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How do women travel when they need assistance to cath every 4-6 hours? I'm taking a cruise in a few months, but I need to fly to get to the coast first. How do you handle this problem?
I forgot to mention that I'll be traveling with my spouse so a public restroom won't work.
[This message was edited by rtr on Feb 26, 2002 at 12:28 AM.]
chickie6789
02-25-2002, 10:52 PM
I always intermittent cath about every 6 hours. When I travel or fly, I have learned to insert an indwelling cath. I insert it in the morning I'm leaving, then when I arrive at my destination, I just take it out. Then I don't have to worry about my bladder. I just empty the leg bag when it gets full (ie: I can get to the bathroom to do this myself). I want to keep the tone of my bladder so I don't use it all the time, but for circumstances like travel, it works great!
We always put in an indwelling catheter (for my mother) for the duration of the flight unless it is a very short flight (like 1 to 1 1/2 hours, when we cath in the public restroom at the airport on each end of the flight). We go on lots of cruises, and plan to put the catheter in at home before leaving, then push fluids on the plane, and remove the catheter after arriving on the ship where we have a wheelchair accessible bathroom. My mother's urologist has her take a Cipro when inserting the catheter and another when it is removed. We take along two extra catheters and insertion supplies (and Cipro) for the return trip (have an extra just in case). This has allowed us to take very long international flights (15-18 hours) when flying to the Middle East, Australia, or South America.
If you need help to cath in a public restroom, as long as there is a disabled stall, we have never had any problems with my dad accompanying my mother into the bathroom to help with transfers, etc. In fact in California there is an actual law that say that disabled folks have the legal right to be accompanied in any public restroom by an attendant of the opposit sex. He just announces at the door that he was coming in with my mom, and we have never had any problems. Keep in mind that you will often need to cath ashore during the day on a cruise, so we plan to be able to do this (often someplace other than a toilet stall, as many countries have no disabled facilities). The back of a van, any private room, etc. all will work, esp. if you take a leg bag to empty into in these circumstances (when cannot transfer to the toilet).
Thanks for your answers. I've never used an indwelling, except for the week after my injury I guess. It sounds kind of "ouchie" to sit on though. It doesn't cause discomfort/AD? http://sci.rutgers.edu/forum/images/smilies/eek.gif
There weren't many responses. I guess there aren't many women with SCI who travel.
monkeygirl
02-27-2002, 12:54 PM
Hey Rtr! I just don't drink till near the end of the flight, not hard to do if you know the hassle of the alternatives.
Sue Pendleton
02-27-2002, 03:27 PM
RTR, you can tape the tubing against the inner thigh using microspore or another easy on the skin tape. Just leave a bit of give in the line to the leg bag. Make sure to buy a bit of extra tubing beacause most foleys don't reach down the average length leg to where most put the collection bag.
If you do your follow up care at a SCI center just ask a nurse what all you'll need and where to find it. Otherwise most RNs should be able to show you so maybe make an appointment with a NP or an RN at your primary care doc's. You can order most of the stuff through Mom's.
http://www2.momsup.com/moms/
Very helpful people there too. You shouldn't get AD if it's inserted correctly and it's not much different from IC. Just drink more fluids as long as you have it in. Only ouch I get really is removing it where the deflated balloon still leaves a bit of bump. Depending on your on shore schedule you may want to leave it in for more than the flight. But if you take ditropan keep taking it and if you're not on a prophylactic antibiotic definetly go with what KLD says and get a couple Cipro. Your doc may even have a 3 pill sample pack for free...
antiquity
03-01-2002, 03:11 AM
Are the nurses on cruise ships equiped to handle B/B needs? Could they be paid extra to help or are there too many liability concerns?
The hospital on the ship is there for emergencies. They do not know how to do bowel and bladder care for someone with SCI. They would not do this type of non-emergent routine care I am sure, even with prior arrangement, and have only limited clinic hours (usually 2 hours in the morning and two in the afternoon).
They charge regular hospital ER type rates for care. The last cruise we were on, the charge to see the nurse was $75, and to see the doctor was $95. Procedures added to the costs. Medications, supplies, etc. are charged extra, just like a regular hospital. They will bill your insurance, but unless this is a covered service under your insurance you will have to pay out of pocket for any care you receive. About the only thing that is free are sea-sickness pills (on most ships...some charge for these too).
The cruise ships make it very clear in their literature that your personal care and assistance is your responsibility. You need to either do it yourself, or travel with a care giver who can provide what you need.
Sue Pendleton
03-03-2002, 12:01 AM
The only line I have heard differently about, KLD, is Seabourn. A friend got rather sea sick and a nurse came to his room, he lowered his jammies and she gave him a shot of something to knock him out. He felt great the next day and no charge ever showed on his bill.
And buy your dramimine before you go unless you want to pay outrageous prices if you need them when the doctor's office is closed. The ship's store is expensive. Ditto any over the counter meds like MOM or immodium. I took a few and never needed them--just in case. I'd back extra chuks and good old hefty bags for bowel and blader needs or if you never need them the bags are good for sorting laundry for the trip home.
And, whatever you do, do not drink water that is not bottled in the tropics. Ditto for sushi lovers, ceviche scallops cooked with lime juice and any unpeeled fruit. Use bottled water to wash fruit if need be, use soap if possible if the item can't be peeled. I like going native as much as possible but after 4 cases of probable salmonella related typhoid from bad seafood near Naples, Italy as an AB, I don't take chances as a DA. I make sure things are cooked or soaked in booze and save my susho eating for close to home. http://sci.rutgers.edu/forum/images/smilies/tongue.gif
Oh yea.....I did have a vaccine against Typhoid and typhus in 1981 and my first bout with the bad seafood in 1985. If you insist on eating neat stuff while vacationing get a booster shot several weeks before you go.
If you will be in either Mexico, the Caribbean, or the Mediterranian and will be swimming or eating seafood, I would strongly recommend also getting vaccinated for hepatitis A. This is the one most easily transmitted through polluted water or seafood from polluted water. You have to get two shots a couple month apart.
Sue's advice about food cautions is wise. Having a bowel accident (or diarrhea) can really ruin a great cruise. We always pack a little bag of emergency meds that we may need, and if we have extra chux instead of packing them when we come home we always donate them to the ship's hospital, which is generally glad to get them for free. We always have plenty of luggage space for taking home souveniers this way!
Clipper
03-04-2002, 09:33 PM
KLD and Sue,
I did it. After years of contemplating a lengthy cruise, I booked one on Holland America. Ten days in the Baltic. My wallet has you guys to blame (and thank). Although I've traveled frequently during my 12 years of SCI, I have not left North America since before my injury.
KLD - are the cruise ship nurses sufficiently trained to put in my foley catheter should it come out by accident? No one in my traveling party is sufficiently trained to do it, nor do I want to rely on them since they have no experience. I will, as usual, bring extra kits and catheters. Thanks in advance.
gr
Sue Pendleton
03-05-2002, 10:35 AM
I wished you'd told me before you booked, GR. I know a great travel agent who took that cruise with a good friend of ours. We see him almost weekly so I'll ask about anything he noticed about access in the Baltics (he does know what to look for by now--LOL). Are you going as far as St Petersburg? And if you are just getting a passport do NOT go to Mail Boxes Etc for the pics. Worse than any DMV photo I've ever had!
KLD, are there any reactions to the Hep A shot? We're heading to Bermuda in October and they are a lot better about pollution and stuff but better safe than sorry. Been there, done that, thank goodness Italian pharmacists can prescribe meds themselves. It's almost impossible to avoid seafood down in Bermuda--I will be having mine well done.
And thanks for the tip on chuks, never thought of it before. More room for souvenier sweatshirts.
Chipper, which HAL ship are you going on?
We found that it was best to contact the Special Services department at HAL (you can get to them through their web-site, or let me know and I can send you an e-mail address) for any special concerns. I am sure the nurses can place a foley catheter if you need to have this done, but be prepared to pay for this, with an additional charge if it is outside the regular clinic hours. It would be best to have the Special Services office check this out before you go, and be sure to take your own supplies as they would not necessarily have the type or size of catheter you need.
Sue, reactions to Hep A are extremely rare (other than a sore arm for a day). I had my whole family get this prior to going together to the Med on a cruise.
We always get our passport or visa photos at AAA. Wheelchair accessible, and they do a good job, and discounted for members.
Clipper
03-06-2002, 01:06 PM
KLD -- We are going on the Noordam. I contacted HAL special services prior to booking. I always bring my own supplies.
Sue -- Yes, we have two days in St. Petersburg.
I was wondering about this question too. Fortuneatly I dont have to Cath, I just go when I need to. Unfortuneatly, when I have to go, there had better be a bathroom within a short distance. If I am on a flight and have to use the washroom, do I have any options? Previously I have always just made sure that there is a transfer at a city midpoint where I go (usually every 3-4 hours). This makes overseas travel impossible.
Transfering in and out of planes is also a total pain in the a** as the washington chair (that skinny little chair they use for boarding) just about ruins my trip everytime. Are washrooms on the plane accessible at all???
Can you stand to transfer? Can you take a few steps? If so, you might be able to get an aisle chair to get you to the bathroom mid-flight (on newer planes) but don't be surprised if the crew does not know where the aisle chair is or how to assemble it, so don't wait until the last minute. Although the newer planes claim to have accessible bathrooms, anything but a standing transfer is pretty much impossible, and it make take some time for the crew to get themselves together to do this.
You might want to consider trying out use of some of the women's travel urinals that you could use in your seat (under a blanket, wearing a skirt). Some are gel filled so that you can dispose of them in a air sickness bag. Not ideal, but better than having an accident waiting for the crew to get their act together with the aisle chair.
KLD,
thanks for the reply! No I cant do a standing transfer at all and I dont think I could take a flight where it was necessary for me to use a travel urinal. How would someone go to the bathroom in one of those things sitting in an aisle seat with at least 4 people watching? No thanks. I didnt really think there was any option available to me, but thought that it was worth checking because my friends were looking at going to Mexico (but it doesnt look like I can go anyway due to accessibility. This new lifestyle is full of perks!!!) Ugh. The cure had better hurry because I am getting sick of waiting!