Bowels, bladders and sex: Rediscovering life after mountain crash

It's not often you meet someone who gets a round of applause for farting on stage.

"I was giving a talk in London and I had mentioned earlier about my flatulence," Niall McCann says.

He'd explained to the audience that a speed flying accident in 2016 - in which he smashed into the Bannau Brycheiniog (Brecon Beacons) mountains at 50mph - had left him with bladder, bowel and sexual dysfunction.

"And then it happened very prominently and everyone started clapping," he says.

We met for an episode of BBC Radio 4's Inside Health.

In the programme he spoke very candidly - and with surprising humour and positivity - about his accident, the surgery to reconstruct his spine and his remarkable recovery.

One of the things we spoke about was what it's been like for him living with bladder and bowel and sexual problems - the intimate challenges that don't often get talked about.

He says he's happy to talk because "there's stigma and there shouldn't be", and he hopes that by being open maybe he will help others.

And while he recognises many others are less fortunate, as spinal injuries can often cause lasting paralysis, he wants to shine light on things people often deal with silently.

'Trying to be a hero when I was a beginner'

On that day almost eight years ago, Niall decided the conditions were perfect to go speed-flying.

He says it is a bit like paragliding, except that instead of gliding, you run off a cliff and plummet to the ground, but on that day he was "trying to be a hero when I was really a beginner".

Niall accidentally turned a few degrees too far, smashing into the Brecon Beacons mountainside.

• Listen to Inside Health podcast: Bowels, bladders and sex: learning to live after my mountain accident

Niall spent 38 days at the University of Wales Hospital in Cardiff, having operations on his spine and learning how to use his legs again.

The major concern was how much damage had been done to his spinal cord, which is a bundle of nerves that transmits information between the brain and the body. If damaged, there can be a range of problems, including paralysis.

But because Niall had bruised his, rather than cut it, the chance of recovery - although often incomplete - was greater.

There were many considerable challenges in hospital but once home, there were even more adjustments to be made - not least to his relationship and how he saw himself.

"At first I had the overwhelming sense of being utterly dependant. I couldn't reach around my backside - so I couldn't take myself to the toilet," he says.

His wife, mother and brother all helped out.

"This wasn't part of the marriage vows," he reflects, "But they did it without complaining."

There was one particular incident that he credits for giving him motivation to regain his independence in the bathroom.

His mother-in-law, who was a nurse, was due to come round just weeks after the accident.

"So she had wiped many bottoms of course, but I didn't want one of them to be mine," he says.

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Humour aside, learning to live with a loss of control of his bowels was not easy.

"What many spinal cord injury patients do is manually evacuate their bowels - using their hands to pull out whatever is in their rectum at the time," he explains.

"It took a bit of time for me to learn to do this."

One of the funniest moments, he recalls, was a few weeks after the accident when he attempted a pull-up at his mum's house.

"My brother had a pull-up bar on the door-frame.

"Of course I wanted to see if I could do it. So I did very cautiously."

This put pressure on Niall's core so he checked his incontinence pad - and it was empty.

"But my brother was stood right behind me and he watched as I curled out a very large stool on the dining-room floor," he recalls.

'Minor imposition'

Over time, accidents like this became less frequent.

And Niall says while it did not feel good to have them he needed to manage this "by-product" of his accident as best he could.

Now it is just "a minor imposition" that he is mindful of at certain moments.

"For example, when my daughter wants me to throw her in the air, I need to think about when I last opened my bowels."

Another consequence of the damage to the nerves in this area is that he cannot relax his bladder to pee, something he has in common with many people with spinal cord injuries.

Niall now uses an intermittent catheter - a tube that allows him to empty his bladder.

But he thinks many people do not realise that spinal cord injuries often cause lasting problems with your bladder and bowels.

And even less frequently spoken about is sex.

'Stepping into the unknown'

For every spinal cord patient the situation is unique - but for some it is an inability to get aroused and there can be ejaculation issues, he explains.

This has been one of the most challenging aspects of his recovery.

"So much starts afresh in terms of your married life when you come home with a life-changing injury.

"You are learning a lot of new things about each other. It is almost like being teenagers."

At the beginning Niall slept downstairs, because the stairs were a challenge.

But when he was able to climb them, he had mixed emotions,

Downstairs, it turned out, had become a bit of a sanctuary.

"It almost felt like a pressure to go back into cohabiting after having had my own space. That almost felt like stepping into something new and unknown again."

But if you really want to pursue an intimate relationship with your partner - then just trying things and finding out what works is so important, he says.

"And this will probably take some experimentation and some frustration and some embarrassment. But the other person is learning at the same time - you are both learning together.

"I am very lucky at how patient, accommodating and accepting my wife has been," he adds.

In Niall's case, he was warned very early on that having children might be difficult.

So the couple immediately registered for IVF.

Niall says he knows how lucky it is that Phoebe was born three years after his accident.

"If I hadn't had my accident we wouldn't have Phoebe - we would have had another child probably - but we wouldn't have had her, and she is the best thing to come out of this."

Niall acknowledges his recovery has had ups and downs, but he says talking about it has been so important.

"A lot of people don't feel like they can, and I am in the fortunate position of being able to. I hope my openness allows other people to share with their loved ones too."

Inside Health was produced by Gerry Holt