Question
Hi,
    I am a home care nurse taking care of several quads in their home.  I have 2 clients with problems.  Please help!  1) 1 client has severe bladder spasms despite being on enablex.  She has accidents daily despite her suprapubic cath.  Also having bowel problems while being on supp/ 3x per week.  2) Another client, quad for 40 yrs experiences severe itching & abd. cramping after bowel program 3x per week.  He is on Zyrtec & benadryl-very little help.  Thanks for your time!  Nurse Ellen

Answer
Hi Ellen-
Hmmm, i know these are areas of common problems for those with SCI. And I have to say I don't know if I have answers, but I can maybe give a couple of suggestions?

The spastic bladder- I've always had trouble with UTIs, and spasticity, but not both in the same place. I never had a drug given to me though that helped with the accidents- eventually I learned to like the cranberry (I have a bookful of cran-recipes...sigh). I know generally spasticity is helped by more movement, exercise- perhaps this could help?

The only other option I have ever seen was on a female quad- she loved it, but it's pretty serious: she'd had her urethra re-routed to where there was a tiny stoma right beside her belly button- just looks like a dimple or my stomach tube scar, not at all weird looking. she had enough hand use to cath from this spot intermittently, had totally stopped having UTIs.  All that sounds great as I swallow another antibiotic... It is surgery though, never any fun. If interested, she could at least talk to a urologist about the potential.

Itching- this sounds like he's allergic to the supp or latex gloves or something! I'd look real carefully at the particulars of his program, has he always had this problem, diet in general, has he ever had a colonoscopy? is the itching outside or in? (i'd assumed inside since I really can't feel much) I've never heard this sort of story, but if all those questions lead to no answers, try changing one thing at a time (gloves, brands, etc)- maybe something will become apparent?

Well. That wasn't very helpful I'm afraid, but it's the best I've got... sorry for that- I do wish you (and them) good luck- please write in again if you have more questions or if you figure out the answers to these!
thanks
leslie