A loo diary

Many wheelchair users require an intermittent catheter, which also means they need a bladder-emptying schedule. Here are a few tips on scheduling your bathroom breaks.

Every spinal cord injury (SCI) and its after-effects are different. However, a SCI above the T12 level, upper back, could allow a wheelchair user to empty their bladder by reflex. While this might mean the individual does not need a catheter, it could still lead to accidents and involuntary urination.

An injury below the T12 level, in the lumbar or lower back, could result in the need for an intermittent or other catheter, as the body will not be able to urinate by reflex. In both cases, there is damage to the nerves that communicate with the brain. The brain cannot tell the bladder to empty, nor can it instruct the bladder to hold off emptying.

In both instances, it is best to draw up a schedule to avoid accidents or a build-up of urine, which can lead to leakage and infection.

Diarise drinking habits

The first step is to note the amount of your fluid intake. It helps to drink approximately the same amount and same type of fluids every day. Drink at least two to three litres of water daily to keep the body hydrated and the bladder healthy.

According to the Spinal Cord Essentials website, drinking 400 ml or less will lead to an intermittent catherisation (IC) in six hours. Between 400 ml and 600 ml of fluid will require an IC in four hours and more than 600 ml will lead to an IC in three hours.

Reminders, alerts and alarms

After you’ve drawn up a schedule, set reminders, alerts or alarms on a mobile device, such as a phone or tablet. You will receive an alert when it is close to or time to do an IC. Alarms can repeat daily or the alarm can be changed as you consume more (or less) fluids. There are also numerous apps available to help you schedule bathroom breaks.

When the bladder goes rogue

No matter how much you plan your bladder-emptying schedule, there will inevitably be instances when you’ll be caught off guard. If it’s a warm day, you might consume more fluids; or you might go drinking with a buddy or have a cup of coffee with a colleague.

You might contract a bladder infection or even take medication that increases the fluids in the bladder. To avoid any accident or leakage, always be prepared: keep Wet Wipes, dry undies and, if necessary, adult nappies handy.

You can also protect yourself from a bladder infection, which is very common among individuals using a catheter, by only using the intermittent catheter once. Learn why reusable catheters should be avoided by visiting the ROLLING INSPIRATION website at www.rollinginspiration.co.za/doctor-question-multiple-use-catheters/.

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