Frederic Foley was a Boston surgeon who invented the catheter around 1930. It is a narrow piece of plastic tubing that is inserted through the urethra and into the bladder. After it is positioned in the bladder then a balloon filled with saline solution is inflated to hold the tube in place. The narrow tube exits the body and is attached to a larger tube, which, in turn, is attached to a collection bag. The whole point and purpose of a Foley catheter is to drain urine out of the bladder, and I may be the only human being on the face of the earth who asks for one.
I was admitted to the Emergency Room and more or less immediately requested a catheter. This always surprises the nurses who say, “Say what? You want a catheter?” You want to have something stuck up your crotch, and you want to drag around a bag of pee? Yup, that’s me; that’s what I want. (I also want colored pencils long enough to draw on the ceiling when I’m lying in bed, but we’ll just take one thing at a time here.)
The reason I want a Foley catheter is because I am weird—er, no, let’s try that again: is because I’m peeing my brains out. Many, many people are willing to stand and attest to the fact that I have no brains; they just don’t know I’ve peed them out. I have—as I have reported so many times that we are all quite sick of hearing it—nephrogenic diabetes insipidus, which is a rare kidney disease caused by a bad psychiatrist prescribing lithium and not monitoring it. The result is that the victim of this bad doctoring puts out a whole lot of urine.
Normal is less than two liters a day. At the time of diagnosis, I was putting out about ten liters. Yeah, that’s terrible. Now I’m down to about six liters a day, which means I have to go to the bathroom three times as often as you do. Now, if you’ve ever been in an Emergency Room then you know that one of the things the nurses are not good about is getting you a bed pan when you need one. Imagine needing it much more urgently and frequently and you’ll understand why I ask for a Foley catheter when I’m in the ER.
So I got a catheter in the ER, which was a relief and a blessing, but they wouldn’t let me keep it after I was moved to Observation or Med/Surg, whichever. And here’s why I wanted to keep it: I was tired. Really, really, terminally tired because, you see, all that getting up and going to the bathroom thing went on all night. On average, I have had to get up and go to the bathroom every two hours for the past ten years. And no, I am freaking not kidding.
Ask the youngest mother you know how she felt the first weeks after birthing her child when she was getting up a thousand times every night. She will look at you with some horror and talk about frustration, despair, exhaustion and seriously wanting to kill people. And she only got it for six weeks or so; I did it for ten years. You cannot imagine; you seriously cannot imagine what it was like, or the damage it did. How long do you think you could survive on nothing but naps?
Before I was hospitalized, it had reached the point that we were looking to get me a lifeline alarm because I realized that what was going to happen pretty soon was that I would get up to go to the bathroom in the middle of the night—I would get up to go to the bathroom several times in the middle of the night—and I would fall and not be able to get up. That’s what was going to happen; it was just a question of time.
In the hospital, it appeared that I was now facing end-of-life issues and the one thing I wanted more than anything else in the way of comfort care was to sleep without having to get up to the bathroom. In short, I wanted a Foley catheter, so somebody ordered it and Brandiss inserted it. Brandiss had been an R.N. for exactly two days (she tells me that I will appear in her memoirs as “My First Catheter”) and she was having some trouble so she called in Christina, the Foley Queen, and the two of them worked together to get the job done. Having one woman pawing around your private parts is something; having two doing it—four hands down there—is something else again. You don’t know what a thrill is until you’ve had this experience.
So then I started to get some sleep. I still slept fitfully and woke frequently, but now I went right back to sleep. And within a week, I started to laugh. It had been a long time since I really laughed out loud and one thing became absolutely clear to me: I wanted a permanent catheter. I wanted to go home with an indwelling catheter so I could sleep all night. Is this too much to ask, I mean, seriously? All this while, we’re working on discharge plans for me and I’m getting the hospitalist du jour. One day’s hospitalist would tell me that she would discharge me with a permanent catheter then the next day’s hospitalist would say he wouldn’t.
This honest-to-God son of a bitch stood by my bedside and said the catheter wasn’t “medically necessary,” to which I replied, “SLEEP ISN’T MEDICALLY NECESSARY?” I don’t get these guys, honest to God. How can a doctor stand there and tell you sleep isn’t necessary? I mean, really, how? Some of these doctors are so incredibly inhuman that it defies description. Or maybe some of them are just sadists making up for how little sleep they got during medical training. (To be continued)