SPC: still getting UTI's....

Johan Markwall · 03-16-2006, 01:19 PM

Dear all,

Its been a hard road.

Bladder collapsed a year ago after tapping for 25 years and I got a SPC installed. I posted up here right before I was going in to surgery.

Its been rough getting used to all this, regular hospital visits, total loss of all knowledge how my bladder works, well, everything.

But no more UTI's right? WRONG.

In this year I've had four and that doesn't seem right to me. What am I doing wrong here? I'm drinking like crazy and taking Hiprex daily.

Any thoughts and advice are sincerely appreciated..........

Kindly,

Johan
Stockholm - Sweden

SCI-Nurse · 03-19-2006, 12:43 AM

Unfortunately indwelling catheters nearly always mean more frequent UTIs. I assume you are referring to febrile UTIs, not just positive cultures, which are NOT a UTI and should not be treated.

Are you taking anticholenergic medications to prevent reflux? How much fluids do you drink daily? What type? How do you clean and care for your drainage bags? What type of care are you doing for your stoma? Have you been screened for stones recently?

(KLD)

Johan Markwall · 03-19-2006, 11:18 AM

Thanks for you answer.

I got one UTI with fever shortly after I was at the hospital and changed my supra pubic catheter. Then I've had three more without fever but that have made me completely drained and exhausted, so I had to take Trimetoprim. The bacteria has been Stafylococks.

I have recived two Botox injection but also take 2x5 mg Ditropan daily.

I drink a lot - perhaps 2-3 litres per day, mostly water, 2 cups of coffee and 1 cup of tea in the morning. I use alcoholc sparingly.

I change urinbags once a day, in the morning. I use Conveen which you can empty yourself. I shower every day and rinse the area around the stoma with water then wash with soap and water.

Hope this helps.

Regards,

Johan

lynnifer · 03-19-2006, 12:01 PM

Perhaps a dumb question - what was the symptoms of your 'collapsed bladder?'

Johan Markwall · 03-19-2006, 12:20 PM

Hi L,

High pressure with dysreflexy, headache.

Pardon my lousy english, don't know all the english expressions for the medical terms. Hope you understand anyway.

Regards,

Johan

noryn · 03-19-2006, 01:47 PM

I dont think there is a way to totally prevent UTIs with an indwelling. It just bypasses your body's normal protection. Cleaning the site with soap and water everyday is great. Do you also clean the catheter down to the tube with soap and water everyday as well?

I am not sure of your lifestyle but the healthier you are, the better your body can fight infection. Eating right is extremely important.

Is your Suprapubic going to be forever? After your bladder was repaired can you not go back to intermittent cathing? Has the doctor talked to you about bladder augmentation?

I know it is frustrating but it really sounds as if you are doing a great job. I would definately do as SCI nurse said and investigate if you have anything else going on such as stones. Also hospitals are just dirty--if you spend anytime in there with an indwelling it is almost certain you will get an infection. You say regular hospital visits so I am wondering if that could be a culprit. If there is a reason behind those visits such as illnesses or surgery then your body will be stressed more and much more prone to infection.

Johan Markwall · 03-19-2006, 02:06 PM

Hi noryn,

Thanks for your kind reply.

I take care of myself pretty well, eat right, work out, drink a lot, a lot of anti-decubitus prevention going on. I work as a journalist and have to to work everyday. No time for a sloppy life style. LOL.

Yes, the SPC is here to stay and I'm a C4-C5 so intermittent is no option since I feel is makes me too dependant. Did an x-ray of the kidneys a year ago and no stones.

The hospital visits are when I go in for a cath change, about every 10 weeks or so. And maybe you are right, the infection I got before christmas was after the Botox injection and the one I got now was after a couple of weeks going in for a cath change.

Regards,

johan

Johan Markwall · 03-24-2006, 10:12 AM

top top

SCI-Nurse · 03-24-2006, 03:11 PM

Sounds to me like you are caring for yourself quite well. I agree that if you do not have a fever, bacteria in the urine is usually not treated and not considered a uti. You did report fatigue so it is a judgment call on your clinician wehther to treat this.

What I find important (unless I am misinterpreting) is that your bacteria
is the same each time-staphylococcus. Trimethoprim must have been sensitive to it by culture-but if you have recurrent + cultures with the same bug, it could mean 2 things- you are colonized with this bug and /or the medication is not adequately treating your particular bug/infection.

Your doctor may consider giving you a more potent sensitive antibiotic or look further to see if there are bugs other than the staph that are going untreated.

Keep up the good care. Only a thought-cutting down on the caffeine in the morning may help but perhaps it is essential to jumpstart the morning.

AAD

AAd

03-16-2006, 01:19 PM	#1
Johan Markwall Junior Member Join Date: Nov 2004 Location: Sweden Posts: 11	SPC: still getting UTI's.... Dear all, Its been a hard road. Bladder collapsed a year ago after tapping for 25 years and I got a SPC installed. I posted up here right before I was going in to surgery. Its been rough getting used to all this, regular hospital visits, total loss of all knowledge how my bladder works, well, everything. But no more UTI's right? WRONG. In this year I've had four and that doesn't seem right to me. What am I doing wrong here? I'm drinking like crazy and taking Hiprex daily. Any thoughts and advice are sincerely appreciated.......... Kindly, Johan Stockholm - Sweden

03-19-2006, 12:01 PM	#4
lynnifer Senior Member Join Date: Aug 2002 Location: Windsor ON Canada Posts: 15,311	Perhaps a dumb question - what was the symptoms of your 'collapsed bladder?' __________________ I think over again my small adventures, My fears, Those small ones that seemed so big, For all the vital things I had to get and to reach; And yet there is only one great thing, The only thing, To live to see the great day that dawns And the light that fills the world. Anonymous (Inuit, 19th century) T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

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03-19-2006, 12:43 AM	#2
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,343	Unfortunately indwelling catheters nearly always mean more frequent UTIs. I assume you are referring to febrile UTIs, not just positive cultures, which are NOT a UTI and should not be treated. Are you taking anticholenergic medications to prevent reflux? How much fluids do you drink daily? What type? How do you clean and care for your drainage bags? What type of care are you doing for your stoma? Have you been screened for stones recently? (KLD)

03-19-2006, 11:18 AM	#3
Johan Markwall Junior Member Join Date: Nov 2004 Location: Sweden Posts: 11	Thanks for you answer. I got one UTI with fever shortly after I was at the hospital and changed my supra pubic catheter. Then I've had three more without fever but that have made me completely drained and exhausted, so I had to take Trimetoprim. The bacteria has been Stafylococks. I have recived two Botox injection but also take 2x5 mg Ditropan daily. I drink a lot - perhaps 2-3 litres per day, mostly water, 2 cups of coffee and 1 cup of tea in the morning. I use alcoholc sparingly. I change urinbags once a day, in the morning. I use Conveen which you can empty yourself. I shower every day and rinse the area around the stoma with water then wash with soap and water. Hope this helps. Regards, Johan

03-19-2006, 12:20 PM	#5
Johan Markwall Junior Member Join Date: Nov 2004 Location: Sweden Posts: 11	Hi L, High pressure with dysreflexy, headache. Pardon my lousy english, don't know all the english expressions for the medical terms. Hope you understand anyway. Regards, Johan

03-19-2006, 01:47 PM	#6
noryn Senior Member Join Date: Mar 2006 Posts: 353	I dont think there is a way to totally prevent UTIs with an indwelling. It just bypasses your body's normal protection. Cleaning the site with soap and water everyday is great. Do you also clean the catheter down to the tube with soap and water everyday as well? I am not sure of your lifestyle but the healthier you are, the better your body can fight infection. Eating right is extremely important. Is your Suprapubic going to be forever? After your bladder was repaired can you not go back to intermittent cathing? Has the doctor talked to you about bladder augmentation? I know it is frustrating but it really sounds as if you are doing a great job. I would definately do as SCI nurse said and investigate if you have anything else going on such as stones. Also hospitals are just dirty--if you spend anytime in there with an indwelling it is almost certain you will get an infection. You say regular hospital visits so I am wondering if that could be a culprit. If there is a reason behind those visits such as illnesses or surgery then your body will be stressed more and much more prone to infection.

03-19-2006, 02:06 PM	#7
Johan Markwall Junior Member Join Date: Nov 2004 Location: Sweden Posts: 11	Hi noryn, Thanks for your kind reply. I take care of myself pretty well, eat right, work out, drink a lot, a lot of anti-decubitus prevention going on. I work as a journalist and have to to work everyday. No time for a sloppy life style. LOL. Yes, the SPC is here to stay and I'm a C4-C5 so intermittent is no option since I feel is makes me too dependant. Did an x-ray of the kidneys a year ago and no stones. The hospital visits are when I go in for a cath change, about every 10 weeks or so. And maybe you are right, the infection I got before christmas was after the Botox injection and the one I got now was after a couple of weeks going in for a cath change. Regards, johan

03-24-2006, 10:12 AM	#8
Johan Markwall Junior Member Join Date: Nov 2004 Location: Sweden Posts: 11	top top

03-24-2006, 03:11 PM	#9
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,343	Sounds to me like you are caring for yourself quite well. I agree that if you do not have a fever, bacteria in the urine is usually not treated and not considered a uti. You did report fatigue so it is a judgment call on your clinician wehther to treat this. What I find important (unless I am misinterpreting) is that your bacteria is the same each time-staphylococcus. Trimethoprim must have been sensitive to it by culture-but if you have recurrent + cultures with the same bug, it could mean 2 things- you are colonized with this bug and /or the medication is not adequately treating your particular bug/infection. Your doctor may consider giving you a more potent sensitive antibiotic or look further to see if there are bugs other than the staph that are going untreated. Keep up the good care. Only a thought-cutting down on the caffeine in the morning may help but perhaps it is essential to jumpstart the morning. AAD AAd