When you’re dealing with bladder issues, the wrong choices can cause a host of health problems.

It was July 23, 2006— about ten days before John “JR” Owens turned 16—and he was having fun riding his dirt bike.

“I had an accident and a brain injury, and I broke my neck,” JR relates in words that alternately tumble too quickly for the unfamiliar listener, or linger as he works to put them in proper order.

“He was 11 days in a coma,” adds JR’s grandmother, Geneva Bordelon. “At first, the doctors told us to call the family in, that JR wasn’t going to make it. Then, when they decided he was going to live, they told us his brains would be like scrambled eggs.”

Wrong again, says JR’s “Nana.” He’ll be graduating from high school, with grades that earned him a place on the A-B Honor Roll. “JR has survived a lot of odds,” says Geneva.

David Duncan was helping a buddy cut trees to mill into wood on October 30, 2005, when a large tree fell on him, leaving him with a T7–8 complete spinal-cord injury (SCI). The accident ended his days as a firefighter, but not the heroic spirit within him.

“I was in a wheelchair as soon as I could get out of bed,” says Duncan. “I had to be lifted from my bed to the chair, but I wanted up.”

He had motivation. “My injuries were really hard on my son, who was just 10 at the time,” Duncan says. “He came to visit me one day before I was even able to sit up, and he sat on my chest and said, ‘Dad, I don’t ever want to see you like this again. I’ll see you when you’re better.’ I wanted to see my son, so I pushed harder to improve.”

It took a few months, but eventually Duncan graduated from the acute hospital, to a rehab facility, and finally to outpatient rehabilitation and a job with AmeriCorps before deciding to strike out on his own and build a disaster-preparedness business from the ground up.

Bladder Issues & Risks

Owens and Duncan are stories of success in the wake of their accidents, but they and thousands of SCI survivors must overcome numerous challenges every day in order to get the most out of life.

That’s because injuries often interrupt the communication pathways between the brain and the bladder and the muscles that control the flow of urine out of the body. The body fails to let the brain know when the bladder is overfull, either because of a blockage in a catheter or other urinary drainage device, a bladder infection, bladder spasms and incomplete emptying, or stones in the bladder.

Even though these individuals can’t directly sense these problems, the body responds to the distress, sending signals through the autonomic nervous system, which in turn communicates signals to the brain that can raise blood pressure and lead to strokes, seizures, or even death. People with SCI at T6 or above must be alert for signs of autonomic dysreflexia (AD), including the following:

·         Pounding headaches

·         Sweating above the level of SCI andclamminess below

·         Blotchy skin

·         Flushed face

·         Slow pulse

·         Restlessness   

They need to act quickly to drain excess urine from the body, while keeping the head elevated. Less serious than AD but still a concern is the formation of stones in the bladder or kidneys.  Because indwelling catheters, diapers, and pads are breeding grounds for bacteria, urinary-tract infections (UTIs) and bladder infections are common among individuals with SCI, and frequent infections can lead to the development of stones.  

Product Problems

Unfortunately, most continence products are the primary cause of UTIs for men and women (men account for about 82% of SCI; women, 18%).

“Diapers and pads may protect outer clothing and bedding, but they hold urine against the skin, which can lead to irritation, rash, and ulcers,” says Dennis M. Kay, MD, an experienced emergency room physician from Florida and inventor of the Liberty external male continence device. “Physiatrists—doctors who specialize in SCI care—recommend avoiding diapers and pads because of the risks of skin breakdown.

“Indwelling catheters aren’t an ideal solution, either, because they can dislodge and spill urine at inopportune times, and they are a primary source of urinary-tract infections.

” Indwelling catheters are said to account for approximately 6,500 UTI fatalities in acute-care hospitals every year.

Condom catheters have their own set of challenges. They are too loose on some men, too tight on others, and can adhere to the delicate skin on the shaft of the penis, causing irritation and even tearing the skin. They, too, can pop off unexpectedly, causing frustrating and sometimes embarrassing accidents, ruining users’ time away from home.  

Another Option

“Loss of urine was one of the reasons JR didn’t feel comfortable away from home,” explains Geneva, “but several months ago we learned about a new product, called Liberty, that has made it possible for him to go places with his friends again and not worry about accidentally spilling urine. One of the best things is that JR can go hunting with his friends again, using a special mount for his gun and scope, and a firing mechanismhe operates with a straw.”

Liberty, produced by BioDerm, Inc., is an external male continence device that seals to the tip of the penis with a skin-friendly adhesive, called hydrocolloid, reportedly without irritating the skin. Inspired by the success of ostomy products in keeping skin clean and dry, Liberty has also been used by NASA to keep astronauts comfortable during manned space flights.

“It’s better for me, too,” says Geneva, who is JR’s primary caregiver. “I don’t have to continually check to see if his cath is dislodged or needs to be changed. He wears it from shower to shower with no worries.”

“Liberty helps me avoid infections,” notes Duncan. “I used to get them, big time, when I had an indwelling cath, and that’s dangerous because I can’t feel the pain of the infection. I have to rely on the color or odor of the urine to alert me, and it used to happen a lot. Since I’ve been using the Liberty, I don’t think I’ve had even one infection.

“The best thing, though, is that I don’t always have to be on the watch for a restroom. I can take my son hunting, fishing, or doing anything that keeps us active. I’ve come a long way, thanks to him.

” SCI can impose many lifestyle changes, including finding effective yet discreet ways of emptying the bladder and disposing of urine. It’s not just a matter of respecting your own and others’ sensibilities; the methods you choose to manage incontinence determine how free you are to enjoy activities outside your home.