You’re going to put that where?!?
How did it come to this?
I’m lying on my back, pants lying on a chair nearby, a team of people staring at my nether regions searching for my urethra. The Urologist, flanked by nurses, virtually straps on scuba gear… he’s going spelunking…
When I’d arrived at the urologist’s office I hadn’t been sure what to expect. Bladder issues are a common challenge in MS and it turns out they’re no joke, threatening infection, kidney problems, and as I discovered some surprise urination mechanics that the game of my life had not advertised.
I sought help after a cranberry escaped my grasp in the kitchen. It was destined for the bin, having already visited the floor of my living room, and in tossing it binwards I missed by some margin, hurtling the cranberry some way across the kitchen floor. I knew I needed a wee but a quick bend would pick this sweet little guy off the floor and he could find his new home with a flick of the wrist. It was on my way down that trouble started. I felt a little strange for a moment and then heard the telltale pitter patter that was me…
…pissing myself all over the kitchen floor.
The urologist’s office is a strange place and inside they’ll ask you to do some strange things. The first job was peeing into a bucket and I thought I’d been pretty successful. However, a slide of an ultrasound wand over the bladder revealed a concerning amount of liquid remaining. The urologist, his tone more serious, told me to go try again and with an expression unmistakably communicating ‘or else…’
I revisited my bucket. After a quick trickle I knew I had more to give and I pulled out all of my best moves honed over the past year of bladder issues. The shake, the truffle shuffle, the walkaround… nothing worked…
Another quick slide of the ultrasound wand revealed some hundreds of millilitres of urine still floated in there, stubbornly comfortable in my bladder. The urologist sighed, in fact he said ‘unbelieveable’, which I still don’t really understand. Was it ‘unbelievable…’ the disappointment of a once proud father, or was it ‘unbelievable…!’ the awestruck discovery of a new undiscovered country. Both, maybe? Whatever, we needed to get those few hundred mil out of the bladder and that meant intermittent catheterisation.
In steps Lucy. Lucy (not her real name) is my favourite nurse today, she has a friend who is transgender en route to bottom surgery (like I have already had) and she is sensitive, kind, and with that firecracker attitude I so love in a good nurse, one that doesn’t pity you for a moment, but rather implicity tells you you’ve got this.
However, my anatomy, sculpted rather than born, features a urethra that is roooughly where you’d expect it to be but that is nonetheless tricky to find. I’m there, pants off, Lucy searching. ‘Is that it?’ she gives me a poke… ‘nope’. She calls to a colleague. They call over the Urologist. They get a mirror. Now I’m helping point out local features like David Attenborough… ‘and here we can see the lesser known labia minora in its natural habitat, note the colouring, and look, it’s in mating season!’
We’re playing ‘pin the tail on the donkey’ but I’m the donkey and the tail is the tip of a disposable catheter. The team rummages around depths of my most intimate areas and finally discover what they were hunting for and out drains 400 ml of urine.
‘You’re going to need to do this once or twice a day’
I bite back tears for a moment. I don’t think I’m upset because of the news, just that the whole situation was so overwhelming. Barely anyone has even seen my most intimate areas much less rummaged around them and here I was in the most vulnerable position I’ve ever been, alone, and I guess in some sense violated. I realise what was happening was medically necessary and everyone had been abundantly kind and appropriate, but people poking around down there still feels like a corruption of something inherently deeply intimate.
I take a breath; this isn’t the moment for tears, that will come later. Right now I need my steel in hand, there’s a battle to be fought.
Challenge accepted.
That night I lie there on my bed, wand in hand, desperately trying to get the gesture right, it takes a cool 15 minutes before expelliamus…
Two weeks later and I can self-catheterise with ease. I now use these little pink cigar-shaped catheter cases, holding a catheter within. I’m unbelievably fortunate that the NHS is willing to provide them and I literally couldn’t live without them; I’m up to 4 times daily, going through 1440 of these things per year, enough to fill a small room.