catheter?

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kepi

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My mom just got a catheter today and was wondering if it was a good or bad thing to do? Is it hard to keep clean and is it easier to get an infection? The nurse forgot to tell us how to clean it and how often. I'm going to call the nurse tomorrow but my main concern was it a good idea? Is there anyone out there with a catheter that can give me some advice....We feel bad enough that we suggested to our mom to get one.
 

andyvaughn

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Hi Kepi,
An indwelling foley cath is a fairly easy thing to keep clean, your mother can bathe/shower as normal, cleanse her perineal area with warm water/soap as usual. Be sure to maintain good bathroom hygeine (ie - wipe front to back). Adequate hydration will help, as well as cranberry juice or cranberry pills.
My husband doesn't have one, but I am an RN, have seen plenty of patients, esp w/neuromuscular diseases or paralysis of any sort, with foleys for YEARS, problem free. The nurse will change the foley every 3-4 weeks, that is always done under sterile technique, as the bladder is a sterile environment, and other than that, you should have no problems!
It will make it easier for your mother at night, or anytime really if bathroom trips are posing a difficulty for her. And it beats the skin breakdown that comes with having urinary incontinence - whether it be from a bladder trouble or simply being unable to get to the bathroom.
Andrea - wife of Pals Jim.
 

kepi

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Thank you for the advice Andrea.... It makes me feel better about the catheter. The reason we are so concerned is because my sister had a Doctors appointment today and her Doctor will always ask about my mom and how is she doing, he didn't think it was a good idea to do the catheter. He thought it would be better for her just to go in her Depends and clean up each time. We thought it would be difficult to keep clean but I feel so much better after reading your reply. My name is Debra, I just used Kepi for the ALS forum. THANKS AGAIN
 

andyvaughn

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Debra,
You are welcome. Your sisters MD's concerns are understandable, however, he isn't the one who would have to face the humilation and discomfort of urinating on himself and waiting for someone to clean it up, sometimes I don't think these docs think it all the way thru... and it is quite common practice to have long term indwelling foley catheters for persons with neurological diseases/injuries.
One note of caution, if you are using the chucks pads as a way for your mother to have bowel movements, then you are running a higher risk of urinary tract infections, (that would be true even without a foley) - the bladder, from the urethra up is a sterile environment, however, the bowel is not, full of bacteria - as the old saying goes, cleanliness is next to godliness (or something like that). I said this already, but if you have a way of getting your mother cranberry juice, it has natural antibacterial properties and is often used as a preventative measure against UTI's (urinary tract infections) - a glass or two a day is a good idea. If your mother has a PEG you could simply give her a cup once or twice a day?
Andrea
 

kepi

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Hello Andrea,
We started giving our mom the cranberry juice today thanks for the info. We still can get my mom up and put her on the commode and before the catheter we used a bed pan at night. It just takes 2 people to put her on the commode that's why we wanted her to have a catheter, also her legs are getting very weak. I know what you mean about MD's, nurses are better to talk to when you need advice and they also have a bigger heart. I just wanted to THANK YOU again for responding so quick. This was my first post so I didn't know what to expect.
Take care,
Debra
 

kepi

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Hi Andrea-
I have another question to ask you about the catheter. Is it common to have a small discharge? We noticed a small amount on Thursday and again tonight when we got her out of bed to clean her. The discharge is not on her but on the chucks pad. It is a light green color w/ slight odor. I'm going to call the nurse on Monday morning but I just wanted to write to you tonight, hopefully you see my post. I'm sorry I have so many questions for you but I 'm just worried about her.
Debra
 

Al

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My daughter is an RN so I have asked her to respond to you. Her suggestion is to call the nurse today because she'll probably need to have it changed as that is a sign of an infection. She may even need an antibiotic as these types of infections can become very serious if left alone in ALS patients. It may be coming from her vagina in that case it is not a big deal but without a proper exam you won't be able to tell where it is coming from so to be safe I would call the nurse today.

AL.
 

kepi

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My daughter is an RN so I have asked her to respond to you. Her suggestion is to call the nurse today because she'll probably need to have it changed as that is a sign of an infection. She may even need an antibiotic as these types of infections can become very serious if left alone in ALS patients. It may be coming from her vagina in that case it is not a big deal but without a proper exam you won't be able to tell where it is coming from so to be safe I would call the nurse today.

AL.

Al,
Thanks for your post, we are calling the nurse now. This is such a great website everyone is SO HELPFUL.
Debra
 

andyvaughn

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Kepi,
I am sorry I didn't see this until now.. I am glad you are calling the nurse. Any time there is foul smelling discharge from anywhere, call the doc... it could be a vaginal infection, as Al states, but the RN can come to the home, do cultures, and administer medications per dr's orders. Even a vaginal infection can get very complicated if left unattended, causing pelvic inflammation and pain, as well as having the potential to become systemic - we have all heard of toxic shock syndrome? (Which incidentally can happen to anyone, male or female) - You did good... but, to reiterate, foul smelling discharge is always a reason to call the doc.
If it turns out to be related to the foley, I would question the technique of RN who put it in, and don't let him/her do it ever again.
Andrea - wife of Pals Jim
 

kepi

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Hello Andrea,
They said a nurse will call on Sunday morning, they just need to call her MD first to see what he wants the RN to do. If it is related to the foley does that mean the RN did something wrong when the catheter was put in, is that why after only 1 day she had the discharge? Also is it easy to find out where the problem started. I knew you would write back so don't feel bad, I really appreciate all your help and also from Al too.....
 

brendapals

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Hey there Debra,
I agree that it is good that a nurse will be checking in on her tomorrow. I am also a nurse and the discharge could be from any number of things, i.e. infection, possible latex allergy?, or just the sudden change to the environment due to the catheter. The insertion of a catheter is a sterile procedure, so I would certainly hope the nurse that put the cath in followed protocol.
My mom had a cath for 13 yrs, and had bladder/kidney infections off and on all the time. We did find that changing the cath only introduced the chance of more infection, so if memory serves me, the nurses only changed it every 2 months. They can also irrigate a cath with saline to help clear out any clogs in the tubing, etc.
I wish you well tomorrow,
talk soon,
brenda
 

andyvaughn

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Hi Kepi,
How did it go w/the nurse?
The source of infection could be relatively easily identified, urine can be cultured from the foley bag, vaginal swabs can be done, etc. Cultures take a few days to get back, the doc could start your mom on a broad spectrum antibiotic in the meantime, and probably a good idea to hit parasitic infections also, as foul smelling vaginal discharge can be related to parasites rather than bacteria (not likely, but possible)
Brenda is absolutely right, foley changes bring about increased risk of infection. The home health I worked for had a policy of every 4 weeks, which seems to be about standard- at least in my neck of the woods, (suprisingly, there are sometimes differing standards of care in different parts of the country). Either way, the removal and reintroduction of a foreign object always brings about the possibility for infection. Some doctors I have worked with even prescribed a low dose antibiotic as a prophylactic (preventative) measure. This is really considered more and more taboo these days, as the "super bugs" around are finding ways to be resistant to medications. However, generally, done right, foleys shouldn't present a problem. I have a patient that I have followed for years (as his case manager) with a foley, and has never had an infection, and have cared for several patients when doing direct patient care that didn't develop any urinary or kidney infections. Some people do seem more prone to UTI's, for reasons above the scope of my knowledge.
Andrea - wife of Pals Jim
 

kepi

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Hello Andrea & Brenda,
Sorry it has taken so long to respond but we are still waiting on the lab results from the vaginal swab. I guess it is like a yeast infection, I can't remember the name but it starts with a "C". They have to grow the culture in the lab to see what kind of antibiotic to use..... Hopefully we will find out soon, also thank you for all the support. I know I have said this before but this is such a great website, everyone is so quick to reply, you guys are great!
Take care,
Debra
 

CindyM

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I hope they are able to resolve this soon, Debora. It sounds uncomfortable!
 

andyvaughn

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Hi Kepi,
They are talking about candida, was your mother on any antibiotics recently? Antibiotics knock out the bodies normal bacterial colonies, and allow yeast to overgrow. They will likely give her something like diflucan, 1-2 tablets is about all it takes, and perhaps give your mother yogurt w/live cultures, (I think all yogurt has it, but it will be marked, as having live cultures) This will help with prevention of yeast infections in the future.
Hope she is feeling better!
Andrea
 
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