I am writing this wee spirt for anyone who doesn't really know the true implications of how URINARY RETENTION can affect a patient.
Firstly when in true ACUTE urinary retention, the pain is unbelievable. In a person with a intact urinary bladder the symptoms can be: BACK PAIN, SUPRA PUBIC/PELVIC PAIN, KIDNEY PAIN, URETHRAL PAIN, STRAINING AND INABILITY TO PASS URINE, INCREASED HEART RATE, B.P. Its not a delicate throbbing pain, its excruciating pain. You have the feeling that you may explode. It may come on slowly, or your bladder may reach a certain level before it screams at you. Don't confuse it with the feeling of the need to hold on to go to the toilet. Or busting for the toilet. It is a feeling closer to immediate childbirth. See complications here
In a person with a Neobladder with a continent catheterisable channel in the abdomen, its different all over again.
I have learned when my bladder is overfull. Firstly it used to leak before retention point, unless it was blocked by mucus or an indwelling catheter.
Before this latest surgery when I did go into retention my belly would ache. Just under my rib cage. My kidneys would crump. Meaning they would start to ache/throb as I have no valve in the ureters to protect my kidneys, urine would back flow. Even at non retentive levels. If I was in a acute retention they would no longer ache. It would be a vice slowly painfully tightening across my upper back. That vice would go from waves until crisis point was reached. I would avoid that however by regular flushes of saline in a 60ml syringe into a catheter. If total retention through blockages occur it becomes a Medical Emergency. Why?
Because the Neobladder can perforate, causing inevitably sepsis, and possibly death. Its serious, deadly serious. That's why I don't piss around, and spend most of my waking hours flushing the Neobladder.
I have heard conflicting reports also. I have been told if I don't empty properly I will end up in Renal failure. Refluxing up the ureters into the kidney has been noted several times during investigations. Yet they don't bother to report it. That doesn't matter though because my body tells me when reflux is happening, I get an ache up there. I have also been told reflux is fine, normal in fact in someone with a Neobladder, unless the urine is full of nasty kick arse bacteria which infects the kidneys. That in turn over time may also cause kidney damage. So I do my best to be clean, clean with my caths, use gloves for every washout/catheterize. Wash hands frequently, keep area clean.
So when I was last hospitalised, and was left in screaming/gagging/thinking was going to die type pain for an hour. It was traumatic and intolerable.
The fentynal / cyclazine /and whatever else they gave me possibly masked the slowly creeping up of retention. When I could see urine in the bag, and my nurse was telling me I didn't drink enough, I thought it was from that.
I was recovering from the third lot of surgery this year, my body was tired, my bowels were up the wop, and the pain that was the most distracting was in my side. Therefore I didn't see it coming. When a patient is recovering all these things need to be taken in account, all of them. I relied on my Urology Ward to know what to do.
Instead I was left. Alone. Begging. Crying. Fearing death. In the end I was covered in sweat, panting, and ready to give up as I could no longer grip the monkey bar above my head to keep my back off the bed. I couldn't actually move a muscle. My abdomen by this stage was rigid, I couldn't even curl into the fetal ball that I wanted to.
It was scary, I'm still scared. I don't want to ever be that vulnerable again. To be honest I would take being In an abusive environment again better than the way I was treated. I thought I knew what pain was until that day. The people who were paid to care walked away
If you cant get help in a HOSPITAL where do you get help?
I don't want to be a patient, vulnerable, reliant on others for basic life crap, labelled, put down, 'uncompliant', or whatever. It sucks. Really sucks. I hate it. I have true empathy towards those who are in pain, or fearful of being in hospital.
While I'm at it that bulge better not be a Hernia, it had better just go away. Because I do not want to have to go back there. No No No.
There purged, verbal diarrhea over, positive thoughts now for good health and wellness!!!