Intermittant Cath (is it relatively safe?)

Sure, but only if you can pee!  I couldn't pee on my own for 15 months ...!   :-P

I think it's urinating BEFORE you self cath. That helps clean/sterilize the urethra. Very hard to urinate right after you cath cause there will be no urine in the bladder! But as Cartoonman has mentioned, some of us just can't naturally urinate at times, or even at all. So don't worry about it. 

Jim

When new ones are so inexpensive, reuse just seems to me to invite trouble!  Use, toss, use new one for next insertion.   I'm cheap, I'm really cheap, but not THAT cheap, as to be risky!  My two cents...

I found out only yesterday that my insurance will cover me 100 per cent on them.

Carry on,

I've heard some like you that have no infection for years, then others are completely different, even though they claim to be very sterile also.

I don't know about a sterile water packet. But, the one's i ordered...the nurse said they are not already lubed, but are just very smooth..possibly the hydro type. My question is: are their one's where you are SUPPOSED to "activate" by rinsiing it with water?

Maybe she meant that you don't need lube and it's activated because once it's in, the moisture will auto lube it in same way.

You said not to touch the first half of the cath. You mean the initial part that goes in, right? What about the rest of it? In your opinion can i touch ANY of it at all?

SpeediCaths are pre-wet, sterile.  Do NOT run anything under tap water!!!!  And do not touch any part that will be inside you!!!   Only the funnel at the end.  You will avoid many problems following these guidelines.  THe ones with the packs of water to burst are a nuisance in my experience.  ANd I have gotten ones that had water packs that were DRY!   I went for SpeediCaths because they are the easiest, safest to use.  For me, they are the end of the discussion!  :-)

 

One thing that that no one has mentioned. To avoid infection, never use  the same catheter more than one time.

Why don't you ask the nurse which catheter she ordered to eliminate any guessing.

Hydrophillic catheters do not require an external lube. Some hydrophillic's come ready to use immediaely, and with some you have to break a small water packet inside the packaging, wait a minute and then use.  Maybe that is what you are talking about with the 'sterile water packet"?

If the catheter she ordered is not hydrophillic, you will then need some sort of water soluable lube like Surgilube.I'm sure they will come with the catheters if that is the case.

 The small individual packets of lube worked better for me. They pack easier and easier to keep sterile.

One of the more popular hydrophillic's here is Speedicath by Coloplast. You might want to go online and order some free samples in the appropriate size and with (or without) coude tip depending on what your nurse wants. Many of us tried various catheters before we found one we liked.

Some catheters have a "sleeve" that you hold/touch to push the catheter in. In this case you're really not touching "the first half of the catheter", you're only touching the sleeve. Some don't have a sleeve and here you have a few options.

There is a "no touch" technique described in this and the other self cath thread, but not sure I would start out with that  as it requires a litte practice, at least for me.

So if no sleeve, you can just wash your hands and feed it in, and yes, you probably will be touching the first half of the catheter here. Alternatively, you could use surgical gloves which would in effect be similar to using a sleeve in that your hands would not touch the catheter. 

If the gloves do not say "sterile", you could squirt some hand cleaner on them and rub it around or just wash them on hands with soap and water like washing your hands. 

You will find many different techniques and instructions offered both here, with different doctors and nurses, and on internet videos. There are a number of "right" ways. Do not obsess on it. Later, you can refine your technique and find what works best for you.

The truth is you will probably get colonized no matter what you do, but that is OK and it should not be treated with antibiotics. As to UTI's, some of us get them more than others. With me, it was just in the very beginning and I believe more a function of the physical trauma to my urethra as opposed to how sterile my technique was. Once my urethra got used to the process, I haven't had a UTI since.

Jim

I'll have to wait and see exactly what i get. But, i did try the speedcaths already. The F14 was too big i think so i tried the F12 and it was better. But the F14's were with the cloude end...i just watched a video and found out that the end is supposed to always stay in the upright orientation. I might try the F14 again and see how it goes.

That might have been the whole reason why the blood. I have the 99.8 per cent bacterial free dispenser (hand pump), and i'd think that i could touch the leading end of the cath with my bare hands after i've cleansed them that well. But, will still try my best to use the plastic end of the cath if possible.

Nothing wrong with the F12 if they worked. In fact the idea is to use the smallest size that works. The notch in the funnel should be facing toward you body. That means the hooked end (coude tip) wjll also be toward you. It looks wrong but it's the right way. 

Not sure what you mean by "upright orientation" but what works for me is to pull the penis out and up gently with the other hand so that the urethral canal is straight. and stretched out.  At the same time I put a little pressure on the head of the penis opening up the meatus so the catheter goes right in and doesn't run on the head of the penis. Keep it pulled out while inserting the catheter with the other hand. But what I, and others here, have found hellpful is to change the angle of the stretched penis as it starts hitting the first spinchter (resistance) so it will glide more easily over the prostate. That is done by lowering the penis so it is facing the wall opposite you. 

Blood in the urine, or a few drops on the catheter, is  pretty normal in the beginning, would not worry about it.

Again, don't obsess too much on technique in the beginning, as there is a lot of new stuff going on. Basic principle is to line up the coude tip properly, get it in, drain the urine and get it out. The rest will take care of itself in time. Just be very gentle throughout the process. Never force. 

Jim

 

Jim, i just double checked a video and she did say the cloud end should be facing UP. yOU are telling me it supposed to face downward. Now, i don't know which is the correct way.

YOU...mean it's supposed to curve towards your body, not away, correct?

Thanks for the informative message.  I understand that colonization is relatively safer; however, i wonder if anyone has found a way to diminish the strong, bad smell that the urine has as a result of intermittent catheteriation.  definitely a lot worse than before i was catheterizing. 

Patin, WHY are you using the coude tip????  If it is required for your specific condition, okay.  But SpeediCath once sent me a box of them by mistake (I order the straight tip, and they really chewed up my insides!!!!  Yes, the tip should be UP, following the curved path from penis tip into the bladder.

But again, you shoul use them ONLY if your specific condition requires them!!!

 

Again, I was told UP...

Ok, well, the original nurse gave me samples of different kinds. I didn't like the cloude tip either and i bled alot.     So, when i just ordered more caths yesterday, i didn't order that kind..just the straight tips

You have asked "can I touch ANY of it at all?", so let's establish some definable guidelines.  For the sake of clarity, let's call the part that goes into you the "first half" and the part that remains outside the penis, with the funnel-like end, the "second half".

Touching something that does NOT go into your body cannot cause an infection by itself; and, washing your hands THOROUGHLY, and using an antibacterial wipe on the end 1 to 2 inches of your penis, and being careful what you DO NOT touch, makes a UTI - unrelated to anything but your hands - highly unlikely.

Some catheters do come pre-lubed; it so happens that the ones that I use - and continue to use because it's been so successful that it's "if it ain't broke, don't fix it" - use the sterile water packet, broken while the entire package remains sealed, to create the slippery condition designed into a hydrophillic catheter. 

I would never use tap water to lubricate any catheter, and I would not add something like KY to the mix if the hydrophillic catheters do their job, as designed.

And I would not depend upon moisture in the urethra to "lubricate" the hydrophillic catheter, because you're it needs something moist on the plastic tube at the very entry point, and thereafter, and depedning upon the urethra's moisture would be chance, and unreliable.

And I would never re-use one of these catheters; they are designed for single us, and then disposal.  

When I am traveling, I bring a gallon ziploc bag (any brand) to hold a catheter, two antibacterial wipes in single packets, and an opaque doggie bag for dispoasl in the trash after all is done.  The extra wipe is just in case there is not soap, or something to dry your hands, and you need to clean your hands, as well as the tip of the penis.  You don't want to use the same antibacterial wipe for both.

Usually I keep the ziploc bag in my attache, and when I go to the mens's room I just transfer the contents into my pocket(s).  The Magic3 by Rochester bends nicely to allow me to put the works into my pocket(s), and then all you need is a mens's room stall, or a Family Rest Room with only one toilet, to get all of this acccomplished.

If I'm going away for a few days, or a week, I simply stuff enough of all of these things into my luggage, and then take them out for daily use. 

As I only know the Magic3 catheters, by Rochester, I can't give guidance on the brand you may be using, and would suggest that you post the brand and type, and ask someone on this site using the same product to guide you.

I hope this is a bit more clear for you now.

I started out with Coloplast Self Cath , lubricant and towelettes . It has a green stripe to orient the coude tip. Eventually I tried the Speedicath coude which did not have the green stripe, but rather a ridge on the green plastic end.Since i had not been educated about the ridge,  i Inserted it randomely, which resulted in bleeding and pain, because the tip was not oriented properly . This to say that if you use a coude tip, you need to make sure it is oriented properly.

Once I understood how the Speedicath works, I stayed with it, because it does not need lubricant, and in fact you can use it without touching any part of it except the green end. You can insert it vertically and it has the right amount of faint rigidity that it slips right in without guiding it. with a hand.

of course, as stated above , maybe a coude tip is not indicated for you.

 

Regarding odor, you could try a bladder irrigation. It's talked about earlier in this thread. I am colonized but my urine has no noticeable odor. 

Jim

There seems to be some miscommunication. It's not a matter of "up or down", the coude tip always faces up (very slightly) even if inserted incorrectly. What I said is that the coude tip should curve toward you, not away from you. If you have the ridge facing your body, that is the orientation you want. 

Jim

Ji

Yes, curve toward your body, no away. As I mentioned in previous post, the coude end always faces up, even if inserted incorrectly. When you have the guide mark facing your body, the tip will curve toward your body.

Jim

It's hard to tell if it's facing the way you want because if you hold the tube at the plastic end, basically the tube curls so much that i don't know if it's still the right orientation.

Curve towards me...as in "a bent finger" is pointing towards my body, not away, right?  iF inserted incorrectly, it'll do it's own thing and point the correct way?

Yes, "bent finger" pointing toward your body, assuming the penis is being held vertically, ie pointing straight up. As to the catheter "doing its own thing" that is what the guide bump is for. When the catheter is pointing toward your body, so is the guide bump. Just make sure the guide bump retains this orientation. Don't know why your catheter tube "curls so much". Are you folding it and carrying it around? Not a great idea with the Speedicath. I've used both FR14 and FR12 and both sizes come out of the package so the curl and guide bump face the same way. Sometimes pictures are better than words. Why don't you call Coloplast and maybe they have visual guide that might explain it better.

Jim

Not so, If inserted incorrectly it will not "do its own thing and point the correct way". .It will end up digging in and hurting, instead of slipping in past the prostate. This happened to me the first time, because I did not know about the ridge. 

The directions in the Speedicath Coude box say:

Tiemnann Coude cathete r(curved tip) only

Before you begin insertion, make sure the curved tip is pointing upwards. The Tiemann indicator (raised ridge) on the connector (green cap) is designed to help you orient the catheter correctly. When holding the catheter horizontally, with the indicator facing upwards, the tip of the catheter will also be pointing upwards. 

I would add:  when you insert the catheter,  you are holding the penis in an upward direction, the catheter is pointing in a downward direction. At that moment, the coude tip is bending towards your body, and the ridge on the   green cap is facing your body. 

I hope that is helpful. Once you do it , it becomes totally simple and foolproof,.Thanks to the ridge you don't even have to look t the tip to see how it is oriented. You do have to look at the tip carefully to insert it into the urethra.

Michael

Ok Jim, i understand it know. Yes, at least the last cath seemed to be kind of twisted..enough that the bump didn't align very well.

Thanks Jim.

Now, I'm confused again. Ok, pointing upwards..the indicator facing upwards.

While holding penis in upward (vertical) position, the catheter is now facing downwards?? How did it go from upwards to downwards?

Once it is inside you................is it like a bent finger curving towards the ground?

I think part of the confusion is that the terrms "up, down, etc." depend on whether you are holding the catheter horizontally or vertically. So unless you are self cathing lying down, you would be holding the catheter vertically. 

So say you are self cathing standing up. You stretch your penis toward the ceiling and insert the catheter. In this oritentation (vertical) the catheter curve will ALWAYS be facing up. It cannot face down. 

So, the question is not if the curve is facing up or down, but whether the curve is facing TOWARD or AWAY from you. The curve should be facing TOWARD you. And when the curve is facing toward your body, the guide bump on the plastic funnel will also be facing toward your body. 

Hope this clarfies. If not, I suggest you have the cath nurse demonstrate or search for an online video. Pictures can make simple what word can make complcated.

Jim

Well, I found that confusing, too, and I've been cathing for 20 months!  :-)

Holding your member more or less vertically, the tip of the coude points toward you, so it follows the CURVE of the path leading into your bladder.  The beak should always be pointing to the inside of that arc.  It should always be following that arc.  If you can picture this, you will never again do it wrong!  I'm an artist; I think visually!  :-)

Just add that should the catheter become twisted and therfore the guide bump and curve not exactly line up, go with the catheter curve not the guide bump. In this case the catheter curve would be facing toward your body. If the catheter is only a little twisted, it should find it's way in OK if started the correct way even if the bump is not aligned. If the catheter is really twisted, probably best to throw it away and use another one. If your catheters are continuously getting twisted, try and store them in rigid boxes or tubes. I find the cardboard packing they come in works fine at home, and when I travel I keep the bulk of them in the cardboard packaging and the ones I might be carrying around with me in a rigid cardboard tube which I put in my back pack. The only problems I've had with twisted catheters are when either I try and fold the Speedicath (not recommended for beginners IMO) or when I'm not careful to keep them in the cardboard box. 

Jim

SpeediCaths (My fave!  :-) ) are pretty tolerant.  Early on, I rinsed a used one, and just played with it, to see how far it would bend, roll up, without folding.  I'm now comfortable, gently rolling new ones, if needed, and slipping into my pocket...

Because I generally only have to cath at night (if at all) I haven't carried around a catheter with me for a well over a year. Back then, I put them in a rigid tube and put the tube in my back pack. I would think by now, the veteran I am , that I probably could get in right even if mangled. Sounds like you're a veteran as well, but I think in the beginning, at least, best to start out with a straight sword! My biggest stress with CIC is that Coloplast will some day decide to either discontinue or "improve" the Speedicath. I have tried numerous others and they really don't work for me. If Coloplast is listening -- LEAVE THE SPEEDICATH ALONE. IT"S THE BEST!!!

Jim

The other thing is that I use the Coude tip. I would think that a straight Speedicath (no coude tip) could go in easily even if mangled. But it is important that the tip goes in right so it curves properly going over the prostate into the bladder. I've thought of trying a straight catheter for that reason, but honestly I'm scared I might nick my prostate. This happened to me a couple of times early on when experimenting with different types of coude catheters. When I get nicked I tend to get a UTI!

Jim

You're an artist, really? I am too. I've done many oil paintings.

Glad you know what i'm talking about. I think all of the samples iv' been given are pretty dang twisted. Must have been that way before i got them. I didn't store them bent at all.

I ordered a lot (first order) and when i get them, i'll know what a really straight cath is supposed to look like.

I forgot now if i ordered speedi caths or not..i hope i did. I don't like lubing them myself at all.

When i insert, i feel tinges of "pain"..and i'm going SUPER slow.

Last few times, no blood at all.    But yes, i'm wondering how much any nick or even irritation invokes an infection........if at all?

Oil painting is where the $$$ is!  I'm a watercolorist!  :-D

The pre-lubed ones have that many fewer chances of contamination.  Send whatever you ordered back (if they're not SpeediCaths!) and order the straight-tipped SpeediCaths, or the coude-tips, if you require them...

I never saw a bent or twisted SpeediCath, and I have used more than 2,000 of the things...  Very strange that this is even an issue...

I second what cartoonman says. The only bent Speedicath's I had were the ones I bent myself due to either intentional bending or due to improper storage/transportation. I assume you're getting them in a rigid box of 30's? Those boxes should protect them fine. Once, in the beginning, I got a whole bunch of loose catheters in a generic packing box. I called up customer service and complained. Fortunately, they were the red rubber type so it wasn't that big a deal but a good distributor should take the time and effort to pack these things right. 

Jim

Jim, yes, that must be it. The one's I speak of were individual ones nurse handed me.........not in a box. I just got my BOX at the door, haven't opened it yet........should be much straighter though. They are hydrophonic...i'll have to look on youtube or somewhere to make sure i know how to use them correctly.

Well, don't want to go off topic from Catheters to Watercolor paintings...but..

i know...i just don't even want to sell mine. I spend 40-100+ hours on them..might not look like it but way too much grief and pain and anxiety.

Yes, a WHOLE different topic... that keeps many therapists well-paid!  :-D

 

I second that 100% 

Hi, Jim,

In the beginning I think we all did some bending when evaluating catheters. I know I did, and made an interesting discovery with the SpeediCath. Flexibility increased significantly when I warmed the catheter up to body temperature (external experiment). The greater the flexibility, the tighter the curve the catheter can get around.

This suggests that a slow catheter insertion would allow it to come up to body temperature and make the process more comfortable.

Alan.

Alan,

Interesting experiment. You can also drop down one catheter size if looking for more flex. The 12 is significantly more flexible than the 14 and in fact might  be too flexible for some and just right for others. I've used both the 12 and 14. Like them both.

Jim

If you really like flex (and some do) nothing beats the red rubbers. Like wet noodles! You can fold up half a dozen in your pocket! I started with red rubbers but switched to hydrophillics (speedicath) after awhile. Still, I could understand why some prefer red rubber because they are so soft. Also, reusable if cost is an issue or if you don't like to pack a lot of catheters when you travel. External lube required although many over at the SCI forum just use water as a lube. 

Jim

I have not been keeping up with this discussion, but was wondering if the speedicath can be reused?   Perhaps washed and  cleaned with an antibacterial  mist spray?   I have just started using the #12 and have absolutely no problem, and I have only done it 4 times so far.  Just don't want a wastebasket full of spaghetti! LOL

Speedicath is designed for single use with a hydrophillic coating. That said, it's certainly conceivable that it could be reused after being properly washed and then inserted with a lube. While I doubt it, there could be some safety issues involved and I doubt you would get any answer on that from the manufacturer other than "designed for single use" only. Personally, unless it was an emergency, I would only use them once as designed. There are so many other reusable types of non-hydrophillic catheters, in a number of different materials, that I really don't see the point in reusing a hydrophillic. But who knows. 

Jim

Yes..that makes sense.

Jim, my order i recieved today are all the hydros...from what i understand, you just bend the water packet, while still in the main cath packet, right? Breaks it, then you remove the cath and slide the water sleeve along it?

I can only take an educated guess because I don't know which brand/model of hydrophilic cathers you received. Sounds like you got one of the ones where you break the water package and then wait a certain amount of time until it activates. There should be instructions. If it has a "sleeve" that's so you don't have to touch the catheter when you feed it in, you only touch the sleeve. Again, you got to read the instructions or call your doctor or the catheter distributor or manufacturer if not sure. The hydrophillic catheters I use and am most familiar with -- Speedicath -- have no water packet to break and have no sleeve. All hydrophillics are not the same. 

Jim

PS if it's stiff enough, you can probably just dispense with the sleeve and feed it in by just holding onto the plastic funnel. If not, use the sleeve. The idea is that ideally you do not want your hands directly touching the part of the catheter that goes inside you. This is both to minimimize infections as well as the fact that hydrophillics are very slippery and can be hard to guide with your hands. 

Jim

I concurr with Jim and have had similar experiences with SpeediCaths, which I've said are my go-to brand.  I have a bunch of left-over (unused) Magic-3's, which I will likely not use; too soft for the vertical unassisted insert, PLUS... I had one unpleasant time when I burst the little water bag and it had only AIR in it.  And it was when I HAD to use a cath to pee, and it was the ONLY cath I had with me.  Bad place to find myself!  It was only one failed unit, but... it certainly shot a hole in my confidence for the brand.  If it happened once...

Nice to hear this corrolation.  In wintertime, when I was cathing every time I had to pee, I would just drop an unopened SpeediCath down my shirt front, inside my sweater, where it would be warmed, I now realize, by body heat.  Which may explain why they always seemed quite flexible enough for me!

Just tried it...yes, i broke the water package with palm of my hand, then opened it and used the sleeve to distribute the coating more...oh, i didn't know you used the sleeve to help in insertion..good idea, because that's why i came on here just now......the F12 is so flexible, i could not get it to go in because of that (when hold it at the plastic end only). So, now i can do a much better job if i hold it closer to penis while holding the sleeve.

Yes, the sleeve is to help with insertion, not to distribute the coating. To distribute the coating, follow the directions. I believe you shake it a couple of times or wait a minute or so, can't remember. 

If the 12 is too flexible to insert by holding it on the plastic end, by all means use the sleeve. That's what it's there for. 

If you like the ones you have, great. If at some time you want to try another catheter, I suggest the Speedicath by Coloplast. The number 12 in Speedicath may be stiffer and you might be able to insert it just by holding the plastic funnel. Or maybe you will need the 14 for more stiffness. Try both. Experiment if you like. That's what I did in the beginning until I found something I really liked, but I was probably more picky than most because my urethra was very sensitive the first month or so and some of them just didn't work very well. 

Most of the catheter companies, like Coloplast (Speedicath) will send you free samples. You could get some in both sizes. On the other hand, if you really like what you have, that's good too.

Welcome to the club.

Jim

Cartoonman,

I don't remember if it was a Magic3 or not, but when I was trying a few different Hydrophillic's, a couple of times there was like no lubrication even when I broke the bag. Scary. Never used those again! Now that my urethra is battled hardened, I'm tempted to try a few other brands to see how they'd feel. But not tempted enough to really do it. The Speedicath works for me and I still remember several painful incidents when a catheter didn't work. Do not want to repeat that again!

Jim

Well, yes.  When you've found the best, why shop around further?  My wife is safe in that respect too.  As...am...I!  :-D

 

I still have this anxiety that one day they will "improve" them, therefore the thought about finding a back up. You know, companies just can't resist ruining a good thing! 

Jim

...or buy a year's supply, just in case?  :-D  That would buy some time,  anyway, until you could find a decent replacement...

Or we could launch a preemptive write-in campaign:  "DON'T F*** THIS UP!  IT'S PERFECT!!!"

Yes, we're on the same page, except they have expiration dates. Not sure how worried to be about those dates, but it is possible that the liquid coating could dry up. 

Ah, true, that!  Of course, if one were to seal said packages in truly moisture-trapping outer packaging, to prevent the migration from the already-moisture-trapping packaging in which they are already sealed...   Or we could trust in them leaving well enough alone...  :-)

 

Jim, I did try the speedicaths several times. I liked them too. Not sure why they didn't send me THEM...but as i recall, i think it was that they didn't carry those...cheapos.

So, for at least this month it's the hydrophillics. I used one last night..Didn't use the sleeve to help insertion though...will next time.

So, after a while of using caths, it gets less sensitive? I almost see that already, but not sure about it yet...still have to go super slow because of tinges of sharpness here and there.

I get mine from these fine folks:  Comfort Medical 800-700-4246