When you're new to catheterization, it makes sense to know what makes one catheter more right for you than another. For most people, starting with Intermittent Catheterization (IC) involves an initial adjustment of the daily routines to the new treatment. Michael Kerr, Paralympian and Wellspect Ambassador uses Intermittent Catheterization, and we asked him about the choices he has made in selecting the best catheter for him.
Michael sustained a spinal cord injury in a diving accident while in Corfu, breaking his neck at C6 which resulted in partial loss of control in his arms, and total loss of control in his legs. He embarked upon a rehab program at the Spinal Injuries Unit of the Southern General Hospital in Glasgow, Scotland, reigniting his passion for sport, and has represented Great Britain at the Paralympics in wheelchair rugby.
The only difference between them, the nurse explained, was that one catheter was already lubricated.
Do you remember the time when you were told you needed to self-catheterize?
Yes – it was a during a check-up appointment at the Spinal Unit in Glasgow. I was told my bladder wasn't fully emptying so I had to start self-catheterization. At that appointment I was given a choice of two catheters. I wasn't really told anything about those catheters; what they do, or how they work – just two catheters placed in front of me, and I was told to pick one. The only difference between them, the nurse explained, was that one catheter was already lubricated and I needed to add water to the other catheter. So, it was 'take your pick' basically.
With my poor hand function, I thought to myself that the lubricated one would be so much easier.
How did you choose the catheter then?
Because of my level of injury and my poor hand function, I just didn’t want to open a sachet and pour water in. I thought to myself that the lubricated one would be so much easier. I also thought that if it's a nurse who was offering me those catheters, well then – they must be fine.
How did you get on with that chosen catheter?
To be honest, I was having a lot of problems with the catheter – ‘sticking’ – specifically on withdrawal. When the catheter was coming back out it was very sticky, very dry. On occasion, there were spots of blood on the catheter, so it was causing quite a bit of trauma. But because I didn’t really know anything about the catheters and what they do; I just assumed it was part of using IC, as I didn’t really know any different.
How did you find the right catheter for you?
Through the wheelchair rugby, I got to chatting with a nurse about IC. She told me that what I was experiencing should not be happening, so I decided to look around. I tried a few other catheters, there were some that I simply could not use because of my poor hand function. Then I tried a catheter with a urotonic surface and it wasn't sticking – no blood – it was as wet coming out as it was going in! And additionally, for me it was very easy to use as well.
All I have to do is squeeze the package, and it activates the surface, so it's ready for use before I've even opened the packaging.
And your hand function?
With my favored catheter, all I have to do is squeeze the package, and it activates the surface, so it's ready for use before I've even opened the packaging. It also has an adhesive tab so I can attach it to any surface, which makes it easier to use. There's an adjustable Insertion Grip that gives control without having to touch the catheter tube during insertion. This means lower risk of contaminating the catheter, so that and the smooth insertion help me avoid a UTI (Urinary Tract Infection).
The most important thing about the catheter is the coating and how well it stays wet.
What's the most important feature for you?
I've been using these catheters for a numbers of years now, I haven't experienced any problems, no sticking on removal of the catheter, no trauma, no spots of blood, practically no infections. The coating on the catheter was so much better! The catheter can be in the bladder for a couple of minutes, so it needs to stay wet while it is in there – for the removal as well as for going in, that’s just as important. So, for me the most important thing about the catheter is the coating and how well it stays wet, when you are using it, not just at the entry phase.
You might think they're all the same. But to us users, it's our way of life.
Why does catheter choice matter?
For people who don't use catheters, you might think they're all the same. But to us users, it's our way of life, it is such a big part of our daily routine. If that catheter doesn’t work for us, it does have a MASSIVE impact on day to day life! You can get infections, and you might get very ill, a UTI can be life threatening if left untreated and is very painful. Not all catheters are the same – and it is not just a catheter! It is an essential part of maintaining my health and well being and it has got to work, every day!
What would be your advice for others?
Ask questions. Ask the nurse about different catheters. Ask the nurse about clinical evidence. Don’t just take it for granted that the nurse is giving you a product that is going to work best for you. Try them, try different ones before you make a decision.
The most important piece of advice I would give somebody is; try to base your decision on the coating of the catheter as best as you can!
Obviously, you need to be able to open the packaging, but practice makes perfect. However you can’t change what is in the packaging – the product! You need this product to be the best it possibly can be.