Melanie broke her neck and back after falling from a horse in 2010. She had a urethral catheter for a few months and then tried intermittent self catheterisation. She found the latter was impossible without help so decided to have a suprapubic catheter.
In April 2010 Melanie fell off her horse and broke her neck at C6, which left her with incomplete tetraplegia. She had impaired hand function and a loss of movement throughout her body from the arms down. She also broke her lower back. Melanie had surgery to plate her neck. She was in intensive care for a while and had an indwelling urethral catheter, with continuous drainage. At first she had morphine and didn’t think much about her paralysed bladder. Her leg bag was emptied by the nurses.
After about two months the nurses encouraged Melanie to try intermittent self catheterisation. She found this difficult and exhausting and she found that she couldn’t manage the procedure without help, so her consultant suggested that she should have a suprapubic catheter. Melanie agreed to this and had one inserted with local anaesthetic. After the anaesthetic wore off she felt very sore for about 24 hours. At first Melanie’s suprapubic catheter drained urine continuously into a leg bag. She managed to open the valve at the bottom of her leg bag herself so that she could empty the bag when necessary.
A first attempt to change Melanie’s suprapubic catheter was unsuccessful. A doctor tried the procedure but the new catheter didn’t go into the bladder and fluid went into the abdominal cavity. Melanie had a urethral catheter again for about six weeks while the bladder healed. She then had further surgery for the insertion of another suprapubic catheter. Since then her suprapubic catheter has been changed every month without any difficulty or complications.
Melanie was in hospital for a year. After a few months nurses encouraged her to try a flip flow valve at the end of her catheter and to manage without a bag. She liked this option because she felt more like a normal person. She could feel when her bladder was full and when she needed to empty it. Melanie went home with this flip flow valve which she opened when her bladder felt full to allow urine to drain into the lavatory. Unfortunately, with the flip flow valve, she had more urine infections than she had when she had the leg bag, and on one occasion when she was out at the cinema she started leaking urine via her urethra, which was upsetting. Eventually she decided that it would be best to go back to continuous drainage with a leg bag.
Now, Melanie’s carers change the leg bag once a week. Melanie has a night bag, which is disposable, and which is thrown away each morning. Melanie still gets a urine infection at least once a month which is treated with antibiotics. She thinks that the infections are caused by contamination from her bowel. She is convinced that bacteria travel up her urethra and cause the infections. She fears that she may have to have a colostomy to prevent cross infection and to prevent the frequent urine infections, which stop her getting on with her life, and affect her physiotherapy and rehabilitation.