Well that was a different way to spend a Monday morning...

[curiouswombat]

I spent this morning learning how to do Percutaneous Tibial Nerve Stimulation - this involved all of us who are part of the uro-gynae team on the island gleefully, or timidly depending on personality, sticking needles into each other's ankles and then sending an electric current through it!

This was to increase the treatments available to ladies who have over-active bladder problems ('ladies' simply because of the team who have learnt - we do a ladies' waterworks clinic). Part of our ethic is that, wherever possible, we should not ask patients to try something we haven't tried ourselves - so we were all there with our socks off and our trousers rolled up, or our tights off if we were wearing skirts, learning on each other - everyone from the clinic nursing assistant to the consultant - he was the first volunteer.

It was actually a really good morning - and the other staff in the vicinity said our laughter could be heard out on the corridor - they all wondered what we were doing that was such fun! And I can honestly tell patients that, having had it done to me, it tingles a little but really would be quite a nice way to spend half an hour a week for 12 weeks.

There is a really good video on YouTube - here for anyone who is interested.

Comments

[zanthinegirl.livejournal.com]

Very interesting! I've heard of that, but wasn't sure what was involved. Very cool!

[curiouswombat.livejournal.com]

It was more straightforward than I expected - and so we now have to finalise our protocol for who we use it on, and get started!

[alwaysjbj.livejournal.com]

A good laugh is very good for you, and to be able to have that much fun at work is great!

It looks like it works much like the TENS machine I have for my feet, only with needle insertion.

[curiouswombat.livejournal.com]

There are certainly a lot of similarities to TENS - and the needles are so very fine that I really didn't feel it going in at all - neither, I'm glad to say, did the doctor I practised on.

There were many jokes about ticklish feet and then the occasional foot 'jumping' as we inserted the needles and so on, so that it was much more fun than anyone might have expected - and certainly team-building!

[estelcontar1.livejournal.com]

If you hadn't said so, I would never have believed something called Percutaneous Tibial Nerve Stimulation could be all that fun. I believe you though. *g*

[curiouswombat.livejournal.com]

I think you could say that practising on each other was team building... One of the nursing assistants' hands shook all the time - she was so worried about sticking needles into someone - and yet actually she got the needle into place and everything wired up faster than anyone else did!

One of the secretaries came down to take pictures - and one of the doctors insisted on not being in them - so lots of jokes about him being a secret spy etc. as well.

[(Anonymous)]

What about pacemaker patients -- is it forbidden for us because of the electrical current?

[curiouswombat.livejournal.com]

Sadly, at least at the moment, yes - although the trainer pointed out this is actually because no-one wants to do the real-patient research on pace-maker patients, just in case, rather than there being any proof that it would give a problem.

Currently we are only going to be using it on patients that have had no result from, or bad side effects to, both oral and transdermal medication (transdermal being 'patches' - in this case oxybutinin patches - Kentera). The meds are safe with pacemakers if you tolerate them well. Otherwise the next step might have to be botox injections into the bladder wall...

But, hopefully, they might clear PTNS for people with pacemakers eventually.

[pondhopper.livejournal.com]

I admire anybody who can do nursing things but especially stick needles into others. The very thought makes me shake and I have never been able to even treat my pets at home with any sort of injected medication or re-hydration.

It sounds like you had a fun training session.
:D

[curiouswombat.livejournal.com]

These needles were incredibly fine - like jewellery wire - much finer than I had expected. Although, to be honest, I don't have much problem doing every day injections, although I am a bit out of practice as I don't have to do them very often in my current role.

It was a much more fun morning than anyone had expected, really!

[nutmeg3.livejournal.com]

That's both kind of creepy and kind of cool. And actually, when I was doing my PT after my hip replacement, I was kind of jealous of the people who got electro-stimulus therapy. It looked kind of neat. I think the coolest thing, though, is that you guys all did it so you can tell your patients about it from firsthand experience.

[curiouswombat.livejournal.com]

<>It looked kind of neat.

I think this would be quite a pleasant form of therapy - we came to the conclusion that a recliner chair was the easiest place for both nurse/doctor and patient - and then you just sit back for 30 minutes with your book/kindle/ etc!

And we are thinking of using the picture of the consultant lying back getting the needle inserted to prove that it really isn't scary!

[evilawyer.livejournal.com]

That is a very sound and very nice ethic that you and the team follow. It's so easy to say "This will sting a little," but "a little" is entirely subjective. When you know someone has tried it themselves, it doesn't feel so bad even if "a little" is more for you.

[curiouswombat.livejournal.com]

It really does help - anything that we can have a go at we do. This was much less uncomfortable that most of us had expected - so we can be really positive about it.

I am one of the few nurses I know who can discuss self-catheterisation from personal experience!

[winsomeone.livejournal.com]

I think it's great that you guys tried it on yourselves, but I have to ask-inquiring minds just want to know-exactly how big were those needles?

[curiouswombat.livejournal.com]

The needles are about 3 inches long - but not all of it goes in - although I think it needed at least an inch for everyone. But they are incredibly fine - so fine they are bendy. A bit like fine jewellery wire.

[engarian.livejournal.com]

OOOOK! I don't have a problem with accupuncture, but I couldn't even watch past the first 45 seconds of your video without turning it off and shivering. I have extreme needlephobia - don't think this would work well for me.

- Erulisse (one L)

[curiouswombat.livejournal.com]

Actually the needles are like very fine acupuncture needles - but hopefully you'll never have the problem that requires PTNS!

[gwaelinn.livejournal.com]

That actually sounds really cool to me since we supply and train patients to use Transcutaneous electrical nerve stimulation (TENS) units for pain management)--no needles, though! I will have to share this with my boss/friend who is a nurse; I think he'd find it interestin, too. Love that buzzing feeling!
~G

[curiouswombat.livejournal.com]

Please do share it.

It is quite similar to TENS - but we are able to target one nerve in isolation by using the needles - which were much less scary than we thought. There is quite a bit of research now to prove how well it works - and so we can tell patients with conviction that there is an 80% chance of improvement in their condition, and it is really not painful at all.

[inzilbeth-liz.livejournal.com]

Other people's jobs always sound so interesting!

[curiouswombat.livejournal.com]

That bit of it really was - but today's been pretty boring...

[debris4spike]

We had leeches on our ward today - modern nursing!

[curiouswombat.livejournal.com]

Oh - that would be interesting - was it for a skin graft?

[debris4spike]

Yes, I was on the Plastics ward and they get used sometimes on grafts, and on one girl that was having a thumb re-vascularisation.

I just spent the time avoiding them!

[myrhiann.livejournal.com]

Totally fascinating! I wanted to be a nurse.

[curiouswombat.livejournal.com]

As a job it has changed over the years - but I have enjoyed my work almost all the time, which is more than so many people can say.

[cbtreks.livejournal.com]

You can cure overactive bladder by zapping the ankle? (I know that's an extremely simplistic way to put it.) That sounds far better than having to take pills every day. Does 12 weeks of treatment mean no treatment ever again, or can the overactive bladder start up again?

You all are great for trying on yourselves!

[curiouswombat.livejournal.com]

It is one of those things where they are not 100% sure why it work, but it does. Probably the repeated stimulation going into the spinal plexus means that it begins to ignore some of the bladder sensory signals so the motor signals that trigger off the over-activity are not sent so quickly. Or something like that!

12 weeks of treatment is usually followed by 'top-ups' as required - some clinics are doing these once every 3 months, others do them 'on request' which seems to be about every 3-6 months.

[keswindhover.livejournal.com]

I'm sad that this entry doesn't have a photo to go with it.

[curiouswombat.livejournal.com]

Someone did have a camera - I must see if I can get one of the pictures - especially because you asked.