Both men and women whose MS causes incomplete emptying of the bladder respond well to intermittent self-catheterization, or ISC, despite their natural initial reluctance. Urine is periodically drained by inserting a thin tube through the urinary opening. It is actually a painless procedure, and is generally much easier to do than it sounds, even if MS has caused numb, uncooperative fingers. Diagnosis by a qualified physician is a must. Similar bladder symptoms may have different causes. Instruction and a practice session with a nurse are also required.
It's better with a box-for women
by Lynn Zink
I have been self-catheterizing for many years and have found it well worth having healthy kidneys, confidence in staying dry, and the freedom to leave the house and be away from the toilet!
But ISC was taking a lot of time.
A year ago, during a driving trip with my husband, Tom, I found it was taking me an hour or more because of the raised seat in handicapped toilet stalls. As I explained to Tom, it was hard for me to get my legs apart and to lean back slightly while sitting up so high.
"Why not raise your feet?" he asked. We stopped at a drugstore and he found a box for me.
Any small box could work, but he bought a Rubbermaid Snap Case, for about $4. It is 4 1/2" x 13" x 7", with ridges on top that keep my feet from slipping. The only modification I made was to stick four self-adhesive vinyl bumpers on the bottom to keep the box from sliding on the floor. I can carry it with me easily and discreetly. I use a cloth book bag with long straps, which I've dyed black to match my wheelchair.
My box has had such a good effect on my life! I now use it at home with a regular toilet and away from home with raised-seat toilets. I've cut the time I spend in a bathroom down to 15 minutes-saving hours for more interesting pursuits. For women, ISC is definitely better with a box.
by Suzanne Rogers
This long time Society volunteer, author, grandmother, and veteran of 33 years of living well with MS could not benefit from ISC. She and her doctors found another solution. The suprapubic catheter she refers to is surgically fitted into the bladder directly through the wall of the abdomen. The thin tube is connected to an external drainage bag. Users commonly wear a larger one overnight and a smaller one, which fits snugly to the leg and is hidden under clothing, during the day.
In the April-June 2003 issue of InsideMS ("inbox"), there is a letter about indwelling catheters. Mine gave me the best thing I have had in about two years: Freedom!
Self-catheterization was too hard for me. Dr. Philippe E. Zimmern, professor of urology at the University of Texas, Southwestern Medical Center at Dallas, after doing a complete urological study, felt that I was a suitable candidate for a suprapubic catheter.
As your letter writer said, urologists may be concerned about infection, but that hasn't been a problem for me. This new "plumbing" has made it possible for my husband and my family to do their own things without having to worry about when I might need to go to the toilet.
Before the suprapubic catheter, our lives were determined by how far away we were from a bathroom. I don't think many people who have MS know about this option.