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Urine scald

I am having a lot of discomfort since beginning a medication that makes the kidneys filter glucose (diabetes 2) from the blood into my urine. I have rarely needed to use a barrier cream before ( but now even with use I cant seem to get over the soreness which at times is almost raw. Even more unpleasant is that my foreskin is now constantly enflamed and tightly contracted so that it is painful to retract to wash or achieve an unobstructed urine stream. I have been given something for that but it keeps coming back. Anybody know how to deal with this?

Please see your GP ASAP.

I don’t mean to frighten you but I had a sore on my Willy that turned gangrene and I died. Resuscitated by the marvelous Intensive Care Staff at my local hospital.

It’s taken 6 months but now I’m bramer.

Get yourself to GP or A E.

George

Bob

Obviously I’m not a chap so can’t exactly relate to your precise problem!

But, it sounds like you need to talk to a urology nurse. Have you tried the bladder and bowel service local to you? Or do you see someone from the urology department of your hospital?

(I honestly think you should try to get your catheters delivered by a specialist company, like Coloplast or Scripteasy. They have their own nursing support services and can offer suitable products to protect against things like this. As well as different products to try.)

It sounds really bloody painful. If all else fails, try your GP practice nurse.

Sue

Hi Bob, I am having a similar problem, forgive me if I am wrong but I am assuming that your problem is caused by incontinence, and that it is in effect, rather depressingly nappy rash? I apologise if I am wrong. If it has been caused directly by new medication I would suggest you see your GP. I have no solution for you unfortunately other than to say that I seem to experience the same thing every year in warm weather. This year to a greater extent, especially as I try to stay hydrated. The only thing that I have tried is changing pants/pads more often to try and ensure I am as dry as possible at all times. I understand how hard this is as nobody would wear incontinence pants without a need, and that if you are out and about you can be wet for a while due to a lack of available toilets. I am seeing the continence nurse tomorrow, if she has any suggestions I will let you know, but I expect the solution offered will be a sheath/catheter. Good luck finding a solution to a painful problem.

Thanks George. Wow that story is hard to beat. Glad it had a happy ending! I think you might be referring to a danger caused by paraphimosis where the inflamed retracted foreskin tightens so much that it wont go back and cuts the blood supply to the head and can cause gangrene. I have been very careful not to let this happen as I have already once been sent straight to A and E before when it happened because of the swelling from a Botox op. Doc said if it happened again I would have to be circumcised. Never thought of a local Bladder and Bowel Service Sue but will check if there is one and if they can help. I don’t want to think about a legbag as I now having occasional bowel issues and would still have to wear a pad. Actually Bri I think you may have hit the nail on the head, it is incontinence but didn’t think of the weather and its certainly gone on a few weeks and my wife says its nappy rash and I guess as a mum she should know. As I am not working for a while I think I will try ‘going commando’ for a few days at home with just a towel and a jug and see if that does the trick.

Hi, everyone has given brilliant advice in you getting an appointment in urology department. I worked in a hospice for many years & some people used to come in with severe urine burns. We used to use Metanium, very effective nappy cream. It’s quite thick though, not like ointments that soak in. It did however ease the soreness & was an excellent barrier cream, far better than Sudacrem etc. Might be worth ago until you can get to see someone. Tracey

Thanks Tracy, I will give the Metaniun a try as Sudacrem hasn’t worked. Hadnt heard of it but see its available from Sainsburys. Reluctant to see the doc as he might stop the diabetic medication and insulin injections would be a likely next step.

Hi Bob, I said I would let you know if I found anything interesting from the continence nurse. Unfortunately nothing much new learned the advice I have been given is to use bigger pads/pants that have a greater absorbency and start using a sheath system. On the positive side at least I am being offered both pads and sheaths to be used as needed. I thought it may have been an either or thing. Sorry I cannot offer a better solution. Best wishes.

Thanks Bri

I want to change the pads anyway as the ones I am provided give such poor protection from leaks, but from what I recollect last time I spoke with the nurse the next step up would be significantly thicker and look too bulky and obvious under trousers to get away with it in my job.

Hi Bob, a couple of points from my perspective (full disclosure, I am the guy with Cerebral Palsy that posted anon on a similar topic last week. Bear in mind I can’t relate to an MS diagnosis and I am not yet 40). But as one disabled guy to another…About the bigger pads a lot depends on what your job is? whether you have to wear a tight fitting suit? And whether you are the boss? whether you are incontinent at work? Daily, weekly, monthly?

I’m sure that nobody is going comment even if they are big and bulky and obvious surely people would not? I have never experienced that. But then my disability is obvious. I don’t know if yours is or not as far as mobility is concerned? Put another way if we saw each other in a cafe just assuming we could tell that we are both wearing incontinence pants are we really going to have a conversation about it?

About visibility you can always buy trousers one size bigger around the waist. A lot depends upon the incontinence you have for example are you making it to the toilet but having a small accident saved from a wet patch by the pad? Or are you not making it to the toilet at all and using the pad instead? Saved from having to change your trousers and the pad? They are two completely different scenarios both describe incontinence. Or like me at the moment are you having to change trousers anyway because the pad is leaking? From my perspective I would suggest that having colleagues that suspect you use pads is preferable to colleagues that can see you with a leaking pad with wet trousers? It is not fun dealing with incontinence at work I understand that.

I would suggest that needs must if you have leaking pads, for me there is no alternative. I don’t actually care what people think, just remember that people are very self obsessed and won’t really be thinking about what underwear you might be wearing. As much as it might make you feel self conscious. Best wishes

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Hi Bob, I apologise for the slightly incoherent reply before. I have just re-read it in places it makes no sense, sorry. For example when I said are you incontinent at work? I was not meaning to be nosey I was thinking my problem was more on the commute to and from work as at work I was surrounded by toilets also out and about I suffer because of a lack of accessible toilets. I was thinking about how often I had issues actually at work (infrequently, although it did happen) as oppose to outside of work (frequently, daily). In terms of my disability being obvious I think people assume I that I have continence issues because my mobility is poor, as much as they consider it at all. But then in turn I assume that most people with mobility issues have continence issues too because of my own experience (and that of elderly relatives). Maybe I need to revise that? Having to change trousers at work was a big fear of mine just because it highlights the problem. (In my opinion the less people know the better). It would have left colleagues and friends in no doubt about the existence of a problem. As much as they can suspect I am wearing large pads/pants, they cannot know for certain unless I tell them. I now say I have no alternative because I am too frequently not making the toilet, having a large accident and needing an immediate change of pull up as a minimum, I didn’t mean to suggest you had no alternative, sorry I apologise for that.

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That’s OK Bri, my anxiety is because I teach, last year a kid even asked why I had a nappy in my pocket, I had forgotten about it as I left my car but managed to come up with some kind of excuse that convinced him otherwise. Same place I had to deal with a kid (special needs) who went around patting people on the bottom, including me, and couple of times I have forgotten to button up my body vest which stops pads falling out of place and down trouser legs which has happened. Have had a number of close shaves with actual leaks, sometimes shielding with a coat or bag. One time I wet another teachers fabric chair but as it was last lesson it was able to dry overnight. Have had to be extremely meticulous about using any opportunity to visit the gents. Fortunately last term the toilet was right outside the staffroom. Double periods are a nightmare. Have also had a number of accidents out and about and hid behind shopping trolleys and so on, but though embarrassing they are recoverable unlike work.

Hi Bob, I understand your anxiety. Having been an incontinent kid at a mainstream school (before pads/pull up pants were widely available) I can empathise with your problem. (Your post has reminded me just how difficult it was to get from lunchtime to home time without using a toilet - they were locked during lesson time, only opened a break and lunch time) First of all, I know you know this but kids can be very cruel (so can adults admittedly) I don’t want to heighten your anxiety but you need to get your pad/pants sorted over the summer as all it will take is one accident for you to gain a reputation or nickname that might be hard to shake. And it will be dressed up as banter…although whether kids should be bantering with teachers is another matter. Larger pull ups may at least prevent pads from falling down your trousers and the kids would not be able to prove you are wearing them, even if they suspected I don’t think they are that obvious. As for the kid patting you on the bottom, even if he was patting a nappy through trousers, could he tell? I am not sure that he would be able to. Again I don’t want to be nosy but do your colleagues know about your disability? Or the incontinence? If a kid was to start a rumour about Mr Owen wearing nappies, how would you deal with it? Have you given that any thought? As a just in case, I’m not saying it will happen. Again as one disabled guy to another, embarrassment is not an option. Needs must…I am slightly worried now for you as you mentioned the occasional bowel accident earlier/above have you considered what happens if this occurs during a lesson? Have you a strategy to get yourself sorted straight away if you need to? It might be worth thinking about. Depending on how often you are having this problem. I would suggest a conveen but am aware you have already tried one, it may be more discreet then pads but then it only takes one leak, so it is as they say swings and roundabouts. It depends on how often you are having accidents and the extent of the accident, versus how often you make it to the toilet no problem . Is there an option for you to leave class to change your pad in the event that you have an accident at the start of a double lesson? Reasonable adjustments? Good luck, genuinely meant, (remembers some of the “banter” from school, not a good experience).

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Hi Bob, I have just re-read you original post on the thread. Quick question, forgive the bluntness please: Are you having to sit through double lessons whilst needing to change your pad? Or having to see lessons out with a very wet pad? Which lots of respect, if you are that may explain the nappy rash. Again don’t mean to be nosy, just a thought. Best wishes.

Mr B.

I’d have gone for Sudocrem first and then tried Aveeno.

Oh, the joys of dealing with our basic functions. I use pads and pee bottles along with a masterpiece of daily planning.

I’m on top because I am clever and MS is stupid; a very powerful stupid but still stupid.

Steve

Hi Bob, another quick question: Why the body vest and not tight fitting boxers? Does the body vest not hinder access when you really really need the toilet? Or maybe urgency is not a problem? I’m now wondering what happens to the pad once you open the body vest. I am sure you have used what is best for you. I am a bit confused. (For me it would create more problems than it would solve, in my world the pad would end up falling in the toilet!) Re: the post above and reasonable adjustments I was thinking maybe not teaching Year 7 as a double lesson last thing so you could leave class briefly if needed? That sort of thing…best wishes.

Hi Bri, the body vest serves a number of vital purposes: it guarantees to stop anything accidentally becoming visible should my trousers ride low or I have to bend down to something; they are made of tight stretchy lycra which really pulls the pad flat against my body preventing a visible outline and also stopping the pad slipping down or the front of it wilting down, either of which cause me wet pants; it copes with my beer belly - boxers, net pants or whatever tend to slip down because of it and so don’t keep the pad up close but the vest cannot slip off my shoulders, compression pants might work but I don’t think they are available for men. You are right that it causes an extra step to being able to getting to pee but I am usually already leaking before then anyway and I only need to undo a single popper to retrieve my tackle which also means the pad cant fall out. In my last permanent position after a long absence I did email the school nurse about my incontinence and asked her to confide in the Head. However, I gave up full time work for health related issues and now do temporary contracts and supply and do not feel able to confide something that may lead to me not being offered agency work and certainly couldn’t come out with it to the staff of a school I have just turned up to for a day or few days work. This is why I cant request 'reasonable adjustments’and I could be disciplined for just leaving a class. As to being disabled, no-one would know it unless they spent some time with me. Currently my only mobility symptom is the occasional knee buckling and poor balance and I usually successfully pass that of with a joke about having drunk too much. Double lessons cause both problems, desperation and being unable to change a saturating pad but as the nappy rash has gone on now some four weeks after stopping work I think it wasn’t a big factor. You are right that I only need to have one public accident at work and it would probably be an irrecoverable situation at that school. However this almost seems an inevitability at some point right now as I cant come up with any guaranteed strategy. I take your point about planning Steve, but that is how I proceed but the fact is there are lot of uncertain factors and factors outside of my control with my work. Surely the bottom patting could have revealed my secret depending on what thickness I was wearing but I never moved so fast and I gave him such a bawling out I think it would have overwritten his sensory experience before he could begin to process it. I could only hope to laugh off rumours as I don’t see anything else would work. In terms of incontinence being an issue I noticed this term that by the end of almost everyday my black trousers were dampening at the crotch despite changing at lunch or mid morning break and often on the journey home in the car or as I got out the other end it had become much worse, sometimes a flood. At least twice in the term I had to change my trousers before ending work. Bowel accidents I almost don’t want to think about but I managed to survive two at work, one because I just happened to be free to immediately go and change in a suitably equipped toilet space and the other because it was the end of the day and I just left. Cant think how you managed in a mainstream school and before pads. I think people like you and I might not have been able to work if that was still the case as I assume the only alternative would have been cloth nappies

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Hi Bob, Well you are certainly in a difficult situation. I understand about the body vest now, thanks for the explanation. The always already leaking by the time you get to the toilet I empathise with, but it is a problem in my opinion that needs addressing as this means that every pad you use, gets “used”. I understand you cannot confide in colleagues as you are working supply/temporary contracts. I understand you cannot just leave a class, therefore reasonable adjustments are not really applicable.

I sadly agree from what you have mentioned in the posts the a visible accident is an inevitability as you appear to be “using” your pads to destruction/maximum capacity. Is that a fair comment? I cannot offer you a guaranteed strategy unfortunately but a bigger pad would give you more wriggle room for bigger accidents. The one thing I can guarantee is that if it is fair comment above something has to change. I think you know this. The wet chair you mentioned above could have easily been seen, by staff or students not to mention how uncomfortably soaked you must have been at that point, clothes and all. Quick question: What would have happened if a curious kid, (like I was) had come to you with question at the end of the lesson? (Because I would have noticed your then situation, ok and said nothing to other pupils. I may have said something to you though, kind and empathetic along the lines of “you too?”) I respect you a lot for going into a classroom to teach kids knowing you are going to wet yourself during the lesson, that takes guts. Ultimately though you can’t be leaving work with wet trousers every day, that is not good and eventually someone will notice. You have a tough decision to make as a bigger pad may be more visible but may save you anxiety about leakage. What if the wet chair occurs before break? (Sorry, just playing devils advocate) The other thing is that your current pad from what you have said is just not absorbent enough, the fact that you have had to change trousers at work emphasises this. (Bags and coats will only hide so much and are much more effective winter than summer). Sadly that is going to change that between now and September. You may have to try bigger pads and address any rumours if they start, I know that is not ideal.

I have no idea how old you are? How many more years that you would do this in an ideal world? I suspect regular bowel accidents would leave you unable to work? Maybe other people would disagree? I would suggest you hope for the best, plan for the worst. This includes being honest (with yourself) about how you would feel or react were the worst to happen (I don’t have bowel accidents very often, but I was very upset when it happened for the first time at work). Ultimately once it had happened, it had happened you have to move on. There is always the scenario where people are nice and supportive and that the bad “banter” does not happen. It could happen.

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Hi Bob, a couple of typos: It should say every pad that you wear gets “used” and further down sadly that is not going to change between now and September. Another quick question about planning for the worst outcome. Are you ever, like me in a situation where you have a saturated pad and a full bladder? (My day to day worst case scenario) If that were to happen the outcome would not be good. I would like to think that the school at which you were working would be supportive in the event of a worst case scenario. I know these are not easy things to consider but trust me it is better to be prepared (to the extent that you can be). Best wishes

I did see the doc in June and asked for a referral back to the continence service after a couple of absolute floodings which I’d never had before (fortunately not in work)and because I was having to get up as much as five times each night and because I was just starting to get a serious rash and to discuss a change of pad. He found and treated a UTI and thought this was the cause. However, he got me a very quick appointment with the Urologist who felt urinary retention was the issue and told me to make sure I used ISC twice a day which I have and which has helped a little.Fortunately he arranged a follow up for September and a repeat of Urodynamics which might give an answer. Tried contacting the continence service myself but it seems to be temporarily (I hope) affected by a staff shortage. District nurse has sent me some forms to fill out so they may be able to help. To answer your question, if a kid said something, I’d probably say I spilt coffee or sat on something wet. I do make sure now I stay on my feet as much as possible since leaks are far more likely sitting. To answer your other question, yes if I cant get to change a pad and driving is another scenario. Have also faced it when out on a school trip. Driving I guess I’ll try to keep working at least until both my children leave Uni - three years time.

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