View Full Version : dribble dribble dribble
08-03-2001, 07:44 PM
Hi, Im new here to this forum. I have a couple of questions. I am considered an incomplete quad due to a subluxation at the C6 level.
My problem now is I have a little bit of dribble dribble. When I am asleep at night I usually wake up with wet unders! Some times during the day I find the same thing. I have urges to go most of the time, but have trouble emptying completely. I have seen my uroligist a couple of times and she noted nothing wrong. I'm wanderring if I should be doing some type of catheterization as I did before or should I just learn to live with it?
08-03-2001, 08:42 PM
spineyboy - What is your method of bladder management? How long have you been injured? Have you had any urodynamic studies done?
The leakage you are experiencing is likely from bladder spasms and a sphincter that is not functioning correctly. If you are not emptying your bladder fully, this becomes a reservoir for bacterial growth and, most importantly, can create increased pressures in the bladder. Increased pressures are harmful, if allowed to persist, to the upper urinary system. There are many urological studies that should be done to assess accurately the function of your urological system.
Has your urologist had expertise in managing SCI patients? If not, are you near your original rehab; could you go back there for an assessment by the urologist? Another option is to ask your urologist to consult with an SCI doctor as to tests, evaluation of the tests and then an appropriate management program. I would urge you to have an appropriate assessment soon.
The following sites will give you a greater understanding of bladder management both medically and on a daily schedule: University of Alabama at www.spinalcord.uab.edu (http://www.spinalcord.uab.edu) Click on 'information and statistics', then click on 'SCI InfoSheets' and scroll to #11. University of Miami at: http://calder.med.miami.edu/providers/MEDICINE/scimed.html There is also a patient section on this site however, this particular section explains the range of tests that can and should be done. CRF
08-03-2001, 09:52 PM
I actually see a uroligist that specializes in SCI's. Ithink because I'm incomplete and have a lot of residual sensation and strength the doc kinda dismisses everything.
My accident was in 1998 and I have since regained about 90% in my arms. I have diminished dexterity in the hands. I can walk fairly easily.
I have had this bathroom problem since day one. I kinda kept it quiet because I just wanted all of this to go away. I havent had any problems with infections or anything like that. I just want to quit leaking on myself!
My last visit to the urologist was an experience. I dont have the records in front of me, but they did the thing where they fill the bladder and see when I had the urge. It wasnt fun being poked and prodded on thats for sure:)
The urologist wanted to get me started on a IC program, but the SCI doc wanted to wait and see how things turned out in the future before doing anything like that.
My biggest problem is that I was in the Navy at the time of my accident and my medical records have been hard to find. (this is another unbelievable story) I was in the hospital under a false name etc......
This new doc just doesn'tseem to believe me and I hate going to appointments there, but being in the VA system I have no other options.
Should I worry about this if I'm not having any major problems with it? other than the occasional wet pants...
08-04-2001, 10:54 AM
spineyboy - Your added information is most helpful. First, let me say that I can understand your response to all of this....but I think that since it has been a problem from the beginning and that you (I am assuming from your description) have had a lot of return, now need to figure out exactly why this occurs. Yes, I do think someone needs to ascertain why you have leakage; the biggest reason is the possible effect of back flow of urine and increased pressure on your ureters and kidneys. The long term presence of these conditions can do lasting damage to your kidneys and ureters, a serious consequence that one should avoid if at all possible.
Did you ask the urologist why he wanted you to start on an IC program? What did the SCI doc want you to wait for? It has now been at least 3 years since your accident. We know that the greatest amount of return occurs within the first two years post injury. We also know that for some persons, there may be increasing return many years post injury of some small amount of function. It would seem to me that the prudent action for you at this point is to begin the program your urologist has recommended. If at a later time this is not necessary, one could change your management program.
A comment about your medical records - I assume that you know that it is your right to have your medical records. In today's world of health care, it is important that persons do keep their medical records, even if you need to put them in a large binder. Ultimately, you are responsible for your health and well-being....so I would encourage you, if you do not have them, to try to get them all collected. If they are in a binder, chronologically, you can always take the binder with you on each health care visit, as a valuable ready reference. CRF
08-04-2001, 12:59 PM
You're right I have alot of return. I have not been set up on any type of bowel or bladder control program since a few months after the accident. The leaking is not that bad. As I said before it is just a few dribble dribbles here and there.
I aslo have another question about blood in my stool. What can be the cause of this. I havent said anything to a doc about it. Much lie I havent said much about the pee pee problem,
I have normal urges to urinate I go and usually dont get it all out an dit ends up getting my unders wet. At night sometimes I tend to leak a little more.
My urologist did give me some external caths, but I used them within a couple of weeks. I never went back to get any more.
Would being on a ICP stop this leaking?
Should I worry about this stuff. I think it is more of a nuisance and comfort issue than a large medical problem,
08-04-2001, 08:04 PM
spineyboy - I am glad that you found this site as you are asking important questions. For all persons, but it is even more important for you as a SCI person, it is essential that one discuss with the doctor any changes that are noted. If you have a question, concern or lack of understanding, you should ask. My motto with my patients has always been that no question is inappropriate to ask and it is always better to err on the side of caution and careful judgment...
Bladder problem - yes, a consistent IC program should eliminate the residual urine in your bladder. There still remains the question of bladder sphincter function. While your concern may be more from a comfort focus, as a nurse I urge you to consider that it can become a more serious medical problem, as I noted in the earlier post. Preventive health practices help one stay healthy and avoid the medications and potential need for hospitalization that will/can result when a medical problem develops.
Do you purchase medical supplies through the VA or do you buy them on your own? If you want to get external catheters, several of my patients have been most satisfied with ordering from Uromed, 800-841-1233, a company that is primarily run by persons who are SCI. I am sure that others using this site would have several suggestions for you.
Bleeding from bowel - When does this occur? Is this a new symptom? Are you on a bowel program or is elimination normal for you? If the former, is the bleeding following your bowel routine? What color is the bleeding, i.e. dark, bright red, pink, etc and how much?
I would urge you to make a list of all of your concerns; add to it as you think of other things or notice something new. Take your list on your next visit; jot down the answers so you have that to refer to after you get home. I think you will find this will be a most helpful process for you. CRF
08-04-2001, 10:10 PM
Actually under active duty military regulations you are allowed copies of all your records. The easiest way to do this is to contact retirement services at the nearest Navy base. They should be able to help you with the appropriate addresses if you are an early retiree due to medical causes.
If......if, you have special circumstnaces that may effect who is currently holding your medical records, contact your US Congressman and ask for his help in contacting the Department of the Navy for your full medical records to include copies of films from MRIs, Xrays and CTs. :-)
08-05-2001, 09:00 AM
As far as the medical records go.. My records were lost a couple of times and the only active duty records I have are the ones I made copies of. I am actually in the process of obtaining all of my records so I can put a claim in for higher disability.
As far as my PVA NSO he is not too reliable. He told me he sent a claim into the VA back in November of 2000. As of today they still haven't received it. I have been on him ever since and he still insists he sent it. Oh well, somethings are better left done by yourself.
As far as the bleeding goes. It is bright pink and has been ongoing since my accident. I am not on a bowel program. I was in the past, but not anymore.
I get most of my supplies from the VA, but then again I hate dealing with the VA medical system. The only good thing is that I dont feel like the docs are out ot get my money like all the other ones I've seen.
08-05-2001, 03:17 PM
spineyboy - Do you know if you have hemorrhoids that could be being irritated with the passing of stool? Since you have indicated that you tend not to discuss symptoms with your doc, I would strongly urge you to talk with him about the bleeding....when it occurs, how frequently, how much. Does your diet include a good portion of fiber and liquids? Both of these will help keep the feces in a softer, less harsh form
Thanks, Sue for your information. CRF
08-05-2001, 03:29 PM
I will try to increase my fiber intake
08-06-2001, 03:08 PM
It is likely that you have either high pressures in your bladder, or that you have a uncoordinated sphinter that allows your urine to drain whenever you bear down (valsalva).
Urodynamics tests, which should be part of your annual exam, can tell which problem is occuring. Until then, if you are only having a little bit of dribbling, you may want to try a male "drip collector" which is an absorbant pouch that you wear inside your underwear (it sticks to the fabric like a peri-pad) and tuck the penis inside. Conveen makes some nice ones. We provide these at the VA SCI center where I work. They are more comfortable and easier to use than an external catheter, and each will absorb about 80-100 cc. of urine. I know many w/c athletes who only dribble when they are exerting themselves and they find these are a nice alternative to an external catheter. (KLD)