Recipes for avoiding UTI's

[Lazlo]

I use a new catheter each time, sterile lube and also anti-bacterial "WetOnes" from Playtex to clean off my hands and like Bob Clark emphasizes.....particularly the meatus of the penis. I sometimes find a little bit of dry mucous there.

I get that too, I think the dry stuff is just dried out Surgilube. I forgot to mention, after I cath I try to work some of the excess lube out of my urethra.

One other thing I've noticed with the antibacterial wipes is that they tend to dry out and irritate the skin on the tip of the penis. Since I don't want to push bits of dry skin into my bladder, I have to clean them off, which irritates the skin even more. I haven't figured out a solution to this but I've seemed to find a balance where I can keep things clean without the skin getting too sore.

[bob clark]

Bob, that's a meticulous technique but it must take forever! I agree with you though, keeping bacteria out of the bladder in the first place is the most important part of avoiding UTI.

Theoretically, if your hands are sterile, and the lube is sterile (single use packets), and the catheter is sterile (also single use), then the only way bacteria can get in is by pushing it in from the entrance of the urethra, right? So I take extra care to clean it with an antibacterial wipe first, even getting inside the urethra a bit with it, then I lay the wet wipe underneath my penis. I clean my hands with another wet wipe, open the lube and cath packets carefully and set them on the wet wipe. I clean my hands with purell, pull the catheter out of the package, apply the lube making sure to hold it as far up the catheter as possible, and insert. When I'm done I clean things up with another wet wipe and that's that.

Now I don't have a long track record yet but this procedure works pretty well for me and only takes a couple minutes.

Hi Zero,

Actually it doesn't take much time at all. I can easily hold 1000ccs in my bladder so I only catheterize about 4 times a day. If I drink beer and whiskey (once or twice a month) then a few times more than that. The trick to getting drunk without having to cath so often is drinking a shot of whiskey with every 2 beers... whiskey dries you out and gets ya drunk faster so there's less watery beer drinkin' goin' on! I only drink Samuel Adams Boston Lager now and that has a higher alcohol content than Bud or Miller, etc. More alcohol, less water, less catheterizing.

There's always a dish or two in the kitchen sink that needs washing so that time can't be counted. And the 1 minute water/detergent/bleach solution washing of hands can be cut down to 30 seconds so that's not much time spent doing that either. You should wash your hands often anyway, especially during the flu season. And especially if you push a filthy wheelchair around. There's no such thing as clean handrims or tires unless you disinfect them often.

Then about 15 seconds squirting the H2O2 inside my meatus isn't much time. Then a quick spray of 70% isopropyl alcohol onto the rim of my urinal and onto my hands takes about 10 seconds. Then I give my hands a quick washing/wringing with the alcohol and rinse it off with the bottle of H2O2 that my catheter is in. I need to open the bottle anyway so that only takes about 15 seconds to do. If I inject the H2O2 into my urethra with a syringe and piece of 14fr catheter (I only do it once every other day now) that only takes about 15 seconds too.

What takes so long and is so boring is draining 1000ccs of urine into the urinal. I do my deep thinking at this time! Or almost fall asleep. The rest of the procedure is just what everyone else does after catheterizing... except I give everything on my sink vanity a 5 second spray of Lysol and quickly get the hell outta the bathroom. I don't like breathing that stuff in. I can handle 2-3 packs of cigarettes a day but no Lysol spray... that stuff can kill ya!

When I'm dressed and catheterize I recently started putting a waterproof "chux" pad underneath the towel I use to hold the urinal in place and to keep the H2O2 from getting onto my jeans. That H2O2 will bleach denim and eat the zipper right off the pants. I think I have 6 pairs of 1 month old jeans that have no zippers in them! And the black pair of jeans I had turned grey around the zipper area. Not cool. So the "chux" pad prevents that from happening. The H2O2 doesn't have much effect on cushion covers or terry cloth towels. I don't why... that's just the way it is.

What I always found time consuming was getting a new catheter out of my closet, opening it up, being careful not to touch it in the wrong place before washing my hands with a lot of soap and water, making sure the opened package didn't flip and end up on the floor and every time (okay, 75% of the time) I'd try to drop that damn empty catheter package into the trash can next to my sink, I'd miss. Then I had to bend over and pick it up and place it in the trash! Maybe I'm just a bad aim. Actually, I would just leave it there until I got so tired of looking at it that I'd finally pick it up and put it in the trash can.

It's a bit time consuming to carefully open up those single-use lube packets and hand wipes too. And as you wrote, the hand wipes can be irritating to the delicate tissue of the glans, especially if you get the older or dried out ones! That's a bitch. Put a little alcohol (or whatever disinfectant they use) on those damn wipes you cheap-ass bast*rds! I just squirt the glans, meatus and about an inch of urethra with H2O2.

I bet I can cath faster than you... not counting the time it takes for drainage as volume may vary by person.

What I'm trying to convey is that any procedure gets easier and faster with practice and time. I'm sure (or I think) that Schmeky would agree. It's not a big hassle after you do it for a week or so. I do it while I'm half asleep.

The only problem I see in what you're doing is that you're not getting far enough into the urethra where bacteria can live and multiply at. Bacteria multiply at a phenomenal rate and do so where it's dark, warm and moist. So they have no choice than to travel inward. Other than that your procedure sounds good to me. I might use 2 of those disinfectant wipes as an added precaution and wash my hands thoroughly before applying a hand disinfectant such as Purell or Germ-X.

Bottom line is keeping the bacteria out of our bladders. Whatever achieves this goal is cool by me.

Happy New Years,

Bob.

[Grange]

OK. I have a question for you UTI storm troopers. What kind of cranberry juice do you drink? I have been told the Ocean Spray cranberry juice or any others made from concentrate won't do the trick. I have found a brand that is not made from concentrate. It is unsweetened cranberry juice. It taste like #$%^@#^& and cost a bunch of $$$$$. I buy it and mix it with Ocean Spray so I can stomach and afford it.

What do ya'll drink? (Yep I am from the south.)

I haven't had a problem with UTI's recently but my pee is not the crystal clear shimmering yellow I used to produce. It stays mildly cloudy and a bit smelly. Last time I thought I was getting a UTI I went to my urologist for a C&S. He said the bacteria in my bladder where common for someone who does intermittent catheterization. I guess this is what I have seen reffered to as "colonized". I drink tons of water each day and the above mentioned juice mix with my meals. Right now it ain't broke so I'm not really looking to solve a problem but I respect the wisdom of this forum and want to know what ya'll drink.

I haven't posted alot here but I do learn alot from ya'll. There is alot of wisdom in experiences shared.

Thanks ya'll in advance.
Grange

[SCI-Nurse]

You could probably do better with cranberry capsules. Cranberry juice must be taken in the concentrated (not diluted) form if it is going to help with prevention of sticking of e.coli to the bladder wall, which is what was done in the studies on cranberry juice. Ocean Spray, etc. also is full of sugar, and you can put on a lot of weight drinking the gallon or so daily you need to get an equal amount of cranberry. Cranberry has not been shown to reduce infections from other bacteria.

Also keep in mind that cranberry is full of oxalates, which can predispose you to calcium oxalate stones, one of the more common types found in people with SCI.

(KLD)

[Grange]

Thanks KLD. I do take 6 of the AZO Cranberry pills daily. I used to take 2 a day but was having UTI's Since I went to 6 per day nothing but the mildly cloudy and slightly odoriferous pee as described in my previous post. With the capsules I am taking are you saying I don't need to drink the cranberry juice?

[wtf]

I intermittent cath as well and do not take anything special at all. I've had one UTI in seven or eight years, before that I had a few when I was newly injured. I am curious why they are so common with others.

I'm curious too as I'm the same. I know I don't drink nearly enough as I should, probably 40-50 oz a day and I haven't taken an antibiotic for a uti in atleast 10 yrs. I reuse my catheters and do let them properly dry before using again.

[agnes]

* Zero, I have had the same problem of irritation and the antibacterial wipes (I dont cath, but used the wipes in the past for cleaning myself). My skin used to get extremely irritated. Inspired by one of Bob Clark's posts, I got a prescription and bought Dermacyn:

http://www.mrsanotes.com/mrsa-healin...n-from-oculus/

I use it on toilete paper to wipe, and I also have put it on a spray bottle. THis one is particularly handy just to spray around after some "activity" that may result in bacteria coming close to the urethra. I let it air dry. Again as Bob Clark said in a previous message on this thread, bacteria like dark, warm and moist places.

* I have been taking D-mannose and it seems to work.

* NoDecaf, thanks very much for this thread, it was a brilliant idea!

[Lazlo]

I bet I can cath faster than you... not counting the time it takes for drainage as volume may vary by person.

A cathing duel! Lubed catheters at twenty paces, may the best man win!

You're probably right though, one thing I'm meticulous about is advancing the catheter very slowly. I've had nurses jam the things up in a few seconds but that always made me cringe. I take my time and let light, constant pressure eventually work the catheter all the way up.

[Mona~on~wheels]

So use dermacyn to clean around stoma of suprapubic catheter daily?

[bob clark]

A cathing duel! Lubed catheters at twenty paces, may the best man win!

You're probably right though, one thing I'm meticulous about is advancing the catheter very slowly. I've had nurses jam the things up in a few seconds but that always made me cringe. I take my time and let light, constant pressure eventually work the catheter all the way up.

Hi Zero,

I don't use any lube.... the H2O2 is enough so I'll beat ya to the draw. But I also insert and withdrawal the catheter slowly. You get the feel for it.

I haven't had anyone cath me since my original SCI rehab 28 years ago. But I had a Physician's Assistant shove a cystoscope into my urethra and cut an artery. The blood shot 12 feet across the room and 6 feet up on to the wall. Good ol' Roger the Butcher. The saving grace was that he got blood all over himself. He should have been a plumber, not a Physician's Assistant.

They rushed me in for some barbaric emergency operation to get a Foley installed. There was so much bleeding the doctor couldn't see his way into my bladder as he was was using these long metal spring-like implements. The nurse was squeezing the bags of saline as hard as she could so he could see in there better. They brought in a janitor's bucket to catch all the blood and saline from getting all over the floor. Wouldn't want the doctor to slip and fall and sue me. I could hear it pouring/dripping into it. I got such a severe headache and case of AD that I passed out for a short while. They kept telling me to "Hang in there Bob!". I imagine they had a cystoscope, those metal springs, Foley and the tubing for the saline solution shoved into my urethra all at the same time! It was like a torture session from the Dark Ages.

After they finally got the Foley in there and a couple blood absorbing 4x4s wrapped around my dick they shoved me out the front door and locked it behind me. It was past 5:00PM and they had better things to do. They were so generous because when I asked them for a towel so I wouldn't get any blood on the car seat, they gave me two. They released me while I was still bleeding.

I take back the generosity part. When I received the Medicare bill they had the nerve to charge for a cystoscopic bladder examination which was never done since the cystoscope never got past my prostate and they charged for the emergency surgery that they were the sole cause of. And they charged Medicare and me for the follow-up visit to remove the Foley too. They should have paid me for the pain, damage to my urethra, travel expenses and the inconvenience they caused. Ridiculous. I kept this rendition short since I wrote about it before.

It isn't their urethra, what do they care? They just shove things in there as fast as they can (production) and pull 'em out as though they're starting an ornery lawn mower!

So in 28 years I've never had my bladder cystoscoped. One try was enough for me. Bladder cancer or whatever be damned! If I didn't need a doctor to write prescriptions (gabapentin) I'd never go to one. They're useless in my opinion. When your time is up, it's up.

Bob.