http://i160.photobucket.com/albums/t172/ShakeyMarble/help.jpg
I have been having a running battle with Cather's. Being a man I first tried the condom Cather's. These worked for about 2 months. Irritation to the glue developed and I was forced to go to a permanent (30 day change rate) Cather. I have been on these for about 8 months.
I started to develop bladder spasms about 45 days ago where I would feel like I needed to pee real bad, and the urine would flow outside my Cather. My Hospice nurse said no problem, just needed to flush out the Cather. What was clogging up the Cather's tip? Blood clots.
It has gotten worse since then. They have put me on anti spasm meds for my bladder vesacare I think is what it is called, 5 mm.
To make a long story shorter, nurse has been out 4 times in past 7 days trying to come up with a solution. Spasms are very bad and frequent. We went from a 18 French to a 20 French still same problem.
Two days ago flushed 4 times and over 50% of the sterile water solution came back on the outside of the Cather. It did not help.

Last night a really bad spasm hit and I deflated the balloon and removed the Cather. I put on 2 pairs of depends and several absorbent pads for my bed and just let the urine go where it wanted all night. Just wore out fighting this battle.
Still in pain this am, I am trying to get in to see a urologist, but meanwhile just sitting in pee 24/7:idea:
Any ideas, clues, suggestions, :?:

Hi Al sorry to here of your problem, but it's ironic the wife and I had a similar conversation this morning. She's trying to avoid a cath, but can't wake me at night and wakes up with a drenched bed in the morning. Depends don't cut it. I actually went online line this morning and there are several sites for adult training pants. I thought I'd give them try. Not a good long term fix, but may help for the short term. Good luck with the cath. http://www.fetware.com/

i'm sorry you are having problems. I am trying the cath for the second time. I as well gets those spasms, not nice. Also went to a bigger one. I do get bypass once in awhile, but i grin and bear it. I was limiting my fluid intake to 1 cup a day(not good). would you be able to use a urnial cup instead?! Us women don't have that option, besides we can't aim...lol (little humor).

I did how ever buy sterile water and sringe and flush it myself. I do it every 2-3 days or as needed. The sediment i have may be due to the meds as my last test was negative for infection. That could help instead of waiting for the nurse. I'm not a nurse i just trial and error for waht works for me :)

well 2 1/2 hours after calling the nurse because it was clogged, i ended up taking it out. hopefully they'll call tomorrow.

That is what upsets me so much. when you are hurting so bad that you are crying and no one has time to come out and fix the problem.
I cannot use a urinal because I cannot control my bladder due to nerve damage years ago. I also cannot move to side at night in bed even if I could use a urinal.
Been using 2 pairs of super depends for a few days to let my urethra heal or whatever. Maybe that will work?

Not all condom catheters are the same. I think I remember you saying you tried them without success. A few PALS recommended this one to me.

The absolute best condom catheter we've found is Clear Advantage by Mentor.

Worth another try?

Thanks for the suggestion. I just sent off for some more samples of a couple of types I have not tried before. Hollister was the one I had trouble with the irritation. It got so bad one time the skin came off when it was removed. OUCH.
Another thing they fail to tell you with some of these is they call them long term wearable. I found out they meant 24 hours max wear time. What has been your experience on time before change?
Thanks

If it does not come off easily then leave it for another day. This was also recommended to me:

We have been using condom catheters and leg bags for about 1.5 yrs now. We like the ones from Rochester Medical--they will send you a sampler.
http://www.rocm.com/

First we used the ones with adhesive-sometimes we put a bit of powder on his penis and then they come off easier, or wait a day if it doesn't come off. Then we switched to their "natural cath' which unrolls but with no adhesive, then a strap is velcroed around it. We were skeptical but they stay on very good--granted he isn't active anymore so they don't get as stressed. And, FYI...they do--uh-- tolerate erections, for example during sleep and they stay on..they are built to handle that.
Regarding hair, we keep it just trimmed short (.5 inch?), not shaved--shaving is not really recommended as you get more skin stress--hair protects us

I am not yet using on so I can't make personal recommendations.

I left the Cather out for 3 days, took my antibiotics, and the stuff that turns your urine blue which is suppose to make the urethra numb. I just doubled my depends and doubled the pads on the bed at night and in my wheelchair.
The urethrae pain slowly eased off and I thought it was time to have the nurse put in another 20 French catheter. She came yesterday and installed it for me.
I was doing great while she was here, we had flow coming through the tube and everything looked good. That was about 11 AM. By noon, the spasms were back with a vengeance and no flow was going thru the Cather at all. Flushed it at least 3 times and got out one blood clot, but most of the flow went around the outside of the Cather. We had initially put 10ml water in the balloon. I had discussed the possibility of adding more as a test to see if it helped. I added 5ml for a total of 15ml. The Cather max amount stated on the box is 30cc. At the time this did not seem to change anything. Over period of about 5 hours had bad Spasms and flow coming outside as before, nothing going through the tube into the collection bag.
Went to bed and hoped and prayed for the best. For the past 4 hours there was zero flow going in the bag. I had 2 spells where I spasmed and the flow by passed again. I went on to sleep after taking my pain meds.
This morning there was about 1/2 the normal amount of fluid captured in the Cather bag, better than nothing. I have been watching it for over 6 hours now and I am getting flow in the tube with very little outside the Foley. We are having to wait for the holidays to try to get in to see a urologist. Hopefully that will be soon.
My thoughts are that I may have closure of the tube because of my enlarged prostrate. That still does not explain the many blood clots?
My nurse said she has had bad results with her patients over a 15 year period using the condom Cather's. I also had trouble with them coming off or irritation from the adhesive. I have ordered from three different brands to try them again. Anything that works at this point I am giving a chance.

Any thoughts or suggestions would be appreciated.

Blood clots are not normal! Go to the emergency department to have proper care! The The blood clots are probably obstructing the catheter and causing the bladder spasms!
Patsy

All these Doctors and nurses here are saying blood clots are to be suspected in the urine with a catheter??? I'm confused.
It didn't flow but about 1/10 the volume it was suppose to last night. Guess the only solution now is the Urologist or ER.
Thanks again.

I am a old urology nurse and I can tell you that blood clots are not normal. You should not have to suffer spasms and urine bypass incontinence! I wish I could help you more, sorry.
Patsy

Al, you are in my prayers. Tomorrow, if you haven't had the ER trip, I pray you will get someone like "Nurse Patsy" in the above post, who knows what they're doing... May God go before you and make the path.
Love,
Ann

Thank you so much. That is good to know. I am trying to get in to see Urologist soon.
I guess in many things I have learned to be a skeptic in my old age. Trust but verify. And never depend on just one opinion.:-|

Well aint that a pisser !

Hope it gets resolved real soon.

Glen

Relief at last, thank God Almighty relief at last. Sorry for so much detail but if anyone else is having or will have this problem, I wanted you to know the possible options. These bladder spasms are very painful.:shock:

My problems may all be related to the spcinhter muscle spasms and enlarged prostrate.
Went to VA hospital yesterday and spent about 4 hours there while they figured things out. Their solution for now was to go to a much larger catheter. Size 23. Did not know there were bigger ones, but they say they go even larger than that. They wanted to try this while waiting to get me an appointment with the urologist. It seems also that I may have the problem described below. that can be solved by a special Cather called a COUDE that is curved on the end.:shock:

Urology (http://en.allexperts.com/q/Urology-Male-issues-989/) - catherazation problems with spcinhter
Expert: Arthur Goldstein, M.D. (http://www.allexperts.com/ep/989-19017/Urology-Male-issues/Arthur-Goldstein-M.htm) - 7/19/2007

Question
QUESTION: I am a 35yr, old quadriplegic who catheterize to urinate. But I have been having problems get my catheter to pass my spcinhter at times. It's tight as soon as I insert my catheter. I have tried using flomax and I'm presently taking uroxatral but my problem continues every so many days it's like it has a mind of it's own. Help please.

ANSWER: Jay, although you did not state your sex, I am going to assume that you are a male. My suspicion is that you either have a stricture (narrow area in the urethra secondary to scar tissue) or some early enlargement of the prostate that is causing the difficulty. The diagnosis can easily be made by your urologist if he does a cystoscopy. For a stricture, the treatment would be periodic dilations. However, the more likely scenario is that it is your prostate is causing the problem. This can usually be resolved by using a special type of catheter with a COUDE (curved) type end. With insertion, the curve should be facing upward so that as it rides through and over the prostate gland the tip is pointing upward towards the ceiling. These catheters are readily available but it might require a prescription and demonstration of use by your urologist. I would try the COUDE catheter first. if this doesn't wok for you, your urologist would have to check you further. If the COUDE is successful and you just take the Uroxatral to make insertion easier, you probably could discontinue this if okay with your urologist. Good luck.

I had a Foley placed 5 days ago. I can't find a way to sit comfortably. Tips anybody?

They change my Foley about every 30 days. When they do this it hurts for about 3 days after the procedure. I think it is more like an irritation pain than position pain. After that I usually cannot feel it inside my bladder unless they insert it too far and it is lying against the back wall.
You may want to ask your urologist about this if it does not go away soon. I wish I could be more help.

I couldn't take it anymore so I called the VNA. The nurse who came guessed the first cath wasn't placed in far enough. She replaced it. Problem solved. Whew!

For those who may be squeamish, I advise you not tread this post.
I NEVER IMAGINED THIS MIGHT EVER HAPPEN TO ME.
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My hospice aid was preparing me for my bath. For some reason she forgot I had a Cather. You know what is coming.
She was having trouble tearing my depends on the sides to remove them before the bath, and she was in a hurry. Friday rush to get things done. She has done this at least 20 times without a problem. She grabbed the pants and tore them off me, she had the Cather in her hand with it and tore it out of me, or at least most of the way out of me. I of course screamed and asked my wife for a syringe to deflate the bubble at the end. It was only inside me about 3 inches at this time. I released the water from the bubble and it fell out and blood squirted across the room to sounds I do not remember coming from my mouth.

Yes it hurt like nothing I can describe. A golf ball size bubble trying to come out there? :roll::roll:
I tried to reinsert the Cather but it had already swollen shut. I had to go to the ER and have one put in asap. I had a size 22 before the accident, they put back a 16 COUDE and used a syringe full of the stuff they numb you with for stitches to numb the urethra before they put it back in. The pathway by this time had swollen and the bleeding had stopped.
I only tell this story to warn others of the possible dangers of other people trying to help you and causing a mess, a very painful mess. Also be sure you have one of the special syringes on hand that lets the water out of the balloon on the end of the catheter. I guess if you had to, you could cut the tubing and let the water drain out. Also to let you know more about these catheters:
Coude-tip catheter has a slight curve or bend in the insertion tip. Coude or curved tip catheter usage will make it easier for some men to thread the catheter past their prostate. Coude tip catheters are also good for anyone with narrowing of the urethra and that have any blockages in their urethra pathway.

This is what they will be using on me from now on because I have an enlarged prostrate and been having bladder spasms.

Thank God that is over and thanks to the ER staff for being so considerate and getting me back where I was before all this happened. It was the VA hospital. They got me in in less than 5 minutes and began work on me within 10 minutes. :confused:
WHEW........What a weekend.

Al, have you ever discussed getting a suprapubic catheter? You may know, it's a catheter placed through the abdomen into, I believe, the bladder. I'm really glad the VA hospital got you fixed up so fast, just concerned about the ongoing problems you're having.
Praying for you,
Ann

Sorry to hear of the trouble you're having Al. I can only imagine the pain. I cringe just thinking about it. Hang in there.

AL.

Cringe thinking about it ... not even .. I still cringe at the word catheter.

Capt AL , I fell sorry for your pain, and I didn't even cause it. OOUUCCHHH .... shudder.

Hope you are feeling better real soon.

Glen

That was nasty!

I hope you don't go through anything like that again!

Got test results back from yesterdays visit to Hospital. I have a kidney infection. Plus I am not producing much urine. I have a catheter so I can see how much output I have each morning. It was about 10% of normal last night. That does not look good.
Please pray that my kidneys are not going into failure.
I love you guys and gals.

We love you too Al, get well soon!

Thinking of you and praying for you Al!!!!! You are an inspiration!
Rick

Sending out prayers & good thoughts.

Sorry to hear that Al. Let's pray for each other as my kidneys are also bad. I always said ALS wasn't going to kill me. LOL. My kidneys might.

Al we all are sending mountains of love your way. And lots of prayers too. Can the hospital admit you and sock the IV antibiotics to you?
Laurel

Al, my prayers are with you. Hang in there. I love you too!

Sending prayers your way! Nasty business, this! Hope you recover soon!!!

Capt Al ,

Sending you Cranberry Juice wishes for you to get better soon.

Glen

Capt. Al ... I'm praying for you, too. We can't get along without you.

Finally got the culture back and I have a severe kidney/bladder infection. They have put me on an antibiotic called Sulfamethoxazole 800/Trimeth 160mg. I have never heard of this med before.
I think this was probably stirred up from the aid ripping out my catheter about 4 weeks ago. I was told that sometimes this can cause scar tissue to form in the urethra, from the bleeding, making it harder to insert catheters..
I have been running a fever and having bad pain in the kidneys, in my back it feels like 2 hands on each side of the spine, low back area.
I am doing better, thanks for the prayers. I believe prayer changes things and changes people. I am humbled by your concern for me. Thank you so much.

My prayers are with you and hope you are feeling better soon.

Capt. Al,

Hope the antibiotics work quickly for you! I don't know if it was mentioned in this thread or not, but have you tried those pills that are now OTC that "numb" the urethra? I think it is called AZO. That might help a little with some of the pain, if you are having the burning sensation. Can't take them all the time though, or they could mask symptoms of a new infection after this one clears.

Good luck!

Al, my heart just sank when I saw you again are having this trouble, and infection. You are daily in my prayers. I hope the antibiotic totally does the job this time. God bless you.
Ann

Hello,

I am a PALS, but also a Family Nurse Practitioner, and...I have to do intermittent self-catheterization. So I have a few observations:

1. An 18 or 20 French catheter is VERY small for an adult indwelling cath. I have used 20fr on 7 year old kids, NOT adults. I was taught to use a 12 or 14 fr. on adults Why? Because the holes in the cath are larger, and you can pass tissue (clots) much more easily. The fact that irrigation results in fluid around the cath seems to support this statement.
Going to a 12fr, with routine 4x daily irrigations w water would be my first move.
2. Having clots that plug up the holes in the cath leads to bladder infections, which means more clots...thus the vicious circle. You should have a urine culture & sensitivity for bacteria, then be treated with the appropriate antibiotic.
3. If your cath is getting plugged up, your urine is not passing freely, and it can back up to the ureters & kidneys & damage/infect them. This can be VERY serious. Dialysis and ALS do not equal a good quality of life!.
4. Once urine is flowing w a bigger cath, drink at least 2 quarts of water daily. You can't let the urine get concentrated.
5. Watch your blood pressure. Higher than normal BP could mean kidney problems.

I have used an indwelling cath for up to 45 days in a row, with no problems. Simply put, you are not getting adequate medical/nursing care.

If I am being too blunt, I apologize. As a PALS and a (male) RN & Nurse Practitioner, it angers me that they are allowing you to suffer when it it not necessary.

PM me if you want to discuss this opinion.

take care,
gramps

whoops, I forgot one suggestion:

If you continue to have the bladder spasms, ask for B & O suppositories. They are actually Belladonna & Opium, and will help a great deal w the spasms. The Belladonna helps stop the spasms, ans the opium settles the area doen a bit.

God bless you,
gramps

Thanks for the info I appreciate it. One question is a 14 smaller or larger than the 18? You say the 14 has larger hole opening, did I understand that right? Just learning all this stuff.