KLD -- a question or two

mingo · 06-21-2005, 03:09 PM

Quote:

While this is technically possible for many, it is not advisable. Stagnet urine sitting in your bladder for 9-10 hours is a set-up for developing UTIs, regardless of how you empty your bladder. This includes ABs and is why teachers and nurses (who often don't take the time to go while at work) are notorious for having frequent UTIs.

(KLD)

KLD, this Mitro question has peaked my interest. First, perhaps you could give a quick run down on what a "Mitro" is ... please. Maybe your answer will indicate that I'm not really at such a high risk. (I think you will not be saying this, however.)

Medicare cut me back several years ago on how many condom caths they allowed on a monthly basis. It's basically one a day now. So, trying to get the best cathing out of one changing, we thought the morning was the best time to change. Your opinion on this please.

AND

Hospital stays have generally involved the use of the same condom until somebody either yanks it off or lets it twist and blow. Of course you know these people can not put one on that stays for any length of time. This in turn means a wet bed for hours before its caught. On one occassion I happened to have a nurse from Shepard who confirmed the staff was clueless on this, so what is your suggestion there?

On one hospital exit my urine turned bloody on the day of discharge, but I was past irritated with the place and checked out AMA and pushed fluids at home.

This question of stagnant urine though ... If you can only change once a day, but you reflex void on a fairly constant basis ... is this still a problem?

I mean, it's diluted. Yes, no?

Thank you

Aly · 06-21-2005, 03:21 PM

Here is a link to a thread that should answer most of your Mitro questions. Several people have posted their experiences and questions that they felt were important. There are also several pictures you can look at. Hope this helps.

Mitro thread

www.cawvsports.org
The trick is in what one emphasizes. We either make ourselves miserable or we make ourselves strong. The amount of work is the same. ~ Don Juan Matus

mingo · 06-21-2005, 04:06 PM

Thanks Aly,
I had caught part of that thread. Hard to keep up with all of it here.

Those other questions remain.

SCI-Nurse · 06-21-2005, 05:24 PM

Mitro = Mitrofanoff. A surgical procedure that creates an artificial opening into the bladder from the abdomen. Used for intermittent catheterization. Used more for women than men, but there are some men who have had this done too. You can find a lot more information in the links below.

It is a personal choice what time of day you change an external catheter. May change in the AM so they can do it in conjunction with bathing and skin inspection. Many choose the time based on when they have assistance available if unable to do it themselves. Evening is fine too.

Stagnant urine is often a problem for people who manage their bladder only by reflex voiding. This is because incomplete emptying is common. If you void 100 cc. and leave 100 cc. behind (called post-void residual), that urine will be colonized with bacteria and will only make the additional urine coming into your bladder equally colonized. This is a major problem for those who do not use intermittent cath at least 1-2X daily in addition. More often may be needed.

If you void with high pressures, over time your bladder can get stretched out and "decompensate" which means the muscle becomes less and less effective at voiding completely, and residuals may climb. Total retention can occur over a long period of time.

Most nurses are clueless about the proper use and management of external condom catheters (or anything else related to SCI). Unless they have special training provided through skills workshops or OJT, this is not well covered in nursing school.

When you are in the hospital, you must be your own advocate, or have a family member advocate for you. If you have a planned hospitalization, I ALWAYS recommend visiting the hospital first and speaking with the head nurse or clinical nurse specialist about your specialized needs as well. You should also plan for your special needs by having your physician write orders for specifics.

If you don't get the care you need, ask to speak to the RN in charge of your care (you may be cared for by a CNA, tech or LVN). If this does not resolve the problem, ask to speak to the charge nurse for the unit or floor. Next call the nursing supervisor (nights, weekends and holidays) or the head nurse. You can work your way up to the director of nurses of the hospital. It does no good to complain about your nursing care to your physician. The nurses do not work for nor are they supervised by the physician. You should also know who the patient advocate or representative is at the hospital, and how to reach them.

(KLD)

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06-21-2005, 03:21 PM	#2
Aly Senior Member Join Date: Feb 2005 Location: Radford, Va Posts: 2,112	Here is a link to a thread that should answer most of your Mitro questions. Several people have posted their experiences and questions that they felt were important. There are also several pictures you can look at. Hope this helps. Mitro thread www.cawvsports.org The trick is in what one emphasizes. We either make ourselves miserable or we make ourselves strong. The amount of work is the same. ~ Don Juan Matus

06-21-2005, 04:06 PM	#3
mingo Senior Member Join Date: Feb 2004 Posts: 519	Thanks Aly, I had caught part of that thread. Hard to keep up with all of it here. Those other questions remain.

06-21-2005, 05:24 PM	#4
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,341	Mitro = Mitrofanoff. A surgical procedure that creates an artificial opening into the bladder from the abdomen. Used for intermittent catheterization. Used more for women than men, but there are some men who have had this done too. You can find a lot more information in the links below. It is a personal choice what time of day you change an external catheter. May change in the AM so they can do it in conjunction with bathing and skin inspection. Many choose the time based on when they have assistance available if unable to do it themselves. Evening is fine too. Stagnant urine is often a problem for people who manage their bladder only by reflex voiding. This is because incomplete emptying is common. If you void 100 cc. and leave 100 cc. behind (called post-void residual), that urine will be colonized with bacteria and will only make the additional urine coming into your bladder equally colonized. This is a major problem for those who do not use intermittent cath at least 1-2X daily in addition. More often may be needed. If you void with high pressures, over time your bladder can get stretched out and "decompensate" which means the muscle becomes less and less effective at voiding completely, and residuals may climb. Total retention can occur over a long period of time. Most nurses are clueless about the proper use and management of external condom catheters (or anything else related to SCI). Unless they have special training provided through skills workshops or OJT, this is not well covered in nursing school. When you are in the hospital, you must be your own advocate, or have a family member advocate for you. If you have a planned hospitalization, I ALWAYS recommend visiting the hospital first and speaking with the head nurse or clinical nurse specialist about your specialized needs as well. You should also plan for your special needs by having your physician write orders for specifics. If you don't get the care you need, ask to speak to the RN in charge of your care (you may be cared for by a CNA, tech or LVN). If this does not resolve the problem, ask to speak to the charge nurse for the unit or floor. Next call the nursing supervisor (nights, weekends and holidays) or the head nurse. You can work your way up to the director of nurses of the hospital. It does no good to complain about your nursing care to your physician. The nurses do not work for nor are they supervised by the physician. You should also know who the patient advocate or representative is at the hospital, and how to reach them. (KLD)