Calling for catheters
Bladder problems are a fun little effect of MS, experienced by the majority of people with the disease. The urinary system is a delicate system in which the muscles that control the flow of urine remain closed until they receive a message from the brain that it’s time to release. For people with MS, our messengers aren’t the best. Their postal bags have holes in them, their maps are drawn in crayon, and their bicycles are all made of jam.
My bladder regularly doesn’t get the message and while it opens pretty readily when needed it tends to close again too early. To pee fully, then, I use little pink cigar shaped devices in a process officially called ‘intermittent catheterisation’ but which we lovingly call ‘tapping the keg’.
I used to order these online but recently the local NHS has changed to a more centralised service which, as is often the case with NHS services, requires a phone call.
I call... noone answers.
My emotional response to the answering machine picking up my call tells me something about my relationship to these little pink cigars and the services that provide them. They have become fundamental to my way of life, an integral part of how I go about one of the fundamental tasks of existence. While they are as familiar as a toothbrush, or my favourite eyeliner, if I didn’t have either of these for a few days it would be at most an inconvenience and at worst a frustration. If I run out of catheters it’s a situation.
I remember once a good deal before I started to catheterise when I went out to the pub and decided to drink for once. My bladder issues were inconvenient but not dangerous, until the alcohol created a context in which both I and the postal service of my nervous system were both legless as farts. The relevant nerve tasked with opening the bladder couldn’t get a signal to it at all. I’d sit on the toilet, wait, and find that I couldn’t empty at all. If the situation had lasted any length of time it would be a medical problem necessitating a trip to a hospital. Thankfully I sobered up just in time to avoid an embarrassing trip to urgent care.
The catheters quickly became a way of life, the solution whenever this problem arose. Indeed whenever I couldn’t empty enough to make my visits to the toilet a convenient infrequency I could pop open a catheter and get the job done. Before long car journeys, proper cooking sessions, serious workouts, I could whip out a catheter in anticipation. My quality of life improved dramatically.
The thought that I might run out of catheters fills me with a profound sense of unease. In all honesty I’d probably be fine. I can now empty pretty well recruiting a move somewhere between a manual squeeze of the bladder and the truffle shuffle, and we’re a long way from the total inability to pee that once created so many problems.
That this call went unanswered, though, left me anxiously redialling. Were they wanting to change the catheters I use to cheaper alternatives? Might they aim to reduce my dependence on them? Might this service just be woefully overstretched and not be able to send me them in time? Do they know I’m trans…?
I really can’t describe to you how tired I am of the inevitable vigilance that comes with being trans. I thought that over time I’d become less vigilant, less ready for battle, but the world has become no less dangerous and I can’t become any less trans. A nurse was taking my blood recently and she asked for my name and address and hesitated, seeing two names on the system. Instantly that vigilant part of me drew her sword in my mind and I told her a lie I always have chambered in moments like this: ‘…I’m a twin’. She proceeded to ask me about my experience and I improvised an invented member of my family. She asked ‘Are you close?’
‘... yeah, I can’t seem to get rid of him’
I phone the number again. I practice my voice while it rings remembering the lessons of my voice training. It would be unwise to give myself away with too deep a greeting, too much vocal fry, too little resonance, too hard an intonation. I can feel that vigilant part of me ready herself. We wait…
The phone… answered.
The nurses clarify the tools I need, place the order, and even ask if I need the wildly unnecessary complementary items in the pack. I very nearly shed a tear into the phone as I thank the nurse profusely. She’s taken aback when I call her ‘legendary’ as she can hear the emotion in my voice, the relief. I’m not blowing smoke up the service’s ass, I am appreciative, grateful, beyond words. To them it’s a Tuesday, to me I’ve just been rescued by the kindness of a stranger.
The next 120 catheters are on their way to me now and I have plenty in my room ready in case the delivery is delayed. Another problem solved.