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NEED HELP CONCERNING SELF CATHING

Posted , 9 users are following.

tom512836
tom512836

Today I went to my UR office to be trained in self cathing.  I went in there sporting a foley hanging out my front door because about a week ago I went into total retention and I was forced to endure another ER butchery until today.

The training session went fine.  I then went food shopping with my wife.  While in the supermarket I felt that my bladder was really full.  I had no option but to use the store's John and try to go normal and see what happens.  To my absolute amazement I had a solid stream and I don't know if I voided totally or not but I left that John feeling fine.  And that's the way it continued all through the afternoon and early evening.

The UR said the two most important cathings are bed time and morning wake up time.  I tried to cath tonight before bed time but nothing flowed.  Thinking I did something wrong I sacreficed another catheter and still nothing.  I don't understand what I'm doing wrong?  I'll try again tomorrow AM.

My catheters are those fancy kind that have that curve at the tip to help you through the sphincters.  I was told to keep the curve elevated toward the ceiling and I do but once it's inside you and it turns how would you know?  I put this question to the company that my doctor deals with and that said that there was a guide of some sort way up toward the other end of the catheter.  They must have used invisible ink because I can't find it.

Can any of you experienced cathers make sence out of my tale of wow?

Tom

PS:  The reason for my self cathing is weak bladder muscles.    

1 like, 34 replies

34 Replies

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  • stebrunner
    stebrunner tom512836

    Posted

    Tom,

    A couple of things. First, what size catheter are you using? My uro wanted me to use size FR 18s, which really tore up my urethra after having a Foley in for 3 months. I tried to compromise and ordered FR 16s. They, too, were painful. Then I went with FR 14s, which were far more comfortable. I know others are able to use FR 12s, which are even better.

    The second thing I learned is that sometimes the manufacturer doesn't line up the funnel mark up with the coude tip. It can be 1/8th or 1/4th of a turn off in either direction. I make a note of that before inserting so that I know where the tip is.

    I also inspect the tip before inserting. On one batch of catheters I found a tacky substance on the tip, causing it to pull on the urethra on insertion and withdrawl. The manufacturer said it was a manufacturing defect.

    Early on I had a lot of pain pulling the catheter out. Had to learn to make sure the tip was still in the correct position. And I had to pull my penis up to a 45 degree angle--the same angle used when inserting. Otherwise withdrawl was painful.

    Hope some of this helps.

    Stebrunner

    • nealpros
      nealpros stebrunner

      Posted

      If smaller is better, why doesn't everyone use small catheters, if they are not passing blood clots?

      Neal

    • jimjames
      jimjames nealpros

      Posted

      The suggestion is to use the smallest size catheter that WORKS. In my case, for example, I use FR12. A FR10 would probably be too thin and therefore too flexible to work with easily, A too flexile catheter also might not be able to pass around an enlarged prostate and/or the urethral sphincter. That's why in some difficult cases they actually recommend a very large catheter size (like FR18) so it can push through. Think nail versus thumtack. 

      Jim

    • jimjames
      jimjames nealpros

      Posted

      Welcome Neal, but on re-reading I don't like my "nail vs thumtack" analogy for various reasons, including the "ouch" factor. biggrin Haven' had my morning coffee yet so really can't offer a good complete analogy but "spaghettti" comes to mind with a catheter size that is too small. biggrin

      Jim

    • nealpros
      nealpros jimjames

      Posted

      Thanks for the clarification! I understood your point. ...

      It's helpful information.

      Neal

  • tom512836
    tom512836

    Posted

    Consider this an update.  I dumped the coute tipped cathiters in favor of trying a fr14 straight.  

    I have been diagnosed with weak bladder muscles but when they took the foley out I found out that my bladder muscles are not completely dead.  I have found that when I feel the urge to urinate I can pee a fair amount of urine on my own with a fair stream and it is enought to take the pressure off.

    Before bed time tonight I performed my first self cath using the fr14.  Before I cathed i cleared as much urine as I could the way God intended.

    After that I cathed.  Surprisingly, there was not all that much urine left.

    What I did notice was this:  I noticed that there were moments of pain going in so I stopped, took a breath, wiggled my toes, coughed etc.  In shory, all the tricks they teach you.  For a short time afterward my urinary track hurt for a while.

    Question:  Does it get any easier as time goes by?

    Tom

    • jimjames
      jimjames tom512836

      Posted

      Hi Tom,

      Last time I believe you used the Coude but had inserted it backward. Have you tried the Coude the correct way, and if so, what was your experience? If not, I would give that a try because the Coude is designed to navigate around enlarged prostates without sticking them.

      Also, you said "there was not all that much urine left". Did you measure it? You should. Get a 500ml plastic beaker at the grocery and first measure how much your naturally urinate and then measure how much comes out of the catheter. This will give you important data on how to schedule your catherizations, or even when to stop self cathing. 

      Some pain, discomfort, false urgency, and bleeding are all very common during the first few weeks of self cathing. That doesn't mean everyone will have these issues but many do. I did. But over time, all these issues go away, so "yes" it gets a lot easier. For me, at this point self cathing is about as bothersome and painless as brushing my teeth except it takes less time. 

      Jim

    • tom512836
      tom512836 jimjames

      Posted

      I don't need a Coude catheter.  I had the laser surgery on April 7 and that's how we discovered I had a bladder issue.  Even with a "wide open highway" I wasn't voiding as I should.

      Tom

    • jimjames
      jimjames tom512836

      Posted

      Assuming an atonic (flacid) bladder, your bladder issue should have been discovered prior to the laser surgery through urodynamic testing, not afterwards. That said, sounds like the catheter rest did your bladder some good if indeed you are now having very little to cath out although you really need to get some numbers by measuring output.  In fact, depending on your PVR you might even be able to stop self cathing soon with periodic checks. 

      Jim

    • tom512836
      tom512836 jimjames

      Posted

      Speaked of "catheter rest", rest, I was foleyed for the better part of 2 months.  Right in the middle of my urology problems I come down with a heart attack requiring a stent in an artery.

      MOST INOPPERTUNE TIMING!

      It was funny, in the hospital I had be constantly telling the DOLTS that I was suffering from 2 UNRELATED ISSUES1!  

    • gbhall
      gbhall tom512836

      Posted

      Actually, possibly NOT unrelated issues Tom. The stress of your urology problems could easily have precipitated a heart attack. You may think, why am I being pedantic about it, even if one caused the other, what of it?

      Well there is a reason. That reason is - it is important if possible to discover WHY you had a heart attack. If it was stress-related, then fair enough, but suppose it was caused by build-up of colesterol in the arteries, then you need to be considering certain drugs, and especially modifications to your diet and exercise regime.

      In simple terms, treat the causative condition to extend your life.....

    • tom512836
      tom512836 gbhall

      Posted

      It was caused by a artery being almost completely blocked.  Hence the stent.  At the moment on Plavex etc.
  • gbhall
    gbhall tom512836

    Posted

    As others have said, it is very important to learn about how much you get out naturally, and how much is left behind. There is a temptation to start thinking you no longer need to cath when regularly only less than say 150 ml gets left. But that 150ml is a super breeding ground for infections. Infections are not fun. Always take care with anti-sepsis and try to be completely empty at some point every day. You are doing good
    • jimjames
      jimjames gbhall

      Posted

      It depends somewhat on your frequency of self catherization. For example, if you are self cathing 4x per day and your cathed volume is 150 or under, you might continue cathing but drop schedule down to 2x per day. If on the other hand your cathed volume is 150ml or less when cathing only once in 24 hours, on a repeated basis, then it might be reasonable to stop the self cathing program and then periodic check residual volumes either via ultrasound or through self cathing. While the point of emptying your bladder completely every day is ideal, not necessary in everyone especially as we get older. Many docs for example would be quite happy with let's say a post void residual of say 100ml after a TURP operation. They would not put that patient on a program of self catherization, as self catherization also has risks associated with it such uti's. I probably carried around over 300cc in my bladder for years before I started self cathing and had very few UTI's.

      Right now I need to cath every once in awhile depending on activity and fluid intake, because if I don't I cannot urinate. However, if I didn't have this problem and my only issue was a residual of 100ml, I'd stop completely.

      Jim

    • tom512836
      tom512836 gbhall

      Posted

      Measuring "before and after" in a very good  idea.  I'll start doing that.

      Tom

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