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Thread: Bladder/Bowel Care Question

  1. #1
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    Bladder/Bowel Care Question

    Quick questions about bladder/bowel function. I take 2 mg daily of Detrol to help manage my overactive neurogenic bladder. I am a T-5 incomplete. My question is twofold: is 2mg daily a fairly low dose of Detrol? I don't think it's helping me as much as it should...I probably urinate 8-12 times a day and would like to lower this.

    Also, as a musician, I need to be quick in the bathroom during rehearsals and concert situations. I have learned that to fully empty my bladder (though I can void on my own) I can also use digital stimulation in my rectum. I often don't have time to sit and wait (I take Flomax for this reason), so I often resort to "Plan F". "F" of course stands for finger. Plan F is fairly reliable. The only downside to it that I have noticed is finding a way to the sink to wash my hands without touching things. My question is this: Is this dig stim method common in SCI patients as a way to help void the bladder? I used to use it solely for the bowel, but now it's more all-purpose. Do I run the risk of long term damage to my body if I continue this practice? I am gentle with it, btw. But I ask this only because it has never failed me when I need to go quickly, and I would assume there must be a catch to this method. Thanks so much for the reply!

    Dave
    "Leela, you look beautiful. Incidentally, my favorite artist is Picasso."

  2. #2
    I've never heard of digital stimulation to empty the bladder.

    How do you manage your bladder, condom catheter, intermittent catheterization, other?

    Have you had urodynamics studies to determine bladder pressures and residuals.
    Last edited by gjnl; 03-18-2017 at 11:03 PM.

  3. #3
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    I am a T-5 incomplete. I void without cathing, but it takes me a while. I'm taking Tamsulosin and Tolterodine. I will sit on the toilet and try to relax until I can void. You know, I hope I'm not the only person who dig stims to pee. That would make me really sad, because sometimes I feel like if I didn't do it, I'd be sitting on the toilet for a half hour I try and vary between using dig stim and just sitting and waiting. But like I said, while dig stim makes it go faster, if I'm in a public situation, I have to get to the sink and wash my hands thoroughly without anyone noticing my hand.
    "Leela, you look beautiful. Incidentally, my favorite artist is Picasso."

  4. #4
    Senior Member djrolling's Avatar
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    Why not cath? and why not use a glove?

  5. #5
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    Even if i use gloves I still will have to wash my hands. Carrying gloves wherever I go seems inconvenient. Wearing them does not mean i still won't wash my hands thoroughly afterwards.

    As for cathing, my injury is such that I can void on my own. It's a matter of speeding the process up with the finger method. Someone please tell me I am not a freak for doing this.
    "Leela, you look beautiful. Incidentally, my favorite artist is Picasso."

  6. #6
    Just one point: If you continue this method, your post screams "get surgical gloves". They come in a box of, what, a hundred or so? Put several in your pocket or, better yet carry a small backpack, or briefcase, in which you stash the following: several gloves, (which you remove when soiled by making them come off inside out, not touching your skin); a few zip-lock bags for a "waste disposal"; a few "wet wipes" that are available in small packets. Once you are all done with this in the bathroom stall, go to the sink and wash up with soap and water.

    I hope you will respond to posts by gjnl and djrolling. I believe a person who can void on their own, can also cath. I'm not SCI so don't know for sure.
    You are SO fortunate to play music!! Hopefully, you will get medical and other input regarding your issue.

  7. #7
    If you have sensation I certainly understand not wanting to cath.

    I'm not in your situation (T8 complete), but at times I have used suprapubic pressure to help empty my bladder. If you are slender (ie not too much belly covering the area below your belly button) this is probably a better way to put pressure on your bladder. If you're pushing from inside your anus you're not delivering nearly as much force as you can get from the front, although if you are fairly obese this probably isn't a viable option.

    Also with regard to the Detrol, this is going to make it harder to empty your bladder fully. If the problem is that your bladder spasms and you urinate before your bladder is full, it is an appropriate medication. If (as your post seems to suggest) the problem is that your bladder is not fully emptying, the Detrol is going to make this worse because it prevents the bladder muscle from pushing to help void.

    Either way, if you haven't had one recently (in the past year) you should certainly see a urologist, who I am quite certain would want to do urodynamics to determine whether or not you are fully voiding and how high the pressure inside you bladder is getting (make sure it's safe).

  8. #8
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    The dig stim method is entirely different than palpating the abdomen. Palpating the abdomen increases bladder pressure to assist in voiding through an opened urinated sphincter (aka catheter).

    Dig stim puts pressure on the sphincter and prostate resulting in a temporary relaxation of the sphincter such that it opens to allow voiding.
    T3-T7 complete since Sept 2015

  9. #9
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    Oh gloves. Just take them off inside out to get to the trash.
    T3-T7 complete since Sept 2015

  10. #10
    I used this method to void my bladder for years. I believe it is called "valsalva". It worked well for many years. As long as you massage your sphincter to help relax it, you shouldn't have any issues.

    Carry a glove or have a stinky finger.

    Good luck.

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