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Thread: Sleeping positions with SP catheter - Is sleeping on stomach okay?

  1. #1
    Senior Member wheeliegirl's Avatar
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    Sleeping positions with SP catheter - Is sleeping on stomach okay?

    Hi. I have an appointment on Nov 9 to have a suprapubic catheter put in and I have a couple of questions, hopefully another woman will answer who has an SP catheter, or someone who is close to a woman who has one.

    I am switching from intermittent catheter due to flap surgery I had back in April, and transferring to my commode chair is causing small skin tears on the scar tissue on my butt. So, best to be safe, I am eliminating the commode chair from my life, and only using it if I have an "accident" and need it to help me clean up my perennial area if transferring to bed to clean up will cause a huge unsanitary mess.

    The thought of using an indwelling urethral catheter long term doesn't sound attractive to me, and my urologist says that it isn't good for long term because it can damage the urethra, cause irritation, infections, etc. etc. etc. Plus, from having one for months, it's hard to keep clean when on my period.

    After 20 years of using a manual wheelchair, I have bad shoulders, and the ONLY comfortable sleeping position I can find is sleeping on my stomach, or simi-side, which the latter is difficult to change position to/from in the middle of the night.

    My questions are:

    1) Will I be able to sleep on my stomach when the SP catheter is put in?

    2) Also, does anyone use a flip-flow valve or catheter plug instead of hooking up to a leg bag during the day? I have a friend who uses a flip-flow valve during the day, and she likes it. My urologist says that she doesn't have any or much knowledge about them, and has no patients who have used one.

    I have ordered a few to try when the catheter is put in. They have to be replaced once a week, and they are really hard to find right now. The company that I use to order most of my supplies (Allegro Medical) hasn't had them in stock, and doesn't know when they will be back, and buying them on the internet is difficult because if you can find a company that is selling them they have jacked the prices up to about $12 a piece.

  2. #2
    Quote Originally Posted by wheeliegirl View Post
    My questions are:

    1) Will I be able to sleep on my stomach when the SP catheter is put in?
    Here is a website from Craig Hospital about bed positioning and pillow placement. You may need to experiment, but the stomach position with pillows spaced above and below the supra pubic stoma might work. Otherwise, there are side positioning suggestions you could use. https://craighospital.org/resources/padding-in-bed

    The smaller and softer the catheter tube the better luck you are going to have sleeping on your stomach. Talk to your doctor and understand what size catheter he will initially place. I'd suggest not placing anything larger than a 16Fr and not increasing that size unless you have problems with clogging or drainage. Sometimes doctors will place a 22Fr or 24Fr supra pubic and that is like having a garden hose sticking our of the stoma. No matter what material the catheter is made of, the larger sizes are always going to stiffer than smaller sizes.

    Poiesis makes a catheter specifically designed for the supra pubic. It is called a Duette and has two balloons with the drainage lumens between the balloons. http://www.poiesismedical.com/products/duette/
    Generally your urologist or a nurse will change your first catheter after 4-6 weeks. After that the stoma channel is healed enough and you or a caregiver will change your catheter. Poiesis will send you free samples (14, 16 and 18 Fr.) to try.

    2) Also, does anyone use a flip-flow valve or catheter plug instead of hooking up to a leg bag during the day? I have a friend who uses a flip-flow valve during the day, and she likes it. My urologist says that she doesn't have any or much knowledge about them, and has no patients who have used one.
    Our SCI nurses do not recommend using a plug or a flip flow valve because in the event that you can't get to a place to empty your bladder, you run the risk of urine reflux back up the ureters and into the kidneys. The plus side of using a plug or flip flow valve is that the bladder has a better chance of maintaining a normal size.

    I have ordered a few to try when the catheter is put in. They have to be replaced once a week, and they are really hard to find right now. The company that I use to order most of my supplies (Allegro Medical) hasn't had them in stock, and doesn't know when they will be back, and buying them on the internet is difficult because if you can find a company that is selling them they have jacked the prices up to about $12 a piece.
    I'm surprised that the flip flow valves have to be replaced once a week. Leg bags only need to be changed once or twice a month, but cleaned daily. I would think that you could clean these valves adequately enough to get through a month. But, I've never used one so I can't speak with any knowledge. There are plugs that I use to plug my catheter when I instill Microcyn or HydroCleanse on a daily basis. These plugs are made of plastic and cost under $1.00 a piece and last indefinitely. See picture below. This one is distributed by Bard, but there are several companies that make similar products


    All the best,
    GJ







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  3. #3
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    I prone sometime go to sleep so far neve a problem I done do pillow as I have no one here to help used both regular cathe now the ducette 18 fr

  4. #4
    Yes, you can prone (lay on your stomach) with a SP catheter. You may need to bridge the area with some pillows or pieces of foam rubber if this tends to pinch your catheter though.

    If you have a neurogenic (spastic) bladder, it is not advisable to clamp the catheter, as this can lead to reflux of colonized urine from your bladder up to your kidneys, cause hydroneprosis, and for those with higher injuries, cause autonomic dysreflexia.

    (KLD)

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    I wanted to do the same thing years ago when I got my suprapubic. My doctor discouraged it – – said it was important to keep things flowing, for the same reasons, I suspect, that the SEI nurse explains. So I with schizophrenia defer to them while I still share that I sometimes wish I had done it that way,, kept my bladder from shrinking. Apparently I do have a neurogenic bladder, but my biggest reason for getting the suprapubic was the inability to physically access the toilet and arrange my clothing.

    There have been times when I’m really relieved I don’t have to get somewhere private or do anything to manage my blotter, when any system I would’ve arranged would have been too complicated. But, if you can feel when you have to go, and just pee through your urethra if the catheter gets clogged or blocked so you don’t have a reflux problem, and draining yourself regularly would not be a practical challenge, I might quietly ask you to go for it and let me know how it goes

  6. #6
    Senior Member wheeliegirl's Avatar
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    I figured I would manage my bladder with the flip flow just the same way I did with IC and go every 5-6 hours. I had bladder aug many years ago so I can hold a little more than the average person, tho I noticed after having the indwelling catheter in my urethra during the 2 years of being in bed attempting to get the wound to heal, my capacity is less than it was before. Though I have been experimenting here at home with the flipflow valve and I think I would have trouble with accessing it to empty unless I used extension tubing and ran it down my leg or taped it to my abdomen, but even then it may not reach a toilet. At least with leg bags they hang low enough, but a full leg bag looks really weird with the huge bulge next to my knee. Im not yet sure what I'm going to do.

    I also have trouble getting pillows positions around me. Ive never been able to get them arranged and always gave up and threw them on the floor. Hopefully it wont be an issue.

    Physiologically is there a certain side that SP needs to be placed because of anatomy? Right verses left? Or does it come down to surgeons preference. How much will the bladder aug influence where it's placed? She did mention to me that it could be difficult to place the SP and it might be necessary to have it put in using radiology or something. I didn't fully understand this part. She said it wasn't that common, but he bladder aug does make it take longer and there are some challenges that wouldn't otherwise come into play.

    Cheers everyone!

  7. #7
    The bladder augmentation probably does have some influence about how the supra pubic is placed. That said, my supra pubic is placed directly below my belly button, by about 3-4 inches, not to the right or left side of that center line.

    All the best,
    GJ

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    Yeah, I have trouble getting my SPC to reach the toilet without risk of spill. However, one of the beauties of the SPC with Flip Flo is that I can very easily drain my bladder into a bottle or container the way guys who intermittent cath often do. Empty 2-litre milk bottles work well for me, I can hold one in position with my knees (my legs work well enough for this) which gives me both hands free to manage the flip-flo (it's definitely a two-handed job for me--three would be better!--especially when the flip flo is new and stiff. It's been suggested that I try leg bag valves, etc, instead of flip flos). I've read of someone on CareCure who uses large ziploc bags to cath into. Haven't tried it myself, but if workable that's a very portable way to make sure you always have somewhere to pee into.

    Disclaimer: I don't have SCI, my SPC was put in purely because of how difficult it was getting to do all those transfers, and I live in New Zealand where the medicos seem a lot more relaxed about Flip Flo use.

  9. #9
    As far as placing the SP, it is advisable that you have some input into the placement of the stoma. make sure that you can easily maneuver it -
    The rest is usually up to the surgeon.

    Good luck! Hopefully this gives you the freedom that you want.

    CKF

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