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Impact of bladder and bowel dysfunction on a person with spinal cord injury

Writer Melanie Reid broke her neck in 2010 and was left doubly incontinent. Watch her talk about the impact her bladder & bowels now have on her life.
My name is Melanie Reid, I’m a journalist with The Times and I write a column every Saturday about my experiences as a paralysed person called The Spinal Column because almost exactly 5 years ago, I was riding a horse, I fell off and I broke my neck at C6/7. Incomplete break but I was left doubly incontinent and I spent a year in the Spinal Unit in Scotland learning how to manage having a paralysed bowel and a paralysed bladder.
My biggest issues have been trying to keep my bladder functioning happily with the supra pubic because I seem to be one of the unlucky ones that gets repeated bladder infections and it has been a battle, it continues to be a battle, even right now it’s a battle, at this moment in time, I’m waking up in the middle of the night, I know there’s something wrong with my bladder, it doesn’t appear to be manifesting itself in an infection of the actual urine, but I suspect I may have a recurrence of thrush in my bladder which has happened before.
I just have the symptoms building up, I have that feeling of pain, a little bit of seepage from the supra pubic hole, a feeling of great pain around the urethra area but the actual urine itself seems to be fairly clear. It doesn’t smell which is my way of testing whether I have an infection or not, but I can feel my legs are swollen, everything is hurting, so I know that something, there’s damn well something wrong down there but because I am paralysed, I can’t say, in any specific way, it’s X, Y or Z. But it takes a few days, you know, and you live with this uncertainty all the time.
Plus it’s a really lousy for you to be taking so many antibiotics, I mean I worry all the time that there were people that I was in the Spinal Unit with, young people who have subsequently died of Sepsis and always at the back of my mind, there is always this fear that the Horseman of the Apocalypse is gonna come along and say, “Sorry mate your time is up, you’ve got Septicaemia from a bladder infection and your modern antibiotics can’t help, can’t stop it this time” and I am not a worrier but that is always my terror. My bladder dominates my life. Well my bladder and my bowels dominate my life. More so that other aspects of your disability?
Totally, I mean in the Spinal Unit they teach you there are three
things: your bladder, your bowels and your skin. Those are the three things that if you don’t keep on top of those three things, you’re in trouble, you’re going to end up in bed, you’re going to end up back in hospital, those three things you are going to have to master for the rest of your life and they really are like the Three Horseman of the Apocalypse and so I work at them daily. Daily it’s a constant checking, checking, checking. Smelling, checking, checking, smelling the bladder, does it look clear? It totally dominates my life. It is fair to say that there is always a little alarm bell at the back of my mind thinking, is the bladder OK?
You know, and I tap my leg to think, is it running free? And is that more so your bladder than your bowel? Yeah. Yeah. The bladder somehow is more of, how can I say this without sounding doomy, it’s more of a, it feels more like a guillotine hanging over my head, the bladder. I think because of Sepsis. They are all vital organs but the fact that I have a foreign body sitting in my bladder all the time, that I am conscious of, and if I move around too much I can sort of feel it banging against the walls of my bladder. Ok yeah. And that, it’s a constant reminder. I live with that.
If someone had said to me more than five years ago, if somebody had said to me you’re going to spend the rest of your life with something sticking into one of your vital organs to keep you live, and you’re going to be able to feel that, you are going to have to watch that and monitor it, make sure it’s healthy and clear and it’s not infected, I would have looked at them in terror and disbelief and say, “I can’t do that, I can’t go on like that” but one has to go on like that because that’s life, that’s how I survive.

At the Association for Continence Advice we are privileged to have as one of our Patrons Melanie Reid, an award winning writer and columnist at The Times[1], who writes a column every Saturday about her experiences as a paralysed person called The Spinal Column.

In 2010, Melanie was riding a horse, when she fell off and broke her neck at C6/7. It was an incomplete break but she was left doubly incontinent and she spent a year in the Spinal Unit in Scotland learning how to manage having a paralysed bowel and a paralysed bladder.

Your task

Watch this interview with Melanie and reflect on the importance of good bladder and bowel function to a person with a spinal cord injury.

  • Were you aware of the vital role bladder and bowels play in the the overall health of a person with a spinal cord injury?
  • Do you think there is enough recognition of bladder and bowel needs in the general population?

Share your thoughts with fellow learners.


1. Melanie Reid: profile page. The Times website. [Cited 24 August 2018]. Available from:

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Understanding Continence Promotion: Effective Management of Bladder and Bowel Dysfunction in Adults

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