10 december 2020


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Dr Ian McLauchlin

miscellany

3. THE PIPING OUT OF THE CATHETER


It was mid to late August 2018. At last the day had arrived. Bottle of water for flushing, check. Box of tissues in case of accidents, check. Stock of dubious questions to disorientate the nurses, check. Right, into battle.

Ever-helpful daughter, bless her, took me - three ears are better than one. "Ian McLauchlin?" Nudge nudge, that's you Dad.

Hello, my name is Gill. She said that, not me. "Just come with me into my little room." I bet you say that to all the virile young men. (Yes she'd probably heard that dozens of times but would feel disappointed not to hear it again today.) Lie down on this bed (Ditto). "Now, how are your bowels?" Having a wonderful time. Hope yours are too. "Have you been this morning?" Yes, thanks. Why do you ask? "Well sometimes when you remove a catheter, the sensation causes the bowels to empty." She made sure I was lying centrally on a pile of absorbent pads and took one pace backwards.

When you take it out, can I have it? Her face told me that she hadn't heard that one before. "I haven't heard that one before" her face said slightly before her mouth said it. "NO you can't" she said with a smile. Why not? I've reserved a special display cabinet for it on my toilet wall.  "Well . . .  (this wasn't in the script) . . . er . . . it's an infection risk (that should do it). You never know where it's been."  On the contrary, I know exactly where it's been and will have the scars, both physical and mental for ever more . . . .

In a very pleasant yet firm way, she'd made up her mind and since she was in charge, nothing would change it. Ah well.

"What did you do for a living then?"  My answer caused everything to fall into place. I wasn't a weirdo then. Well not her version of one. "You ask some strange questions." That's exactly what I did for a living. Then answered them . . .

This figure approached me with a syringe - horror-film-like. "First we have to drain the anchoring water from the balloon."

(When they first insert it - note the satisfyingly rounded tip, though the tories are working to change that as I write - they anchor it in place by inflating a balloon inside the bladder - MY bladder actually. Two concentric tubes go into the bladder. the inner one inflates the balloon and a valve in one of the dangly bits keeps it inflated, while urine drains through either of two slots just below the rounded end, through the outer tube and into the catheter bag.)

Dr Foley's Fiendish Device:

The syringe went in, the sterile water was withdrawn (about 10 ml), a second try made sure it was all out, and with one bound the catheter was free -ish. "I just have to gently pull it out while you hold onto your bowels, and the bedhead, for dear life" she said from an especially safe distance. No, nothing. Just hang on a bit longer. She called for reinforcements - the receptionist, the postman, two men mopping a trail of blood from the main corridor and a delivery driver. "On the count of three,  3."

I may have imagined that last bit.

It gently came free and slid slowly out, gripping its familiar urethra like a child saying goodbye to its mother. You could see the tears (rhymes with shears not lairs). How did it feel? Like a minor disembowelling - I've experienced a few and they stung a little.

Quickly on with the man-sized nappy and mesh underpants. Then she put them on me too. "How much have you had to drink?" Lifetime? This week? About three quarters of a litre. "Right, here are two bowls. For ease of use, I'll mark them 1 and 2. When you want to go, fill the first in this toilet here and leave it on this shelf here. An NHS fairy will know it's there, sprinkle it with disinfecting dust, and make it magically appear in my little room. Then drink some water, it goes in here, and when you're ready go again."

After lots of unnatural drinking, I completed the task, with photographs to prove it. Number one was pinkish with floating debris, 160ml, number two was comfortingly pale yellow with no floaters, 240ml.

"OK you can come to my little room again. Don't drink tea for a few days and especially not coffee (Starbucks instantly  withdrew their NHS sponsorship). They irritate." I know what she means about Starbucks. I had a final spanner to throw in her works. When you gave me the bowl marked Number 2 I had a sudden semi-literal urge to obey she who must be obeyed  . . . . "Right, you can go now."

That was the end of the hospital scene. On the way home other things happened to make my day complete.

"Would you like us to take you out for lunch? Dave, the kids and the dog are canoeing down from Exeter Quay and we could meet in the Double Locks - a popular canal-side pub. But they won't arrive for an hour. Would you fancy a trip to IKEA?" Sounded like a good idea and I hadn't visited the new store in Exeter yet. Do they have a toilet?

First things first. Toilet. First time. Should I stand up or sit down? Let's live dangerously and stand up. The only one free was a children's one so it was low down. First to happen was a drop of blood on the one area that no flush could possibly reach. Do you remember seeing two of the Red Arrows performing a roll manoeuvre while spiralling upwards leaving red white and blue twisting smoke trails? Well the smoke represented my stream, except that it was going roughly downwards, across, more random and more widely spread. No, actually, an unrestrained hose pipe thrashing around at the free end is a better analogy. I hurriedly washed my hands and left.

The new IKEA was very interesting and roomy, in both senses, and also had the uncanny knack (how do they do this?) of making my bladder loom large in my field of vision. I think I need to go again. Sat down this time - why didn't I do this before? Mid slightly-painful stream, the toilet violently flushed, all by itself. (The hospital had obviously phoned ahead.) I've never shot off the toilet so projectilely in my life and thank goodness the ceiling was high. After I'd dried myself, the floor, my shorts and the bag and socks of the person in the adjoining cubicle, I noted that there was a non-touch flush 'button' on the wall behind me. For a laugh, the installers had clearly set the trigger distance to include the toilet bowl too. I'd stupidly, and entirely unpredictably, moved slightly while seated.

The family had canoed to the pub and got there, dry as a bone, before us. Had a pint ( . . . er . . ) and a good meal. The dog intently studied the waitress taking finished plates back to the kitchen and, typically and expertly, caught and swallowed a stray chip before it hit the floor. I went to the loo and all was right with the world.

On the way back to Exmouth, the traffic suddenly ground to a halt. It ground to a halt for 10 minutes, 20  minutes, blue flashing lights appeared, rushed past us then ground to a halt. A few cars turned round and drove back the other way. The bladder started to tap me on the shoulder . . . We would normally have been home by now.

Eventually we inched forward and found they'd closed the road. (The hospital had obviously phoned ahead again.) We turned off, along with others, through Exeter-dormitory housing estates I didn't know existed, down country lanes that didn't know I existed, lanes that got narrower and narrower until the traffic stopped. But the bladder didn't. Through some miraculous knowledge of the precise length of the car to the nearest nanometre, daughter turned round in the road. Sat-Nav went "Psst, I know another way out of here." It did but it didn't know that way was blocked too.  We headed for the motorway. Queues. Inched into the traffic to the sound of horns from queueing traffic and bladder.

There's a local service station up ahead. Yes, let's try for that. More queues. I know let's just forget societal norms and take that relatively empty lane to the Park and Ride car park. It's quite big, leafy, unpopulated and private-ish. The blood didn't show on the verge and, not for the first time, I'd started a trend. Another interested motorist had a go. A passing Park and Ride bus drew up and passengers applauded loudly. Fire engine arrived and hosed it and us down . . .

We and the Sat-Nav decided that the route to Exeter Airport opened up several options and passports weren't necessary if you were simply going home, were they? Down a road marked "Unsuitable for long, heavy or any vehicle at all actually" and, after several reversings to allow mostly grateful oncoming traffic to continue to oncome, I was home at last. Never has my toilet been so grateful to see me. We hugged and we kissed. It was embarassing. So embarassing that one of us flushed.

And the remaining unused catheter night bag? I'll hang it on the end of the bed. You never know, might get a surprise at Xmas.


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