bowel management programme can have serious consequences for your health and lifestyle. Ask your local spinal unit to write down the details of your bowel care. It is very important for you to recognise that the nurses believe they are acting in your best interests. You should be able to reassure the nurse that manual evacuation is acceptable and appropriate for your individual care needs. Suggesting a consultation or a phone call with someone with more experience in the field of spinal cord injury is helpful most of the time. Its a good idea to always have the number of your local spinal unit to hand.