Self Catherization: Issues and Problems

Hi Bryan,

You said: Now that catching I do not feel triggers to nv. Is that normal? 

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It could be that your not getting signals earlier enough because your bladder is stretched. If that's the case then self cathing could help if you keep volumes under 400ml. Another reason, but less likely,  is that you're cathing when you're bladder isn't full.

In any event, I suggest that you do a void log to keep track of how much is in your bladder when you cath. Meanwhile, when you do cath, push out gently at the same time to exercise the detrussor muscles. You will know if they're working because the urine will come out of the catheter faster. You don't have to do this every time, or for the entire cath process, but I did it now and then just to keep the muscles active.

At work, the issue I assume is privacy. Just use the stall and figure a way to get the catheters back and forth privately. Unfortunately, Speedicath's don't bend that well but they do fit in a briefcase, back pack, or you can simply stuff one in your sock and hide it under your pant leg. You could also have a seamstress make special pockets if you like. Coloplast will be coming out with a "flex" model this Spring which should fold into your pocket. They currently have a "compact" model but it doesn't come in a Coude tip and it's a little on the short side but should work if you don't need a Coude.

I think you mean "Crataeva nurvala"? Personally, don't know anything about it but let us know how it work out. 

Jim

Jim

Hi Bryan,

I agree wholeheartedly with JimJames.  Especially the void log!  It will show you patterns and may give you heart!

I've been doing CIC on and off for 2 1/2 years now.  I started after emergency room release of 2500cc of pee.   Yes, you read those numbers correctly!  

I had a Urolift 14 months ago; it worked beautifully, but only for a couple of months.

After finding this Forum, I took JimJame's advice, and cathed 5–6 X per day.  My uro-doc worried about UTIs, and got me to cath only 3X per day.  But this had me cathing from 600-1100cc!!!!   OUCH!

Additionally, I, like you, did not have the physical sensations in the normal feedback loop, to tell me I needed to pee.

 

I thought it important to do my best to try shrinking the bladder.  The docs said "No, you can't do that!  Once over-stretched, always over-stretched." On a hunch, I went back to the 5-6 X per day, regimen, and started "listening" very closely to my body's signals.    Now, after doing this approach continuously since late Summer, my signals are once again kicking in, and I get regular "notices" at about 300cc, that it's time to cath.  At home, I cath into a measured beaker, and the amounts range from 200-400cc, but 300 is the most common amount.  

I do very little NV, and only if my bladder has 400cc or more.  But I've reached the first goal of shrinking the bladder, and will shortly be looking at alternatives to deal with the prostate again...

(Thanks again, JimJames!) 

Also:  Yes, SpeediCath slides up the pants, then down into sock or boot, no problem.  Also, I have gently rolled them and slid them into jacket/coat pockets, without problems.  Also, have dropped em down my shirt, or slid 'em into my jeans, with the belt holding them.  THey are pretty resilient!

Cartoon: Also, I have gently rolled them and slid them into jacket/coat pockets, without problems.  Also, have dropped em down my shirt, or slid 'em into my jeans, with the belt holding them.  THey are pretty resilient!

Young Lady: Is that a Speedicath in your pocket, or are you just glad to see me

Heh, heh.  As you wrote to Brian, what starts out as scary, after a while become the norm, and even something to joke about.  Oh, the unrepeatable comments and teases my wife has come up with!  But with The Moderator looking over my shoulder, I will just let you imagine...    

 

HI JIM, i need your advice .Lately i get the urge to pee every 3 hours.

Should i hold off , hold it as long as i can,or just do it ,cath?

Is this a normal thing when you cath? Some days i can hold off for 5 or 6 hours,then i void a 500 ml and i get the urge to pee every 3 hours?

Thanks JIm my friend,

frank,

It's normal to feel the urge after 3 hours, so I would just cath when I feel it. In fact, its  not good to hold it in for 5 or 6 hours.

Remeber, it's OK to cath up to 6-7 times a day if you need it. Just write down for a few days how much comes out each time.

Jim

 

Thanks Jim and Cartoon man. In last day or so I have this cic thing down. The speed baths made all the difference! I can do this! Doctors know a lot but forums by people who actually do this daily is invaluable. I am taking your advice under 400 and thank you again for sage advice. I will post back on the herbs results after couple months if helps. And be in touch. Take care guys

Bryan,

Glad you're getting "this cic thing down". 

We're all different, but here are the stages of CIC as I went through them: 1) shock, fear and depression; 2) not so bad, I think I'm getting it; 3) Can't believe how easy this has become 3) the empowerment that you have taken your life back.

Jim

Hi, Jim, advice needed! I am quite good at cathing now, but have some questions. I am doing it every 4 hours or so, but yesterday in the afternoon the amounts were surprisingly small (150) although no NV. At night I had to get up twice and it was 350 each time.Does this happen for no real reason?

Otherwise I believe I have chronic prostatitis because I have chronic pelvis pain, sometimes I cannot sit at all. I have tried Ibuprofen, helps a little. I wonder whether taking occasionally some cortisone would help more? What is your opinion? No UTI this time.

Tomorrow I will have my first travelling experience while self-cathing. A little tense. I use Speedicaths, so it's discreet, but what with everything being sterile...Sure, I don't touch anything, have an alcohol swab and a spare catheter...

Hi Jim,my cath outputs are usaually 250 ml to 350 ml. Sometimes it gets higher,400 or 550 ml,also sometimes 650 ml .I know you said to keep it under 400ml.What does it mean if its over 400ml?

Thanks JIm,

frank

...and JimJames, step 4)  Being able to joke about CIC!  

Frank, if it's over 400cc, cath more often!  If you are cathing every four hours, try every three.  Also, if you have consumed a larger amount of liquids, especially alcohol, expect to cath sooner after doing so...

 

ZD, Sounds normal. Sometimes there will be more, sometimes less. Lots of factors. Only way you can tell in advance is to purchase a portable bladder scanner but those are a little pricey and really not necessary for someone on a cath schedule. 

You mentioned that you like Speedicath Compacts so they are perfect for travel. So are the IQ's that fold up. I haven't taken catheters out of the house for maybe 6 months now, but when I did I prepared several zip lock kits, as well as kept a small alochol hand cleaner in my pocket. In the zip lock was the antispectic swab (or swabsticks) as well as folded up paper towels. When I used the red rubbers (first six months) I folded up one of them in the bag as well. In your case, you could throw in an IQ cath or just have the Compacts separate unless they fit in the bag. I always packed more than I needed in case I either had to cath more or dropped something. If you're traveling by air, make sure you carry enough on board, and a note from your doctor wouldn't hurt given airport security these days especially regarding liquids. The individual packets made things easy as everything was in one place. First I unpacked the paper towel and laid it down to create a clean surface. Then laid out my supplies on it and took it from there. You will probably drop a cath from time to time so again have xtras with you. Good luck and don't stress. It's just like doing it at home  just takes maybe a little bit longer because of the unpacking, etc.

I never took cortisone for prostatitis. Are you thinking about taking it orally or by injection.  I would start with something less agressive first like Ibuprofen and/or sitz baths. 

Jim

Just wanted to add that if you are going to be out of town for an extended period of time you might want to contact your catheter distributor and let them know that you may need an out of town delivery in case you run out on the road. My cath distributor said they could overnight them anywhere in the country should I need them. Alternatively, you could have some shipped in advance if you don't want to pack all of them.

Jim

I would just cath when you feel the urge even if it means cathing more often than you are now doing. Just keep track of your voids with a log. 

Ideally, you want to keep it 400ml or under because that is about what a normal bladder holds. If your bladder holds more on a consistent basis it will remain stretched. That said, don't worry if once in awhile it's over 400ml. That's going to happen. With me that used to happen late in afternoon. With others they tend to produce more urine overnight. Not to worry if it's a little over now and then.

Jim

hi cartoonman, I guess it's all what we eat or drink ,is the reason for a large output or a small one. I 'm not sure about this?Sometimes i can drink a lot of liquids ,juice water tea or coffee,and the output could be 300 ml or 350 ml.

Thena at times i don't drink a lot of liquids and the output is high? i don'e get it?

 

Neither do I, Frank!  There are similar times for me, and no rhyme, no reason, no consistency.  Keeps me humble, I figure...

An additional thought re air travel and cathing...  After getting caught in the loo, while cathing and hitting turbulence over the Rockies, it was major fun & games to not wind up in a loose-loose situation.  Thankfully, I managed everything, but since then...  I cath 15 or so minues before boarding, and rarely, hardly ever have to cath in-flight.  (Most of my flights are 5 hours or less.)  But even flying trans-Atlantic, the cabin air is so dry that I rarely have to cath.   

Also, I travel with a handful of single-use, foil-wrapped sterile alcohol prep pads for prepping...less messy and no fuss with TSA.  And after finding a few of the pads "dry" upon opening, I always have extras close at hand... 

Frank and Cartoon,

It's first in, last out if that helps. In other words, when you drink a glass of water and feel the need to urinate soon after, it's not that glass of water that is coming out it's probably the soda you had yesterday. Then there's the retention issue that many of us have when we get older. So, depending on excercise, diet, drugs we're taking, sodium intake, etc, -- we might hold that glass of water for different periods of time. All this makes it very difficult to predict what any given output will be but hopefully it explains why there's no apparent rhyme or reason for differing voids. I mean there is a reason but it's far from apparent.

Jim

Jim,Thanks for this info. It's still not clear to me,that if i don't have the urge to pee,why do a cath? right? Why try to keep on a schedule of cathing?

Thanks again for this info. 

frank,

The nerves that signal that give you the urge to pee can become dysfunctional when your bladder gets stretched out over the years. That's why the catherized volume is a better indicator than what you feel. 

To keep it simple: 1) try and keep your catherized volumes under 400ml when you can; 2) If you feel the urge to pee, don't hold it in, just cath yourself even if it means increasing the number of times you cath a day; 3) Keep a log of what time you cath and what are the volumes. The log will help you make any adjustments moving forward.

Jim

Thanks JIm,!!!

frank

Hi, Jim, Neil, Ken and all,

Just wanted to report that I had my bladder stones removed earlier this week in Seattle at the Kidney Stone Center. A young, female urologist did the surgery--a urologist who listened!! She said she'd have to access the stones through my abdominal wall due to my large median lobe issue. My local urologist did not give me that option.

When she placed the camera up through my urethra into the bladder, she determined she could remove my stones via my urethra. No TURP was involved! My urethra is still sore from all the equipment they used so my CIC times--and comfort--have decreased a lot. But I think once I've recovered it will be ok.

Stebrunner

Hi Stebrunner,

Glad the stone surgery went well! Be even more gentle with the caths till you heal and consider temporarily decreasing frequency if you can get away with it.

Jim

Hi JIm, I need your answer to this question JIm? Why is it so important to keep your void under 400 ML? Mine are usually under 300 ML. I don't understand what happens to the rest of the liquid  we consume?

Thanks,

frank

Hi stebrunner, what are symptoms for large median lobe ? Difficulty ? Hesitancy ? Retention ? Incontinence ? Etc. Did you try alpha blocker meds like flomax or doxazosin ? Thanks. Hank.

Hi Frank,

You want to keep your void under 400ml to keep the bladder from getting too stretched out.

If you add up all the liquid you consume every day and you add up all of your voids you should come up with a similar figure, not necessarily on a daily basis but at least on a weekly. The difference would be that food also contains water and conversely that we can lose fluids through perspiration. So the numbers will probably never be exact.

Jim

Hi Jim, Thanks for this info,you should have been a doctor.and i would be your first patient,

Thanks  again JIm.

frank,

Hi Frank,

Except if I were  you doctor, I wouldn't take the time to answer your questions. They never do

Jim

Hi, Hank,

My prostate median lobe is large and presses into the base of my bladder, creating a volcanic cone on the bladder floor. This means that my bladder drain opening is at the top of the volcano and is higher than the floor, so I don't ever completely empty my bladder. Not completely draining my bladder was a factor in developing my stones.

The bladder stones were on the floor surrounding the volcano, and the urologist said her equipment wouldn't bend around enough to get to them. Her plan was to access the stones through my abdominal wall rather than my urethra, which is the usual way. Fortunately, my PAE reduced part of the volcano cone which allowed her to reach them the traditional route.

Good questions about how a large median lobe affects us. From my research on treatment options, I found it elliminated several options. I think if I had an MRI done, it would show me exactly where my urethra is constricted. It could be that my median lobe is causing most of the problem, but it could also be another part of my prostate. The uro did say a TURP could be done to remove my median lobe, but I'd rather CIC than have a TURP.

Haven't gone the meds route as I don't like taking drugs. There are too many possible side effects for me. My BPH and rention problems may have started years ago when I was taking lots of antihistamines for allergies. One of the listed side effects for my antihistamines was difficulty urinating. When I mentioned that to my urologist at the time, he was shocked. Claimed he had never heard of it. Yet it was on the manufacturer's web site.

Stebrunner

Hi jim, I am so glad you are not my doctor then. Hank

Thanks Stebrunner for a thorough explanation. Re antihistamine, I used to take it too for sleep. I think it caused my retention because I was too sleepy to get up to pee. Re meds, I read somewhere that alpha blockers don't work for large median lobe. Hank.

Stebrunner, Glad you are fine.  I had my bladder stones removed a couple of years ago. I was worried, because I was urinating blood, and it turned out to be a large bladder stone!  My urologist, went in with a laser, and destroyed the bladder stone, into little stones so he could remove it via a vacuum.  I went in to see him this past Tuesday, and he told me that because I am self-cathing, that I would probably not have bladder stones in the future. The stale urine, is a good enviorment for creating bladder stones.  Best thing I ever did for my prostate and bladder, was to self-cath. I also have a friend that at age 75yrs., after self-cathing for over 2 years, had trouble inserting the catheter.  He has to wear a bag now until they figure out what to do.  I told my urologist, about him, and my urologist, said that he thinks, my friend, must have injured his urethra, with the catheter, and so it created a scar tissue, which blocked the passage way into the bladder.  So everyone, that is reading this message, please be careful when inserting the catheter, to avoid problems such as my friend's!  I used to try and see how fast I could insert the catheter, but now, I take me sweet time.  I go in slowly, so as not to cause any kind of discomfort.

Hi Dennis, 

Of course anything is possible, but your urologist's opinion on a patient he has never examined is quite suspect. CIC  tends to open the urethra, not close it, and that's why it's often indicated for strictures. More likely then, your friend's difficulty is due to a growing and/or inflamed prostate which can have many causes. If you read the literature on CIC, and it goes back quite a number of years, you will not find the formation of scar tissue as a common (if existent) problem. If more uro's really studied up on CIC, there would be less erroneous info out there. But yes, "speed cathing" is not a great idea  

As to your friend, he could try another type or size of catheter. The IQ cath, for example, is supposed to be good for hard to navigate canals. Coloplast is also coming up with a flex tip catheter this Spring.

The other avenue is a suprapubic catheter through the lower abdomen with a Flip-Flo bag. So much more comfortable than a Foley as nothing in the urethra. Also less incidence of UTI's. With the Flip Flo valve, no bag to carry around and the detrussor muscles can be exercised when the urine is expended through the valve. Optionally, if he wants an uninterrupted night's sleep, he can use a bag at night and the Flip-Flo during the day.

You mentioned you hurt yourself a little during one of your "speed cath" events. Are you healed up yet?

Jim

correction: It's a "flip-flo valve", not "bag"

Hey, Dennis,

Thanks for your encouragement. Since my stone removal about 3 weeks ago, I had to slow my cathing time down, too. Seems that everything was inflamed--and I still have some trouble getting past the external sphincter. Just today I was finally able to use my Speedicath FR12. For the past 3 weeks I've had to use my Origo FR14s as they were the only ones that could get past the sphincter.

The doctor who did my stone removal expressed surprise that I was okay with continuing CIC. She proposed doing a TURP or placing a suprapubic cath as a way to relieve me from the burden of CIC. I explained it's no longer a burden now that you, Jimjames and others on this forum helped me to master it. I even explained Jim's divebomb method!

Like you, I think CIC is the best thing I've ever done for my bladder and prostate.

BTW, my stone removal doc said she thought keeping my bladder volume at 400 ml or less was a great idea as it would reduce stale urine in my bladder. She also thought it might help rehab my bladder tone.

Stebrunner

It wasn't really bad.  Just that I noticed blood in the catheter, but no pain. The next time, I did the cathing, no blood at all.  I think it was from my turp that I had done in the summe of last year.  A piece of tissue, was present along with the blood. The tissue, looked like  something old and dark in color, like old blood.  I remember something similar when I did my first TURP, seven years ago. That's why I wasn't too concerned. Just old tissue, sloffing off from the bladder.

Glad you are doiing well!  Too bad, we all didn't live in close proxcimity...we could have a meeting every three months or so, and see how everyone is doing.