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LOSS OF CONTROL OF URINE AND/OR FAECES (INCONTINENCE, FISTULAS AND STOMAS) PART 2

May 18th, 2009

The first and second reasons tend to go together, because you usually lose both feeling and muscle control when the nerves to the bladder or bowel are damaged. The trouble spot could be in the pelvis or spinal cord. If it is in the spinal cord you are likely to have some loss of strength and feeling in the legs as well.

Incontinence due to nerve damage can take a special form called overflow incontinence. Here the bladder muscle is so weakened that to start with you can’t pass urine at all. Then the bladder gets so full that small amounts of urine start to leak away, quite out of your control. A similar thing can happen with the bowels—they can get stretched with motions which you cannot pass. At that stage, small amounts of slimy fluid may start to come away, again, quite out of your control. This form of incontinence in the case of the bladder can be mistaken for cystitis and in the case of the bowel can be mistaken for diarrhoea. Such mistakes will not be made if a doctor or nurse examines you properly, including examining inside your rectum and your vagina with a gloved finger. In fact, this form of examination is necessary to work out the reason for every form of incontinence.

*202/40/1*

BREAST CANCER: WHAT TO TAKE INTO HOSPITAL

April 22nd, 2009

As you are unlikely to be in hospital for longer than a few days, there are very few things you will need. The following list may be helpful.

1    Nightclothes. Loose, comfortable nightclothes are best. You will be given a hospital shift to wear during the operation itself.

2     Slippers.

3     Dressing gown.

4     Towel and washing things.

5     Money. A small amount of money may be useful for newspapers and the telephone. Large sums of money, wallets and handbags should not be taken into hospital as these may have to be kept in an unlocked cabinet by your bed. If you do have to take any valuables or large sums of money into hospital, you should give them to the nurse in charge of your ward when you are admitted. You will be given a receipt listing each item and should keep this safe so that you can collect your possessions when you are discharged. However, hospital authorities strongly discourage people from bringing anything of great value with them unless absolutely necessary.

6     Boob, magazines, puzzles, knitting. There will inevitably be periods of waiting between visits from medical staff before your operation, and you may want something to occupy you during this time. Apart from reading, it may also be possible to write letters or do some types of business work if your stay in hospital is longer than overnight.

7     Clothes to wear to go home. Following a mastectomy operation to remove a breast, you should be fitted with a soft, temporary prosthesis before you go home. The breast care nurse or ward sister will put this inside your bra as an interim measure until a permanent prosthesis can be fitted, some 6 to 8 weeks after the operation when the wound has completely healed. For this reason, you should take into hospital with you a well-fitting, comfortable bra which is not wired or low cut, preferably made of Lycra or elastic to provide support, and in good condition. You may also be asked to take a tight-fitting T-shirt or similar garment to wear while the nurse is matching the shape of the prosthesis to that of your other breast. You will probably prefer a loose shirt or sweater to go home in.

8     Drugs you are already taking. Once your admission has been arranged, your GP will have been asked to fill in a form stating all the drugs you are taking and their doses. You may also be asked to take your drugs with you when you go into hospital so that their dosages can be checked and so that you can continue to be given any which are necessary. All your drugs will be kept for you during your stay as you must only take those which are given to you by medical staff. If you are asked to take your own drugs into hospital, these should be returned to you before you leave.

9     Admission letter. An admission letter will have been sent to you from the hospital, and you should take this with you when you are admitted for your operation.

Jewellery

Whenever possible, all jewellery should be left at home. Although wedding rings may be worn during an operation, there is a risk that any jewellery you take off before surgery may be lost or stolen. If you have to take any jewellery into hospital, it should be given to the ward sister for safe keeping.

Wedding rings, or any other rings which are very precious to you or which cannot be removed, will be covered with adhesive tape before your operation as metal can cause electrical burns or electric shocks during the process of electrocautery which is used to control bleeding during surgery. In electrocautery an electric current heats the tip of an instrument which then shrivels and seals the little blood vessels and stops them bleeding.

*27/39/5*

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