The vicissitudes of the condom cathether

I was totally incontinent for about three months. I initially thought that diapers would manage the problem, but even the most absorbent brand would last only 45 minutes without getting heavy and beginning to sag down between my legs. I went back to work with a full patient load 11 days after my surgery. It quickly became apparent that a diaper alone would not work. Going back and forth to the restroom in between every four or five patients got old very quickly. I then tried the technique of adding an absorbent liner inside the diaper and only changing that, but the liner was cumbersome as well, and still I had to dispose of and replace it several times a morning. I soon found that the only thing that would let me have freedom from all the paraphernalia related to diapers was a condom catheter. We used to joke as urology residents, saying, “I’m going to go empty my leg bag,” instead of saying we were going to go to the restroom. There were residents who would take condom catheters from the urology clinic and put them on at baseball games so they could drink beer without the inconvenience of going to the stadium restroom. I ordered several types to try out (I won’t tell which size I ultimately used) and actually got along quite well with them. The ones I used were like a condom with sticky glue on the inner surface. As you roll it on, it sticks to the skin and forms a water-tight seal; the end of it has a spout that connects to a tube and a bag that attaches to a leg, hence the term “leg bag.” I could wear this under my scrubs and no one knew I had it on. I worked in the office, operated, and even taught youth Sunday school with this set-up undetected. This system malfunctioned and popped open only once. This soaked the pant leg of the scrubs I was wearing, but no one saw it and I was able to correct that quickly with a new pair of scrub bottoms. There was an ever-present fear that it might leak at an inopportune time, but that never happened. I had told very few people that I had had my prostate removed, so hardly anyone knew that I had a “leakage” issue and was wearing a leg bag. I would be speaking to a patient about what they should do for their prostate and answering questions about incontinence, all the while wearing my leg bag. It was an odd time; I elected not to tell patients about my situation. I bet in those three months of wearing protection that I must have treated hundreds of patients with prostate issues. “What would you do if it were you?” they would ask as I could feel my leg bag filling up. The bag holds about a pint, so I could feel it getting heavy and bulging the scrubs at the calf level of my leg. If you let the bag get too full, then it begins to pull down on the tubing, which in turns pulls down on the condom, which pulls down on the… You get the picture. With time, as I am sure it is with most inconveniences that patients endure, all of the issues associated with the condom catheter became second nature, just part of my life.

 

I would take off the condom before my shower and then jump around to see if the leaking had improved, and each morning for those three months, I was disappointed. Following the shower, I would dry the area to perfection and then carefully roll on my condom catheter and begin the process of hooking everything up. I had a routine that took about 15 minutes. On one particular morning, some of the skin of my “you know what” was very irritated and little blisters were all over the skin, particularly where urine would contact inside the condom. The condom catheter’s glue made taking off the condom a very unpleasant experience, as it would pull at the irritated areas of skin and open the blisters as well. It was very painful to take off the old and miserable to then put on the new. I remember being quite depressed by my situation that morning, more so than usual. As if it were not bad enough to be leaking all the time, now my system for dealing with it was also problematic. The thought of wearing this contraption all day, considering all the movement and discomfort that this entailed, also added to my despondency. The other issue was that if the skin kept getting irritated, I would not be able to use the condom catheter and would have to go back to diapers. I was pondering my plight and was just about “situated” when my wife entered our master bath. I was stooped over in order to connect the rubber straps of the bag to my calf and looked up at her. She looked at me oddly and with what I perceived as a look of concern. I thought that maybe she had detected my frustration and slight depression. I remember being disappointed that my true feelings might have been revealed, as I had been trying to down-play to my family the pathetic “urinary” situation that had become my life. By the way she peered down at me I was sure she was going to ask, “Is everything O.K?” She then said,” John, I think I see a black hair on the tip of your nose.” Somewhat relieved, as I connected the last leg strap, I said, “Thank you dear.”                             From “The Decision”

 

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