MS and Catheterization, Part 2: Outside the Hospital

Catheterization training in the hospital did not prepare me for how to manage on a daily basis. In my last column, I described how I ended up in the hospital unable to urinate at all. In this column, I will cover more details about what I learned along the way that made life requiring a catheter almost seem normal.

Bathtub catheterizing

One problem with self-catheterizing in a bed, bathtub, or in most bathrooms, is the total inadequacy of lighting. Men, for obvious reasons, do not have the difficulty with catheterizing that women do.

Bed pan (aka jug): It’s for use with longer catheters by women while lying down.

I used the bathtub because the hard surface was better than a soft bed. I had a desk lamp for additional light that I put in the tub with me. The tub edge provided a safe clean place to lay supplies. If the jug spilled or urine leaked out of the long tube on either end, it was on an easy-to-clean, hard surface meant to get wet. This felt ridiculous and embarrassing, but when it is the only way you know you can urinate, you get over that feeling fast. If you need to do this in a bed, absorbent disposable cloths called Chux help with spills.

Portable catheter: The longer one requires sterile lubricant. In the foreground is one that’s self-lubricating and opens with a twist and a pull.

Catheters come in various lengths, but I didn’t realize this at first. The nurses only gave me long ones that required lying down. Which was fine if you are bedridden, like I was in the hospital, but not good for daily use. Unfortunately, it took me many weeks before my brain kicked in to thinking about this, and I realized there must be short catheters, too. I spent the first month lying down in the bathtub and using the long catheters and jug just like in the hospital.

How I hook a mirror onto a toilet seat for visual aid while catheterizing.

Mirrors for women

The hospital gave me a kit to start me off with the long, tube catheters and a small, circular mirror that can clip on the rim of a traditional home toilet seat. This is a problem for public toilets because they have a cut-away in the front. It requires a sideways, awkward placement.

Recently, for this column, I checked online and found some other mirrors, including one with a bendable, flexible neck connecting to the mirror. It attaches with a suction cup to stick on the toilet bowl. There is an ick factor there, but dampening the suction cup with water from the sink (instead of licking it, for example) would work.

Headlamps are a lifesaver, even for in-home use while catheterizing. The light adjusts to several angles and reflects on the mirror to cast light helping women see the target.

Light, or rather, lack of light

Most bathrooms, especially public toilets, do not have adequate lighting to be able to see the urethra with most mirrors. Plus, you are juggling lubricant and sterile wipes while unwrapping the catheter packaging. If you manage to hook a mirror onto the side of the split toilet seat, and haven’t dropped anything, you will discover that there is not enough light to see anything. What little light exists is blocked when you lean forward to see in the mirror. Lack of light is a huge problem.

Fortunately for me, I have a very smart girlfriend who suggested a head-mounted light, like ones hikers use. I even already owned one, but I never thought to use it. This light makes all the difference in the world. I highly recommend buying one of the many possible versions. Mine has an elastic band that easily goes over the head and stays in position. It is small, very portable, and has a very bright multi-directional light. The light shines on the mirror and reflects upward to light the urethra for insertion. It runs on two AAA batteries.

In addition to all of the above supplies, I carry wipes to clean before attempting to cath. Only use one side once. Tear in half to maximize economy. I bring hand sanitizer for my hands, even if there is a sink to wash my hands. By the time you get in a public stall, your hands need to be cleaned again before touching sterile catheters.

If the opportunity arises, please support better lighting in bathrooms for women, especially in the stalls. A non-split seat for ladies’ toilets would be helpful. Shelves, or at the very least, flat surfaces on toilet paper dispensers or sanitary napkin disposal bins would be very helpful to lay out supplies!

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