What kind of care does the CUB Program provide?
The CUB program is a multidisciplinary program and it’s been in place for upwards of ten years. It is served by the Gastroenterology Department, as well as Urology and Neurosurgery and General Surgery. It’s manned by physician specialists under those subspecialties, as well as three nurses: a nurse practitioner for Gastroenterology, myself, and Sandy Quigley, who is our skin care specialist. We see boys and girls with chronic incontinence of the bowel and bladder due to anything with the spinal cord, excluding myelodysplasia – so that includes children with cloacal anomaly, some cloacal exstrophy patients, children who have presented with chronic incontinence and on a work-up we find that they have a tethered cord. So it’s more than just a developmental issue or a kid who’s wetting their pants.
Rosemary Grant, RN, Nurse
The CUB Clinic and GI are huge in helping to manage our patients’ constipation, which will then impact their bladder function. Constipation can make it hard to empty the bladder correctly, and kids who have neurogenic bladder often have neurogenic bowel, and so therefore we need to find a way to optimize their management. For a lot of them, if they’re socially continent, it’s okay for them to be a little bit constipated because then they’re not leaking. So it’s trying to balance that fine line.
The anticholinergics that help relax the bladder also can also lead to constipation, so it really is about finding the right regimen that works with different kids, and then to avoid having constant leaking of one kind or the other.
Rebecca Sherlock, PNP, Clinical Coordinator, Myelodysplasia Program