In this issue: Intermittent Self-Catheterisation (ISC) ISC explained and the reasons for performing it and how often. Overactive Bladder Syndrome (OAB) A condition in which a person feels the frequent and sudden urge to pass urine. Swim 10 miles in July Challenge update Carolyne successfully completed her 10-mile swim in just three weeks. Affi nity News Issue 12 – Autumn 2023 Member of the
Welcome from our Director 3 New recruits 3 Intermittent Self-Catheterisation (ISC) 4 The team at Manfred Sauer 7 Overactive Bladder Syndrome (OAB) 8 Swim 10 miles in July Challenge update 10 Autumn word search 11 Useful links 12 Pumpkin soup recipe 14 Christmas opening hours 14 Free Home Delivery Service 15 We would love to hear from you 16 Inside this issue 14 4 15 10 8
New recruits Dear reader Welcome to the Autumn edition of Affinity News. It's hard to believe we are heading into Autumn already, where did Summer go? Our Manfred Sauer team continues to expand! It gives me great pleasure to introduce you to our two new recruits. Steve Marriott, our Warehouse Manager, who comes with over 20 years’ experience in logistics and warehouse management, and Sharon Thursby, our Helpline Adviser, who has a wealth of knowledge and experience in care home management and operational training. I am sure you will all join me in welcoming Steve and Sharon to the Manfred Sauer team. The articles in this edition are Overactive Bladder and Intermittent Self-Catheterisation (ISC). Both articles have been written by our Nursing Services Team. I am sure you will find the articles interesting. Carolyne has just completed a 10-mile swim in July to raise awareness and funding for MND Association, our charity for 2023. On the subject of sponsorship events and challenges, the Manfred Sauer team will be climbing Snowdon in September. If you would like to sponsor the team, you can do so via our Just Giving page www.justgiving.com/fundraising/ manfredsaueruk. (See page 10 for QR code to donate.) Your support would be much appreciated. Please do let us know what you would like to see in the forthcoming editions of Affinity News. Send your stories or hints and tips to us by email to [email protected]. I hope you enjoy reading this edition. Kindest regards. Kim Taylor Director & General Manager Sharon joined us in June as a Helpline Adviser here at our Northampton Office. Sharon has a long career in healthcare as a Registered Manager for Nursing and Residential Homes, as well as a trainer in Health and Social Care. Sharon is passionate about providing high-quality responses to customers and ensuring they receive information and support with a friendly ear. Sharon is married with three grown-up children and six grandchildren, that she adores spending time with. Having just moved to the Northampton area, she is enjoying living close to the forest and riding bikes with her grandchildren and husband. Sharon loves dogs, and has two that keep her entertained on walks. She also supports a dog rescue centre. Sharon is enjoying being part of the team, and is committed to providing the best care possible. Sharon Thursby Helpline Adviser My name is Steve Marriott and I am the new Warehouse Manager in the UK. I have over 20 years of logistics experience within the industry and have most recently been involved with recruitment from a logistics perspective. My passion is people and I am thrilled to be joining a business with values that I share and to be able to have a positive impact on people’s quality of life. I have thoroughly enjoyed my Manfred Sauer experience so far and can’t wait for what our journey looks like moving forward. Steve Marriott Warehouse Manager Issue 12 – Autumn 2023 3 Affinity News
Reasons for performing ISC ● Chronic urinary retention/incomplete bladder emptying Some people are unable to empty their bladder completely when they pass urine. This may be due to a neuropathic bladder (when the nerves don’t send a good enough signal) or hypotonic bladder (a stiff bladder that can’t contract) as often experienced with illnesses such as MS, after a CVA/stroke or after having botox treatment into the bladder. Alternatively, it can be caused by a partial obstruction to the bladder outlet. This is usually the prostate being enlarged in men or a narrowed urethra. If a bladder is unable to empty completely for any length of time, it becomes overstretched and loses its muscle tone. If there is a large amount of urine in the bladder, it can cause back-pressure on the kidneys and lead to kidney problems. The risk of UTI is also greater if the bladder is not emptying. It is important to perform ISC frequently enough to prevent these complications. (Please see the frequency guidance on page 6.) ● Acute urinary retention People with acute urinary retention are unable to urinate even though they have a full bladder. This is usually due to bladder outflow obstruction caused by an enlarged prostate. ISC is an alternative to having an indwelling catheter. ● To instil treatments into the bladder ● To prevent stenosis (narrowing) of the urethra – known as urethral dilatation This is performed to prevent strictures in the urethra narrowing thus preventing the need for recurrent surgical procedures. Intermittent Self-Catheterisation (ISC) What is ISC? This is the process of sliding a lubricated straw-like tube, called a catheter, up the urethra to drain the bladder of its contents periodically. Once the urine has drained, the catheter is removed and disposed of. It is quick and easily performed and doesn’t usually hurt – most people find it mildly uncomfortable. Once established, it can be performed in any public toilet although it is usually recommended that you use the disabled toilet when possible as there is a sink in the same cubicle as the toilet which aids good hygiene practice. 4 Issue 12 – Autumn 2023
Requirements for success The person must have the incentive to do it. They must have a good capacity bladder and be able to store urine. They must have the physical capability and good hand dexterity. They must also have the mental ability to understand and remember what to do and when to do it. They must adopt a good hygiene regime. Types of catheters There are a variety of single use catheters available. Some have integral drainage bags which may be needed for people who are immobile. Others are designed to enable you to carry them discreetly and use over a toilet. Male catheters are much longer than female catheters due to the length of their urethras. The size of catheter is important. Your clinician will tell you what diameter of catheter you should use e.g. for patients performing ISC for stricture therapy (known as ISD), you will be asked to use a larger diameter catheter such as a size 16ch or even 18ch. In many cases, the clinician will off er a variety of catheters to try to ensure you have the most comfortable one to use. If you use a home delivery service, it is possible to ask for samples of alternative catheters to try. In the case of urethral dilatation, some catheters are unsuitable due to their fl exibility. Your clinician will be able to advise you. The advantages of ISC: It promotes independence – a person can manage their bladder problems independently. It reduces the risk of recurrent UTI and urethral trauma caused by an indwelling catheter. It reduces the risk of renal impairment. It enables an unrestricted sex life. Promotes a positive body image. Comfort – it is more comfortable than having an indwelling catheter. It enables you to pass urine normally, if able, then drain any excess urine after. Issue 12 – Autumn 2023 5 Affi nity News
In conclusion, ISC is widely seen as a preferred option to having an indwelling catheter due to the reduced risk of infection (UTI) and for the comfort and independence of the patient. It is not an option for everyone and not everyone is willing to try it. The thought of performing intermittent self-catheterisation for the first time can seem very daunting, but many who try it get on very well with it once established in a routine and find it a very easy and painless procedure that can be performed anywhere you would normally pass urine. For urethral dilatation (ISD): Your clinician will advise you, but this is a popular regime: Frequency Period Daily 1-2 weeks Alternate days 1-2 weeks Twice a week 1-2 weeks Weekly Ongoing Voiding/volumes drained Times per day Unable to void Four to five catheterisations a day (keep residual volumes at approximately 500mls) >500mls Three times a day 300-500mls residual Twice daily (morning and evening) 150-300mls Once a day (if less than 150mls for three catheterisations stop ISC and review) Ref, Naish.W 2003 Professional Nurse How often should I perform ISC? Your clinician will advise you. Usually, it depends on whether you can pass urine and, if so, how much is left behind in your bladder after passing urine. The table below is a guide: 6 Issue 12 – Autumn 2023
The team at Manfred Sauer To speak to a member of the team, please contact the helpline on: 01604 595 696 [email protected] Carolyne Tobin Tracy Reed Aga Leskiewicz Terri Dolbey Andrew Harrison Janine Starkey Craig Smith Tom Rust Laura Johnston Carol Hutchings Adrian Serkowski Ellie McBride Tayla Trigg Jason Tate Issue 12 – Autumn 2023 7 Affi nity News
Overactive Bladder Syndrome (OAB) What is it? Overactive bladder syndrome is a condition in which a person feels the frequent and sudden urge to pass urine. It is diffi cult to postpone passing urine when the urge strikes and often leads to urge incontinence. In a normal, healthy bladder the nerve endings attached to the bladder wall pick up when the bladder is fi lling and send nerve impulses up the spinal column to the brain. The brain relays messages to get the person to go to the bathroom. Once ready, the nerves stimulate the sphincter, controlling the exit of the bladder, to relax and the bladder is stimulated to contract to push all of the urine out through this relaxed sphincter. In an overactive bladder, the messages are mixed as if these nerve endings are on ʻhigh alertʼ. This means they fi re off messages frequently and urgently. Investigations: These symptoms can be related to other conditions so thorough investigations need to be carried out. Firstly, a consultation will be held to look into any relevant past medical, lifestyle and medication history. A sample of urine will be tested to check for any abnormalities that may indicate possible infection or diabetes. A physical examination and bladder scan will also be carried out. Urodynamic investigations will usually be carried out. This is a procedure that looks at how well the bladder, sphincter and urethra work to store and release urine. Causes of symptoms: ● Neurological disorders such as Multiple Sclerosis or strokes ● Conditions/injuries aff ecting the spine ● Diabetes ● Urinary Tract Infections (UTIs) ● Hormonal changes during/after menopause ● Conditions aff ecting the bladder – tumours, stones ● Medication ● Incomplete bladder emptying ● Drinking too many known bladder irritants ● Declining cognitive function The eff ects of OAB: ● Embarrassment ● Social/work isolation ● Distress ● Depression/anxiety ● Sexuality issues In an overactive bladder, the brain messages are mixed as if the nerve endings are on ‘high alert’ 8 Issue 12 – Autumn 2023
1. Behavioural Lifestyle changes may be recommended such as: ● Fluid intake - quantity and types of fluid may be recommended. ● Weight loss/healthy weight maintenance. ● Reducing bladder irritant foods and drink – caffeinated drinks, citrus fruit juices, carbonated drinks, alcohol, spicy foods, tomatoes. ● Stop smoking. ● Pelvic floor exercises. ● Timed bladder holding and voiding (bladder re-training). 2. Medication ● Antimuscarinic medications such as Solifenacin, Mirabegron or Oxybutynin. However, these medications can have side effects such as dryness of the mouth and eyes, as well as constipation. ● Vaginal oestrogen which strengthens the muscles and tissues. 3. Intravesical Botox This procedure involves a surgeon looking into the bladder with a scope and inserting several injections of the botulinum toxin into the bladder wall. It is usually carried out under a local anaesthetic. Botulinum toxin binds to the nerve endings and calms down the nerve transmissions/limits muscle contractions. A possible side effect of this is the inability to pass urine or empty the bladder completely when passing urine post-treatment. The patient is, therefore, usually taught how to perform ʻintermittent self-catheterisationʼ (ISC) prior to having this procedure to enable them to self-manage this if needed. Selfcatheterisation is relatively easy to perform and not uncomfortable to do. Intravesical Botox is a recurring treatment as the effects gradually wear off over a period of time. Most people require treatments every 6-8 months. 4. Nerve stimulation Sacral nerve stimulation – A minimally invasive procedure where a stimulator is attached to the sacral nerve. A neurostimulator (approx. the size of a £2 coin) is placed just under the skin in the upper buttock. A thin wire is also connected to the back near the tailbone. It acts a bit like a heart pacemaker and the electrical impulses then stimulate the nerves. This can help reduce the symptoms of an overactive bladder. Percutaneous Tibial Nerve Stimulation (PTNS) – A thin needle is placed through the skin near the ankle usually once weekly for 12 weeks. A maintenance treatment is usually given every 3-4 weeks after. The treatment aims to reduce the symptoms of urgency, frequency and urge incontinence episodes. 5. Surgical options Bladder hydrodistension – A procedure to enlarge the size of the bladder/improve bladder capacity. Bladder removal – last resort. The bladder is removed and a stoma or neobladder is formed. Overactive bladder is more common in women than men. The prevalence of the condition increases with age. Studies vary considerably and reports prevalence anywhere between 3% and 43%. One thing is certain – it is a condition that ‘rules your life’ and people who suffer from it can become mentally depressed and feel very isolated. The aim of this short article is to encourage anyone who feels they have the symptoms to consult their GP in the knowledge there are treatment options available. Treatments: Issue 12 – Autumn 2023 9 Affinity News
10 miles is 644 lengths of a 25m pool, so Carolyne swam 215 lengths per week in three sessions for two weeks and two sessions during the third week. EASY! Completing this challenge has re-kindled her love of swimming and Carolyne now swims regularly, 2-3 times per week. Next year she may take on the Swim the Channel Challenge – 25 miles (in a pool of course)! To donate, please scan the QR code or visit: For further information or support, please contact MND Connect: 0808 802 6262 [email protected] www.justgiving.com/fundraising/manfredsaueruk Registered Charity no. 294354 Manfred Sauer's nominated charity for 2023 is the MND Association. Carolyne successfully completed her 10-mile swim in just three weeks. When agreeing to the challenge, she forgot she had a week away and would be unable to swim! Swim 10 miles in July Challenge update Thank you to everyone who sponsored Carolyne in this challenge. It’s not too late to add to the Manfred Sauer fundraising eff ort – by clicking on the link below you can donate. Every little counts and is greatly appreciated. 10 Issue 12 – Autumn 2023
For the chance to win a £20 voucher all you need to do is complete our Autumn word search. Then identify the missing word and send your entry, along with your name and address to: Newsletter Word Search Manfred Sauer UK Unit 3, The IO Centre, Barn Way, Lodge Farm Northampton NN5 7UW OR Email: [email protected] Competition closes Friday 27 October 2023, T&Cs apply, please see below. Autumn word search ACORN AMBER BREEZY CHESTNUTS CHILLY CRISP GOLDEN HARVEST LEAVES PUMPKIN RAINY RAKE Prize Draw Rules 1. No purchase necessary. 2. The closing date for entries is Friday 27 October 2023. The winner will receive a £20 voucher. 3. The winner will be notified in writing. 4. Entry to the prize draw is free and open to residents of the UK aged 18 and over. 5. Only one entry per person. 6. Employees of Manfred Sauer and their families are not eligible to enter the draw. 7. The winner’s name and county will be available after the closing date by writing to Manfred Sauer. 8. Entry to the prize draw is deemed to be acceptance of these rules. 9. Manfred Sauer reserves the right to amend these rules or withdraw the prize draw at any time without notice if events or circumstances occur outside the control of Manfred Sauer which makes this necessary. 10. The prize draw from all correct entries will take place on Monday 30 October 2023. Win a £20 voucher Answers will be published in the next issue. Summer issue word search solutions Missing word was WARM Name: _________________________________________________ Word Search M D I C F I F A G G J U M G B Z P H R W Z L T J E B P J S E I D D H O I D Q E T D Q P R K J I I A O H N I S F E Y C Q R P M W G U U J C N V H R C C W E N S Y V W Y L L I H C P N U V A G C Q Q O T F Y M P C H E S T N U T S P Z V U O X X Z A R G J B F G W D R T E F T O Z P D Y V J O Z L P N K Y G I A D G I H J V O R D Y H S R A K Y S E V C T S E V R A H D O I S X W S O F B K Z I X H U C T G A G O D Z Q H C G Y Z H O V R F R Y V Z R R T O G S O F Y C Q L Y Y B A U D A C R I F S P A K U O U O I E O K V A W D U Q M I X A W N Z J K Z Z X O F T D N Z V J R S S X J N D L V D U Y E M U R E I M O T J U X I C M U X Y S E V A E L S I G C L G G I G Z D M X O H V S R E B M A B C N I K P M U P M D R V U P Y Z E E R B C I I I S M I B R F F B Find the following words in the puzzle. Words are hidden and . ACORN AMBER BREEZY CHESTNUTS CHILLY CRISP HARVEST LEAVES PUMPKIN RAINY RAKE Autumn word search Name: Phone no: Missing word: Address: Postcode: Name: _________________________________________________ Summer J X R D T V A S V D E U D X H S V P G H K Y X X B F U S X Z K U D B O A G N E S C I N C I P U E R J R Y Q U Y N E X F X Z A E P E J G H J Y S E L E K W E C I G X S Z F S V R X J W F D G I F N W T Y B F S Z L T J M H A U E Y S K M X L T J O S P S S Y H M A R U E W I W F Z T G B P O L L A G N I P M A C S G L Z L F O Y I B K Y A R F U H T R A V E L G S L M M T Y H M Y O X L H K K D Q J F K V D K B E R A U X I Q F S K Q K K U Z F M W K E Y O G H S J Q Y M F Y G N T O T N G U K S F B A V H F C E Q F L Z N Q A D Y A I E N I H S N U S H G C C D O U O X E I R X C R Q U T C Z K B U A B C N O N T P N T J A Q C S W M I A M Q Q D N E E R C S N U S T R B U E Z D V Z E W V U W I Q L V R K D E M W Q Q Q Q Z C D H B L N Q E Q H O L I D A Y U Find the following words in the puzzle. Words are hidden and . BEACH CAMPING FLOWERS HOLIDAY PICNIC SEASHELL SUNGLASSES SUNSCREEN SUNSHINE TRAVEL WAVES Created using Word Search Generator on Super Teacher Worksheets (www.superteacherworksheets.com) Affinity News Issue 12 – Autumn 2023 11
A Age UK Love Later Life www.ageuk.org.uk Tel: 0800 055 6112 Alzheimer’s Society United Against Dementia www.alzheimers.org.uk Tel: 0333 150 3456 ASPIRE Association for Spinal Injury Research www.aspire.org.uk Tel: 020 8954 5759 B Back-Up A National Charity www.backuptrust.org.uk Tel: 020 8875 1805 Bladder & Bowel Community www.bladderandbowel.org [email protected] Bladder & Bowel UK Information & Advice for all on Bladder & Bowel problems www.bbuk.org.uk Tel: 0161 214 4591 Bladder Health UK Living positively with Bladder Illness www.bladderhealthuk.org Tel: 0121 702 0820 Bowel Cancer UK Community www.bowelcanceruk.org.uk Tel: 020 7940 1760 C Cauda Equina UK www.caudaequinauk.org.uk Tel: 0800 989 0053 Cerebral Palsy Support https://www.thebraincharity.org.uk Tel: 0800 008 6417 Colostomy UK (Colostomy Association) Comprehensive Information for Ostomates www.colostomyuk.org Tel: 0800 328 4257 Complete Care Shop An online shop for all your healthcare needs including aids for mobility and toileting www.completecareshop.co.uk Tel: 0333 016 0000 CONTACT For families with disabled children www.contact.org.uk Tel: 0808 808 3555 D Dementia UK Specialist and Compassionate Support www.dementiauk.org Tel: 0800 888 6678 Disability Rights UK (Formerly RADAR) www.disabilityrightsuk.org Tel: 0330 995 0400 E ERIC Expert Paediatric Continence Care www.eric.org.uk Tel: 0808 169 9949 F Fight Bladder Cancer A charity that supports anyone affected by Bladder Cancer fightbladdercancer.co.uk Tel: 0184 435 1621 Useful links 12 Issue 12 – Autumn 2023
I IA – Ileostomy & Internal Pouch Association https://iasupport.org Tel: 0800 018 4724 M Men’s Health Forum To Improve the Health of Men and Boys www.menshealthforum.org.uk Tel: 020 7922 7908 MIND The Mental Health Charity Support and Respect www.mind.org.uk Tel: 020 8215 2243 Mitrofanoff Support Helping you navigate your way through life with your Mitrofanoff www.mitrofanoffsupport.org.uk Tel: 07903 382013 Motor Neurone Disease Association We fund research, improve care and provide support for people with MND, their families and carers. www.mndassociation.org MND connect Helpline: 0808 802 6262 MS Society https://www.mssociety.org.uk Tel: 0800 032 3839 MS Trust Reliable Information about MS www.mstrust.org.uk Tel: 0808 800 8000 P Support with Parkinson’s Disease www.parkinsons.org.uk/information-and-support Tel: 0808 800 0303 Parkinson’s Disease Article published by Pacific Medical Training https://pacificmedicalacls.com/parkinson-disease Prostate Cancer UK prostatecanceruk.org Tel: 0800 074 8383 S Samaritans 24 hours a day listening ear www.samaritans.org Tel: 116 123 Shine Providing specialist advice and support for spina bifida and hydrocephalus across England, Wales and Northern Ireland www.shinecharity.org.uk Tel: 01733 555988 Spinal Injuries Association Helping Spinal Cord Injury people lead fulfilled lives www.spinal.co.uk Tel: 0800 980 0501 The Stroke Association ‘We’re in this together’ www.stroke.org.uk Tel: 0300 330 0740 U The Urostomy Association Assisting People with a Urostomy https://urostomyassociation.org.uk Tel: 01386 430140 V Vanilla Blush Specialist underwear and support garments for continence, hernia support, ostomy etc. www.vblush.com Tel: 0141 763 0991 Issue 12 – Autumn 2023 13 Affinity News
Christmas opening hours Dates Times Friday 22 December Open as usual 9.00am – 5.00pm Monday 25 December (Christmas Day) Closed Tuesday 26 December (Boxing Day) Closed Wednesday 27 December 9.00am – 4.00pm Thursday 28 December 9.00am – 4.00pm Friday 29 December 9.00am – 5.00pm (Stocktake – only emergency orders to be dispatched.) Monday 1 January (New Yearʼs Day) Closed Tuesday 2 January Open as usual 9.00am – 5.00pm Last date to guarantee delivery before Christmas is: Monday 11 December Prep: 10 mins Cook: 40 mins Ingredients: 1 tbsp extra virgin olive oil 1 large onion, coarsely chopped 1 (1.8kg) pumpkin 4 cloves garlic, crushed 1 low-salt chicken or vegetable stock Salt Freshly ground black pepper 120ml double cream Instructions: 1 Heat oil in a heavy soup pot or casserole dish over medium heat. Add onion and garlic and cook until golden. 2 Meanwhile, halve, peel, and scrape out seeds of the pumpkin. Cut into chunks. 3 Add pumpkin chunks and stock to pot. Season with salt and pepper. Bring to the boil, uncovered, then reduce heat to a simmer. Simmer until pumpkin is fork-tender, about 30 minutes. 4 Remove pot from heat and, using an immersion blender, blend mixture until smooth. (Alternatively, let soup cool, then blend in a blender.) Stir in cream and season to taste. 5 To serve, ladle soup into bowls, and garnish with pepper. Pumpkin soup Serves 4 14 Issue 12 – Autumn 2023
Affi nity News To join, please contact: FREEPHONE 0800 999 5596 [email protected] Please have the following information to hand: Name, address and telephone number Date of birth NHS number GP name, address and telephone number Product reference Prescription exemption status (if known) Wash bag containing radar key and ‘Just Can’t Wait’ card are available with fi rst order only. Complimentary items are available with every order. Free Home Delivery Service Join our Free Home Delivery Service and enjoy the benefi ts 20 years’ experience and knowledge in dispensing medical devices. Swift, effi cient and discreet delivery, on a day that suits you. Personalised product customisation. Electronic Prescription Service (EPS) and postal prescriptions welcome. Our Standing Order Service takes the headache out of remembering to place regular orders. We supply all makes of urology, stoma and wound care products Issue 12 – Autumn 2023 15
Manfred Sauer UK, Unit 3, The IO Centre, Barn Way, Lodge Farm Industrial Estate, Northampton NN5 7UW Telephone: Prescriptions: 0800 999 5596 Helpline for advice and samples: 01604 595 696 Email: [email protected] [email protected] [email protected] We would love to hear from you We value each and every one of our customers, therefore, any suggestions for our next edition of Affinity News would be welcome. You can send them via email to: [email protected] or pop them in the post to the address below.