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Thread: Cath Problems

  1. #1

    Question Cath Problems

    Hello, I guess I should give some background since I am new here. I broke my back at age 17 and bruised the cord as well as had some bone splinters, was told I may never walk but managed with allot of PT to get around on my own for many years. I had multiple back surgeries for bone spurs and the last one I had was for lower back pain that would keep me down for days at a time and they fused L1-L5. This was Aug. 7th 1999, things went bad and I was bleeding internally and put pressure on my cord and paralyzed me again. At age 50 I just could not recover as well and ended up in my wheelchair I could get up enough to use a walker and get to my bathroom but not much more. At the end of January my legs finally gave out completely and I could no longer stand and since then my bladder is not giving me much warning as to when I needed to go. I have always used a catheter if we were traveling but never more than 3 or 4 days, last week I decided I was tired of being tied to my bathroom and not able to go anywhere any longer and would go on my catheter full time. After 4 days it plugged up with a milky looking substance and I had to remove it, I have a problem of not drinking enough water and my urine can be quite strong at times. Would this cause the build up in the catheter, I also see small strings of what looks to be blood normally just after installing the catheter and never very much. I found this group during a net search and it seems as though many here are quite knowledgeable about these things and I am not scheduled to see my Dr. till June so any help would be appreciated as I am now tethered to my bathroom again until I figure this out.

    Thanks for listening
    Jyd

  2. #2
    What country do you reside in? If in the USA or Canada, what state or province? This helps us direct you to appropriate resources.

    You need to see a good neurologic urologist, and have some tests done. How your bladder is managed should be based on the results of urodynamics studies, and other tests.

    if you have only used the indwelling catheter for a few months then you probably do not have a small contracted bladder yet). An indwelling catheter is going to increase your risks for urinary tract infections (UTI), stones, and other complications; plus you need to wear a bag all the time when it is installed. And yes, when using an indwelling catheter, you should be trying to drink at least 3 liters of water daily. Do you have any other symptoms of a UTI (fever, chills, flank pain, general malaise)?

    At your level, you should be able to do intermittent catheterization. Intermittent catheterization should be done every 4-6 hours throughout the day, with a goal to not have more than about 450 ml. of urine in your bladder when you cath. This means you may need to watch your fluid intake, and cath more often if you have more to drink (or if drinking a lot of caffeine or alcohol).

    How are your bowels? Problems in this area usually go along with a neurogenic bladder.

    (KLD)

  3. #3
    Quote Originally Posted by SCI-Nurse View Post
    What country do you reside in? If in the USA or Canada, what state or province? This helps us direct you to appropriate resources.

    You need to see a good neurologic urologist, and have some tests done. How your bladder is managed should be based on the results of urodynamics studies, and other tests.

    if you have only used the indwelling catheter for a few months then you probably do not have a small contracted bladder yet). An indwelling catheter is going to increase your risks for urinary tract infections (UTI), stones, and other complications; plus you need to wear a bag all the time when it is installed. And yes, when using an indwelling catheter, you should be trying to drink at least 3 liters of water daily. Do you have any other symptoms of a UTI (fever, chills, flank pain, general malaise)?

    At your level, you should be able to do intermittent catheterization. Intermittent catheterization should be done every 4-6 hours throughout the day, with a goal to not have more than about 450 ml. of urine in your bladder when you cath. This means you may need to watch your fluid intake, and cath more often if you have more to drink (or if drinking a lot of caffeine or alcohol).

    How are your bowels? Problems in this area usually go along with a neurogenic bladder.

    (KLD)
    Thank you for the response. As for draining my bladder, it is not that I can not urinate it is that I only get about a min or so warning before I will go so I don't know if self cath would be the answer I also have a retraction problem which would make it very hard for me to do this on my own along with my being over weight.

    I will talk to my Dr. about the tests you mentioned and see what he suggests.

    I am in the USA and live in Kansas. As for my bowels I need to stimulate and still have to clear myself as I can become impacted very easily but this has been like this for many years now. I don't believe I have a uti as of yet but maybe I am wrong since I had the cloudy substance inside my catheter.

  4. #4
    You still need urodynamics to determine the best way to manage your urgency and also probable lack of full emptying.

    I would also suggest that you see a physiatrist who is expert in SCI care.

    (KLD)

  5. #5
    Quote Originally Posted by Jyd View Post
    Hello, I guess I should give some background since I am new here. I broke my back at age 17 and bruised the cord as well as had some bone splinters, was told I may never walk but managed with allot of PT to get around on my own for many years. I had multiple back surgeries for bone spurs and the last one I had was for lower back pain that would keep me down for days at a time and they fused L1-L5. This was Aug. 7th 1999, things went bad and I was bleeding internally and put pressure on my cord and paralyzed me again. At age 50 I just could not recover as well and ended up in my wheelchair I could get up enough to use a walker and get to my bathroom but not much more. At the end of January my legs finally gave out completely and I could no longer stand and since then my bladder is not giving me much warning as to when I needed to go. I have always used a catheter if we were traveling but never more than 3 or 4 days, last week I decided I was tired of being tied to my bathroom and not able to go anywhere any longer and would go on my catheter full time. After 4 days it plugged up with a milky looking substance and I had to remove it, I have a problem of not drinking enough water and my urine can be quite strong at times. Would this cause the build up in the catheter, I also see small strings of what looks to be blood normally just after installing the catheter and never very much. I found this group during a net search and it seems as though many here are quite knowledgeable about these things and I am not scheduled to see my Dr. till June so any help would be appreciated as I am now tethered to my bathroom again until I figure this out.

    Thanks for listening
    Jyd
    OK I installed my catheter on Sunday and so far the only problem I have is some seepage around the insertion point of the tube. Is it normal to have a small amount? I have just been cleaning it up when I am in the bathroom. Been trying to drink much more water and my urine has cleared up a bunch, so I will keep forcing the fluids. I forgot to mention that I am on some medications that tend to dehydrate me also, Hydrocodone 325/7.5 (5 times a day), Gabapentin 300 mg. (5 times a day), Oxycotin 30 mg. (2 times a day) and Baclofen 10 mg. (5 times a day).

    Thanks again for all the advice.
    Jyd

  6. #6
    I would suggest a consult with an urologist or the nurse in the urologist office who are really comfortable with catheters. you could be leaking if the balloon is not fully filled or if the catheter was not in the bladder and instead in the urethra. also make sure urinary tract infection has been ruled out.

    pbr

  7. #7
    OK I did find a urologist and talked things over and decided I would keep the foley. A few weeks after seeing him I got my first UTI and ended up in the hospital for a few days. My urologist told me that I had become septic and that I had pseudomonas which was one of the worst UTI's to have. Since then we have changed our catheter changing procedure and have had a good summer and fall so far. I am having some bladder spasms this week but that is the first trouble I have had lately.

    I do have a question. How long, do those of you that use a leg bag, use a bag before changing to a new one and what brands do people like? I have been using Hollister and they seem to work pretty good but I get a pin hole leak at the top where the plastic nipple, for the inlet tubing, is welded into the bag after wearing one awhile. I never have a leak while wearing it as I never let it get that full but my wife finds it when flushing out the bags.

    Thank you in advance and Thanks to those that run this forum.

  8. #8
    It depends, some people can change them out weekly but clean them daily and switch out with a larger bedside bag at night. Some people change them out more frequently like daily, every other day or three times a week depending on the bags and frequency of UTIs.

    Hmmmmmm interesting about the pinhole, make sure and check all your bags to make sure it is not a vendor related issue.

    pbr

  9. #9
    Quote Originally Posted by SCI-Nurse View Post
    It depends, some people can change them out weekly but clean them daily and switch out with a larger bedside bag at night. Some people change them out more frequently like daily, every other day or three times a week depending on the bags and frequency of UTIs.

    Hmmmmmm interesting about the pinhole, make sure and check all your bags to make sure it is not a vendor related issue.

    pbr
    I use the larger Hollister leg bag and change to a bedside bag every night. My wife flushes and cleans the leg bag every night and the bedside bag every morning and once a week she uses a bleach mixture to clean them also, this was suggested by my urologist. I have been using one bag for more than one catheter change, I think my first bag was used for about 3 or 4 months. I had no idea they were supposed to be changed so often. As for the pin hole, I never seen the first couple that had the leak but this last one I looked over just now and it is not a pin hole it is torn at the base of the inlet nipple like it had to much weight in the bag. I don't think having the leg strap tight would cause it since they stretch.

    Also does anyone know if the bags are covered by Medicare at all?

    Thanks again to the group and moderators for this great group.

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