Last week I received a question from a reader. It threw me a bit because I was tempted to put on my “Mommy hat” and say, “No, stop, you don’t want a bladder infection, stay home!” Luckily, I have an adventurous side, as well. I met my husband in Europe and as you can see by this picture, we backpacked. I can completely understand the need to at least try. Let me first share Cara’s question with all of you:
I’m new to your blog. I am 31 years old, and I also suffer from neurogenic bladder and bowel due to a spinal cord tumor that was removed two years ago. My boyfriend and I are planning a three-month backpacking trip to Southeast Asia, and I’m at a loss of how to plan!!! I’m not at [all] worried about intermittent cathing, but I’m worried about how I’ll handle my bowel regimen when I’m not even sure what toilets are going to look like in the various towns we visit. Do you have any connections or resources with anyone who has done a similar trip?
I have never backpacked in South East Asia but I have backpacked enough to know that clean hands are nearly impossible and reliance on your water purifier is very important. My question to you is have you traveled much? Are you ready to work through obstacles and if you need to are you able to pay for medical services?
I did ask a dear friend, Sue, who has done extensive travel to the area. She said that the nicer places have western-style toilets. For the remainder, expect a hole in the ground. She has visited several doctors over the course of her travels. Once she was bitten by a rabid dog (yes, she had to have the shots because there, the people get the shots, not the dogs) and another time she had a sinus infection. Both times she found the doctors competent.
I wrote a letter to David Chancellor from the Underactive Bladder Foundation, a group dedicated to improving lives for those of us with an underactive bladder. I know you wrote that you are interested in backpacking and David’s reply speaks to staying in hotels. I will share this all the same because it has some very useful information.
~From David Chancellor~
I trust you are well and it’s great to hear from you! I agree that this is an important topic from one of your reader’s. Thanks for shooting me an email!
Having traveled near that part of the world (Taiwan, China, Australia), I do have some concerns for your blog reader- but life is meant to be lived and with planning this can work! Her post did get me thinking, so I will ramble a little below . . . .
To answer her question, you’re correct in asking if she has travel experience and maybe more details where she is going. The challenges associated with her travel will mostly depend on the areas she plans to visit. In the big cities or major tourist areas of the more industrialized countries like Thailand, Malaysia, and Indonesia, I am confident she will find adequate restroom facilities nearly anywhere.
*When out and about she can rely on medium and large hotels for good bathrooms, as well as large malls or food chains – these can be googled in advanced and plotted out before leaving. When going to the less industrialized countries, as well as rural destinations, access to large enough restrooms may not be as reliable.
*Heat may also be an issue, as it is hotter and more humid and AC is less widespread than at least I am used to coming from Pennsylvania. In those areas you need to be prepared to rely on yourself and limit situations where you will be away from restrooms or lack privacy. This might mean spending a little more money for accommodations with private bathrooms compared to hostels with eight people per bathroom.
*Also I don’t need to mention that airplane bathrooms are very small and she should be prepared for that. Travel can be very rewarding so it can be worth the challenge, but she should be aware of some of these unique situations.
*Ideally she should bring enough supplies (hand sanitizer, wipes, catheters, and some backup antibiotics) to last the entire trip. Unfortunately, that will mean packing more but that does not have to be a huge burden.
*While there are pharmacies in every country should you need to restock, looking for a specific product in a panic without speaking the language is unpleasant. As a backup – google the translation for brands (or the names of local brands) and names for different goods that you can relay in the local language should you need to restock your supplies.
I have noticed that you have written some insightful blog posts about dealing with neurogenic bladder and bowel while traveling. You should share these in case she has not seen them!
[Feel free to copy any part of what I wrote . . . it’s just some ramblings, no need to credit me!]
Founder, Underactive Bladder Foundation
In conclusion, my suggestions are to make sure that you bring along:
*Catheters that have an extra sterile component, offering a hands-free device for the part of the catheter going into the bladder. An example of this is the catheter described in last month’s blog post. Sometimes I will pack along a condom to use on the finger that I insert the catheter with, to keep it clean.
*Be sure to bring along an assortment of catheters (some will melt in the intense heat)
*The bowel issue can be managed with these items: Antibacterial soap and hand sanitizer. Handy-wipes are a must as well as zip lock bags.
Whatever you do not trust the water!
* Set up a built-in device to help you empty your bladder regularly. Coloplast offers a timing device app for your cell phone that will help you plan cathing intervals. Alternatively, you can get a watch with a little alarm clock to help with a regular voiding schedule. You will have jetlag and so many interesting things to see, but be careful. I you are like me, you do not feel the urge to pee unless your bladder is too full. We want to save our kidneys by going every 4 hours or so.
*Please make sure you bring enough money to be able to visit a doctor, if you need one A good hotel might be a good respite as well, at regular intervals between backpacking trips.
Right now you have a pretty healthy bladder because you are new to using a catheter. As time goes by you might experience more bladder infections. Be sure you bring along some emergency antibiotic. You might talk to an infectious disease doctor to ask for guidance or your trusted urologist for suggestions as well.
Have a good time & PLEASE write back and tell us about your trip.