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Thread: Foley catheter

  1. #1
    Senior Member mattcorregan's Avatar
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    Foley catheter

    Help! Lately I've been waking up in the middle of the night needing to cath. I try to regulate what I drink, getting all of my liquids in before 6 PM, but I still hold my fluids until the middle of the night. It's driving my wife and I crazy because we can't get the sleep we need. Would it be advisable to put a Foley catheter in at night and remove in the morning thus avoiding having to Cath in the middle of the night?

  2. #2
    Mattc - I would not recommend a foley at night. Have you tried to cath just before you turn the lights out for the night? This may reduce the need to catheterize a little later. You might also try to cut your fluid intake by 5 PM and see if that helps. CRF

  3. #3
    I have that problem too. When I was in the hospital I asked my doctor about it and she said your kidneys process better lying down so I would always have that. My Mom gets up at 2 every night to cath me.

    Marie
    Unbroken by the grace of God

  4. #4
    Senior Member mattcorregan's Avatar
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    I always cath before lights out, and I've tried stopping drinking earlier but I still have the same problem. I used to be able to sleep through the night without being cathed, but now I seem to be able to hold less in my bladder. I'm taking more Ditropan because my last urodynamics showed that my bladder pressures were too high. Plus, I'm drinking less because I worried about my bladder overfilling. What kind of risks am I taking by wearing a Foley at night? My wife has a full-time job and she can't continue to be up at night cathing me.

    I feel for you Marie, it's such an aggravation. Everything seems to work against you, a body just tends to dump urine when you're lying down, you would think it would slow down when your metabolism slows.

  5. #5
    MattC - How long has it been since you had your urodynamic studies done? Was the problem you are now experiencing present then? Have you discussed management options with your urologist? If not, I would urge you to do so.

    Decreasing your fluid intake is not necessarily going to help the problem of high pressures in your bladder. That is a function of the neurological deficits, from your SCI, that affect your bladder. An overactive bladder (spasticity) will contract when partly full; the sphincter does not relax as the bladder contracts and thus the bladder cannot empty. This creates dysserngia and there is an increase in pressure within the bladder. I would encourage you to keep your fluids at about 8 8oz glasses daily, to help reduce the risk of UTIs and promote good bowel function.

    The problem with using a Foley is that you do increase your risk of UTIs and your bladder will alternately be continuously drained while the Foley is in place and then emptied intermittently during the day. I would encourage you to discuss, with your doctor, the best management approach for you, your needs and the impact this is having on your lifestyle needs. CRF

  6. #6
    Ask your physician to check your daytime (2PM) and nighttime (2AM) ADH blood levels and urine osmolality. Some people with SCI, esp. with higher injuries, have less ADH levels at night, which is the opposit of what is normal. If this is the case, you may be a candidate for use of DDAVP at bedtime.

    (KLD)

  7. #7
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    I too couldn't go the night without cathing and hated bothering my wife. I now insert a red catheter, tape it to my penis and connect it to a night bag. That way I can drink a glass of water before bed and rehydrate myself without worrying.

  8. #8
    Senior Member mattcorregan's Avatar
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    KLD, I got lost in your lingo -what are ADH blood levels (hormones from the adrenal glands?), how would I get a 2 AM ADH blood level, and what is DDAVP?

    Also, what do you think of 24/7's solution? I would love to not have to wake my wife up every night...

    CRF, I had my urodynamics done about three weeks ago and I had to up my Ditropan another 10 mg. It has helped, I can retain more urine now.

    [This message was edited by mattc on 11-14-04 at 07:52 PM.]

  9. #9
    Mattc - glad to hear that the increased ditropan has helped.

    Re: KLD's post...ADH is antidiuretic hormone and I am not sure about DDAVP. KLD is away until Nov 21; she is periodically checking her emails. Hopefully she will pick up on this post at some time to further explain her suggestions. CRF

  10. #10
    mattc - I was able to contact KLD; here is her reply:

    "Some people with SCI, esp. quads have reverse levels of ADH (antidiuretic hormone) excretion at night for some reason, resulting in high urine output in spite of fluid restriction in the evening. We did a published study on this in the early 1990s (Szollar, Dunn, et al). The treatment is the use of DDAVP, which is usually given as a nasal spray at bedtime. Normally it is used as the drug treatment for diabetes insipidis.KLD"

    I would show this information to your urologist and discuss the options for obtaining a 2 AM blood sample. I would imagine this would either entail a short overnight hospital stay for this....i.e. in a bedtime, out in the morning or to investigate the possibility of blood being drawn by a home health person at 2 AM.

    Hope this helps. CRF

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