21 June 2012

Posted by DMC on 22 June 2012 in Diary |

For some weeks now Alice and I had been trying to have our commode replaced. Now, in the normal way of things this would not warrant any comment. However, there is an enigma here that needs resolving. The commode with which we were initially supplied doubles up as a shower chair with a reasonably comfortable padded plastic seat. However, it suffers from one fundamental defect, not to put too fine a point on it, the hole is scarcely large enough to cover both points of evacuation!. This being so, we tried using the plastic bottle in conjunction with it, but despite the narrow break in the seat of the front. It was virtually impossible to put the bottle in such a position as to fulfil its function.

Bearing in mind that the male and female anatomy are different and accepting that this was one of those cases where ‘one size fits all’, I specifically asked for a male model. You can imagine my disappointment then, when the new one arrived and was precisely the same as the earlier version, but had a 2 inch plastic frill, all around the under side of the hole, the purpose of which one can only guess as being some sort of insurance that most, or rather hopefully all, the evacuation from the front and the back hit the bucket and did not find its way through the between the padded seat and the receptacle below.

Apart from there being a break in this frill, which coincided with the break in the padded seat at the front, it was potluck as to whether or of the evacuated material found its way into the bucket. Or, put another way I consider this commode was ‘not fit for purpose’. Not being sufficiently familiar with the female anatomy to know whether this padded seat and frill arrangement would do its job, I can only comment on the shortcomings for male patients. One such shortcoming was that when the bucket was inserted or removed it struck the scrotum, which was not very pleasant.

In my case, I am also fearful that any contact with the right hand side of my scrotum, which accommodates my artificial urinary sphincter could knock the valve, which at present seems to be jammed, half open or half shut, the consequences of which would mean reverting to a catheter and leg bag heaven forbid. (See the 13th March & 14 March 2012 entries).

Bearing in mind that when ordering my replacement commode initially I specifically asked them for one suitable for males, you can imagine my disappointment therefore when the replacement chair arrived except for this 2 inch wide gap in the front of the padded seat and there was also a break in the frill in the same position. These modifications in no way improved using a bottle at the same time as using the commode.

Having said that one of our Ross Nursing carers informed me that one of her patients had a male commode, which had a larger, more accommodating, hole!, but it’s only drawback being that it did not have a padded seat, but could still be used as a shower chair. I would have expected my Occupational Therapist (OT) to be aware of the availability of such an important item of equipment. I telephoned my OT explaining, yet again, the problem I was having with this commode. She was rather sharp with me and said that was only one that the NHS provided. I agreed that had I been endowed with a 12 inch long penis it might well have been possible to use the urine bottle in conjunction with this, but sadly I did not meet this specification, not even before my radical prostatectomy (when my urologist surgeon had pointed out, post operatively, “that there would be some inevitable forshortening!” This might have been a bit strong for some carers that these OT’s were pretty tough lot and had been weaned on ‘Grey’s anatomy’!There was obviously no point in arguing with her without having ascertained some positive facts, so I said fine, I will take the matter up myself.

I telephoned Ross Nursing’s Office and ask them if they would be kind enough to find out which of their patients had this male version with the larger hole, and at the same time ascertain that it was provided by the NHS, and I would take up the matter with the next level up from the OT’s. Frankly, this is a ridiculous state of affairs that no sick patient should have to get involved in and sort out for themselves. The whole point of the OT, as I understood it, is to deal with such problems

Clearly this whole sorry mess occurred through a  failure to communicate , in many cases the true meaninghaving been lost in translation . Click here to see some  instances of this type of failureto communicate .

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