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Anniversary news Sponsorship updates The functioning ... - Astra Tech

Issue No: 20

the magazine for continence product users

from the manufacturers of LoFric ®

select

I N T H I S I S S U E :

Anniversary news Sponsorship updates The functioning bladder Helpline support


Welcome to

Liz & Karen

We all have enough stresses

in our lives and finding a

service that makes life that

bit easier can only be a good

thing! As most of our users will

tell you, Select does just that

– we can deliver any bladder

and bowel products that

you need within a few days

and in most cases get your

prescription, so what could be

simpler?

This is our biggest issue yet of the

magazine and we are celebrating

the 10th Anniversary of Select as

well as LoFric ® and Astra Tech’s 25th

Anniversary – so it is a truly special

year for us. The Medical Matters

feature looks at the Functioning

Bladder, explaining how things should

work and what happens when they

don’t. We are keeping you up to

date on the support we provide to

Healthcare Professionals, product

users, sports teams and associations;

and have more user experiences

and stories then ever to inspire and

encourage you. Mary White and

Stephen Burns are both specialists

in their fields and are available for

you to speak to about medical and

lifestyle issues, so please remember to

give us a call if you are finding things

difficult or want more information.

As always we also have product

information, association news, Select

updates and the Dolphin Club page.

We hope you enjoy this issue and look

forward to hearing your feedback,

ideas and stories for the future.

Freephone: 0800 783 7027

Fax: 01453 791001

Email: select@astratech.com

Post:

Astra Tech Select

Freepost SWC 1804

Stonehouse GL10 3BF

WE WANT TO

HEAR FROM YOU

We really enjoy receiving your letters and

stories and think it adds such value to the

magazine. It helps us to consider new ways to

improve our service and is such a useful tool for

communication – helping those that may be in

similar circumstances. We really appreciate

your involvement and because of that, we

would like to offer each letter writer in the next

edition of Select Magazine a £20 voucher for

a major high street store. So … start sending

in your news and hopefully you will make the

print! Good Luck!

T E A M U P D AT E

We welcome George and Liz to our team of

administrators and they will help you however

possible when you call to request a delivery or

with a query.

2

C O N S U L TAT I O N U P D AT E

Many of you will have received a letter from us in August,

updating you on the consultation and asking for your assistance

in contacting your local MP.

We would like to thank the many

of you who supported us by writing

to your MP and the Health Minister,

Dawn Primarolo.

The consultation closed on 9th

September 2008 and we have

submitted our response to the

proposal. We are now waiting to

G O I N G G R E E N . . .

Being a Scandinavian company,

we are very aware of the impact

businesses have on the environment.

In the offi ce, we recycle 90% of

our paper and cardboard and

even collect all our teabags and

banana peels for composting.

We have an environmentally

friendly water boiler and recycling

bins for glass and plastic.

hear whether the Consultation will be

adapted in any way.

We will keep you informed of the final

result, however the most important

thing for you to know is that Select

will carry on! There will be no charge

to you or drop in service level.

While we try to keep packaging to

a minimum with your deliveries,

we want to ensure the products

are well protected and secure so

that you receive them in the best

possible condition. We also want

to keep waste to a minimum. So if

you fi nd you are not using all the

disposal bags or wet wipes that we

supply, please tell us so that we

don’t keep sending them to you.

Your say … A big thank you to those who received and returned a

recent questionnaire that we sent out to a snapshot of Select customers.

It was fantastic to hear your thoughts on the key aspects of our service

that we have wanted to build on, and helped greatly in our efforts to

implement successful changes to our fi rst class service. Your involvement

is paramount in keeping our service relevant and your point of view will

always be invited and welcomed.


Ordering

with Select

Quick … Simply place your order

by calling our FREEPHONE number to

talk to one of the friendly Select team or

sending a prescription.

Confidential … Your order is

entered into your account on the Select

system which updates your details (all of

which are stored confi dentially).

Efficient … Your order is sent to our

warehouse where your products are

carefully boxed ready for delivery.

SELECT 10 TH

ANNIVERSARY

We are delighted to be

celebrating our 10th

anniversary this year and

hopefully you will have

received a copy of our

Birthday Book with your

delivery.

The service has grown

tremendously in those ten

years and we have seen many

changes. When the service

started we had a few hundred

clients and one person spent half

a day looking after it. Now we

have a team of people working

hard to provide assistance to

thousands of clients.

As well as Select’s birthday, it is

the 25th year for both Astra Tech

UK and LoFric ® . We are not just

ISC specialists on Select though,

we supply all products for

bladder and bowel management

available on prescriptions.

So just give us a call or email if

you want to fi nd out more about

what we can do and how we can

support you.

A big thank you to everyone

who congratulated us on this

milestone and to those who have

sent in their stories and thoughts,

some of which will be featured in

this issue.

“ Congratulations on your birthday – well

done on a brilliantly sensitive and caring

service … Thank You!” Patsy - Select User

Discreet … To ensure that your

delivery remains discreet, we use a nonmedical

national carrier. All deliveries

are made in plain brown boxes so that

no one else will know what they contain.

Delivery… All customer boxes are

collected daily from the warehouse at

5pm for next day delivery. These are

taken to a local depot, allocated by

region and then taken to a depot in your

area. Your order will then be delivered to

you by our carrier the next day*.

First deliveries … To ensure that

you have stock when you arrive home,

your initial order is often arranged by the

hospital on your discharge – remember

that we still require a prescription to

cover this.

*If you order before 3pm, we will try

to ensure next day delivery (excluding

weekends and Bank Holidays). If your

delivery is delayed for any reason,

we will let you know at the earliest

possible time.

0800 783 7027

REMEMBER! Order your bladder and

bowel products a week before you need

the stock. This way, if there is a delay, it

won’t affect your routine.

3


25 years of

clinical excellence

This year has marked the 25th Anniversary of LoFric, and Astra Tech has been

proud to take the opportunity to celebrate the most documented and unique

hydrophilic catheter in the world by commemorating its history of clinical

excellence and looking ahead to the consistent developments of its future.

The Anniversary has been marked in a number of ways:

A S T R A T E C H S TA F F

Astra Tech staff enjoyed an “80’s”

themed party which looked back

to the era the LoFric Story began.

Everyone took the theme very

seriously and made a great effort,

as our picture shows!

B I R T H D AY B O O K

A ‘Birthday Book’ was

commissioned to highlight the

LoFric journey from its

beginnings in 1983

and we hope

you will have

received a

copy in your

delivery.

It is fi lled with

stories from

LoFric users, Astra Tech

staff and healthcare professionals

who discuss how LoFric helps

their patients.

It highlights our educational

initiatives and our partnership

with worthwhile events and causes.

It focuses on the recognised

pioneering work of Astra Tech in the

fi eld of Urology, and our enthusiasm

and commitment to continuing to

develop products that improve the

quality of life for ISC users, without

compromising long-term safety.

S W E D E N

In June 2008, 25 healthcare

professionals were taken to

the Astra Tech Headquarters in

Gothenburg, Sweden, as part

of the celebrations of the 25th

Anniversary.

With almost 24 hour sunlight

to be enjoyed, everyone made

the most of their opportunity to

explore this diverse city and its

picturesque surroundings.

It was a fantastic opportunity for

LoFric customers to network and

exchange stories. They were given

a tour of the production facilities,

a presentation on the evolvement

of LoFric products, it’s clinical

heritage, as well as hearing about

the continued development of the

future of LoFric.

All who participated agreed

that the trip was a celebration of

25 years of clinical excellence

and will have fond memories of

Sweden and their experience.

“ … It was a fantastic trip; we

learned lots and expanded our

knowledge of the products that

we use. Great opportunity also for

extending our ‘networking maps’,

meeting healthcare professionals

from other regions and directorates”

Craig Taylor, Paediatric Urology Nurse

“ This was a great opportunity for

me to see how LoFric operates, and

how the catheters are made. I enjoyed

meeting new and interesting people

and felt very honoured to have been

asked in the first place …”

Carolyn Hall, Urology Nurse Specialist

4


“Many thanks for the latest delivery

of LoFric catheters, received as usual

within a couple of days of posting my

prescription …

I would like to join the many others who

have congratulated you all on achieving

this milestone. I’ve been using LoFric

catheters now in excess of eight years,

and bless the day I was introduced to

them. Indeed, what would life have

been like without them? I dread to think!

Healthcare professionals at the beginning of the 25th

Celebrations in Sweden

In days of old when knights were bold,

ye common serfs had to use stalks of

straw to empty the bladder. Ouch!

The very thought makes me shudder,

so please don’t ever go back to those

days (as if you would!)”

Select User

Astra Tech has been delighted to

hold two In Good Company events

in 2008; both symposia focussing

on MS & Continence – Bridging

the Gap. The fi rst took place in

June, at the Belfry in Warwickshire

and at the time of going to press,

the second event is imminent, being

held at the Novotel in Manchester

in September.

The aim of the symposium is

to bring continence and MS

specialists together and to promote

the best practice in the continence

management of those with MS.

The June meeting had a fantastic

turnout of delegates and feedback

was extremely positive, in relation

to both content and the facilities.

We would like to extend our

gratitude to all those who spoke at

the symposia. We would also like

to thank everyone who attended,

in making these engagements such

a success. The generous feedback

enables us to make future events as

informative and relevant as possible;

which is our aim in the running of In

Good Company events.

Neurogenic

bladder

leaflet

At Astra Tech we

have developed

a new piece of

support literature,

written by healthcare professionals

entitled Bladder Health in

Neurological Conditions. The aim

is to help people with neurological

conditions keep informed

about bladder management

strategies. It is designed to be

used under the guidance of a

healthcare professional, to give

a short overview about bladder

management and to help bridge

the gap between disease-specifi c

care and continence management.

The guide contains useful, practical

advice and also the contact

details of various relevant support

organisations. If healthcare

professionals would like to receive

copies to share with their patients

please contact your local Astra

Tech Product Specialist or call

0800 652 3350, email:

urology.uk@astratech.com.

APPG

At the end of April, the All

Parliamentary Group (APPG) on

Spinal Injury Care was launched

in the Houses of Parliament.

The event was hosted by the SIA

and supported by Astra Tech.

The launch was extremely well

attended by MPs thanks to SIA

members who invited their MPs

to appear. One of the aims of

the Group is to raise the profi le

of SCI services and improve the

resources available, to ensure that

Britain will continue to be a leader

in this fi eld of care. The group will

allow representations to be made

at the heart of government which

will set the scene for SCI Centres

to deliver a lifetime of care and

support.

Astra Tech are very proud to have

sponsored the launch and look

forward to working closely with

SIA in making the important future

developments for spinal injury

care, and to continuing our long

and successful association.

5


Sponsorship

REVIEW

“ When I ski, I am living my

life on an equal footing to

those around me. I do not

feel hindered, disabled or

at a disadvantage. I race

against able-bodied skiers,

ski with them as I used to

and, on the odd occasion,

beat them. Whilst skiing,

I can forget about the

problems of paralysis and

feel as though I am fully

involved in a sport I have

always loved.”

In search of 2010 …

6

We are delighted to support Talan Skeels-Piggins through his journey to the 2010 Winter Paralympics.

Without government or lottery funding the donation is a lifeline; supporting his long-term goal of competing

for his country. Ever motivated, Talan is committed to breaking down barriers, with the help of LoFric,

to reach his dream of a medal.

In March 2003, Talan – an active PE

teacher, former Royal Navy fi ghter

controller and experienced skier –

suffered a motorcycle accident which

shattered his spine and fractured his

neck in several places. The odds of

surviving the accident were initially

estimated at 1 per cent and he was

then given a 30 per cent chance of

recovering from the trauma.

Talan was left paralysed from the

chest-down and told he would spend

up to two years in hospital. Once

again he defi ed expectations to

be discharged only six and a half

months later. In less than a year,

he was back on the ski slopes in

a specially-adapted sit-ski. Weeks

later, he was invited to join the

British Disabled Ski Team and is

now training for the 2010 Winter

Paralympics.

The British Disabled Ski Team

consists of various disabilities:

including blindness, amputees and

those suffering from paralysis. Each

skier competes in the four disciplines

of slalom, giant slalom, super-giant

slalom and downhill. A factor based

on the disability adjusts the racer’s

fi nishing time so that it is the skier’s

ability, not their level of disability,

which will determine the outcome of

the race.

Talan has climbed up the IPC

Downhill ranking to number 5 in

the world and fi nds his time on the

slope inspiring. In addition to his

sporting achievements, Talan has

launched his company ‘Solutions for

Accessibility’ which provides access

consultancy advice to companies;

develops inclusive education

training for PE teachers; and

delivers motivational talks. He has

previously worked at Bath University

Sports Village as Disability Sports

Coordinator; increasing the number

of disabled people using the Sports

Village and developing it as a centre

of excellence for Paralympic athletes.

He has also managed to return to

his passion of PE teaching, working

as a supply teacher in the Bath and

Bristol region.

Importantly, he became the fi rst

offi cer to be retained in the Armed

Forces following paralysis, and uses

his experience to help injured service

personnel to remain part of the

Armed Forces.

Talan’s determination has allowed

him to participate in a wide variety of

sports from waterskiing to kite-surfi ng

and also to travel the world. As an

established LoFric user, Talan fi nds

LoFric ® Primo TM to be invaluable as a

way of managing his bladder whilst

in countries where he is unsure of the

water quality or access to facilities

proves diffi cult.

“Whether I’m travelling abroad for

competitions or for pleasure, the last

thing I want to get is a UTI. In order

to perform on the World Cup circuit,

I’ve got to remain healthy and in top

shape. Water quality can often be

an issue, for one reason or another,

but I find reassurance with LoFric

Primo catheters. It’s a safe and easy

way to make sure I always have the

best protection from infection. Their

clinical research and dedication to

providing the best solutions for bladder

management give me peace of mind,

so I can concentrate on representing

Great Britain or enjoying my holiday.”

Talan will be providing a diary of

his activities to feature on the LoFric

website and in subsequent editions

of Select as we follow his journey

toward his goal; so do look out

for updates from such a dynamic

sportsman and campaigner. For

more information about Talan visit

www.talan.org.uk


BASKETBALL TAKES

CENTRE STAGE …

Astra Tech are very pleased to

be sponsoring the International

Wheelchair Basketball Federation

(IWBF) with the aim of encouraging

and supporting the junior segment

in wheelchair basketball. Working

closely with the IWBF and our local

organisation, the Great Britain

Wheelchair Basketball Association

(GBWBA), Astra Tech are

sponsoring an annual tournament

for the junior team. This is called the

Astra Tech Junior Challenge and will

be held in a different participating

nation each year.

In response to the sponsorship

Christian Thorup, Astra Tech’s Head

of Market Communication said:

‘’Sponsoring this IWBF Europe

initiative, aimed at getting more

young people active within sport,

is defi nitely within our sphere of

interest. The more kids who get the

chance to develop within sport, the

greater the benefi ts for increased

life quality and health. At Astra Tech

we want to contribute what we can

to this.’’

Thrillingly, Astra Tech and GBWBA

are to host the 2009 Astra Tech

Challenge in Stoke Mandeville, the

birthplace of the Paralympic games.

This will offer the United Kingdom

the opportunity to celebrate the

60th Anniversary of wheelchair

sport, at Stoke Mandeville, the

home of wheelchair sport, thus

increasing exposure for wheelchair

basketball and the Paralympic

movement as a whole. This should

help raise the profi le of wheelchair

basketball and be very exciting for

the team and all their supporters.

The GBWBA has a strong junior

league, strong women’s league

and strong national league in

wheelchair basketball with over

850 players competing on a

regular basis.

As the mens and womens teams

battle at the Paralympics in Beijing

we will follow the story of the next

generation of athletes as they reach

for their dreams. Please look out for

the team in future editions as we

will feature the junior team through

our website and forthcoming Select

magazines, introducing you to a

few of the characters and their

stories.

BEYOND

BOUNDARIES

Beyond Boundaries 2008 was held

in Kent in July and Astra Tech was in

attendance over the two days. This

event is aimed at all those with a

disability and there was an excellent

amount of visitors to the exhibition

and conference as in previous years.

The programme was packed full of

interesting and creative sessions;

from ballroom dancing, basketball

and cookery to motivational aspects

and travel ideas.

Astra Tech thoroughly enjoyed

attending this event as always, and

looks forward to participating in

next years … perhaps we shall see

some of you there too!

MS LIFE

The MS Life event took place in

Manchester’s GMEX in March.

A superbly well attended occasion,

and a date which Astra Tech always

enjoys. It was lovely to meet some

of you there.

USER LETTER

To the Editor

Memories of things past are

sometimes vivid, sometimes not so.

Some of my vivid memories are as

a surgical houseman, working in

the urology department, learning

and performing catheterisation on

elderly and not so elderly male

patients. We used Foley rubber

catheters, with “Introducers” and

other hardware. If I caused them

pain and distress, may their ghosts

forgive me.

Time passes, nearly 60 years,

comprising 35 years of medicine

and 20 years of retirement. I then

found myself on the other side of

the consulting room table, with

rather complex prostatic problems

and treatment. My urologist advised

me that I should catheterise myself

early. This suggestion reminded me

of painful (not to me) memories,

but after instruction from the charge

nurse, I started daily catheterisation

with a LoFric catheter. I have to say

that I fi nd it very easy to do, with

very little discomfort.

So much has improved over the

years and those patients faced with

what one might think is a daunting

and possibly painful task – isn’t.

Dr Daniels

General Practitioner (R’td)

Editor: It’s great to hear how

treatment has progressed over

the years from one who has

watched that progression and

experienced the results of unique

technology. We value your

comments and thank you for

sharing with our readers.

7


M E D I C A L M AT T E R S

The functioning bladder

The human body performs many vital functions, one of which is that it continually produces

waste. Some of this is filtered out by the kidneys and empties as urine through the ureters into

the bladder, a muscular bag, which expands and stretches as it fills.

A cycle of events takes place

within the body, which begins

when the bladder fills up. Pain and

stretch receptors in the bladder wall

send impulses up the spinal cord to

the brain which then sends motor

impulses to the bladder, completing

the cycle.

The bladder is a muscular organ

that acts as both a reservoir for

storing urine and as a mechanism

to empty the urine when it is

appropriate. It is made up of a

‘balloon’ type muscle called the

detrusor, which expands upon

filling. The sphincter muscle is

located at the neck of the bladder

and acts as an opening and closing

mechanism. In order for the bladder

to empty, the detrusor muscle must

contract and the urethral sphincter

relax at the same time. At rest,

the sphincter remains closed, thus

maintaining our continence and

keeping us dry. At the bottom of

the sphincter is the urethra through

which urine passes out.

In general the bladder should be

emptied 3 – 4 hourly (6 – 10 times

per day), however, much depends

on how the bladder has been

trained. The amount of urine your

body produces depends on how

much you eat and drink and most

adult bladders should be emptied

at between 350 - 450mls.

As the bladder starts to fill,

messages are sent to the brain.

However, the brain will send other

messages back to the bladder

telling it to ‘hold on’ until an

appropriate toilet is found.

bladder

urethra

The female urinary system

The female urethra is 3 to 5 cm long

kidneys

ureters

When a toilet is found and you are

ready to empty your bladder, the

brain tells the detrusor muscle to

contract and the sphincter ‘opens’

thus allowing you to pass urine.

When you have finished passing

urine, the detrusor relaxes and the

sphincter closes again and remains

closed so that you can remain

dry. It is these functions that may

be impaired. It is also important

to remember that bowel function

can affect the bladder as well.

Generally, both systems have to

work well independently for them

to work well together.

In women, the urethra is fairly short,

only 3-5cm in most cases and is

straight as is runs through the pelvic

floor muscles. However, in men,

the urethra is generally 18-22cm

long and forms an S curve.

The mechanism of emptying your

bladder can go wrong in several

different ways, giving rise to four

basic types of bladder dysfunction.

D E T R U S O R I N S TA B I L I T Y

The detrusor muscle contracts

involuntarily as the bladder fills,

and the signal from the brain fails.

This can result in symptoms of:

• frequency (having to go often)

• urgency (having to go soon)

• urge incontinence (going before

you want to)

• nocturia (going at night)

• enuresis (bedwetting)

Often, detrusor instability is a result

of neurological disease (caused

by congenital abnormality of the

spinal cord), such as a stroke,

multiple sclerosis, spinal cord

injury, diabetes or bladder outflow

obstruction.

G E N U I N E S T R E S S

I N C O N T I N E N C E

This is also called urethral

sphincter incompetence. The

urethral sphincter fails to hold

urine in the bladder, and leakage

occurs. This may only occur when

pressure inside the abdomen rises,

eg: during physical exertion or

coughing. The “stress” associated

with this type of incontinence is

physiological, not emotional.

Stress incontinence can occur in

men as a result of accidental or

surgical damage to the sphincter,

but is much more common in

women. The shorter female urethra

and the physical trauma of childbirth

may be contributory factors.

8


A cross section of the female anatomy

A cross section of the male anatomy

spine

spine

uterus

bladder

pelvic bone

rectum

bladder

pelvic bone

rectum

prostate

urethra

anus

opening of urethra

vagina

anus

penis

opening of urethra

O U T F L O W O B S T R U C T I O N

Partial blocking of the outflow of

urine from the bladder can give rise

to several symptoms:

• frequency

• nocturia

• urgency and urge incontinence

• straining to void

• poor urinary stream

• post-micturition dribbling

Sometimes, there is overflow

incontinence – the bladder fills to

the point where the sphincter can

no longer hold it in.

In severe cases, the bladder cannot

be emptied at all – acute urinary

retention. This is a painful medical

emergency. Usually there is a high

residual volume (significant quantities

of urine) left in the bladder between

attempted voiding. This is a focus for

urinary tract infections, which can

spread up to the kidneys.

The most common cause is prostate

enlargement in men, which occurs

to some degree in all men after the

age of about 50.

Outflow obstruction can also be

caused by urinary tract infection,

or as a result of a urethral stricture

(blockage).

Sometimes, neurological disease

can disrupt the coordination

between detrusor contraction

and sphincter relaxation, so that

the sphincter contracts when the

detrusor contracts.

U N D E R A C T I V E B L A D D E R

In an underactive bladder, the

contraction of the detrusor is

ineffective and the bladder does

not empty properly. The residual

volume of urine builds up, leading

to infections, and often there

is overflow incontinence. An

underactive bladder can be caused

by neurological damage, as in

detrusor instability.

M U L T I P L E D Y S F U N C T I O N

In reality, people with incontinence

do not always fall neatly into one of

these four categories. Sometimes,

there is more than one type of

bladder dysfuction, and one type

can lead to another. For example,

outflow obstruction can lead to

detrusor instability. Genuine stress

incontinence and underactive

bladder often coexist as a result of

the same underlying neurological

problem.

Sometimes there are just symptoms

of frequency and urgency with no

specific cause. This type of nonspecific

incontinence is common in

older people.

TA C K L I N G B L A D D E R

P R O B L E M S

It is very useful to find out how

much your bladder can hold and

recording how it behaves. By

measuring the urine output and how

often the bladder is emptied during

the day and at night, you will be

able to find the optimum capacity

of the bladder. The bladder can

be trained to hold larger amounts

of urine to reduce frequency and

urgency, which can be caused by:

• Beverages – such as tea, coffee,

fizzy drinks and alcohol, which

make the kidneys produce more

urine, giving rise to a frequency

problem.

• Urinary tract infections.

• Our emotional state - frequency

and urgency commonly occur

when we are anxious or

depressed.

• Seasonal changes – hot and cold

weather.

• Constipation – a distended

bowel can press on the bladder

and irritate it.

• Frequent bladder emptying –

becomes a habit, which prevents

the bladder from filling to its true

capacity and causes irritability

and shrinkage.

• Weak pelvic floor muscles – can

cause leakage.

• Certain drug treatments.

Full and thorough assessment is

required if appropriate bladder

management is to be established.

There are different ways of

managing incontinence such as:

1. Bladder training – to gradually

extend the interval between visits

to the toilet.

2. Pelvic floor exercises - to

strengthen the muscles of the pelvic

floor.

3. Drug treatments – available

for most types of bladder

dysfunction.

4. Surgery – available for most

types of bladder dysfunction, but

not always successful.

5. Pads & Sheaths – used to collect

and dispose of urine.

6. Indwelling catheters – left in the

urethra for anything up to 6 weeks.

7. Intermittent self catheterisation

(ISC) – inserting the catheter

to empty the bladder, then

removing it. This is the preferred

type of catheterisation.

For more information, advice or

to speak with our nurse advisor,

please call 0800 783 7027.

9


LoFric Range

LoFric ® Primo TM is small, foldable and discreet and can be opened in several

different ways to suit individual needs and circumstances. With an integrated

water-pocket and a handling aid for hygienic non-touch catheterisation,

LoFric Primo combines convenience with long-term safety.

LoFric ® Hydro-Kit TM II comes with an integrated water sachet,

handling aid and a 1000ml urine drainage bag. It’s small, flexible

and foldable, making it easy to catheterise anywhere.

Catheter Portability

Being able to fold LoFric Primo and LoFric Hydro-Kit II catheters means that it is easy

and discreet to take your day’s supply out with you – and we have made it even easier!

Male pouch

Designed to hold 3–5 LoFric catheters,

along with some wet wipes, this pouch

resembles a camera case that can be

attached to your belt.

Female pouch

Our new leather case looks

just like a purse and will

hold three LoFric catheters

and some wet wipes.

LoFric is our standard

catheter, available

for men, women and

children, in different

types, tips and sizes.

A special LoFric catheter without

drainage eyes - developed

specifically for urethral

dilatation.

10

LoFric ® Plus is made of

PEBA and is a better

alternative for the

environment. It also

provides more flexibility and an

even greater ability to attract water.

The luer-lock on LoFric ® Insti-

Cath TM connects to the syringe,

making intravesical instillations

safer and more convenient.


All bladder and bowel

products

Select supply the majority of bladder and bowel management

products available on prescription.

Select have always been specialists in ISC management, as the LoFric range of catheters are

manufactured by Astra Tech Ltd.

If we don’t have it in stock, we can order it in for you, so why not give us a call to see how

else Select can support you and make life that bit easier…

Products include all ISC catheters, indwelling catheters, sheaths, leg & night bags,

continence accessories (gloves, syringes, solutions) and stoma products.

For more information on any products,

please call us on freephone 0800 738 7027

11


HELPLINE

Because we have 25 years

experience in the theory and

practise of ISC (Intermittent

Self-Catheterisation) we are

confident that we can answer

your questions and help you

to get the best out of the

NHS.

There are many reasons why some

people have to resort to intermittent

self-catheterisation to empty their

bladders. We make and supply

catheters for all; from tiny babies

with congenital problems who will

be lifetime users, to adults who

have sustained injuries to their

spinal cord or developed illnesses

which have altered their bladder’s

ability to empty normally. We also

make and supply catheters to

people who may have to selfcatheterise

for a short time only.

One of these is Gilly. She is a

normal healthy young woman who

gave birth to a beautiful baby boy.

After her baby was safely delivered,

Gilly could not pass urine normally.

Her midwife waited and waited and

then passed a catheter. To Gilly’s

surprise, the midwife drained nearly

two litres of urine from her bladder.

In the days that followed Gilly found

that she still could not pass urine

SUPPORTING

The Select Helpline is as busy as ever with many service users calling in for advice.

naturally and so the hospital staff

showed her how to catheterise herself,

up to eight times a day, using LoFric

Primo catheters. And so, to her

surprise, Gilly left hospital with her

baby, some LoFric Primo catheters and

a prescription for Select.

With each passing day, Gilly felt

the sensation returning and so she

phoned the Helpline to ask whether

she should still catheterise herself.

Because she is now able to pass

urine normally, we suggested that she

pass a catheter last thing at night and

first thing in the morning for a few

more days. This is so that she can

make sure her bladder is completely

empty and, therefore more likely to

remain infection free. Once she finds

that there is very little urine remaining

in her bladder, she can stop using

catheters altogether.

We are happy to report that Gilly,

her bladder and her baby son are

all doing fine.

Mary White

Specialist Continence

Adviser

15 MONTHS

ON AND

STILL HERE

A lot has happened in the 15

months since joining Astra Tech and

the Select team.

My name is Stephen Burns and

being a fulltime wheelchair user

due to a spinal injury 24 years

ago has been challenging to say

the least. However, I do have a

very full and active life, working

fulltime. This wasn’t the case for

the first 18 months due to product

selection for my bladder and bowel

management. Once this was sorted

my life took off and I have now

been working in the continence

arena for 11 years, advising

both end users & healthcare

professionals on bladder & bowel

management from the user

perspective.

Below is a quick snap shot of some

projects I am involved n:

1. Did you know there are11 spinal

units in the UK and this includes

Scotland & Northern Ireland?

Astra Tech sponsored “The Backup

Trust” www.backuptrust.org.uk

a charitable organisation who visit

C R A N B E R R Y R E C I P E

Muffins … Yum!

12

10oz/275g plain flour

3oz/75g brown sugar

2oz/50g caster sugar

2 teaspoons baking powder

1 teaspoon salt, optional

¼ pint/150ml milk

¼ pint/150ml orange juice

¼ pint/150ml oil

1 egg

170g Dried Cranberries

1/2 teaspoon orange zest

75g chopped pecans

Sugar

Preheat oven to 200°C/400°F.

Grease or line a 12-case muffin

tin. Combine flour, sugars, baking

powder and salt in a medium

mixing bowl. In a separate mixing

bowl combine milk, orange juice,

oil and egg.

Add the liquid ingredients to the

dry ingredients, stirring just until dry

ingredients are moist. Stir in Dried

Cranberries and orange zest.

Fill each muffin case 3/4 of the

way full with mixture. Sprinkle the

top of each muffin with pecans and

sugar.

Bake for 18 to 20 minutes or until

golden brown. Leave to cool for 5

minutes in muffin tin then remove

the muffins from the tin and cool

on a wire rack. (Makes 12 muffins)


G YOU…

all the units to teach newly injured

people wheelchair skills. Even after

24 years I learned new skills too.

2. I also present patient

educational programs within the

spinal units which is entitled “Life

after Discharge, 24 years on”.

This contains lots of practical

advice including continence

management from the user

perspective.

3. I went along to exhibit at the

BPA in Birmingham, prior to the

paralympians heading out to

Beijing.

4. I am now working closely with

the Select team, so if you have

any continence issues you need

to discuss, please call, as there

is normally a solution to your

problem. Don’t suffer in silence

as I did for 18 months.

Team Select are renowned for

the great advice they give on the

helpline but sometimes they do get

asked tricky questions about “nonstock

items”.

The Select Team asked me to call

one of our Select customers.

This chap was successfully doing

intermittent self-catheterisation (ISC)

using LoFric Primo during the day,

but at night times he would apply

a penile sheath, connect this to

a leg bag and onto this, he

would connect a two litre night

drainage bag.

During the night he was having

problems with the sheath detaching

from the penis and leakage

occurring. This meant bed sheets

were being washed on a daily basis

and self-confidence shattered.

Firstly, I advised that perhaps the

sheath he was using might not be

the correct size and I arranged

to send a measure guide with a

sample sheath from a different

company. I also asked him to

connect the two litre night drainage

bag directly to the sheath and to

discard the leg bag. The reason

for this method when using sheath

drainage is that a vacuum can

occur between leg bag and night

bag, and the sheath possibly

“blowing off”.

The outcome is that we now have

a very happy chap. The moral

of the story is, Select can help

in most aspects of continence

management, not just in ISC

procedures. If you would like to

talk to me, please call Select

and I will call you back at a time

convenient to you.

Regards

Stephen

Stephen Burns

Key Account Manager

Cranberry juice is believed

to promote the health of

your urinary tract, but please

remember that before

including cranberries in your

diet you should check with

your GP. Cranberries are

not suitable for diabetics or

those using Warfarin.

13


A LIFE DOES GO ON…

Astra Tech are very proud to have sponsored Steven O’Donnell in his recent challenge

to climb Ben Nevis with a 5ft colostomy bag! The Ben Nevis climb is a fundraising

climb and a launch event for The Life Goes On Foundation; a Scotland-wide social

network infrastructure he has created to introduce new ostomates to the available

support networks, manufacturing companies and most importantly to each other.

The foundation makes free designer

pouches for Scottish ostomates

and redistributes donated ostomy

supplies to those in developing

countries and areas of natural

disasters. Steven and the other

participants battled for eight long

hours in the wind, rain, sleet, hail

and snow to make it to the summit.

Steven was diagnosed with

colo-rectal cancer on the 24th

December 2004 and after various

failed treatments, had to have

extensive surgery to remove his

bladder, prostate and rectum. In

March 2008 he underwent major

surgery again to have his urostomy

transformed into an Indiana Pouch,

which must be catheterised every

four hours from a small stoma next

to his pubic bone.

Steven had some problems with the

new pouch until he was introduced

to LoFric:

The catheters kept blocking up

with the lube and I had to carry

a large bladder syringe and lots

of salinated fl uid to fl ush the

blockages. Retention was an

issue back then, often building

up and leaking extensively. It was

quite soul destroying having to

have such a large daily routine

dictating my life just to pass urine.

The urology nurse decided to

have a try at catheterising my

new bladder and came out with a

LoFric Primo catheter. She simply

squeezed the fl uid out of the

sachet attached to the wrapping,

hung it upside down for 30

seconds and catheterised me.

My jaw nearly hit the fl oor, what

a simple idea. From that day forth

my confi dence levels have gone

through the roof.

“ Since that day I have been a

different person: mountain biking,

hill walking, and my canoeing

weekend went without a hitch.

LoFric catheters are so simple to

use and hygienic (as you never

have to touch the catheter with

your hands) that I am confi dent

that my climb of Ben Nevis at the

end of June will pass without any

problems. I intend to catheter

three times on the mountain-side.

Now that I have discovered LoFric

catheters I am ready to take on

the world once more”.

After a successful climb, Steven is

still challenging himself and aims

to complete another hike up Ben

Nevis at the end of August. For

more details about his foundation

please visit:

www.thelifegoesonfoundation.org.uk

Living with a spinal injury.

14

I know it’s hard, but part of human

nature is to adapt and that’s what I

have done.

It was June 17th 2007 and I

was just coming back from a TA

weekend when I was involved

in a road traffi c accident. I was

sent to Middlesbrough Golden

Jubilee Spinal Centre where I was

cared for by the dedicated team

of Doctors, Nurses, Physios and

Occupational Therapists who

were brilliant and motivated me to

where I am now.

Thirteen months on I am in a

wheelchair, I am currently having

some adaptations done to my

house, I am back to work, driving,

and even going out on nights

out. Life doesn’t have to change

because you’re in a wheelchair

or even paralysed. I am doing

everything that I did when I could

walk and more. I now use LoFric

catheters provided by Astra Tech

to empty my bladder, which I fi nd

easy and fast to use so that when

I am out it’s simple. I am 18 and

life still goes on. If you fi nd yourself

wanting to talk you can email me

on scottmsteele@hotmail.co.uk

and please do.

Regards

Scott Steele

Editor: Thank you so much Scott

for sharing your story and your

inspirational determination to

adapt your life and move on.

Thank you also for allowing our

readers to contact and share their

experiences and thoughts. I know

that many will fi nd your point of

view motivational.


The Dolphin Club!

We enjoy reading your letters and

stories so much that we want to

encourage more of you to share

such interesting tales with us.

So we’ve decided that for every

story we print in the next edition of

Select Magazine we will sponsor

a Dolphin on your behalf. More

details will follow in that edition.

In the meantime, get your stories

into us and we’ll look forward to

receiving them! Good Luck!

Spot the

difference

There are 5 differences between the

two pictures. See if you can spot

them all.

YOUR CHANCE TO

SPONSOR A DOLPHIN!

Kirstie, age 5

My mum has helped me to use a catheter since I

was born. I’ve started school this year, so have to

do it myself now. It was hard at first because LoFric

is so slippy, but I use a big grip (Cath-Grip) to help

me hold the catheter.

I am learning to use LoFric Primo, so that I already

have the water I need. I’ve just got the watch to

help me to remember. It vibrates on my wrist so

it doesn’t make a noise. My teacher knows that I

need longer in the loo, so I get extra time. I haven’t

told any new friends yet, but I guess I will if we have

sleepovers.

David, age 14

Hi. I’ve been doing ISC for ages and it has made my

life easier. Before, I had to wear nappies and pads, so

it was great to have something that was really private

and meant I was dry. I love sports, especially football

and swimming, as well as hanging out with my friends.

My best friend knows that I use a catheter but I don’t

want anyone else to know and coz it’s easy to do,

no-one needs to find out.

Please also remember

that if you have any

questions at all about using

your bladder and bowel

products do send them in

and we will get answers to

you as soon as we can!

15


ASTRA TECH IS PROUD TO SUPPORT MANY ASSOCIATIONS A

SIA Aims to

Give Everyone a

Sporting Chance

With preparation for the

2012 Olympic Games

well under way, Spinal

Injuries Association

(SIA) has launched a

brand-new initiative

designed to promote

the benefits of regular

sports participation to

wheelchair users across

the UK.

Over the next two years,

Rebuilding Lives Through Sport

(RLTS) will see an expert panel,

appointed by SIA, award grants

amounting to around £500,000

to clubs, organisations and

charities who can demonstrate a

commitment to the development

of wheelchair sport.

In order to qualify, applicants

must be recognised by the

appropriate governing body

and be able to demonstrate that

at least one wheelchair user is

actively involved in one of 20

paralympic wheelchair sports

recognised by the IPC in 2007.

They will also be expected to

outline plans to promote and

grow their activities with the

ultimate aim of significantly

increasing wheelchair users’

participation.

With the core ethos that ‘life

needn’t stop when you’re

paralysed’, SIA is a unique userled

charity offering wide-ranging

advice, support and services to

anyone affected by spinal cord

injury. With in-depth knowledge

of the manifold benefits of active

sports participation for wheelchair

users, SIA is keen to highlight

that RLTS is not exclusive to spinal

cord injured individuals and that

applications from the broader

disabled community are actively

welcomed.

For further details, full terms and

conditions and an application

form, please call the RLTS Team on:

0845 071 4350 or visit the SIA

website at: www.spinal.co.uk

Launch of the Bladder and

Bowel Foundation

Following months of hard work, the Bladder and Bowel Foundation (B&BF) has now been officially

launched and welcomed by patients, healthcare professionals and organisations alike. These are

exciting and challenging times and the Board of Trustees and the staff are all committed to improving

the help, care, treatment and support available for patients, carers and healthcare professionals.

16

Formed out of InContact and

the Continence Foundation,

B&BF incorporates the objectives

of both organisations. It will

continue to provide information

and support for all types of

bladder and bowel related

problems, both for patients and

professionals and will work in

partnership with other charities

and organisations in the field.

B&BFs brand new website,

developed with input from

noted healthcare professionals,

clinicians and industry will be

a major resource for anyone

looking for information. It offers

easy access to the latest materials

regarding treatments, products,

and management techniques,

whilst keeping users up to date

with research news and policy

developments.

If you would like to know more

about how the Bladder and

Bowel Foundation could help

you or if you are interested in

supporting our services, please

contact us.

General Enquiries:

01536 533255

Nurse Helpline:

0845 345 0165

Counsellor Helpline:

0870 770 3246

www.bladderandbowelfoundation.org


AND ORGANISATIONS

MS Trust

The MS Trust is a charity working with and for the 85,000 people in

the UK with multiple sclerosis. Our vision is to enable people with MS

to live their lives to the full.

We provide:

• information that is tailored to

what people want to know

• education for health

professionals about what

people with MS need

• research into better

management of MS

• support for anyone affected

by MS

Publications

Recent additions to our list of

free publications include Falls:

Managing The Ups And Downs Of

MS, Sexuality And MS: A Guide

For Women and Move It For MS

- our DVD of exercises featuring

Mr Motivator (there is a charge of

£1 for the DVD).

We also have 19 factsheets on a

range of topics including bladder

and bowel symptoms. To keep up

to date, sign up for Open Door,

our free quarterly newsletter.

New look website

The MS Trust’s redesigned website

is packed with new features and

information

• a wide ranging A-Z of MS

• regularly updated news pages

• a comprehensive guide to

research

• maps of MS services around

the UK

• pages focussing on information

for men, women, partners and

for people recently diagnosed

• Stay Active pages containing

a wealth of information about

sports and activities for people

with MS

MS Trust, Spirella Building,

Letchworth Garden City, SG6 4ET

01462 476700

info@mstrust.org.uk

www.mstrust.org.uk

Some 75% of people with

MS experience bladder

problems.

New guidelines; a ‘UK Consensus

on the management of the bladder

in MS’ will be issued later in 2008.

The guidelines will help people with

MS to be referred appropriately,

whatever their level of disability

and wherever they live, and will

recognize that all people with MS

require active treatment to manage

bladder problems.

New treatment for incontinence in MS

A recent research study funded by

the MS Society has helped to deliver

an advance in treatment – botulinum

toxin injected directly into the

bladder muscle. The treatment is

not yet licensed for MS bladder

incontinence, although several

practitioners around the UK have

been trained in its use. However,

if fi rst-line treatment has failed

and the patient can perform selfcatheterisation,

they can ask their GP

for referral to the local urologist to

see if they can offer the treatment.

The MS Society issues a booklet for

people affected by bladder

problems. MS Essential 07:

Managing bladder problems is

available from the MS Society at

www.mssociety.org.uk/

publications or by writing to the

Information Team, MS Society,

372 Edgware Road, London,

NW2 6ND.

Telephone: 020 8438 0799;

email: infoteam@mssociety.org.uk

MSRC (Multiple

Sclerosis

Resource

Centre) is a

national MS charity

committed to supporting

anyone affected by Multiple

Sclerosis. We offer advice, support

and information to anyone who

is living with the disease. We help

carers, family members, partners

and professionals as well as the

person with the disease themselves.

We offer the broadest range of

information through our freephone

helpline, our comprehensive and

interactive website and through

New Pathways magazine, written

by people with MS, for people

with MS.

Our welfare and benefi ts advice is

available through email or on the

telephone.

Our 24hr Telephone Counselling

Service is staffed by people who

either have MS themselves or who

have a familial link to the disease

and is available every day of the year

for anyone who needs to talk about

how they are feeling. The service

receives calls from people who

have MS themselves and from those

close to them who might be having

diffi culty coming to terms with their

diagnosis, or other issues that have

arisen as a result of their MS.

If you want unbiased, honest and

individually tailored information

and support, call or email MSRC

today.

www.msrc.co.uk

0800 783 0518

info@msrc.co.uk

17


ASSOCIATIONS AND ORGANISATIONS continued

‘Enabling people

with spinal cord

injury to surpass

their aspirations’

Registered Charity 1072216

THE BACK-UP TRUST

The Back-Up Trust is a registered charity that supports people with spinal cord injury.

Our residential courses are just one of the services Back-Up offers to spinally injured people.

From drama in Wales to skiing in Sweden, from work skills in Canary Wharf to horse-riding in

Devon, there is something fun yet challenging for every nurse and carer!

18

WHAT’S INVOLVED?

Nurses and carers assist a spinally injured person

with their personal care - so they are able to fully

participate in the activities. Volunteers are as much

part of the group as any other participant and fully

involved in the activities. Back-Up is committed to

meeting the full expense of the place on the course,

including accommodation, meals, course activities

and travel.

Apart from having a fun filled week away in a

beautiful setting with a great bunch of people, the

courses are a fantastic opportunity to extend your

professional development, and to learn about

what’s possible for people with SCI.

NEED TO

GO CARD

The Association for Spina Bifida and

Hydrocephalus has launched a free continence

card to help service users access toilet facilities

more easily.

The aim is that the cards will make it easier for service

users to approach staff in stores and shops, which

don’t have toilet facilities available to the public.

The card is available free

of charge but anyone

requesting one will need to

register their contact details

with ASBAH.

Nurse Grace Nicholson highlights that “anyone in

a rehabilitation post that went on a Back-Up course

would bring so much back with them that could be

used on the wards. I often find myself using skills I

have developed on a course with my patients.”

SOUND INTERESTING?

If you’re interested in experiencing what Back-Up

has to offer or know of a spinally injured person

who you think will benefit from any of Back-Up’s

services then please contact Samantha Byles at

the Back-Up office.

Sam can be contacted on 0208 875 1805 or at

sam@backuptrust.org.uk

Linda Lewis, Helpline Manager, told us: “People with

spina bifida can have continence issues and need to

use the toilet at regular intervals. Having one of our

cards should help them to access a toilet more easily.

Some people are embarrassed about having to

explain their urgency so hopefully the cards will

make their lives easier and give them the confidence

to go out and about more often.”

Anyone wishing to have a ‘Need to Go’ card

should call the Helpline on 0845 450 7755 (local

rate call) or email: helpline@asbah.org.

The helpline can also tell callers about all the

information and advice available from ASBAH on

continence issues, or visit ASBAH’s new website at

www.asbah.org. Alternatively you can write

to Helpline, ASBAH House, 42 Park Road,

Peterborough, PE1 2UQ.


Catheter Support Group

Lorraine Easton, Astra Tech Product Specialist

I have been a Product Specialist with Astra Tech for

nearly nine years and enjoy the varied role immensely.

In the past couple of years I have

become involved with a Catheter

Support Group in my territory.

We meet up about four times a

year and encourage anyone who

handles catheters, i.e. a user or a

carer, to attend.

The aim of the group is to provide

support and share ideas. Initially the

group was joint-coordinated by two

nurse specialists but we have now

handed over the reins to one of the

group who chairs each meeting.

Each time we meet we try to invite a

guest speaker to talk about subjects

of interest to the group.

This particular group have a variety

of medical reasons for using a

catheter but the majority perform

intermittent self-catheterisation.

From my point of view I feel very

honoured and privileged to be

asked to attend each meeting and to

be so involved, as there are so few

groups like these available.

The group use this opportunity to

ask me questions about the products

and service as well as discussing

unique, innovative ideas that they

may have to make improvements. I

then feed everything back to Astra

Tech to see if we can implement any

of these changes.

By attending these meetings the

users get a more personalised

service from myself and the

company, and they now feel

comfortable enough to contact me

directly if the need arises.

The group gives me a unique

opportunity to meet with the end

user; giving me a greater insight

into how our catheters can change

someone’s life for the better.

It’s just a shame that there are not

more of these groups available as

the users, carers, nurses and myself

fi nd it invaluable.

In addition to Lorraine’s

perspective of the great

benefits of this group, we

ask, what’s it like to be a

part of the group itself? …

In January 2004 I started using

LoFric catheters for intermittent

self-catheterisation. These were

recommended by Wendy Naish,

the Nurse Consultant at the

Urology Unit in Epsom Hospital.

My bladder wasn’t emptying

properly and whilst I was delighted

not to be woken at night or to

have to look for a toilet when on

an outing for the day, it appeared

that this was not a bonus. In spite

of Wendy’s endless patience

in instructing me on the use of

catheters, my fi rst attempts almost

reduced me to tears. It was a

comfort to know that Wendy was

at the end of the ‘phone. She

advised me of the home delivery

service provided by Astra Tech

and this has worked well for me

– in fact it has never failed even in

far off Australia! It may be just a

coincidence but since switching to

LoFric Primo catheters I have not

suffered with any further bladder

infections and fi nd them far more

convenient to use.

With all the support that I received

from Wendy I felt duty bound to

support her when she sent a notice

to me about a catheter support

group she was forming. I had no

idea what to expect, went along

in fear and trepidation, and was

pleasantly surprised to fi nd it is a

small mixed group of people living

in the area, with various bladder

problems. Two husbands come to

our meeting in their capacity as

carers for their wives, one other lady

comes as she is a carer looking after

her husband and the rest of us are

best described as mostly being past

our sell-by-date. But we still retain a

sense of humour which is important

and makes it easier to discuss any

bladder/catheter problems in front

of the opposite sex! We have lots of

laughs! We meet at eleven o’clock,

usually on a Monday morning,

four times a year and fi nish about

one o’clock. Wendy and Denise,

Continence Specialists who arrange

for the room at the West Park

Hospital for our meetings are usually

with us, and Lorraine Easton always

attends representing Astra Tech.

The three of them offer invaluable

advice, often on small practical

things. Occasionally we have a

guest speaker which, again, is very

helpful. Personally I can’t remember

ever coming away from a support

meeting without feeling thankful that

my own problems are very minimal,

thankful that there are people like

Wendy, Denise and Lorraine who

are prepared to give their time to

a few of us. I for one always pick

up a few tips from attending the

meetings and hope that they may

long continue.

Support Group Member

“I have been using catheters for

a number of years, when I was

speaking to Julie Lawes, Urology

nurse at Dorchester Hospital.

I said how embarrassing it was

to have to collect them from the

chemist.

She then arranged to have them

delivered directly from you.

You have an excellent delivery

service; your staff are always

very polite, friendly and

understanding. I would like

to thank all concerned for the

wonderful service, it is much

appreciated”.

Select User

19


H O M E D E L I V E R Y S E R V I C E

Feeling free to live the life you want.

Register with Select and we will arrange to deliver your

bowel and bladder products direct to your home.

Simply call us on freephone 0800 783 7027 and one of our friendly

Select team will guide you through the ordering process.

Our nurse advisor can assist if you have any medical enquiries.

We are here to help and make your life easier!

0800 783 7027 email: select@astratech.com

www.astratechselect.co.uk

Astra Tech Limited, Freepost GL73, Stonehouse, GL10 3BF www.astratechuk.com

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