It´s February 1992 and on the PA system I hear ”Bob en piste”. I am in Albertville, France, during the olympics and for some obscure reason I ended up watching the 4-man bob-sleigh. We shall not go into detail about that story for the sake of you readers...
However, something became very clear to me when I saw these olympic athletes competing. The first thing they measured was the starting time, basically how fast they were able to run to a certain point and then get into the Bob. The top teams always had the best start times. Those who were way behind these first few seconds had no chance to win any medals. The race was not won during the first few seconds but a good start was important to stand a chance during the rest of the race.
I think the same is true in most aspects of our life. A good start makes the rest easier, it lays a foundation to build upon. A good basic education helps our academic studies. A good foundation is essential for a stable house. A good start with catheterization makes it easier for us to set good routines for the rest of our life with self catheterization (CIC).
Awakening
My start was far from ideal. After my accident I had an indwelling catheter, as most people have after an injury like mine, or a major surgery. After about 10 days they told me I should change to self catheterization. I knew that was a great step forward and thought that I would soon be able to pee like normal again. The day after I slowly started to realize that I may had misunderstood my situation. And then the insight emerged that I would, for the rest of my life, use a 40 cm plastic tube every time I needed to pee. That was the first time after my accident that I actually cried. It was a clear marker that I had lost even the most basic function; the ability to pee.
Getting started
That insight was hard, but I had an easy introduction to CIC and it worked well for me. I only needed help the very first time to get the procedure right. But it was a bit awkward to have to ask the nurse to come and fill the catheter package with water and then hang it on the table for me to use.
It's not all that easy for many people who start to use CIC. They may need specially designed catheters to get through to the bladder. Or they may have limited hand function and need someone else to catheterize them for a longer period. For many this means vinyl gloves, some grip tools and maybe even more things, just to get this simple task of emptying the bladder done. All of a sudden its not just a simple task anymore. For women its even more complicated as their urethra is far harder to find than men's.
Empty the bladder away from home
About two months into my rehab, some friends and I went to an ice-hockey game. During one intermission, I needed to go to the bathroom to empty my bladder. The bathroom was not the cleanest, to put it nicely, and it felt scary to put the catheter under the running water in the sink to fill it up. Unclean to say the least. Later I spoke about this issue with one of my friends who had been injured a few years prior to my injury and he told me about catheters with a pre-filled package or a water pouch that you activate to use it. How I wished I knew that a few weeks earlier.
Not all catheters are the same
Reflecting on my own experience and all those I have met and talked to during the years, I realize that it's so important to have a good start. My spinal cord injury was a huge trauma in itself. Then you add all the other things that come as a result of this trauma. If we can find ways to make this transition period as smooth as possible, it will help.
I wish for all to be able to get a catheter that reduces the hazards, that makes the self catheterization as simple as possible. Not all catheters are the same. Not all catheters are ideal to start with. And not all people are the same with the same needs. Helping people to adjust by providing a smooth and easy start is a humanitarian act that will pay off in every aspect in the long run. As a society, that's the least we could do for those who require this medical equipment for their survival.
