A few months ago, I made an appointment with a urologist because my output had slowed down quite a bit.  Before my dad passed away years ago (from an unrelated issue), I had remembered him telling me that he had an enlarged prostate.  So, I figured that it must run in the family.  But that wasn’t the problem.  It turned out that my prostate wasn’t that big; rather, my bladder wasn’t working very well.  Apparently, my bladder was three times the size of a normal bladder, and it didn’t have enough strength to evacuate more than about 30% of its contents.

Six months later, after two cystoscopy procedures (where they examine the urethra, sphincter, prostate, and bladder lining), two urodynamics tests (which tests bladder strength), and opinions from two urologists, the conclusion was simply that my bladder didn’t work very well, they had no idea why, and there was nothing that could fix it.

In the meantime, I was introduced to the world of intermittent self-catheterization.  This involves inserting a long tube into your urethra and pushing past the sphincter (and prostate for men) in order to empty the bladder.  You typically do this five to six times a day, including in the middle of the night.  Even if you are very careful, there is some significant discomfort involved.  When you have a urinary tract infection, though, the pain is often excruciating.

When you self-cath (that’s the cool term for it), you become susceptible to two general kinds of associated medical problems.  First, you are more prone to urinary tract infections.  I had three infections in the first four months of self-cathing.  When you run a catheter through the urethra and into the bladder, there is a possibility of introducing bacteria.  The bacteria can lead to an infection.  It’s as simple as that.

Second, self-cathing makes you more at risk for internal scarring.  The whole urinary pipeline — from bladder to prostate (for men) to sphincter to urethra — wasn’t designed to transport anything but a stream of liquid.  Working a pointy, unevenly lubricated catheter backwards through the urinary pipeline can significantly irritate the tissue, sometimes resulting in bleeding and scarring.  If too much scar tissue builds up, it has to be surgically removed.  So far, I’ve only bled once.  But it’s only been seven months, and I could end up doing this for another thirty years.

Medical issues aren’t the only thing that you worry about with self-cathing.  There’s also some social impact, especially when you are away from the home.  When you go to the bathroom, the process is much more involved and it takes considerably longer — especially if you want to minimize the medical issues.  When you are in a public bathroom, you can have some privacy with a stall, but there is part of the process that occurs at a sink — again, if you want to minimize medical issues.

Also, there are some minor logistical issues — including carting around one or more 16-inch disposable catheters (in a discrete way, if possible), working around things such as unclean facilities and lack of soap or hot water, and figuring out the best time to self-cath during the day.  (When you have a flaccid bladder, you can’t always tell when you need to go.) 

When you do anything that disrupts your routine — going out for the evening, visiting a friend or relative for the day, going to a graduation or wedding, going on vacation for a week — you often have to adjust your self-cathing plans and figure out the logistics.  If you experience a change to your typical water intake or use (e.g., exercising or working on a hot day, eating things that require more water for digestion) — you may have to adjust your plans and logistics.

Finally, although you get used to self-cathing over time, there is some significant embarrassment, depression, and anxiety associated with it.  It helps to have a supportive family, supportive friends, and supportive work colleagues — all of which I have.  It also helps to see a therapist and join a support group — both of which I did.  But you now have a lot more to worry about.

All that said, as the title of this blog post suggests, I actually feel blessed by my issue.  Why?  Well, I believe that it brought me closer to God and that it helped me to be more humble at a time when I really needed it.  You see, for many years, I felt as though I had a message that I needed to share with others, but I struggled significantly to find a voice for that message.  I now know that the voice that I needed was genuine humility, and I finally have that.

(I have several other things from my past that help me with humility, as well, but the self-cathing took it to a new level.  I’ve been trying to learn more about humility, and I will have a follow-up post on what I’ve discovered so far.)

I am in good company with feeling blessed by something like this.  The apostle Paul (author of much of the New Testament) suffered from a thorn in his flesh, which Paul believed was put there to keep him from feeling exalted and privileged to have received important revelations from God.  At first, Paul resisted the thorn, asking God three times to remove it.  In the end, though, Paul came to accept his thorn as a blessing.  It brought him the humility that he needed when he needed it.

It is not always easy to see an affliction as a blessing.  In fact, it is blessing in itself to be able to see an affliction as a blessing.  And so it is that, as troubling as my bad bladder and the self-catheterization is, I truly feel doubly blessed.