what we’ve got for today – three unexpected things that can cause urinary incontinence – and some helpful hints for what you can do to help your body. Do you know of something we missed – let us know in the comments or in an email.

Get Help Now!


 

Topics: urinary management, kegel exercises, incontinence

How to Pack for a Trip to the Hospital (if you're incontinent)...

Posted by Mens Liberty

Nov 10, 2015 2:00:00 PM


Welcome back – this week we’re going to be tackling some really practical advice. If you’re like me, when you are planning a stay in the hospital, whether it is for inpatient surgery, or another reason, it is important to be prepared. A well-packed bag is essential for having a comfortable stay in the hospital. But the big question is – what does “well packed” mean exactly?


Never fear – here is my MUST-HAVE list. Feel free to change this around to suit your needs but this is what gets me through a hospital stay.

  1. Pajamas or night clothes for each day. You spend all day and night in your PJ’s and tend to sweat more in the hospital,(especially with those plastic coated mattresses,) so you can usually only wear PJ’s for one day. Also don’t go for skimpy items. I have seen patients in hospital PJ’s or other clothing made of nylon and they tend to make you perspire and become uncomfortable, when in bed for any length of time.
  2. Socks and slippers – hospitals are filled with recycled air and they only have one temperature – cold! So even if you’re not a “hot” person by nature – don’t forget the fuzzy socks. A new pair for every day.
  3. Baby wipes or wet wipes for cleaning up hands, face and bottoms and for overall “freshening up,” especially if you can’t shower as often as you like. These are an absolute lifesaver!
  4. 2 in 1 shampoo and conditioner – this saves time washing your hair when you feel awful. Even better try using Dry (i.e. waterless) Shampoo – for freshening your hair when you are unable to wash it yourself. While it’s not as good as a real hair wash, if you are unable to get out of bed or wash your hair as much as you would like, then this can be a good alternative.
  5. Moisturizer – Some hospital atmospheres can be very drying on the skin, especially if it has air conditioning or you are having bed baths. So don’t skimp on lotion or moisturizer. I particularly like the spray on moisturizer from St Ives for those hard to reach spots!
  6. Incontinence Supplies – hospitals will have pads or diapers but they buy them in bulk from the cheapest supplier possible so they feel just slightly better than sand paper – not okay. And let’s be honest here – no one wants a Foley catheter if they can avoid it. So whether or not you use Men’s Liberty, bring your supplies with you – one for each day plus two just in case. You’ll be glad you did.
  7. And last but not least – bring a comfortable outfit to wear home. Something slightly nicer than your PJs but comfy. Your going back out into the world and for some reason they don’t seem to like you to wear your PJs 24/7.

Well that’s my list – did I forget anything? What can’t you live without? Let us know in the comments!


 

Topics: urinary management, doctors visit, proactive patients, tips from Men's Liberty users

The other “I” word for active baby boomers

Posted by Mens Liberty

Oct 20, 2015 11:00:00 AM

 Hello my friends – a few weeks ago, we were lucky enough to do a radio interview with Health, Wealth and Wisdom – part of Senior Voice America. And one of the questions really struck me – “why is it so important to have a conversation about incontinence?”

We talk about it a lot – but maybe it’s not clear enough yet – incontinence is a REALLY big deal.

And you don’t have to believe me – listen to the Centers for Disease Control or the
 National Institutes of Health.

The CDC published a study last month that showed more than 50% of all community dwelling people over 65 reported experiencing urinary incontinence. So in a room full of people that age – one in every two of them is dealing with this issue.

The CDC also estimated the financial burden associated with incontinence. In the US, the cost of bladder incontinence among adults in the year 2000 was estimated at $19.5 billion, with $14.2 billion incurred by community residents and $5.3 billion by institutional residents.

Nearly 75% of those costs are resources used for incontinence management or ‘‘routine care’’ such as absorbent pads, protection, and laundry. That is horrifying. Care costs like this are coming straight out of your pockets – no insurance, no co-pay, just seniors on a fixed income spending thousands of dollars a year on adult diapers.

If all of the above wasn’t enough – the CDC subtly suggested and I quote: “Individuals who are incontinent may carry an emotional burden of shame and embarrassment in addition to the physical discomfort and disruption of their lives that occur with episodes of incontinence. Bladder and bowel incontinence significantly impact quality of life even after adjusting for co morbidities and demographic differences.”

That’s pretty strong wording for a bureaucracy.

And they’re absolutely, 100% right. Incontinence is the other “I” word. Ten or 15 years ago it was “impotence” but Viagra really brought erectile dysfunction out of the closet – if you’re like me, you think its time to do the same thing for incontinence. So join us and do your part – share this, make a comment, talk to a friend and spread the word – you don’t just have to accept incontinence and its costs.

Find Out About  Diaper Alternatives!

 

Topics: urinary management, bladder control

Fear & Medicine, a Lesson for Healthcare Professionals & Caregivers

Posted by Sarah Woodward

Sep 30, 2013 9:55:00 AM

Today I wanted to share a blog from Danielle Ofri of Slate.com, a MD and PhD, who wrote a moving story about fear and medicine. And it spoke to me, although she wrote as a mother, I know a very similar fear as a caregiver. Trusting our loved ones to a complicated system, filled with jargon we may never truly understand requires a leap of faith that anyone who hasn't walked a mile in our shoes will probably never understand.

So take a look, does any of this sound familiar to you? Do you have a story to share? Let us know!

Orange Line

When my son was 18 months old, his doctor recommended that he get tympanostomy tubes in his ears because of recurrent ear infections. He might not be hearing clearly during this critical stage of language development. Being a physician myself, I researched this thoroughly. It turns out the evidence supporting the procedure is slight—it may help with hearing and language, but all kids seem to catch up whether or not they had the tubes.

In the end, though, I made my decision more as a parent than as a doctor—I wanted my child to have the best opportunity for language development, and besides, it was a low-risk  procedure.

Two weeks later I scooped my sleeping boy out of bed before dawn, buckled him into his car seat, and hailed a taxi on the darkened city streets. At the hospital, my son snuggled in my lap as I sat on a recliner that was wheeled into the OR. Everyone was cheerful and friendly. The nurses sang songs, and the surgeon pointed out the elephants on his hat. I was given a hose with anesthetic to wiggle in front of my squirming son, to sedate him enough for the staff to get him onto the table.

We played with the hose for 10 minutes. Just when I thought that this technique would never succeed, my son slackened slightly, lolling his head against my chest. At that moment, the OR staff clicked into action. The cheery demeanor dissolved and everyone was all-business. The patient was whisked from my arms and in less than three seconds he was strapped on the table with a mask over his face, preternaturally still, unhumanly still.

At that moment, my faith in science plummeted from beneath me. My decades of medical training, my Ph.D. in biochemistry, my grounding in the scientific method, all evaporated in the blink of an eye. The sight of my son—stone-still on the OR table, deathly rigid—completely unhinged my confidence that “everything would be OK.” Suddenly, I was not sure that anything would be OK. My little baby—23 pounds including race-car pajamas and diaper—was minuscule and fragile under the ministrations of five lumbering adults and gargantuan, stainless steel equipment. And there was nothing I could do to help him.

An orderly began to lead me out of the OR, and suddenly I stopped and clenched onto his arm. “Please,” I beseeched him. “Please make sure my son is OK.” He nodded and reassured me, even though he had no role at all in the surgery. But he was wearing blue scrubs, so to me he was somehow part of the frightening medical complex that had swallowed up my son.

I paced the waiting room, the knot in my gut twisting painfully. What if something bad  happened? Adverse outcomes were rare for this procedure—I knew that—but when a procedure is performed frequently enough, rare occurrences will eventually happen. I circled the waiting room stiffly, nursing my guilt.

When the surgeon appeared without my son in tow, my heart stuttered to a standstill. I steeled myself for the bad news. “It’s done,” he said with a shrug. “He might be a little cranky when he wakes up, but everything went fine.”

It took some time for the reality of his words to sink in. Even when a sleepy, tousled boy was placed in my arms, the panicky choke of fear still gripped me. I have always been a rational person, confident in the power of facts. Knowledge armed me against the existential fears of the universe. Yet here I was facing a minor surgical procedure, and all of my armor crumbled in a heartbeat. My heart ached for parents whose children are truly ill, for the frightening bargain of uncertainty they must make as they entrust their children to the medical system.

It is as though there is a precipitous drop in front of you, but a Plexiglas bridge extends across the void as in the classic behavioral psychology experiments. The medical system beckons, “It’s safe. We’ll guide your child across the glass bridge.” But your emotions, your life experience,
your gut, and your eyes can only see the sheer drop. 

Cradling a restless boy in my arms, it suddenly dawned on me that we ask patients every day to step over this void, to trust in the system. In matters both small and large, we ask them to step onto a glass bridge, reinforced only by our assurances. Even if they are able to  intellectually evaluate the risks and benefits, at some point they have to make an all-or-nothing decision whether to cross that bridge.

My son recovered rapidly—he was into trouble before lunchtime—but my emotional vulnerability lasted far longer. I’m still an empiricist, and still hold strong faith in the power of the scientific method, but now I appreciate now quickly and resolutely this armor of rational protection can dissolve.

When I sit with a patient now, deciding on a treatment, I still lay out the risks and benefits as systematically as I can. But then I take a moment to acknowledge the raw fear that cannot be assuaged by even the most convincing clinical data. This conversation can’t eliminate the necessary leap of faith. But at least there is some recognition of the stomach-plummeting sensation that occurs when the patient edges their toes out onto that clear glass bridge.

Danielle Ofri is an associate professor of medicine at NYU School of Medicine and editor-in-chief of the Bellevue Literary Review. Her newest book is What Doctors Feel: How Emotions Affect the Practice of Medicine.


 

Topics: family, urinary management, doctors visit, Caregiving, healthcare professionals

Helpful Ways to Beat The Heat with Multiple Sclerosis

Posted by Sarah Woodward

Aug 26, 2013 8:03:00 AM

Those with Multiple Sclerosis (MS) know what it’s like when in a hot environment. It’s not pleasant, and heat can make symptoms worse.  Between 60-80% of those with MS have some intolerance to heat, producing symptoms of numbness, fatigue and more.

There are a number of strategies the experts recommend to help control the effects of heat among MS patients.  Most people with MS are heat sensitive because of the scars in their central nervous system.  Where they have demyelination even in the spots that are repaired by their own system, those areas do not insulate the nervous system as well as the original myelin coating.  As a consequence, increases in body temperature can cause an almost immediate change in their reaction to heat.

Heat exposure can cause previous known symptoms to be reactivated or new symptoms to appear.  The upside is that these symptoms don’t cause permanent damage. Additionally, people with MS have trouble regulating their body temperature and their sweat glands don’t work like they are supposed to.  Consequently, they need additional help to regulate body temperature when its hot.

Among the many heat sources in our environment, those external ones we can sometimes avoid...i.e. the sun.  Internal heat sources are a different story, and they can include heat from a fever, menopause, hot flashes, hot beverages and spicy food. Medicines can also cause  fluctuations in how the body functions, so it’s a good idea to review your drugs and their side effects. Most of these internal heat sources are hard to control, but there are ways to stay more comfortable. 

Here are a few tips:

  • Stay hydrated- Drink plenty of cool drinks, especially water. Sodas and juices don’t quench thirst as much as water.  Limit the caffeine and alcohol you consume, because they can elevate your temperature. Take along a cool drink if you’re traveling. Additionally, eat cool foods that contain water like grapes and watermelon.
  • Cool Places-  Stay in the shade, or if you must be out in the heat, keep a spray bottle nearby and spray yourself when you feel too hot. Stay near water, and take a dip in the pool when convenient. If you’re about to get into a hot sitting car, let the air conditioner run for a bit before you get in and start driving. Air condition your house, or stay near an AC window unit.  If your utility bills get too high, tint and insulate your windows. Stay away from appliances, particularly stoves, grills, dryer, heaters, ovens and other machines, which give off heat. Finally, create your own shade by carrying an umbrella.
  • Shower-  Before doing something strenuous like playing sports, walking or running, cool off with a shower before the event. It will increase your tolerance to heat. Alternatively, you can take an ice water plunge with your feet and hands to cool your core temperature before venturing out.  The benefits of pre-cooling your body can last up to two hours in regulating your internal temperature.  During your activity, take cool down breaks and don’t push yourself to the point of being overheated.
  • Prepare for Heat-  Be strategic about your exposure. Run your errands that require you to be outdoors early or late in the day.  Avoid the mid-day heat between 10am and 2pm. Humidity can also play a big role in how your body reacts to the heat, so plan accordingly.
  • Dress appropriately- Wear light-colored clothing made of cotton, or athletic “dry-fit” clothing that can wick moisture away from the body.  You can also purchase cooling garments like neck scarves or wrist bands that you pre-soak in water. You can also create your own cooling garment by moistening the clothes you are going to wear, creating your own evaporative system that will regulate rising body temperature.

If you suffer from Multiple Sclerosis, don't be discouraged by the heat of the summer months. Find the strategies that work best for you, because you can beat the heat!

David Novak
David Novak is a international syndicated newspaper columnist, appearing in newspapers, magazines, radio and TV around the world. His byline has appeared in GQ, National Geographic, Newsweek, The Wall Street Journal, Reader's Digest, USA Today, among others, and he has appeared on The Today Show, the CBS Morning Show and Paul Harvey Radio. David is a specialist at consumer technology, health and fitness, and he also owns a PR firm and a consulting company where he and his staff focus on these industries. He is a regular contributing editor for Healthline. For more information, visit http://www.healthline.com/.

Topics: urinary management, wheelchair

Understanding Spinal Cord Injury with Caleb: Part 2

Posted by Sarah Woodward

Jul 29, 2013 3:28:00 PM

CalebAs I promised last month I will be sharing a bit about life with a spinal cord injury. Most of the symptoms or side-effects of a damaged spinal cord are similar across the board. Degree and intensity of these effects are determined by the factors I outlined in my last post, level and severity of trauma being key. Much of what I will share today is subjective based on my personal experience, but in my communication with friends in the spinal cord community and study of the condition many experiences are the same, if not variations on a particular set of issues.

THE PHYSICAL EXPERIENCE

Before I go any further please understand that many of you know me personally. Much of what I am about to discuss has remained intensely personal and only a few people know the extent of my physical situation. I will be explicit so be forewarned. This is not an attempt in any way to gain sympathy, it is simply a presentation of a very real life as I have lived it, be it right or wrong over the last 19 years.

In April of 1994 during my junior year of high school I was swimming with 2 friends in an above-ground pool in Crescent Beach, Florida. I have lived around water and water sports my entire life. My father is a surfer, an excellent swimmer, avid fisherman and sailor. He saw to it both of his sons were comfortable around water. By 16 I was a surfer as well with several large hurricane swells under my belt, more than a few Northeasters, river rafting Florida's springs and diving for conch in the Bahamas. I've had reef scrapes, fin cuts, banged my head, bounced off of packed sand bars, gotten pounded in the shore break, even dove into the shallow end, but for some strange reason on that day I caught it wrong.

I foolishly was attempting an upside-down cannonball, which is called a "watermelon". The point is to of course make a big splash. Which I did, but not quite in the way I intended. I did not clear a full rotation before connecting quite solidly with the bottom of the pool. I landed across the back of my shoulders where my neck meets my back. The sudden impact forced my neck forward so violently it crushed the C5-C6 Vertebrae. X-rays later revealed what is called a "burst fracture". This means that the spinal column became so compressed it caused the vertebra caught in the pressure point to "explode". Imagine you are holding 3 checker chips between your thumb and forefinger. If you apply enough pressure the one in the middle will pop out. This is essentially what happened in my neck.

I immediately knew what I had done. The first sensation was that my body vaporized into thin air, accompanied by what seemed like thousands of air-raid sirens between my ears. Next was the pain. I didn't know pain like that was possible. Like a hot dagger at the base of my neck shooting lightning bolts of electricity into my skull. In my field of vision I could tell I was face down, floating just below the surface of the pool, my arms floating like limp seaweed unresponsive to the survival impulses of my brain telling them to get me to the surface for air. I knew I was drowning and in seconds it could be over.

The next thing I felt was rising up out of the water. I realized my friend Jennifer was holding me in her arms. All I wanted was air. I could barely get enough because the muscles that expand the rib cage had been paralyzed along with my diaphragm which would not return without intense respiratory therapy three weeks later. I could barely speak the words "I've broken my neck..." To this day I owe so much to two very special women, April Johnston and Jennifer Tooley who acted quickly and maturely to save my life. Within the hour I was life-flighted by helicopter to what is now Shands Medical Center in Jacksonville, FL. The flight was loud and cold and only added to the intense ringing and pain growing in my head and neck. As my body went into shock I vomited up and into the oxygen mask, the contents of my stomach pouring into my ears and hair and down my neck. This happened twice. Upon landing I was rushed into the ER. At this point things became a blur of wires, tubes, scissors, clipboards and questions. Finally with the pain, now worse than ever, like fire burning my brain, I fumbled with the words, but got them out, "Please... put me out." That was it, everything went black.

I awoke 8-10 hours later in a morphine-induced stupor, wires and tubes everywhere. In my nose. In my mouth. An oxygen mask over my face. I still could not feel my body. What followed over the next three to five days all runs together. I remember many details, bits and pieces, but don't ask me to put them in order. The diagnosis was acute spinal trauma, incomplete, caused by a crushed C5 vertebra. To repair the damage bone was grafted from my left hip into my spine and my C4, C5 and C6 vertebrae were fused together using a titanium plate. My neck was stabilized by what is known as a Halo. A rather ghastly-looking device that uses a ring around the crown of the head fastened to the thickest part of the skull by four screws. That ring is in turn secured to four steel rods which bolt to a rigid vest lined with lambs' wool and worn tightly around my chest.

Because of inhaling massive amounts of pool water within 48 hours I developed a massive infection and critical pneumonia. Unable to clear my lungs they collapsed and after 18 hours on a C-PAP machine it blew a hole in my right lung. Regular suctioning left me choking and vomiting. I had to be put on a ventilator via a tracheotomy and given massive doses of antibiotics. A G-tube and J-tube for feeding rounded out the ensemble and I spent the next three and a half weeks in the trauma ward of University Medical Center. Slowly sensation began to return is various ways. It often felt like sparks, bursts of electricity. I thought for sometime,  until they told me otherwise, that I was lying in some sort of traction contraption because my spine waking up felt like I was balanced on a metal beam. Tingling and burning, shooting pains, buzzing and popping in my brain. My lungs getting vacuumed out frequently. The prognosis was that I would spend my life attached to a breathing machine, but in my unit there was a very special person who truly was one of those along the way to whom I owe my life. They called him "Trauma Bob". He was my respiratory therapist, a tough old Navy veteran who was covered in tattoos and smoked like a chimney. Bob understood that the lungs and diaphragm are muscles and in the same manner by which physical therapists could strengthen and develop arms and legs a respiratory therapist could help regain use of the respiratory system. Little by little each day he worked with me. I blew up balloons, inhaled and held my breath, yawned, coughed and all sorts of other breathing exercises. Then Bob would step outside for a cigarette. Go figure.

Years later however, I would thank God for every breath, whenever I'd get a cold or infection that would land many a spinal cord injury survivor in the hospital with pneumonia, I would think about Trauma Bob, wonder where he is, say a prayer and hope he quit smoking. I spent exactly four months in the rehab hospital of Memorial Medical Center in Jacksonville. As I slowly regained strength and rest the emotional impact of what had happened to me began to set in. I will get to that in-depth in next month’s posting, but it bears great importance here because as I began to understand the limitations of the injury the reality of what was potentially ahead of me was not something any 16 year-old should ever have to face.

One of the first sensations to return was hunger. Then I slowly acquired what is known as deep sensation. I could tell where my legs were, but if you squeezed my left foot I would confuse it with the right. Pain and burning around the injury site left rather quickly to be replaced by shooting electric impulses up and down the spine. My hips and legs felt as if they had fallen asleep and the tingly returning of blood was waking them up, only they weren't waking up and the tingling remains to this day. The moment they sat me up on the therapy mat I went white as a ghost, dizzy and vomited. You would too if you'd been flat on your back for a month.

The indwelling catheter draining my bladder was removed and replaced by a scheduled catheterization four times a day. This was done to encourage the bladder to drain on its own, something I could not regulate and control on my own and so it remains to this day. To prevent accident an external catheter is worn which is essentially a condom lined with an adhesive and open at one end that is attached to a tube, the tube allows the urine to drain into a bag concealed under my clothes. Yes, it comes off, yes you get wet, yes you must be washed, dried, changed and so must the wheelchair and its cushions. The entire process can take up to an hour and half and is still something that occasionally happens. During my time in rehab it happened as often as three times a day. Over the last nineteen years it has occurred in restaurants, the car, on a friend's rug, in church and with house full of guests over for a holiday. The next step was to regulate my bowels. One of the primary causes of disease and detrimental conditions in spinal cord injury is the body's inability to remove toxins on its own. For instance, I don't sweat. Most of my body cant tell hot or cold therefore it doesn't know when to perspire. I've suffered burns, cuts and insect bites and not known of them for hours afterward. So in the case with regulating my digestive tract an enema was administered every other night followed by a sponge bath, and later a shower when the halo was removed. That schedule continues to this day and for those of you who are thinking this through, yes accidents do happen, the various causes can be detected and prevented in the future, but yes, they happen. In the car, on an airplane, in Madison Square Garden, even during dress rehearsal for a play you're directing in college. This personally is perhaps the most difficult aspect of spinal cord injury from a mental and emotional standpoint and I'm sure the reader can understand why.

As my strength returned my ability to balance my torso became key. I have no nerve control over my core and therefore those muscles have greatly atrophied. This is why I currently have a condition called "quad belly". As the muscles that hold the inner organs in place atrophy gravity pulls the organs forward giving a somewhat beer-belly appearance. It becomes more accentuated with weight gain obviously. Back to balancing the torso... the best description I've heard for living with paralysis from the chest down goes like this... Go to your local gym, find the biggest pilates ball in the place, sit on it, place your hands in your lap, lift your feet up off of the floor and try not to fall over. Now do this everyday, all day for years on end. You must learn to eat, shower, get dressed, maneuver a wheelchair, open doors, even make love all while feeling like the lower half of you is about to roll right out from underneath you, which sometimes, it does.

In the early 90s the strides forward in physical therapy were yet to come. The general attitude was get them healthy, get them the skills to cope and send them home. Anything else they achieve is up to them. So in late September of 1994 they sent me home after five months in the care of the hospital. Since that day very little about my day to day schedule has changed. While there have been moves across the country, college, career changes, an ever-changing spiritual journey, new friends, old friends and even dating and relationships it's still pretty much the same. In the morning the external catheter is removed, I'm washed and dried and a new one is applied. The bed-side bag that has caught the urine from the night before is emptied, washed and put away and replaced with a small one strapped to my leg. My skin is checked for red spots, sores, any blemishes or injuries of any kind. Then I get dressed with the assistance of a family member and lifted into the chair. Either an aide or a family member assists me with my hair and brushing my teeth. I can burn myself on the stove so my meals are prepared. If I need to use the restroom I can feel my bladder and lower abdomen constrict, my blood pressure goes up slightly and the bag on my leg fills up. It is then drained in the bathroom. This too requires assistance. In the cold weather my bones in my legs and hips develop a deep soreness related to the arthritis and bone loss from sitting for nineteen years. This usually causes me to become tired around 2pm so I sleep for an hour by propping up a pillow next to my desk and leaning on the wall. Because my digestive system moves much slower than normal I've developed a gluten allergy. In recent years I've become very conscious of diet. Spirulina, alkaline shakes, herbal tea, fruit juice, smoothies, organic eggs, chicken, fresh fish, green veggies and salad are staples. I've lost weight in the last year and I have a bit more to go. In the late evening I transfer back onto my bed, remove my clothes and transfer to a special chair that allows me to use the restroom and shower. My bathroom is modified so that I can roll in, turn around and roll into and out of the shower with little effort. The shower is large with two heads, one is removable to ensure I am thoroughly rinsed. Any soap residue can quickly turn into a nasty, raw rash. Once the whole process is complete which takes over an hour, I am transferred back to my bed where another new external catheter is applied along with the bed-side bag. I wear white anti-embolism stockings to ensure good circulation. This is when I get a fresh pair. Finally my aide positions me on my side, propped up by pillows, where I will sleep several hours until I wake up and need repositioning. In the morning the process is repeated all over again.

Caleb 2This has been my primary mode of life since my injury. Spinal cord injury affects every single area of your life. Through all of this the people I owe everything to, and that includes my very life, are my family. My father, my brother Chris, my brother Ethan and my mother. Ethan and my mother above all. I owe them everything. It is because of them I am as healthy as I am. Doctors and other medical professionals are often amazed at my level of health and resistance to disease. It is because of their daily commitment and self-sacrifice, 24 hours a day for nineteen years that I have never had another over-night stay in the hospital. They have taught me what true love and friendship is and what it means to be loyal. I love them with every fiber of my being.

Topics: urinary management, wheelchair, Caregiving, medical research, spinal cord injury, physical therapy

Is Your Prescription Causing Your Incontinence?

Posted by Sarah Woodward

Jul 23, 2013 10:07:00 AM

As most of us know, medication often has some surprising side effects. But did you know that some common medications can affect your bladder control?

So if you're dealing with incontinence and are taking any of these medications, talk to your doctor. It's possible that different medications may alleviate your symptoms!

Medications that can cause urinary incontinence

Medication Effect Symptoms
Diuretics, such as hydrochlorothiazide (Esidrix, Hydrodiuril, Oretic), furosemide (Lasix), bumetanide (Bumex), triamterene with hydrochlorothiazide (Maxzide) Increase urine production by the kidney. Frequent urination, overactive bladder, stress incontinence.
Muscle relaxants and sedatives, such as diazepam (Valium), chlordiazepoxide (Librium), lorazepam (Ativan) Cause sedation or drowsiness, relax urethra. Frequent urination, stress incontinence, lack of concern or desire to use the toilet.
Narcotics, such as oxycodone (Percocet), meperidine (Demerol), morphine Cause sedation or drowsiness; relax bladder, causing retention of urine. Lack of concern or desire to use the toilet, difficulty in starting urinary stream, straining to void, voiding with a weak stream, leaking between urinations, frequency incontinence.
Antihistamines, such as diphenhydramine (Benadryl)Anticholinergics and calcium-channel blockers, such as verapamil (Calan), nifedipine (Procardia), diltiazem (Cardizem) Relax bladder, causing retention of urine; in some cases, increase urine production. Difficulty in starting the urinary stream, straining to void, voiding with a weak stream, leaking between urinations.
Alpha-adrenergic antagonists, such as terazosin (Hytrin), doxazosin (Cardura) Relax the bladder outlet muscle. Leaking when coughing, sneezing, laughing, exercising, etc.

Credit for the above chart goes to: Anthony Komaroff, M.D., Editor in Chief, Harvard Health Publications and the Harvard Health Blog!

 

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Topics: urinary management, doctors visit, medical research