Monday, 12 November 2012

VVF Screening

They're BACK!!!!!!!!!  Insert little gleeful dance!
I loved them last year and I intend to love on them again this year!
We had our first round of VVF screening this morning, and the ladies are just as precious as I remember!

  In an interesting twist for me, my day was full of odd jobs and randomness that had nothing to do with leading a team (normally I lead the general surgery team for the ward).  For the next 4 weeks (or so) I don't have a ward to run, but instead will help my coworkers as needed and try and get a bunch of year-end paperwork at least started if not finished before Christmas hits.  Among my jobs today, I buttered bread (a challenge when the bread is soft and the butter's hard... but really a great time to sit with a friend and chat) to feed our screening patients.  I ran paperwork to various people and facilitated a phonecall through a translator, handed out bags and bags of multivitamins and iron, and started two IV's.  I danced with a 7 year old who was there for other reasons... she had so much energy, was a lot of fun, and had the best cuddles... even with the ringworm all over her head (it just means I scrubbed my face after cuddling with her!). 

And I had my first triumph.  I taught someone a new life skill.  I can only imagine what she was thinking....

Imagine life after trauma... trauma that left you wet.  Suddenly, you have no warning when you need to urinate.  Instead, the urge strikes and within seconds your bladder lets go.  No warning.  You try to sleep, and when you wake up the bed is wet.  Every.  Single.  Night.  You don't understand what is wrong.  You just want it to go away.  And your neighbors wonder what is wrong with you.  They avoid you because they might catch whatever it is you're suffering from.  Plus, they can't stand the smell.  And so your life becomes more and more solitary.  A life of shame.  Controlled by a bladder that you can't control. 
You hear about other women who are wet, and so you come to ask for help.  But after the exam, they tell you there is no hole, there is no surgery.  And you don't understand, because you are wet, just like everyone else.   You are sure that you need surgery!

This was my new friend.  Confused by what we were trying to explain.  No surgery?  But she needed help!  So she tried telling me again and again what was wrong, and I had a long talk with her about what we can do to make her life different.... How do you explain this problem to someone without schooling or understanding of anatomy?  Start simple.  Your bladder is too full, and your body doesn't know how to empty it all the way, so then it gets full again too fast.  Then you don't have time to go to the bathroom, it just overflows.  We want to teach you to put a plastic tube in your bladder to help it empty.  You need to do this every two hours and right before bed.  This will help you stay dry.

We talked about where the hole she urinates from is, how to find it, how to put the tube in.  How to clean herself and the tube, and many other things.  There's a lot to take in, but it's pretty simple once you know what you're doing.  The first time was just for me to show her.  Then she was supposed to try but gave up right away.  So we waited and tried again, and this time I was hands off.  She did it all herself! 

It seems silly, or akward, or wierd... but it was a triumph, because this simple little procedure, this putting a tube in to empty her bladder, this will keep her dry.  And it's something she doesn't have to tell anyone about.  She can do it all in privacy.  There is no shame needed. 

Even after she learned what to do, she seemed uncertain.  I think it finally started to sink in that this might change things when I asked a few simple questions:
"How long do you usually go before you need to urinate (uncontrollably)?" 
"1 hour."
 "Okay.  So in the last two hours since we put the tube in, have you had any wetness, any need to go?"  "No." 
"So you are dry in between?" 
"Yes."  ... A smile slowly lit her face....
"Okay, so the plan is you will try this.  Try this all week and see if it makes a difference.  Will you try this for me?"...
"Yes, I will try."

Sometimes, that's all we can do.  Give someone the skills to make a difference in their own life.  She just wanted a pill, which doesn't exist.  I'm so glad she's willing to try.

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