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Thread: catheter question

  1. #1

    catheter question

    hi spinalnurses, i have been getting a bunch of uti's again lately and i want to find out what options i have in doing my cares. i am so dumb for not doing this back when i had constant infections for 6 months, but i started doing a lot better and kind of forgot about it.

    i go the intermittent route and use the regular clear catheters. we use the "clean" technique and wash the catheter with soap and water before and after each use, and keep the same one for a week.

    how many uti's a year do i have to get before my insurance will pay for a new one for each use? how do i go about getting them if i qualify? (do i need a doctor's letter or do i have to make a pie chart showing the cost effectiveness of keeping me off antibiotics???)

    another question i have is about catheter types. when i came home from rehab i had some of those totally enclosed/contained catheters with the bag connected and i'm wondering if my insurance might be persuaded to pay for those? would i need any more documentation if i try to get that type?

    thanks a bunch guys, melissa

    Life is a lesson you learn when you're through.

  2. #2

    This sucks!

    I'm the same way. I've been having uti's about every month. I use a new cath evertime and still have uti's. Been check for stones and other things, but haven't found anything wrong. I go about 400 to 500cc everytime I cath. I need help too! I'm tired of uti's ever month.

  3. #3
    Senior Member -Andrea-'s Avatar
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    What I do

    I use Mentor CS (Closed System). I use a clean one every time -- your insurance should pay for it! My insurer tried the "cheap" route, but my Dr wrote them and said it was *imperative* that I receive enough every month so I don't have to wash & reuse them.

    Keep me away from the wisdom that does not cry, the philosophy which does not laugh and the greatness which does not bow before children -- Kahlil Gibran

  4. #4
    Senior Member -Andrea-'s Avatar
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    PS

    I used to get UTIs about every month, (even *after* Mitrofanoff/augmentation,) but I have not had one since the beginning of last summer!

    Call that surgeon I told you already!!

    Keep me away from the wisdom that does not cry, the philosophy which does not laugh and the greatness which does not bow before children -- Kahlil Gibran

  5. #5
    Senior Member
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    Hi:

    I managed to get my private insurance to pay for the closed system catheters. I sent them a prescription from my urologist and they covered them with no hassle. After my COBRA coverage private insurance expired I qualified for medicare and had a little bit of a problem. However, after an appeal they covered them as well. Provide as much detail as possible in your request to insurance. I was told to specify, that you have had at least 6 UTI's in the last six months, a doctors letter of medical neccessity (stating you have an sci), and a prescription specifying the amount you need each month. At least that is the type of info that worked for me. Any questions, feel free to ask.

    JP

  6. #6

    Catheters

    Melissa,
    The type of insurance that Tom just switched to is excellent at paying for disposable supplies. Write the letter for your doctor, give it to them on a floppy disk and let them modify and run it on their letter head. List the dates and frequency as well as the amount of time between rebound infections. The more concrete you make it the easier time you will have. Once Tom's new insurance starts, ask to be placed in case management services. The nurses are generally VERY good and see that they can save money by spending it on practical things. If you have any problems, as a Federal employee, Tom can go to OPM and ask to have the file reviewed. The Feds have a 30 day time frame for appeals, as a regular consumer, they can take forever.

    I use straight intermittent caths with few problems. Last year I got a roaring infection that required the hospital and was into both kidneys. My insurance increased the number needed for a 6 month period of time. These days I am self pay, so the week long use is what I do...I just rotate between 4-6 per day, comes to the same number per week, just not using the same cath each time.

    Good luck and hope you are feeling better. Don't get to dependent on that Cipro!!

  7. #7

    Frequent UTI's

    Tigger, the problem you are having may have something to do with how your bladder is working. You may be having high pressures in your bladder without your being aware of them. You may need to catheterize yourself more often. Have you ever had a test called "urodynamics"? You might want to check in with your health care provider to see if you have had this test or if he/she can suggest some strategies to cut down on your infections.

  8. #8
    Senior Member Clipper's Avatar
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    I am wondering if you are treating your infections properly. Anyone who caths will have bacteria present all the time, so a urinalysis will always come back positive. You should only be treating an "infection" if you have significant signs or changes, such as fever, pain, nausea, strong odor or discoloration/cloudiness. Treating an "infection" after every positive urinalysis can lead to immunity from an antibiotic. Urinalysis should always be follwed by a full culture to determine antibiotic sensitivity and bacteria type, but you should consider NOT treating the "infection" unless you have obvious signs. This will benefit you in the long run, and your bank account.

    FYI, I am not a doctor. I am stating my experience only. I am 12 yrs post, C5/6, indwelling catheter.

  9. #9
    Senior Member TD's Avatar
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    Have to agree with Clipper...

    and so does the VA. I figure you can trust the VAs judgement since they have been dealing with SCIs since WWII.
    When you suspect a UTI have it cultured and ask what the bacteria count is. Anything above 100,000 should be treated, otherwise, over time you will develop an immunity to the antibiotics they use to treat you.
    You should also have a second culture done once you have finished the antibiotic to ensure you got the critters. A lot of times a recurrent UTI is one that was not cleared up with the first treatment.

    "And so it begins."

  10. #10

    UTI's

    Tigger,

    have you tried Cranberry Juice? I've been self cath.ing for 16 years probably with a continuous low-grade UTI. The only time it now flares up is if I do something like use an indwelling Folley. If I drink upwards of 100ml Cranberry juice a day the infection seems to keep under control, but if I stop within 2 days I get discharge, pus in Urine and pain from the UTI. This goes in about the same time if I start the Cranberry juice again!

    Works for me, hope it works for you.

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