Catheter...or not?

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Jellycat

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Hi. I'm looking for some help on the sticky subject of catheters.

When my mum first started using a wheelchair full time, the local nurse & occupational therapist recommended having a catheter fitted. Both mum & I felt they were suggesting it for convenience & we were not keen.

Some time has passed. Mum is getting weaker. Slings, hoists & transfers take it out of her, so here I am wondering if a catheter would cut down on some of the tiring transfers or just introduce more problems. Any thoughts?
 
Hi there jellycat
im sorry. i dont have an answer for you, as my PALS is a man. He doesnt have an in-dwelling cath. He uses condom-caths.
yes, it probably would cut down on some of the tiring transfers and all of that. but you must remember that anything that is placed into the body has its risks. I would say the biggest risk is infection. Try to contact any insuraces to find out how many catheters they will pay for in a months time. Also, im not sure how often they need to be changed, so you would need to find that out. also, that may warrent a trip to the dr to get it changed, which will obviously take time out of your guys' routine. But if someone can come to your home and change it, it might be worth looking into. Also, and this is VERY important. Keep it clean! If she decides to get one, make sure the nurse shows you how to properly clean the tubing and find out how often they recommend you doing it.
Hope this helps you some. Good luck.
 
Would they consider a Suprapubic Catheter, Jellycat? I ask because I've heard of women in wheelchairs finding the catheter painful to sit on... and the Suprapubic is surgically inserted into the bladder, coming out of the abdomen, as I understand it... so there is a lessened chance for infection. Foley Catheters have a high infection rate--as Liz said, they need careful cleaning. However, my mother, not in a wheelchair, had one for 18 months, taken care of by my father who was in his eighties--without an infection until 18 months had gone by. A nurse came to their house and changed her catheter once a month.

I'd want a Superpubic, myself. Maybe I'll ask for it for Christmas....The hoists and slings really do wear one down.
 
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Thanks so much for your replies. Infection is surely one of my concerns and was a large part of our first reactions. (Also, if I'm honest, the only person I've known with a catheter was my dad and it hurt him so much it had to be removed.) What's changed for us since it was first suggested is the fatique levels, plus none of the external things like a bed pan or urinal work for us. We're still not very keen on the idea but we know it will be suggested again soon & would like to be a bit prepared.

I hadn't thought about her sitting on it which now that you say it is obvious. I hadn't heard of a suprapubic catheter so thanks for that bit of info. Having never seen a female catheter in place I also don't know if they are bulky & show through clothes. We already have a feeding tube in there. Looking well has always been important to my mum & I'm still trying to keep things as normal as possible on the clothes front, even with adaptations for the hoist & chair.

Thanks for the input so far
 
Jellycat, My mother's catheter (the foley) was used with a leg bag during the day, and the whole thing was not at all noticeable. As for the Suprapubic, I just don't know the facts. What I read on another forum is that the larger bag--not the leg bag--is used. That's something to figure out and to learn if it can be hidden. But the tubing part shouldn't be a problem as far as being noticeable. Also, the kind of wheelchair cushion might determine if the foley is uncomfortable. My mother sat comfortably in her recliner and never needed a wheelchair while she had the foley.
 
For the bigger bags, they usually have some sort of hooks on them that can be hung from a bedside, or wheelchair. There are bag covers available too. some are just plain cloth with either a snaps or velcro across the top. others are more flashy material. you can find whatever you like. or really you could make one. cheaper that way. good luck
 
Hi there,

I was wondering if you can give me any advice for my husband and using the external condom catheters. We have a one month supply but he's not very anxious to start using them unless I'm at home with him all day for the first time using them. He thinks they are going to come off and obviously spill everywhere. What sort of things should I know that they don't tell you? Is there any trick to taking them off or putting them on? How well do they stay put? I appreciate your help.
 
Debruh- The most important thing is to make sure he has the correct size. Too big and they will come off.
When putting it on, make sure the opening of the condom cath lines up with his urethra, even if his is more on the top of the head.
Place it on and hold the end while you roll it down the shaft- just like a regular condom. Then, what I do, is sort of squeeze or lightly roll his penis, to get any air bubbles out of the condom. This ensures a more snug fit. There are condom cath glues, but i find them unnessesary.
Now, obviously the fuller his leg bag or night bag gets, the heavier it gets. so make sure, if there isnt anyone around who can empty it right away, to have the bag tied up to something the help take the weight off of it. If it gets too heavy and is just hanging, it can and will pull the cath right off.
Oh, also, make sure when putting it on that his penis is clean and dry. no powders or creams. and you want it clean just because oil on the skin can allow it to slip off sometimes.
To remove- just roll it off of the penis. If he has recently peed, there may be urine in the tube. But when you break that "seal", it will go down into the bag. Be prepared for some drips though.
Hope this helps. Good luck
 
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